Use Of Painkillers Research Articles

The use of analgesics among Poznań marathon runners

PurposeRunning is becoming an increasingly more popular form of leisure activity. However, intense physical activity, such as running a marathon, can put a significant strain on the body and lead to the use of painkillers to reduce or avoid pain. Therefore, the purpose of the research was to determine the percentage of participants in the Poznań Marathon taking analgesics before or during the run and to investigate the runners’ knowledge about the possible negative health effects of such behaviour.MethodsThe study was carried out in 3 consecutive years (2014–2016) among 308 runners participating in the Poznań Marathon. The respondents completed a survey consisting of 3 parts: (1) personal details, (2) use of analgesics before and/or during the marathon run, and (3) the runner’s awareness of the possible negative effects of using such medicines during increased physical activity.ResultsTaking analgesics before or during a marathon run was declared by 18.6%, 14.9%, and 16.8% of the participants in years 2014, 2015, and 2016, respectively. Compared with men, women used painkillers more frequently (22.3% vs. 16.1%). On average, 59.3% of runners believed that using analgesics might be harmful to their health and increase the risk of injury, but 39.8% of them took painkillers anyway.ConclusionsNearly every sixth participant of the Poznań Marathon used analgesics before or during running because of the pain they experienced or expected. The awareness of analgesic-related side effects did not stop the runners from using painkillers.

Peptide-biofunctionalization of biomaterials for osteochondral tissue regeneration in early stage osteoarthritis: challenges and opportunities.

Osteoarthritis is a degenerative joint disease characterized by the progressive deterioration of articular cartilage, synovial inflammation and changes in periarticular and subchondral bone, being a leading cause of disability. Conventional treatments present several side effects and can involve the use of painkillers and non-steroidal anti-inflammatory drugs. In this sense, researchers have shifted the focus of new therapeutics to biomolecular agents and/or their combination with cells. However, the efficacy of these molecules is dependent on their metabolization which can differ according to the administration route and delivery approach. Consequently, a tissue engineering strategy comprising the use of biomaterials can provide support for neo-tissue osteochondral repair/regeneration whilst conferring proper mechanical and functional features as well as protecting biomolecular agents from premature degradation. The current strategies and challenges used in biomaterials functionalization with peptides that can mimic ECM proteins or other natural soluble biomolecules, important to induce the complex interactions between cells and the ECM, are discussed herein. Many opportunities for treating OA are being explored by means of peptide-biofunctionalization of biomaterials which can be designed to be recognizable, induce differentiation, prevent infection, degrade at an intended rate or act as drug delivery systems for controlled release or even as simple triggers of cell behavior.

Fibrin-hyaluronic acid hydrogel-based delivery of antisense oligonucleotides for ADAMTS5 inhibition in co-delivered and resident joint cells in osteoarthritis

To date no disease-modifying drugs for osteoarthritis (OA) are available, with treatment limited to the use of pain killers and prosthetic replacement. The ADAMTS (A Disintegrin and Metallo Proteinase with Thrombospondin Motifs) enzyme family is thought to be instrumental in the loss of proteoglycans during cartilage degeneration in OA, and their inhibition was shown to reverse osteoarthritic cartilage degeneration. Locked Nucleic Acid (LNA)-modified antisense oligonucleotides (gapmers) released from biomaterial scaffolds for specific and prolonged ADAMTS inhibition in co-delivered and resident chondrocytes, is an attractive therapeutic strategy. Here, a gapmer sequence identified from a gapmer screen showed 90% ADAMTS5 silencing in a monolayer culture of human OA chondrocytes. Incorporation of the gapmer in a fibrin-hyaluronic acid hydrogel exhibited a sustained release profile up to 14 days. Gapmers loaded in hydrogels were able to transfect both co-embedded chondrocytes and chondrocytes in a neighboring gapmer-free hydrogel, as demonstrated by flow cytometry and confocal microscopy. Efficient knockdown of ADAMTS5 was shown up to 14 days in both cell populations, i.e. the gapmer-loaded and gapmer-free hydrogel. This work demonstrates the use applicability of a hydrogel as a platform for combined local delivery of chondrocytes and an ADAMTS-targeting gapmer for catabolic gene modulation in OA.

Pycnogenol®: supplementary management of symptomatic osteoarthritis with a patch. An observational registry study.

The aim of the present observational registry study was to evaluate the efficacy of a thin polycarbonate patch of Pycnogenol® in alleviating symptoms of knee arthrosis, in comparison to the standard management usually applied to treat osteoarthritis (OA). A total of 67 subjects were included in the registry: 34 formed the control group, and 33 entered the active management group in which the Pycnogenol® patch was used. Two Pycnogenol® patches were used every day for three weeks. Each patch contains 110 mg Pycnogenol®. All patients included in this registry suffered from osteoarthritis of the knee. Results from this study show that Pycnogenol® patch allows faster improvement in OA symptoms, with a decrease in the use of non-steroidal anti-inflammatory drugs and other painkillers. Pycnogenol® patch significally reduced C reactive protein and ESR. Pycnogenol® patch was effective in controlling mild to moderate pain and inflammations and its related symptoms in subjects with knee OA over a period of three weeks.

Prevalence and co-occurrence of unhealthy lifestyle habits and behaviours among secondary school students in Tuscany, central Italy.

Unhealthy habits acquired during adolescence may persist in adulthood and eventually increase the risk of chronic illnesses. We reported on a survey conducted in 2013-2015 among secondary school students in Tuscany, central Italy. We compared the prevalence of self-reported lifestyle characteristics and overweight/obesity between genders and age groups (14-16 vs 17-21 years). We partitioned each gender- and age-specific stratum into groups based on cigarette smoking and engagement in sport activities, and compared the prevalence of other unhealthy lifestyles across groups using Poisson regression. Overall, 2167 students (53.3% males, mean age 16.8 years) were included. Males were more frequently overweight/obese than females. Cigarette smoking increased with age and did not differ by gender. Males were more likely to engage in sport activities, drink alcoholic beverages and adopt other unhealthy lifestyle habits, whereas females reported a more frequent use of painkillers. Cigarette smoking was the single lifestyle characteristic most consistently associated with other unhealthy habits. The prevalence and patterns of co-occurrence of unhealthy lifestyle habits varied by gender and age group among secondary school students in Italy. Our findings should be taken into account when planning public health initiatives aiming to combat obesity and tackle unhealthy lifestyles among secondary school students in Italy.

Electroacupuncture Intervention Reduces Post-surgical Pain of Patients Undergoing Total Knee Arthroplasty

To observe the analgesic effect and safety of electroacupuncture (EA) intervention for patients undergoing total knee arthroplasty (TKA). A total of 40 patients undergoing TKA were randomly assigned to control group (simple multi-mode analgesia, n＝20) and EA group (EA combined with multi-mode analgesia, n＝20). Both groups were treated with epidural anesthesia during surgical operation, and conventional epidural automatic analgesia and oral Celecoxib after surgery. Following surgery, EA was applied to Liangqiu (ST 34)-Xuehai (SP 10), Yinlingquan (SP 9)-Zusanli (ST 36), Fenglong (ST 40)-Qiuxu(GB 40) on the operation side for 30 min, once daily for 7 consecutive days. The patients' pain state during rest and motion was assessed by using visual analogue scale (VAS). The active and passive knee flexion range of motion (ROM), use of painkillers including the number of patient's controlled epidural analgesia (PCEA) during 48 h after surgery, and other complications were recorded. After the treatment, the VAS scores under rest and motion state were both significantly lower in the EA group than in the control group on day 3, 5 and 7 after surgery (P<0.05). During 48 h after surgery, the number of PECA was significantly lower in the EA group than in the control group (P<0.05). Of the two 20 cases in the control and EA groups, 3 and 1 asked to receive muscular injection of Tramadol Hydrochloride for pain relief, 3 and 2 experienced nausea-vomiting, 2 and 1 had dizziness and headache, and 2 and 1 had a chest distress feeling, respectively, which had no significant differences between the two groups (P>0.05). The white blood cell (WBC) count in both groups were decreased gradually from day 1 to 7 after surgery, and plasma C-reactive protein content on day 5 and 7 were also lowered in both groups, without statistical differences between the two groups in the post-operative complications, dosages of additional postoperative analgesic drugs, and levels of plasma WBC and C-reactive protein (P>0.05). EA can effectively improve the early postoperative pain of TKA, reduce the incidence of postoperative complications and the use of analgesic drugs in TKA patients.

Low back pain in Brazilian medical students: a cross-sectional study in 629 individuals.

Low back pain (LBP) is a common problem in the general population. Medical students may be at risk of LBP because of demanding curricula. To study the prevalence of LBP in Brazilian medical students and the associated factors. Six hundred twenty-nine medical students (72.8% females, mean age of 23years old) answered a questionnaire containing epidemiological data; data on presence and frequency of LBP, use of painkillers, and LBP interference in daily activities; number of sitting and exercising hours/day, posture habits. They also filled a VAS (or visual analogic scale) on the own perception of anxiety, depression, fatigue, and the Roland Morris functional questionnaire for LBP. In this sample, 81.7% had periods of recurrent LBP that was more common in females (77.6% vs 51.3%; p < 0.0001) and associated with bad posture habits (p < 0.0001). Number of sitting hours, exercising, and study period at school could not be associated with LBP. The mean Roland Morris result was 4.0; IQR = 2-7 and its value showed a modest correlation with VAS of anxiety (rho = 0.21) and depression (rho = 0.33). LBP interfered with social activities in 20.5%, with physical activities in 33.1%, and in school activities in 29.2%. There is a high prevalence of LBP in medical students, mainly females, associated with bad posture habits. Physical dysfunction for LBP showed correlation with anxiety and depression.

Comparison between Cyanoacrylate, Sutureless and Polypropylene Sutures in Mesh Fixation on Lichtenstein Tension free in repair of Open Inguinal Hernia

Background: inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become gold standard in open inguinal hernia repair. Despite the low recurrence rates; postoperative pain and discomfort remain a problem for a large number of patients. Aim of the work: the aim of this study is to compare between cyanoacrylate, sutureless and polypropylene sutures in mesh fixation on lichtenstein tension free in repair of open inguinal hernia regard as postoperative pain, infection, recurrence,& cost benefit. Methods: a total of thirty patients with primary unilateral uncomplicated inguinal hernia were randomized to undergo lichtenstein tension free hernioplasty, and were randomized using close envelope into three groups: Group A: Inguinal hernioplasty with mesh fixation using polypropylene sutures (10 patients), Group B: Inguinal hernioplasty with mesh fixation using cyanoacrylate glue (10 patients) and Group C: Inguinal hernioplasty with mesh placement without sutures (10 patients). Primary outcome was early and late postoperative pain. Secondary endpoints were use of painkillers after 24 hours, morbidity rate and recurrence rate. Follow-up time was 6 months. Results: significantly, less postoperative pain was reported in group B compared to the other two groups (A&C). Additionally, trends toward a higher postoperative quality of life, a faster surgical procedure, and a shorter hospital stay and earlier return to daily activities were seen in patients within group(B).Clinical recurrence was reported in only one patient in Group C after a period of four months follow up postoperatively. Conclusion: cyanoacrylate glue seemed to be a simple, original, reasonable, feasible, reproducible technique and competitive alternative to the standard tissue-penetrating meshfixation devices in open inguinal hernioplasty. It is accompanied by a reduction in chronic inguinal pain, with no increase in the early recurrence rate.

Hypermobility and sports injury

ObjectiveTo determine whether there is an association between hypermobility and sports injury.MethodsA quantitative observational approach using a cross-sectional survey was adopted. Individuals were identified as hypermobile or not. All participants...

Patients’ Knowledge, Attitude and Practice towards Painkillers: Tawau Hospital Experience

Pain management with analgaesics employs a multidisciplinary approach of clinicians towards patients. Nevertheless, preventing drug abuse and misuse in pain management is also an important goal. Understanding patients’ behaviour in the usage of painkillers may facilitate more effective communication and to educate them on the appropriate choice of painkillers. This study aimed to assess patients’ knowledge, attitude and practice towards painkillers. This was a questionnaire-based cross-sectional study conducted from February to May 2016 among patients in Tawau Hospital. Respondents were selected via convenience sampling and interviewed based on a questionnaire to assess their knowledge, attitude and practice towards painkillers. A total of 193 questionnaires with complete responses were analysed. Most of the respondents(60.1%) obtained their painkillers from public facilities. Generally, they were very satisfied with the painkillers that they had used (36.7%). However, most of them (75.0%) did not know the name of the ingredient of the painkillers that they had taken before. They were also not aware of the side effects (73.1%) and allergicreactions (64.8%) caused by painkillers. Most of the respondents (58.5%) had not been informed regarding the side effects of the painkillers by healthcare professionals. Only 25.0% of the respondents had been asked regarding their past medical history, past medication history and allergic history by healthcare professionals before a painkiller was recommended to them. This study highlights the need of continuous efforts by healthcare professionals to inform patients of the proper use and risks associated with painkillers to improve the quality use of painkillers.

School racial composition and lifetime non-medical use of prescription painkillers: Evidence from the national longitudinal study of adolescent to adult health

ObjectiveTo investigate the possible effects of middle and high school racial composition on later reporting of lifetime non-medical use of prescription painkillers (NMUPP) in young adulthood, and to explore whether there is evidence of variability by individual race/ethnicity in such effects. MethodsUsing data from Wave 1 (1994/5) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we categorized the sample's 52 middle schools and 80 high schools as majority (>50%) non-Hispanic white, majority non-Hispanic black, or neither. We used two-level hierarchical modeling to explore associations between individual- and school-level race at Wave 1 and lifetime prescription painkiller misuse reported at Wave 4. We included a cross-level interaction between individual race and school racial composition to assess variability in school-level associations by race. ResultsOverall crude prevalence of lifetime NMUPP in majority white schools (17.9%) was over three times that of prevalence in majority black schools (4.8%), and also higher than prevalence in schools neither predominantly black nor predominantly white (12.4%). Lifetime misuse among blacks in majority white schools was more prevalent (5.2%) than among blacks in black schools (2.8%), as was misuse among whites in white schools (19.3%) compared to their white peers in black schools (15.7%). Two-level random intercept Poisson regression results suggest that attendance in a majority black secondary school lowered a participant's risk of lifetime NMUPP (compared to attending a majority white school: RR=0.66, p = 0.03). Compared to blacks in black schools, blacks in white schools had twice the risk of prescription painkiller misuse (p = 0.004) over a decade later, and whites in white schools had 5.5 times the risk (p = 0.01). The risk ratio comparing whites in black schools to whites in white schools was not significant (RR: 1.30; p = 0.37). ConclusionsWe found evidence of an effect of school racial composition on the risk of misusing prescription painkillers over a decade later, over and above individual race, with higher risk of misuse reported among participants who had attended white schools. Black participants who had attended predominantly white schools were, on average, twice as likely to report lifetime misuse of prescription painkillers compared to blacks who had attended black schools.

Management Strategies in Opioid Abuse and Sexual Dysfunction: A Review of Opioid-Induced Androgen Deficiency.

Over the last several decades, the opioid epidemic has become a national crisis, largely spurred by the spike in the use of prescription painkillers. With the epidemic came a concomitant rise in the incidence of opioid-induced androgen deficiency (OPIAD). Although OPIAD can significantly impact male sexual function and quality of life, it is an overlooked and poorly understood clinical entity that requires more attention from healthcare providers. The objectives of the current review are to highlight the increasing incidence of OPIAD and the importance of an integrated, multidisciplinary approach to identify and treat patients with the condition. This review presents the epidemiology surrounding the current opioid epidemic, with a focus on its origin, followed by a literature review surrounding the pathophysiology, diagnosis, and treatment of OPIAD. Single-center studies were used to determine the safety and efficacy of various opioid and testosterone formulations on analgesia, sexual function, and quality of life. There should be a low threshold for obtaining laboratory studies (testosterone, luteinizing hormone [LH], follicle-stimulating hormone [FSH]) on symptomatic patients who have a history of chronic opioid use. Treatment options include opioid cessation, short-acting opioids, and testosterone replacement therapy (TRT). The patient and physician should weigh the risks and benefits of TRT against more conservative approaches. Options such as clomiphene and anastrozole are available for patients who wish to preserve fertility. Because OPIAD is an underappreciated and underdiagnosed consequence of chronic opioid abuse, healthcare providers should be particularly vigilant for signs of hypogonadism in this patient population. It is reasonable for pain specialists, urologists, and primary care physicians to closely monitor patients on prescription opioids and discuss available options for treatment of hypogonadism. Hsieh A, DiGiorgio L, Fakunle M, etal. Management strategies in opioid abuse and sexual dysfunction: A review of opioid-induced androgen deficiency. Sex Med Rev 2018;6:618-623.

Clinicopathological characteristics of patients with pain after endoscopic submucosal dissection for gastric epithelial neoplasm.

Endoscopic submucosal dissection (ESD) is widely used for large superficial gastrointestinal tumors. Epigastric pain is a frequent complication of ESD. However, little is known about its incidence and associated factors. This study evaluated pain incidence and characteristics of patients with pain after gastric ESD. We retrospectively analyzed a prospectively collected registry of clinical, endoscopic, and pathologic results of patients who underwent ESD for gastric adenoma or cancer from January 2010 to December 2015. A Visual Analogue Scale (VAS) was used to assess pain immediately after, and 2, 12, and 24h after ESD. The primary outcome was the use of painkillers (VAS score > 4). Analyzed data included age, sex, pathology, specimen and tumor size, procedure time, and tumor location. Of 1226 patients, 461 (36.4%) needed a painkiller at least once after ESD (pain group). Compared with the no pain group, the pain group had more females, less alcohol consumption, larger tumor and specimen size, and more antral lesions. In multivariate analysis, female sex (OR 1.559, 95% CI 1.217-1.996, p < 0.001), antral tumor location (OR 1.780, 95% CI 1.398-2.265, p < 0.001), and procedure time over 30min (OR 1.443, 95% CI 1.130-1.842, p = 0.003) were predictive factors for pain. This study showed that a considerable number of patients needed one or more painkiller doses after gastric ESD. The factors affecting pain included sex, procedure time, and lesion location. Endoscopists should use preemptive or aggressive pain management in high-risk patients after ESD.

A Danish population-based cohort study of desmopressin use in adults with nocturia or nocturnal enuresis.

This study investigated how desmopressin is prescribed to adults in Denmark. All adult users of desmopressin over an 8-year period were identified from the Danish National Prescription Registry. Adult patients with nocturia or nocturnal enuresis (NE) were identified by indication codes for "frequent nocturnal voiding" or "involuntary nocturnal voiding", respectively. Patient demographics, desmopressin formulation and dose, and concomitant medication were investigated. In all, 13 871 adults with nocturia and 2872 adults with chronic (i.e. >10 prescriptions) NE were given 102 547 and 43 712 desmopressin prescriptions, respectively. Across the entire patient cohort, 57% were women and mean patient age was 62 years. Over 40% of prescriptions were to elderly patients (≥65 years), and desmopressin use for adult enuresis increased with age. Orally disintegrating tablets were the most frequently used formulation (57%-65% of prescriptions), and a greater proportion of women than men used low-dose desmopressin (60 μg). Concomitant use of painkillers (opioids: 18%-26.7% of prescriptions; non-steroidal anti-inflammatory drugs: 14.2%-16.4% of prescriptions) and antidepressants (14.4%-18.1% of prescriptions) was common in both conditions, and 5.4%-9.2% of concomitant prescriptions were for overactive bladder medications. This study provides insights into desmopressin use among Danish adults. Nearly half the prescriptions were to patients aged ≥65 years, despite historical manufacturer recommendations that desmopressin be restricted to patients <65 years of age. NE is considered a childhood condition, but desmopressin use for adult NE increased with age. A greater proportion of desmopressin prescriptions to women than men were for the lowest dose, consistent with greater sensitivity to desmopressin in women.

Urethral Prolapse in a Dog of the American Pit Bull Breed

Background: The urethral prolapse in dogs is a rare condition known by the protrusion of the urethral mucous membrane and the external orifice of the urethra. It is more frequently seen in young males, especially of brachycephalic breeds, for instance the English bulldog. Despite the pathophysiology of this disorder being little elucidated, it is believed that the cause is related to factors such as genetic susceptibility, excessive sexual behavior, traumas, abnormalities and urinary and prostatic problems. Due to limited reports on the subject, this paper aims to describe the clinical and surgical aspects of a case of urethral prolapse in a dog, surgically corrected.Case: Admitted to the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT) a dog, American Pit Bull, 7 months old, with previous history of bleeding in the penile region and pain while urinating. In the physical exam it presented: intermittent bleeding via external ostium of the urethra, increased volume and protrusion of the distal urethral mucous membrane and the external orifice of the urethra, which was presenting a round shape mass, edematous and little congested of red-purplish coloring, evidenced by the passing of urethral probe. The diagnosis of urethral prolapse was confirmed and, after conducting laboratory tests and obtaining normal results for the species, the animal was sent to surgery. It was opted for the technique of resection and anastomosis of the protruded portion of the mucous membrane. After the anesthetic protocol, it was performed the trichotomy and antisepsis of region, the fenestrated drapes were properly positioned and the urethral catheterization was done, afterwards 3 points of support were produced with nylon thread 3-0, involving the urethra and the external portion of the penis. Subsequently, it was incised 1/3 of the protruded mucous membrane (from a support point to the other) with a pair of iris scissors and the aid of a toothless Adson clamp. Promptly the anastomotic synthesis was manufactured with a simple interrupted suture pattern. By the end of the first one third theremaining ones with go under the same procedure and in the end of the resection and anastomosis of the urethral prolapse the animal was submitted to a bilateral orchiectomy. At the immediate post-surgery it was established antibiotic therapy and the use of anti-inflammatory and painkiller, after 48 h of observation the animal was discharged from the hospital. As a therapeutic measure it was opted to continue with the use of antibiotics and anti-inflammatory, and then recommended the use of Elizabethan collar 24 h a day until the removing of the stitches. It was also recommended that the animal returned for a new evaluation thirteen days after of the procedure.Discussion: That being said, even being an unusual pathology, which the physiopathology is not completely clear, the urethral prolapse is of simple diagnosis, which is based on direct observation of the protruded mucous membrane and by obtaining information of possible factors that cause its appearance, such as genetic susceptibility, in the case of the animalfrom the current report, since it had the English Bulldog as genetic predecessor. Even though there are techniques less traumatic for its diminishing the chosen technique is the resection and anastomose of the protruded portion of the urethral mucous membrane, due to being simple, quick, effective and with lower rates of relapses. Proven by the result of total recovering of the animal and excellent post-surgery healing, not having relapses.Keywords: dog, surgery, urethra.

Evaluation of the use of analgesics for blunt thoracic trauma in the accident and emergency department

Proper pain management is an essential process when dealing with a patient suffering from blunt thoracic trauma, because it blocks the vicious circle that leads to the development of trauma related complications. This retrospective study deals with the use of pain killers administered in the Accidents and Emergency Department (ED) and prescribed at discharge to patients suffering from blunt thoracic trauma. The analysis confirms the existence of oligoanalgesia, that is an inadequate pain treatment, in clinical practice. Out of 214 patients involved in the study, only 78 patients (36.4%) received at least one pain killing drug during their stay in the ED. More than half of the patients discharged within 24 hours of admittance to the ED received no detailed advice about pain relief therapy and 8% of them (11 out of 136) returned to the ED within 15 days for persisting symptoms. Four were eventually admitted to hospital due to deterioration in their clinical conditions.

Unusual cause of a fatal foreign body pulmonary granulomatosis

Pulmonary foreign body granulomatosis is a rare disease characterized by granuloma as a result of exposure to mineral substances. It has been reported in intravenous drug abusers who inject powdered medications. In the present case a 57-year-old female tourist with a history of cancer died in her hotel room. The autopsy revealed pulmonary fibrosis with granulomatosis containing birefringent particles (mainly talc). The cause of death was an acute right heart failure due to chronic pulmonary hypertension triggered by regular therapeutic use of painkillers after cancer occurring in previous years.

Arnica compositum, Hekla lava and Acidum Nitricum Together are Superior to Arnica compositum Alone in the Local Treatment of Symptomatic Calcific Periarthritis of the Shoulder: A Pilot Study.

To evaluate the usefulness of Arnica compositum (AC) + Acidum nitricum (AN) + Hekla lava (HL) ointment in Emergency Medicine Department (EMD) as alternative nonpharmacological local treatment of patients with symptomatic calcific periarthritis of the shoulder (CPS) and to compare the effectiveness of this mixture against AC ointment alone. A series of 41 consecutive patients (20 women, 19 men, median age 49 years, range 25-80 years) with non-traumatic painful unilateral CPS were randomly assigned to receive local treatment with AC+AN+HL ointment mixture (Group A, cases, N=21) or AC ointment alone (Group B, controls, N=20). The radiological Gartner classification of the CPS, and the quantification of pre- and post-treatment pain intensity using a Visual Analogue Scale (VAS) were obtained. The orthopedic evaluation of Shoulder Motion (SM) was also performed. The use of painkillers was reported as a number of doses needed. Age, gender distribution, Gartner type, main calcification size, baseline VAS (VAS-0) and degree of SM did not differ (p=NS) between Groups. After 3-day therapy, the reduction of pain in Group A (4.5±2.5) was superior to that observed in Group B (2.7±2.6) (p =0.03). The same result was observed in the improvement of SM in Group A (69.4±24.9) than in Group B (51.1±21.1) (p =0.015). No local or general adverse effects were noted. The number of doses of paracetamol was similar, but Group A patients used less ibuprofen (p =0.007). Local administration of the AC+AN+HL ointment mixture, which in our pilot study was superior to AC alone, could be safely suggested as an alternative uneventful treatment of patients with CPS.

Health-related quality of life in young women starting hormonal contraception: a pilot study

Objectives: Our purpose was to study whether there is a difference in self-rated health-related quality of life (HRQOL) and changes in HRQOL perception after 3 months of hormonal contraceptive use in adolescents. Seasonal variations in symptoms of depression were also studied.Methods: A test group (T1) (n = 193) and a selected control group (n = 238) of women aged 14–20 years who were visiting a young person’s clinic completed the 36-item short-form health survey (SF-36) and answered additional questions on menstrual history and pattern, need for menstrual pain relief medication, and other regular medication. The test group was reassessed after 3 months of hormonal contraception (T2). Seasonal variations in reported SF-36 scores were studied for the whole group.Results: The selected control group and test group at T1 were similar with regard to age at menarche and menstrual pattern. The duration of bleeding and use of painkillers were significantly reduced and the impact on everyday life was significantly improved after 3 months of hormonal contraception (p = .000, two-tailed). No changes in HRQOL or symptoms of possible depression were found after 3 months of hormonal contraception. The highest prevalence odds ratio for possible depression (SF-36 mental health scale score ≤48), adjusted for group, season and age, for spring vs winter, was 2.15 (95% confidence interval 0.95, 4.85).Conclusions: After 3 months of hormonal contraception both the number of days of menstrual bleeding and the use of medication to relieve menstrual pain were reduced, but there were no significant changes in self-rated HRQOL perception. Seasonal effects on HRQOL were reported.

4.3-O8Reported pain and use of painkillers among Syrian refugees at various stages in the migration process

4.3-O8Reported pain and use of painkillers among Syrian refugees at various stages in the migration process