Visual Analog Scale Ratings Research Articles

Examining the Accuracy of Self-Reported Antiretroviral Therapy Adherence Using a Visual Analog Scale Among Opioid-Dependent People Living with HIV.

Evidence indicates that regular assessment of antiretroviral therapy (ART) adherence is necessary to promote adherence and achieve viral suppression. Self-reported adherence using a visual analog scale (VAS) has been used extensively to measure ART adherence. However, less is known about the accuracy of the VAS for measuring ART adherence among opioid-dependent people living with HIV. In this study, we aimed to evaluate the accuracy of the VAS in measuring ART adherence in opioid-dependent people living with HIV who are enrolled in a methadone maintenance program (MMP). This study was conducted within a larger randomized controlled trial among opioid-dependent people living with HIV (N = 109) who were enrolled in an inner-city MMP. Self-reported VAS ART adherence data were compared to pharmacy refill data, which is a more objective measure. Self-reported VAS ratings and pharmacy refill behavior were significantly correlated at the 6-month post-intervention mark (r = 0.349, p = 0.006) but not at any other time point (i.e., pre-intervention, post-intervention, 3-months, and 9-months post-intervention). Based on the pharmacy refill data, participants did not consistently adhere to their ART medication but self-reported high adherence on the VAS. The self-report VAS may not be an accurate measure for assessing ART adherence among opioid-dependent persons living with HIV and enrolled in a MMP. Based on our findings, it may be more accurate to use pharmacy refill information or other objective measures to quantify ART adherence over extended periods for this patient population.

The Effectiveness Of Physical Therapy And Rehabilitation Approaches In Low Back Pain On Pain Severity And Disability; A Systematic Review

Low Back Pain encompasses nociceptive pain, neuropathic pain radiating to the legs, and nociplastic pain, often classified as non-specific due to central nervous system exaggeration. Globally, Low Back Pain is a leading cause of activity restriction and loss of productivity, significantly impacting finances. Objective; This study aimed to review the efficacy of physical therapy and rehabilitation approaches for LBP, focusing on pain intensity and disability. Materials and Methods; A literature review was conducted in PubMed and Web of Science databases up to January 30, 2024. English studies were required, using keywords: “low back pain,” “pain intensity,” “pain severity,” “disability,” and “physical therapy.” Pain intensity was measured using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS), including the 11-point Pain Intensity Numerical Rating Scale (PI-NRS). Disability was assessed using ADL, IADL scales, Roland Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI). Results; Seven study met the inclusion criteria from 665 initial records. Interventions included osteopathic manipulative treatment (OMT), core muscle exercise with interferential current (IFC), cognitive functional therapy (CFT), dry cupping therapy, high-intensity machine-based core muscle resistance training (C-IPU), heat therapy, TENS, pelvic traction, Reiki, dynamic muscular stabilization technique (DMST), and McGill Big 3 (MB3). Sample sizes ranged from 30 to 1090 participants. IFC combined with core muscle exercises significantly reduced pain intensity compared to each method alone, though not statistically significant (p > 0.05). The C-IPU group had greater pain relief (P 0.05). Dry cupping did not outperform sham cupping. CFT reduced absenteeism in the first two years but not later. Reiki showed significant improvement in pain and ADL compared to drug therapy, but not to physiotherapy. Conclusions; Physical therapy interventions effectively alleviate symptoms and improve outcomes in LBP. However, variability in interventions and outcome measures necessitates cautious interpretation. Further research with standardized protocols is essential to understand the effectiveness and optimal duration of physical therapy for LBP. Keywords; low back pain; pain intensity; pain severity; disability; physical therapy

Early clinical efficacy study on the efficacy of a three-stage conservative Chinese medicine external treatment for acute lateral ankle ligament injuries

To evaluate the clinical effect of a new three-phase Chinese medicine (CM) external treatment for acute lateral ankle ligament injuries. From July to December 2023, 64 patients with acute lateral ankle ligament injuries were randomly assigned to receive either the new three-phase CM external treatment combined with the POLICE(protect, optimal loading, ice, compression, elevation) treatment (observation group) or the POLICE treatment (control group), with 32 cases in each group. The observation group consisted of 17 males and 15 females, with an average age of(30.59±3.10) years old ranging from 25 to 36 years old, while the control group included 14 males and 18 females, with an average age of(30.03±3.19) years old ranging from 24 to 37 years old. Visual analogue scale (VAS) evaluation and Figure of 8 measurement were used to evaluate the degree of ankle joint pain and swelling of the subjects at the initial enrollment and after 1 week and sixth weeks of treatment. At the same time, the American Orthopaedic Foot and Ankle Society (AOFAS) and Karlsson Ankle Function Score System were used to evaluate the improvement of ankle joint function in patients at all stages. MRI imaging was employed to observe the degree of biological healing of the anterior talofibular ligament, with the signal to noise ratio(SNR) indicating the level of healing. A lower SNR suggests better ligament healing, as it represents lower water content in the ligament. All patients completed a 6-week follow-up. There was no significant difference in VAS, AOFAS score and Karlsson score between the two groups before treatment (P>0.05). After 1 week and 6 weeks of treatment, the VAS, AOFAS score and Karlsson score of the two groups were significantly improved (P<0.05). After 1 week of treatment, the VAS score of the observation group (3.21±0.87) was lower than that of the control group (4.21±1.50), and the difference was statistically significant (P<0.05). After 1 weeks of treatment, the AOFAS and Karlsson scores [(50.84±4.70) points, (49.97±4.00) points] of the observation group were higher than those [(46.91±5.56) points, (46.66±5.36) points]of the control group (P<0.05). MRI images showed that after 6 weeks of treatment, the SNR value of the observation group was significantly lower than that of the control group, and the difference was statistically significant(SNR of the observation group was 75.25±16.59, the contral gruop was 85.81±15.55), (P<0.05). Compared with the control group, the new three-phase CM external treatment is significantly effective in reducing pain and swelling, enhancing ligament repair quality, and promoting functional recovery of the ankle joint in patients with acute lateral malleolar ligament injuries.

A central and peripheral dual neuromodulation strategy in pain management of zoster-associated pain.

Spinal cord stimulation (SCS) has shown effectiveness in relieving zoster-associated pain (ZAP), but some patients still experience moderate or severe pain after SCS treatment. This study aims to evaluate the impact of SCS combined with dorsal root ganglion (DRG) pulsed radiofrequency (PRF) as a dual neuromodulation strategy on the prognosis of ZAP. The clinical records of patients diagnosed with ZAP who underwent SCS (SCS group) or SCS combined with PRF (SCS + PRF group) at The Third Xiangya Hospital, Central South University, were retrospectively analyzed to compare the effectiveness of the two treatment approaches for ZAP. Outcome measures included changes in Visual Analog Scale (VAS) scores before and after neuromodulation treatment, response rates, and incidence of progression to postherpetic neuralgia (PHN).13 SCS patients and 15 SCS + PRF patients were analyzed. Admission VAS scores were similar (P = 0.934). Upon discharge, no significant differences in VAS or response rates were observed (P > 0.05). However, at 6-month follow-up, the SCS + PRF group had lower VAS scores (1.53 ± 1.06 vs. 3.23 ± 1.50, P < 0.001) and a lower proportion of residual moderate pain (P = 0.041). None in the SCS + PRF group progressed to PHN in the acute/subacute phases, differing significantly from the SCS group (P = 0.038).Therefore, SCS combined with DRG PRF is feasible and effective in the treatment of ZAP. This dual neuromodulation strategy may be a more appropriate regimen for the treatment of ZAP.

Pain in recessive dystrophic epidermolysis bullosa (RDEB): findings of the Prospective Epidermolysis Bullosa Longitudinal Evaluation Study (PEBLES)

BackgroundPain is common in the genetic skin fragility disorder epidermolysis bullosa (EB), from skin and mucosal injury and inflammation as well as extra-mucocutaneous sites. Individuals living with EB have identified pain as a priority for better treatments.ObjectivesThe Prospective EB Longitudinal Evaluation Study (PEBLES) is a prospective register study exploring the natural history of RDEB across all ages from birth to death. Here, we investigated the characteristics and treatment of pain in different RDEB subtypes.MethodsInformation was collected from individuals with different RDEB subtypes over an 8-year period. Data included visual analogue scale (VAS) ratings of background and procedural pain, its location, intensity and impact on sleep, as well as pain medication. Disease severity scores and quality of life measures were correlated to pain scores.ResultsSixty-one participants (13 children, 48 adults) completed a total of 361 reviews. Pain was common, experienced by 93% of participants at index review, with 80% suffering both background and procedural pain. Across all RDEB patients, the median VAS for background pain was 40 (out of 100) [interquartile range 20,60] and for those having regular dressing changes, median procedural pain was 52 [40,80]. Severe (RDEB-S) and pruriginosa (RDEB-Pru) groups had the greatest increase in procedural compared to background pain of 20 and 22 VAS points, respectively. Correlations between disease severity and quality of life impairment were observed across most groups, particularly RDEB-S. Over half of those studied experienced pain frequently or constantly, and in one third pain disturbed sleep at least 4 nights per week. Skin was the commonest source of pain in all subtypes except inversa RDEB where the mouth was the main site. Despite frequent and severe pain, one third of participants used no medication for pain and, in those that did, pain levels remained high suggesting ineffectiveness of current pain management approaches and a significant unmet need in RDEB.ConclusionThe frequency, severity, and impact of pain in all RDEB patients is significant, particularly in RDEB-S and RDEB-Pru. Our findings highlight that current RDEB pain management is poorly effective and that further research is needed to address this symptom.

Comparative Efficacy of Spinal Cord Stimulation in the Management of Acute Pain and Chronic Pain Related to Failed Back Surgery Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Spinal cord stimulation (SCS) is a well-established treatment for chronic pain. However, its potential in acute pain management requires further investigation. The goal of this review is to assess and compare the effectiveness of SCS for managing acute postoperative pain against chronic pain associated with failed back surgery syndrome (FBSS). A comprehensive search of databases identified randomized controlled trials (RCTs) that examined SCS for both acute and chronic pain associated with FBSS. Pain relief was measured using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS). Study quality was evaluated using the Jadad score and Cochrane risk of bias tool. Evidence suggests that SCS significantly reduces acutepain, achieving over a 50% reduction in VAS scores. For chronic pain associated with FBSS, SCS demonstrated substantial efficacy, with a mean reduction of -2.45 on pain scales compared to baseline. When compared to optimal medical management (OMM), SCS was more effective, showing a mean reduction of -1.17 in pain scores for FBSS.Overall, SCS offers significant benefits in managing chronic pain, particularly in FBSS, by reducing pain intensity and opioid use. While the initial findings for acute pain relief are promising, further high-quality RCTs are needed to better understand SCS's role in preventing the transition from acute to chronic pain. Continued research into optimizing patient selection and stimulation parameters will be essential to improve therapeutic outcomes in both acute and chronic pain management.

Autologous platelet-rich plasma and fibrin-augmented minced cartilage implantation in chondral lesions of the knee leads to good clinical and radiological outcomes after more than 12 months: A retrospective cohort study of 71 patients.

The treatment of cartilage lesions remains a challenge. Matrix-associated autologous chondrocyte implantation has evolved to become the gold standard procedure. However, this two-step procedure has crucial disadvantages, and the one-step minced cartilage procedure has gained attention. This retrospective study aimed to evaluate the clinical and radiological outcome of an all-autologous minced cartilage technique in cartilage lesions at the knee joint. In this retrospective cohort study, 71 patients (38.6 years ± 12.0, 39,4% female) with a magnetic resonance imaging (MRI) confirmed grade III-IV cartilage defect at the medial femur condyle (n = 20), lateral femur condyle (n = 2), lateral tibia plateau (n = 1), retropatellar (n = 28) and at the trochlea (n = 20) were included. All patients were treated with an all-autologous minced cartilage procedure (AutoCart™). Clinical knee function was evaluated by the Tegner score, visual analogue scale, the subjective and objective evaluation form of the International Knee Documentation Committee and the Knee Injury and Osteoarthritis Outcome Score (KOOS). MRI analyses were performed by magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 knee score. Follow-up examination was 13.7 ± 4.2 (12-24) months postoperative. All clinical scores significantly improved after surgical intervention (p < 0.0001), especially the subgroup sports and recreation of KOOS showed clear changes from baseline in the follow-up examination. In the postoperative MRI evaluation, 39 of 71 patients showed a complete fill of the cartilage defect without subchondral changes in 78% of the patients in the MOCART 2.0 score in the follow-up analysis. None of the patients showed adverse effects, which are linked to the minced cartilage procedure during the time of follow-up. An all-autologous minced cartilage technique for chondral lesions at the knee joint seems to be an effective and safe treatment method with good clinical and radiological short-term results. Level IV.

Examining gaze behavior in undergraduate students and educators during the evaluation of tooth preparation: an eye-tracking study

BackgroundGaze behavior can serve as an objective tool in undergraduate pre-clinical dental education, helping to identify key areas of interest and common pitfalls in the routine evaluation of tooth preparations. Therefore, this study aimed to investigate the gaze behavior of undergraduate dental students and dental educators while evaluating a single crown tooth preparation.MethodsThirty-five participants volunteered to participate in the study and were divided into a novice group (dental students, n = 18) and an expert group (dental educators, n = 17). Each participant wore a binocular eye-tracking device, and the total duration of fixation was evaluated as a metric to study the gaze behavior. Sixty photographs of twenty different tooth preparations in three different views (buccal, lingual, and occlusal) were prepared and displayed during the experimental session. The participants were asked to rate the tooth preparations on a 100 mm visual analog rating scale and were also asked to determine whether each tooth preparation was ready to make an impression. Each view was divided into different areas of interest. Statistical analysis was performed with a three-way analysis of the variance model with repeated measures.ResultsBased on the participants’ mean rates, the “best” and the “worst” tooth preparations were selected for analysis. The results showed a significantly longer time to decision in the novices compared to the experts (P = 0.003) and a significantly longer time to decision for both the groups in the best tooth preparation compared to the worst tooth preparation (P = 0.002). Statistical analysis also showed a significantly longer total duration of fixations in the margin compared to all other conditions for both the buccal (P < 0.012) and lingual (P < 0.001) views.ConclusionsThe current study showed distinct differences in gaze behavior between the novices and the experts during the evaluation of single crown tooth preparation. Understanding differences in gaze behavior between undergraduate dental students and dental educators could help improve tooth preparation skills and provide constructive customized feedback.

A Patient-Centered Perspective on Changes in Personal Characteristics After Deep Brain Stimulation

Deep brain stimulation (DBS) results in improvements in motor function and quality of life in patients with Parkinson disease (PD), which might impact a patient's perception of valued personal characteristics. Prior studies investigating whether DBS causes unwanted changes to oneself or one's personality have methodological limitations that should be addressed. To determine whether DBS is associated with changes in characteristics that patients with PD identify as personally meaningful. This cohort study assessed changes in visual analog scale (VAS) ratings reflecting the extent to which patients with PD manifested individually identified personal characteristics before and 6 and 12 months after DBS at a large academic medical center from February 21, 2018, to December 9, 2021. The VAS findings were tailored to reflect the top 3 individually identified personal characteristics the patient most feared losing. The VASs were scored from 0 to 10, with 0 representing the least and 10 the most extreme manifestation of the trait. Change scores were examined at the individual level. Content analysis was used to code the qualitative data. Qualitative and quantitative analyses were performed from January 12, 2019 (initial qualitative coding), to December 15, 2023. Deep brain stimulation. The primary outcome variable was the mean VAS score for the top 3 personal characteristics. The secondary outcome was the incidence of meaningful changes on the patients' top 3 characteristics at the individual level. Fifty-two of 54 dyads of patients with PD and their care partners (96.3%) were recruited from a consecutive series approved for DBS (36 patients [69.2%] were male and 45 care partners [86.5%] were female; mean [SD] age of patients, 61.98 [8.55] years). Two patients and 1 care partner were lost to follow-up. Increases in the mean VAS score (indicative of greater manifestation of [ie, positive changes in] specific characteristics) were apparent following DBS for ratings of both the patients (Wald χ2 = 16.104; P < .001) and care partners (Wald χ2 = 6.746; P < .001) over time. The slopes of the changes for both the patient and care partners were correlated, indicating agreement in observed changes over time. The individual level analyses indicated that scores for most patients and care partners remained the same or increased. In this cohort study, participants reported greater (more positive) manifestations of individually identified, valued characteristics after DBS. These findings may be relevant to informing decision-making for patients with advanced PD who are considering DBS.

Orthopedic Skin Closure in South India: Sutures Versus Staples and Their Postoperative Outcomes.

Introduction Skin closure is an essential step in deciding the success of a surgery. Despite this, the choice of skin closure material is frequently overlooked when making surgical decisions. Skin closure plays an important role in promoting rapid wound healing and decreasing the length of hospital stay, especially in orthopedic surgeries. Our study focused on comparing the outcome of wound closure in orthopedic surgeries with sutures and staples in a South Indian population. Materials and methods We enrolled 120 patients undergoing orthopedic procedures at Chettinad Hospital and Research Institute from July 2023 to February 2024. Patients were randomly assigned to skin closure with either staples or sutures. Wound inspection was done on the 2nd, 5th, 7th and 12th post-operative days. The patients were evaluated at six months using the Visual Analog Scale (VAS) and Hollander Wound Evaluation Score (HWES). Results Staple closure significantly reduced mean closure time (5.2 ± 0.9 minutes) compared to sutures (12.6 ± 1.5 minutes, p < 0.0001). Pain during staple removal was less (VAS score 1.41 ± 0.15) than with suture removal (VAS score 1.57 ± 0.2, p = 0.024). Although patient satisfaction was similar between the groups (Staples: 8.35 ± 0.45 vs. Sutures: 8.0 ± 0.5, p = 0.062), staples provided superior cosmetic outcomes (HWES: 4.1 ± 0.7) compared to sutures (HWES: 3.3 ± 0.6, p = 0.003). Complication rates, including infection, discharge, and hypertrophic scar formation, were comparable between the two methods. Conclusion Staple closure in orthopedic surgeries offers several advantages over sutures, including reduced operative time, less pain during removal, and superior cosmetic results. These benefits occur without an increased risk of wound complications. This study suggests that staples may be a preferable option for skin closure in orthopedic procedures, though further research with extended follow-up is needed to fully assess long-term outcomes.

A Comparative Study of the Effects of Small-Sided Game Formats on Internal Load and Technical Responses in Soccer

This study aimed to evaluate the influence of game formats on soccer players' internal load and technical responses during small-sided games (SSGs) of the 2-a-side and 4-a-side. Twenty-four male soccer players played three SSGs: possession, mini-goal (MG), and goalkeeper (GK). The SSG interventions were randomly allocated to six training intervention groups using SSGs performed in possession, MG, and GK game formats. The internal load was assessed using the perceived exertion (RPE), enjoyment scale, and visual analog scale (VAS) rating during each SSG session. Mental Readiness Form-3 (MRF-3) was evaluated pre- and post-game for mental preparedness. Technical actions were also conducted using video footage captured during all SSG sessions. A one-way repeated-measures analysis of variance was performed to evaluate any significant differences in performance across the different SSGs. Following the interventions, RPE and VAS scores differed considerably between the MG and GK games in the 2-a-side game (P

Effect of background noise and memory load on listening effort of young adults with and without hearing loss

ObjectivePeople with hearing loss often encounter difficulties in hearing under adverse conditions, such as listening in the presence of noise. Listening effort is an indicator used to assess listening difficulties in daily life. Although many studies on listening effort have been conducted in recent years, there is a notable gap in the exploration of how task load influences listening effort in young adults. This study compared the effects of background noise and memory load on task performance and subjective listening effort in young adults with and without hearing loss. MethodsThe study included a group of 8 adults with hearing loss (mean age: 24.1 ± 6.0 years) and a group of 16 individuals with normal hearing (mean age: 27.9 ± 4.9 years). A number memorizing task was conducted, involving two types of auditory digits (either three or seven digits) presented under multi-talker babble noise conditions of signal-to-noise ratio of −5 dB [SN −5 dB] or SN +5 dB. Participants determined whether the number presented in the encoding interval matched the one presented in the retrieval interval. Subsequently, they were asked to complete a questionnaire using a Visual Analog Scale (VAS) to assess their subjective listening effort. Percentage of correct responses, reaction times, and VAS ratings were compared between adults with and without hearing loss. ResultsOur results showed significant differences between the two groups in the percentage of correct responses and the reaction time under the SN −5 dB conditions, regardless of the memory load. Under the SN +5 dB conditions, a significant difference was found only in the percentage of correct responses for seven digits. In the normal hearing group, the percentage of correct responses and VAS ratings tended to decrease as the memory load increased, even under the same noise condition. Conversely, in the hearing loss group, a consistent trend could not be identified in the effects of noise and memory load on the percentage of correct responses and VAS ratings. ConclusionThese results suggest that in conditions of high noise load, young adults with hearing loss show a higher tendency for listening effort to be affected by other loads. We confirmed that for some participants with hearing loss, the task exceeded a certain level of difficulty in the SN −5 dB and seven digits condition, leading to a change in their motivation and strategy used. Future research should examine ways to control for participants’ motivations.

Pharmacoacupuncture for the Treatment of Frozen Shoulder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pharmacoacupuncture (PA) is an alternative injection therapy for a broad range of conditions. This meta-analysis evaluates the effectiveness and safety of PA in treating frozen shoulder (FS) and aims to standardise PA characteristics in clinical practice. Randomized controlled trials (RCTs) assessing PA for FS were systematically reviewed from seven electronic databases up to August 31, 2023. Outcomes measured included the visual analogue scale (VAS) or numerical rating scale (NRS), effective rate, Constant-Murley Score (CMS), Shoulder Pain and Disability Index (SPADI), ROM, quality of life (QoL), and adverse events. Data analysis was conducted using RevMan 5.3, with the risk of bias in each trial evaluated using Cochrane's risk of bias tool. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool assessed the quality of evidence. Thirteen RCTs involving 1034 patients met the inclusion criteria, with eleven RCTs and 872 patients included in the meta-analysis. PA showed low-quality evidence of improvement in VAS, effective rate, CMS Total, and CMS Pain. Moderate-quality evidence indicated improvement in CMS ADL and CMS Mobility. PA was effective in four SF-36 subscales: physical function, social role function, mental health, and emotional role function. No significant difference in CMS strength was observed. One trial reported mild anaphylaxis reaction to bee venom as an adverse event. PA may offer potential benefits as an alternative injection therapy for FS patients. Further well-designed RCTs with rigorous methodology are required to substantiate its therapeutic efficacy and clinical utility. PROSPERO (CRD42023445708).

Pre-cooling for Reducing Pain from Local Anesthetic Injections for Hemorrhoidectomy: An Open-label, Randomized, Crossover Trial.

Excisional hemorrhoidectomy (EH) is sometimes same-day surgery under local anesthesia (LA); however, the LA injection can be painful. We conducted an open-label, crossover, randomised controlled trial to evaluate the efficacy and safety of pre-cooling in reducing pain associated with LA injection. Patients aged ≥ 20 years undergoing bilateral EH were randomly assigned to 1 of 2 pre-cooling sequences: a cooling-first sequence and a cooling-second sequence. In the first intervention phase, 2 minutes of pre-cooling was applied before LA injection in patients randomized to the cooling-first sequence; patients in the cooling-second sequence were asked to wait for 2 minutes (without pre-cooling) before LA injection. The pre-cooling sequences and the perianal sides targeted for injection were reversed in the second intervention phase. The primary outcome was the visual analogue scale (VAS) rating for pain from LA injection, which was obtained twice for each patient. Adverse events due to pre-cooling (e.g., skin disorders) were documented. Of 114 screened patients, 51 were randomized to the cooling-first (n = 26; analyzed: n = 26) or cooling-second sequence (n = 25; analyzed: n = 25). The 2-minute pre-cooling was completed by 48 patients (94%). VAS scores for LA injection pain decreased significantly with pre-cooling compared to without (difference estimate, -1.71; 95% confidence interval, -2.12 to -1.31; p< 0.001). No adverse events were reported. Two minutes of skin pre-cooling effectively and safely reduces LA injection pain in patients undergoing EH.

Minimally Invasive versus Traditional Surgery: Efficacy of PELD and PLIF in Treating Pyogenic Spondylodiscitis.

BACKGROUND Pyogenic spondylodiscitis is infection of the intervertebral disc or discs and the adjacent vertebrae. This retrospective study aimed to compare the effectiveness of percutaneous endoscopic lumbar debridement (PELD) versus posterior lumbar interbody fusion (PLIF) in 40 patients with pyogenic spondylodiscitis (PSD). MATERIAL AND METHODS Medical records of patients who underwent PELD (n=18) or PLIF (n=22) for PSD between 2018 and 2023 were reviewed. The recorded outcomes encompassed surgical duration, intraoperative blood loss, Oswestry Disability Index (ODI) measurements, Visual Analog Scale (VAS) assessments, C-reactive protein (CRP) levels, duration of hospitalization, erythrocyte sedimentation rate (ESR), American Spinal Injury Association (ASIA) grading, lumbar sagittal parameters, and the incidence of complications. RESULTS The PELD group had shorter surgical duration, less intraoperative blood loss, and shorter length of hospital stay compared to the PLIF group (P<0.01). At the last follow-up, both groups had significant improvement in ESR, CRP levels, and ASIA classification (P<0.001), but there was no significant difference between the 2 groups (P>0.05). The PELD group had lower ODI and VAS ratings at 1 month and 3 months, respectively (P<0.01). The PLIF group had significant improvements in intervertebral space height and lumbar lordosis angle (P<0.01). CONCLUSIONS Both PLIF and PELD surgical approaches demonstrate adequate clinical efficacy in the treatment of monosegmental PSD. PLIF can better ensure more spinal stability than PELD, but PELD offers advantages such as reduced minimal surgical trauma, shorter operative duration, and faster recovery after surgery.

The therapeutic benefits of NSAIDs and physical therapy in knee osteoarthritis.

Osteoarthritis (OA) has been established as a progressive wear and tear disease of the synovial joints, which also involves a certain degree of inflammation. Considering there is no disease modifying medication available at the moment, the current guidelines focus on the symptomatic treatment of the affection. Our study aimed to evaluate the therapeutic advantages of the synergistic use of non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy in the treatment of knee osteoarthritis (KOA). The study comprised 46 individuals who were diagnosed with KOA and were admitted to the Department of Physical Medicine and Rehabilitation at the Emergency Clinical County Hospital of Craiova, Romania, between January 2021 and April 2022. All the participants received the same combination of pharmacological (Diclofenac 150 mg∕day, no more than 10 days∕month as needed) and non-pharmacological treatment (a 24-week plan of physical therapy). The patient group exhibited a statistically significant reduction in both the average Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index (p=0.0142) and the average Visual Analog Scale (VAS) (p=0.0023). Additionally, there was a statistically significant increase in both the average Knee Outcome Survey-Activities of Daily Living (KOS-ADL) (p=0.0128) and the average Oxford Knee Score (OKS) (p=0.0023). The study found a significant positive correlation between higher VAS ratings and cholesterol levels (p=0.0092), but no significant correlation between VAS scores and triglyceride levels (p=0.0986). Patients were evaluated for a further 24 weeks beyond the conclusion of the research to see if surgical intervention was necessary during this time. Our investigation tracked the WOMAC, VAS, KOS-ADL, and OKS measurements in a cohort of patients with KOA. The results demonstrate that the utilization of NSAIDs in conjunction with physical therapy effectively alleviates pain and enhances joint functionality.

Exploring the effect of lexicality and listener experience on gradient ratings of Swedish sibilant fricatives

ABSTRACT This study explores the influence of lexicality on gradient judgments of Swedish sibilant fricatives by contrasting ratings of initial fricatives in words and word fragments (initial CV-syllables). Visual-Analogue Scale (VAS) judgments were elicited from experienced listeners (speech-language pathologists; SLPs) and inexperienced listeners, and compared with respect to the effects of lexicality using Bayesian mixed-effects beta regression. Overall, SLPs had higher intra- and interrater reliability than inexperienced listeners. SLPs as a group also rated fricatives as more target-like, with higher precision, than did inexperienced listeners. An effect of lexicality was observed for all individual listeners, though the magnitude of the effect varied. Although SLP’s ratings of Swedish children’s initial voiceless fricatives were less influenced by lexicality, our results indicate that previous findings concerning VAS ratings of non-lexical CV-syllables cannot be directly transferred to the clinical context, without consideration of possible lexical bias.

Effectiveness of Percutaneous Needle Electrolysis to Reduce Pain in Tendinopathies: A Systematic Review With Meta-Analysis.

Tendon injuries are common disorders in both workers and athletes, potentially impacting performance in both conditions. This is why the search for effective treatments is continuing. The objective of this study was to analyze whether the ultrasound-guided percutaneous needle electrolysis technique may be considered a procedure to reduce pain caused by tendinosis. The search strategy included the PubMed, SCOPUS, CINAHL, Physiotherapy Evidence Database, SciELO, and ScienceDirect up to the date of February 25, 2024. Randomized clinical trials that assessed pain caused by tendinosis using the Visual Analog Scale and Numeric Rating Scale were included. The studies were evaluated for quality using the Cochrane Risk of Bias 2, and the evidence strength was assessed by the GRADEpro GDT. Out of the 534 studies found, 8 were included in the review. A random-effects meta-analysis and standardized mean differences (SMD) were conducted. The ultrasound-guided percutaneous needle electrolysis proved to be effective in reducing pain caused by tendinosis in the overall outcome (SMD = -0.97; 95% CI, -1.26 to -0.68; I2 = 58%; low certainty of evidence) and in the short-term (SMD = -0.83, 95% CI, -1.29 to -0.38; I2 = 65%; low certainty of evidence), midterm (SMD = -1.28; 95% CI, -1.65 to -0.91; I2 = 0%; moderate certainty of evidence), and long-term (SMD = -0.94; 95% CI, -1.62 to -0.26; I2 = 71%; low certainty of evidence) subgroups. The application of the ultrasound-guided percutaneous needle electrolysis technique for reducing pain caused by tendinosis appears to be effective. However, due to the heterogeneity found (partially explained), more studies are needed to define the appropriate dosimetry, specific populations that may benefit more from the technique, and possible adverse events.

The Analgesic Efficacy of Erector Spinae Plane Block in Ankle and Foot Surgery: A Randomized Controlled Study

Background: During ankle and foot surgeries, we often use different regional analgesic modalities to reduce patient pain during and after orthopaedic and surgical operations. The purpose of this research was to examine the effectiveness of erector spinae plane (ESP) block for postoperative pain management after ankle and foot surgeries. Methods: Sixty patients, aged 18 to 65, with ASA physical status I, participated in a randomized controlled clinical experiment. Patients were divided into two groups (E and C) at random, with group (E) receiving ESP block and group (C) receiving a placebo. The patients' medical histories were evaluated, and they were all examined and tested. Results: Observations At 2, 4, 12 &amp; 24 hours postoperatively, the ESP group had substantially lower visual analogue scale (VAS) ratings in contrast to the control group. The total quantity of fentanyl and pethidine given during, and after surgeries were both considerably lower in the Erector group in comparison with the control group. Total nonsteroidal anti-inflammatory medication usage did not vary significantly among the 2 groups, however. Conclusions: ESP is safe &amp; effective technique in decreasing pain and providing adequate analgesic effect in ankle and foot ssurgeries. Trial Registration: This study was prospectively registered on https://clinicaltrials.gov/ under the NCT05708742 number (principal investigator: Mohamed Ahmed Hamed), registration date: 24/01/ 2023.

A Randomized, Crossover Trial Assessing Appetite, Energy Metabolism, Blood Biomarkers, and Ad Libitum Food Intake Responses to a Mid-Morning Pecan Snack vs. an Equicaloric High-Carbohydrate Snack in Healthy Volunteers with Overweight/Obesity.

The differential effects of pecans versus other popular snack foods on appetite and blood markers of metabolism and satiety have not been well studied. This study investigated the effects of a single mid-morning snack of pecans or tortilla chips on subjective appetite, food intake, blood measures of hormones and metabolites, and resting energy expenditure. Twenty participants with overweight and obesity were enrolled in a within-participants, randomized crossover trial. Participants had indwelling catheters placed for blood sampling and were fed a standardized breakfast, followed two hours later by a 250 kcal snack of either pecans or tortilla chips, and then by a self-selected lunch. Visual analog scale (VAS) appetite measures, blood markers, and energy expenditure were taken at intervals after food consumption. VAS ratings, energy, food intake and macronutrient composition did not differ between treatment conditions, but glucose and insulin were significantly more elevated after tortilla chips. Free fatty acids (FFA), triglycerides (TG), peptide YY (PYY), and glucagon-like peptide-1 (GLP-1) were higher after consuming pecans compared to tortilla chips. Pecan consumption improves postprandial glucose and insulin profiles which would be beneficial to individuals at risk of developing type 2 diabetes. Further studies are needed to investigate whether increased relative secretion of PYY and GLP-1 after eating pecans versus tortilla chips may affect subjective appetite and energy intake if consumed chronically.