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The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of informatio...
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The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of information and almost unlimited resources on virtually any topic, as well as an almost seamless vehicle for communication. This new medium offers tremendous implications for health care. However, the absence of a single clearinghouse, a single search procedure or guarantee of accuracy often make information access efforts challenging, confusing and frustrating. The present paper provides a brief introduction aimed at increasing appreciation of the Internet and enhancing its utility with regard to chronic pain and its management and offers rudimentary guidelines for efficient accessing of information. Finally, it presents the results of a comprehensive search including nearly 200 useful Internet web links for professionals, patients, family members and other interested persons who assess, treat or cope with chronic pain. Identified resources include numerous organizations, medical, psychological assessment and practical treatment strategies, assessment and treatment reviews, support groups, list serve groups for patients and professionals, advocacy resources, news and assistive technology resources. Special emphasis is given to useful resources to assist professionals treating persons with chronic pain, as well as resources that can assist persons challenged by chronic pain.
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Extensive data document the adverse impact chronic pain can have on physical and psychosocial functioning. However, only recently has chronic pain received attention as a secondary complication in neurorehabilitation populations s...
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Extensive data document the adverse impact chronic pain can have on physical and psychosocial functioning. However, only recently has chronic pain received attention as a secondary complication in neurorehabilitation populations such as spinal cord injury, multiple sclerosis, and cerebral palsy. It is not unreasonable to expect that chronic pain might exacerbate impairments already present due to a chronic, disabling condition. The current paper reviews what is known about the prevalence, severity, and psychosocial impact of chronic pain in neurorehabilitation populations. Although there is variation among different conditions, available data suggest that considerable proportions of these patient populations experience chronic pain and associated sequelae similar to that reported in the extant chronic pain literature (e.g., psychological distress). Research needs to continue investigating the impact of chronic pain in neurorehabilitation populations and work toward development of effective interventions to manage pain and disability in these patients. It is likely that effective pain management will lead to more effective rehabilitation and improved quality of life.
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Chronic insomnia and cognitive impairment are both common complaints among older adults. This study explores the association between chronic insomnia and changes in cognitive functioning among older adults. The study population co...
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Chronic insomnia and cognitive impairment are both common complaints among older adults. This study explores the association between chronic insomnia and changes in cognitive functioning among older adults. The study population comprised two groups: 64 older adults without insomnia and 35 older adult insomniacs. The cognitive capacity of each participant was tested at the participant's home using the computerized “MindFit” test (CogniFit, Inc.). In five categories of cognitive functioning, older adult insomniacs displayed impaired performance compared to older adult good sleepers. Specifically, significant differences were found between insomniacs and good sleepers on memory span, allocating attention to a target, time estimation, executive functioning, and integration of two dimensions (visual and semantic) tests. The findings imply that insomnia may have detrimental effects on some cognitive functions in healthy older adults
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Alle Formen von akuten und chronischen Schmerzen werden, auch in Deutschland, nach wie vor unterbehandelt. Leistenschmerzen und Postvasektomie-Schmerzen sind häufig beobachtete Beschwerden in der urologischen Praxis und treten al...
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Alle Formen von akuten und chronischen Schmerzen werden, auch in Deutschland, nach wie vor unterbehandelt. Leistenschmerzen und Postvasektomie-Schmerzen sind häufig beobachtete Beschwerden in der urologischen Praxis und treten als chronische postoperative Schmerzen auf. Chronische Beckenschmerzen haben meist inflammatorische Ursachen und stellen ebenfalls eine Herausforderung für die behandelnden Ärzte dar. Die Schmerzen sollten so früh wie möglich, gegebenenfalls auch interdisziplinär, therapiert werden, um ein Voranschreiten des Chronifizierungsprozesses, mit Veränderungen von biologischen, psychologischen und sozialen Faktoren für den Patienten mit Einschränkung der Lebensqualität, zu verhindern.
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Chronic visceral pain is a frequent and disabling condition. Despite high prevalence and impact, chronic visceral pain is not represented in ICD-10 in a systematic manner. Chronic secondary visceral pain is chronic pain secondary ...
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Chronic visceral pain is a frequent and disabling condition. Despite high prevalence and impact, chronic visceral pain is not represented in ICD-10 in a systematic manner. Chronic secondary visceral pain is chronic pain secondary to an underlying condition originating from internal organs of the head or neck region or of the thoracic, abdominal, or pelvic regions. It can be caused by persistent inflammation, by vascular mechanisms or by mechanical factors. The pain intensity is not necessarily fully correlated with the disease process, and the chronic visceral pain may persist beyond successful treatment of the underlying cause. This article describes how a new classification of chronic secondary visceral pain is intended to facilitate the diagnostic process and to enable the collection of accurate epidemiological data. Furthermore, it is hoped that the new classification will improve the tailoring of patient-centered pain treatment of chronic secondary visceral pain and stimulate research. Chronic secondary visceral pain should be distinguished from chronic primary visceral pain states that are considered diseases in their own right.
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Objectives/Hypothesis Previous studies showed that chronic rhinosinusitis (CRS) accounts for billions of dollars in healthcare resource utilization. However, all such study estimates of the economic burden of CRS were based on sub...
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Objectives/Hypothesis Previous studies showed that chronic rhinosinusitis (CRS) accounts for billions of dollars in healthcare resource utilization. However, all such study estimates of the economic burden of CRS were based on subpopulations in Western societies. This study aimed to investigate differences in the utilization of healthcare services between subjects with CRS and comparison subjects using Taiwan's National Health Insurance database. Study Design A cross-sectional study. Methods In total, 5,849 CRS subjects and 17,547 selected comparison subjects were included in this study. We evaluated healthcare resource utilization in a 1-year period. Variables of healthcare resource utilization included the following: numbers of outpatient visits and inpatient days, and the mean costs of outpatient and inpatient treatment. We also divided healthcare resource utilization into ear, nose, and throat (ENT) and non-ENT services. Results On the utilization of ENT services, CRS subjects had significantly more outpatient visits (3.9 vs. 1.4, P-<-.001) and significantly higher outpatient costs (US$77.7 vs. US$19.4, P-<-.001) than comparison subjects. As for the use and costs of all healthcare services, CRS subjects had significantly more outpatient visits (27.9 vs. 18.3, P-<-.001) and significantly higher outpatient (US$953 vs. US$665, P-<-.001) and total (US$1319 vs. US$946, P-<-.001) costs than comparison subjects. Namely, on average, CRS subjects had 152% more outpatient visits and 139% higher total costs than comparison subjects. Conclusions This study found that subjects with CRS had significantly higher use of all healthcare services and costs than aged-matched controls. Level of Evidence 2c Laryngoscope, 124:1285-1289, 2014
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Objectives/Hypothesis Although chronic periodontitis (CP) and chronic rhinosinusitis (CRS) both share immunological disturbances as pathological factors, no prior study has investigated the risk for CP among patients with CRS. Thi...
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Objectives/Hypothesis Although chronic periodontitis (CP) and chronic rhinosinusitis (CRS) both share immunological disturbances as pathological factors, no prior study has investigated the risk for CP among patients with CRS. This study set out to provide an estimation of risk by utilizing a cohort study design to leverage the statistical power of a population-based dataset in Taiwan. Study Design A retrospective cohort study. Methods In total, 13,782 CRS subjects were included in the study cohort and 41,346 subjects were randomly extracted for the comparison cohort. We individually tracked each subject in this study (N = 55,128) for a 5-year period following their index date to identify those subjects who received a subsequent diagnosis of CP. Cox proportional hazards regression analysis was conducted to calculate the 5-year risk of subsequent CP following a diagnosis of CRS among the sampled subjects. Results The incidence rate of CP during the 5-year follow-up period was 5.12 (95% confidence interval [CI], 4.95-5.30) per 100 person-years and 3.24 (95% CI, 3.17-3.30) per 100 person-years for the study and comparison cohort, respectively. Cox proportional hazards regression revealed that the hazard ratio for CP during the 5-year follow-up period for subjects with CRS was 1.59 times (95% CI, 1.52-1.67) that of comparison subjects after adjusting for monthly income, geographic region, hypertension, diabetes, coronary heart disease, and hyperlipidemia, and censoring for cases who died during the 5-year follow-up period. Conclusions This study detected an increased risk for CP among patients suffering from CRS. CRS patients should be alerted to pay particular attention to their oral hygiene practices to prevent both CP and its downstream sequelae.
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Воспалительные заболевания верхних отделов пищеварительного тракта (ВОПТ), ассоциированные с дисплазией соединительной тка...
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Воспалительные заболевания верхних отделов пищеварительного тракта (ВОПТ), ассоциированные с дисплазией соединительной ткани (ДСТ), это тяжелые хронические, склонные к прогрессированию заболевания со сложными этиологией и патогенезом. В статье приведены результаты наблюдения 119 детей в возрасте 6-14 лет с хроническим гастритом и хроническим гастродуоденитом, протекающим на фоне ДСТ. Выявлено, что для данной категории пациентов характерны раннее начало заболевания, более высокая частота обострений, большая распространенность воспалительного процесса и склонность к деструктивным изменениям слизистой оболочки ВОПТ. Прослежена взаимосвязь между тяжестью указанных заболеваний и степенью ДСТ.
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Chronic pancreatitis (CP) has been considered an intractable inflammatory disease that is progressive and irreversible after definite structural changes appear in the pancreas. The Japanese diagnostic criteria for CP were revised ...
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Chronic pancreatitis (CP) has been considered an intractable inflammatory disease that is progressive and irreversible after definite structural changes appear in the pancreas. The Japanese diagnostic criteria for CP were revised in 2009. One of the reasons for this revision was to define a diagnostic criterion for the early phase of CP (early CP) to improve a patient's clinical outcome, because the disease progression might be reversed in this phase by a therapeutic intervention. However, the clinical features and outcome of early CP remain largely unknown, and the diagnostic reliability of early CP needs to be verified. Here, we show two patients who met the diagnostic criteria of early CP and then progressed to the advanced, late phase of CP (definite CP). A 64-year-old man with recurrent acute pancreatitis was diagnosed as early CP and later progressed to definite CP with multiple pancreatic calcifications at the age of 69. The etiology of CP in this patient was thought to be idiopathic. The other patient was a 57-year-old man with alcohol abuse (ethanol consumption > 120 g/day). He was diagnosed as early CP and then rapidly progressed to definite CP without any acute attack. He could not remain abstinent after the diagnosis of early CP. In the present report, we retrospectively demonstrated distinct clinical features of the two patients, both of whom were diagnosed as early CP first and then progressed to definite CP. Thus, our findings support the disease concept of early CP and also suggest the validity of the revised Japanese criteria for the diagnosis of early CP.
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Цель исследования. Уточнить связь между снижением функции почек и фибрилляцией предсердий (ФП) у больных с хронической сердеч...
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Цель исследования. Уточнить связь между снижением функции почек и фибрилляцией предсердий (ФП) у больных с хронической сердечной недостаточностью (ХСН). Материалы и методы. Обследованы 340 больных с ХСН (200 мужчин, 140 женщин, средний возраст 58 +- 13 лет). Причиной ХСН у 44 (13%) была артериальная гипертония, у 112 (33%) - ИБС, у 184 (54%) - их сочетание. У 66 (19%) больных был сахарный диабет и 180 (53%) больных перенесли инфаркт миокарда. Скорость клубочковой фильтрации (СКФ) рассчитывали по формуле МБКО. У 30 больных имелись пароксизмальная персистирующая ФП и у 27 -постоянная форма ФП.Результаты. СКФ составила 68,8 +- 20,9мл/мин/1,13м2 (от 19,2 до 149,7мл/мин/1,73м2), при этом, у 114 (33,5%) больных СКФ была < 60 мл/мин/1,73 м2. Протеинурия наблюдалась у 38 (11,2%) больных. СКФ была ниже у больных с ХСН и ФП (58,8 +- 14,2 мл/мин/1,73 м2), чем у пациентов без ФП (69,1 +- 18,8 мл/мин/1,73 м2, р < 0,001). У больных со сниженной функцией почек имелся больший диаметр левого предсердия, и чаще наблюдалась митральная регур-гитация. Логистический регрессионный анализ позволил выявить, что хроническая болезнь почек (ХБП) (относительный риск - ОР 2,3 при 95% доверительном интервале - ДИ от 1,2 до 4,3) функциональный класс ХСН (ОР 1,8 при 95%ДИот 1,0 до 3,1) были независимо ассоциированы с ФП.Заключение. Снижение функции почек предрасполагает к развитию ФП у больных с ХСН. ХБП должна рассматриваться как состояние угрожаемое развитию ФП.
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