RESUMEN
OBJECTIVES: A high incidence of attention-deficit hyperactivity disorder (ADHD) has been reported in chronic pain (ChP) patients. Furthermore, an association between ChP and muscular dysregulation has been reported in adults with ADHD. The present study investigated whether ADHD was more prevalent among psychiatric outpatients with ChP than those without ChP, and if there was an association between ChP, muscular dysregulation and characteristics of pain in patients with ADHD. METHODS: One-hundred and twenty-one individuals remitted to an outpatient psychiatry unit took part in this naturalistic epidemiological cross-sectional study. They were assessed with a pain self-report form (localization, intensity, and onset) and a test of muscle dysregulation (the Motor Function Neurological Assessment). Prevalence of ADHD among patients with ChP, as well as the qualitative characteristics of ChP within the ADHDgroup are reported. Both ChP and pain intensity correlated with muscular dysregulation through Spearman's rho analysis. Additionally, the relationship between various diagnostic categories (ADHD, affective disorders, anxiety, or personality disorders) and incidence of axial pain was evaluated in logistic regression. RESULTS: ADHD was significantly more prevalent in patients with ChP, than in patients without ChP. In the ADHD group, ChP and pain intensity was associated with muscular dysregulation, particularly with high muscle tone. ChP was more axial and widespread, than for the patients without ADHD, and started at an early age. ADHD diagnosis predicted axial pain, whereas affective-, anxiety-, or personality disorders did not. CONCLUSIONS: The study suggests that ChP in ADHD is associated with muscular dysregulation and is qualitatively different from ChP in psychiatric patients without ADHD. These findings may lead to further understanding of potential mechanisms involved in ADHD and ChP, and in turn to new treatment strategies for both disorders.
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Trastorno por Déficit de Atención con Hiperactividad , Dolor Crónico , Humanos , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Dolor Crónico/fisiopatología , Dolor Crónico/epidemiología , Masculino , Femenino , Estudios Transversales , Adulto , Persona de Mediana Edad , Prevalencia , Dimensión del Dolor , Adulto JovenRESUMEN
Chronic diseases and pain exacerbate depressive symptom in Syria. Limited research on hospital-induced depressive symptom among Syrian patients with chronic diseases warrants further study. A cross-sectional study in four Damascus hospitals revealed high rates of pain and depressive symptom. This study aims to investigate the prevalence and severity of chronic pain and hospital-induced depressive symptom in Syrian patients, as well as the relationship between pain, depressive symptom, and medication behavior. This study analyzes the impact of pain, hospitalization, and medication on patients with chronic diseases. The four Damascus hospitals included 453 patients from various departments. Data were collected through structured interviews and internationally recognized scales such as the PSEQ, HADS, and MMAS. These findings offer insights into pain management and psychological well-being, with implications for patient care and support strategies. The study involved 453 patients with chronic diseases, with gender distribution showing 46.6% females and 53.4% males. The age range was from 7 to 87 years, with an average of 46.87 years. Chi-square tests revealed a significant connection between gender and HADS-A scores, where 48.3% of females had abnormalities (χ2 (1, N = 453) = 7.125, p = 0.028). Marital status was significantly associated with anxiety and depressive symptom levels, particularly among widowed and divorced patients. Employment status, education, and comorbidity were linked to abnormal HADS-A scores, while education level showed a positive correlation with HADS-D scores. ANOVA tests showed significant differences in MMAS scores across income groups (F (3, 449) = 3.167, p = 0.024), with a notable difference between low-income and lower-middle-income groups (mean difference = 0.389, p = 0.031. Chronic pain and HID are prevalent among Syrian patients with chronic diseases and influenced by socio-demographic factors. Personalized interventions are needed to address psychological symptoms and medication behavior.
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Depresión , Hospitalización , Humanos , Masculino , Femenino , Persona de Mediana Edad , Siria/epidemiología , Adulto , Depresión/epidemiología , Anciano , Estudios Transversales , Adolescente , Enfermedad Crónica , Adulto Joven , Anciano de 80 o más Años , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiología , Dolor Crónico/psicología , Niño , PrevalenciaRESUMEN
BACKGROUND: This study aimed to determine the prevalence of chronic pelvic pain(CPP) in refugee and non-refugee women, determine the factors associated with CPP, and evaluate the effect of CPP on life quality. METHODS: This was a cross-sectional study conducted among 283 non-refugee and 278 refugee women in Turkey. A questionnaire including questions assessing chronic pelvic pain and related factors, World Health Organization Quality of Life Scale Short Form(WHOQOL-BREF), Depression Anxiety Stress Scale-21, were administered to the participants. Chi-square test, Mann-Whitney U test and multiple logistic regression analysis were used for statistical analysis. RESULTS: The prevalence of chronic pelvic pain was 41.0% in refugee women and 19.1% in non-refugee women (p< 0.001). The prevalence of CPP was 1.68 times higher in refugee women than in non-refugee women (OR;95%CI:1.68;1.01-2.81). In the multivariate analysis performed in the study group, refugee status, low family income status(OR;95%CI:2.09;1.26-3.46), low back pain(OR;95%CI:2.02;1.21-3.35), dyspareunia (OR; 95%CI:2.96;1.75-4.99), number of three or more miscarriages (OR;95%CI:3.07;1.18-8.01), history of gynaecological surgery (OR;95%CI:2.44;1.33-4.50), diarrhea (OR;95%CI:2.01;1.07-3.76), urinary tract infections(OR; 95%CI:1.66;1.02-2.71) and anxiety(OR; 95%CI:1.17;1.10-1.24) were found to be risk factors for CPP. In the refugee and non-refugee groups, those with CPP had lower scores in all subdomains of the WHOQOL-BREF scale than those without CPP (p < 0.05). CONCLUSIONS: Refugee status independently contributes to the risk of developing CPP. Targeted interventions to address CPP and its associated risk factors are needed, particularly in vulnerable refugee populations, to improve their quality of life.
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Dolor Crónico , Dolor Pélvico , Calidad de Vida , Refugiados , Humanos , Femenino , Calidad de Vida/psicología , Dolor Pélvico/psicología , Dolor Pélvico/epidemiología , Dolor Pélvico/etiología , Adulto , Refugiados/psicología , Refugiados/estadística & datos numéricos , Estudios Transversales , Dolor Crónico/psicología , Dolor Crónico/epidemiología , Turquía/epidemiología , Factores de Riesgo , Prevalencia , Encuestas y Cuestionarios , Persona de Mediana Edad , Adulto Joven , Depresión/epidemiología , Depresión/psicología , Ansiedad/epidemiología , Ansiedad/psicologíaRESUMEN
OBJECTIVE: To explore whether sedentary behaviour could modulate the association between overweight or obesity and chronic low back pain (CLBP). DESIGN: A retrospective cross-sectional study. SETTING AND PARTICIPANTS: A total of 4289 participants in the US cohort from the National Health and Nutrition Examination Survey were included. PRIMARY AND SECONDARY OUTCOME MEASURES: CLBP was the outcome. RESULTS: After adjusting for confounding factors, an increased risk of CLBP was identified in people who were overweight (OR 1.41, 95% CI 1.13 to 1.76) and obesity (OR 1.48, 95% CI 1.01 to 2.18). No significant association between sedentary behaviour time and CLBP was observed. In body mass index (BMI)<25 kg/m2 vs BMI≥30 kg/m2 group, sedentary behaviour time showed a modulatory effect on obesity and CLBP (p=0.047). In the sedentary behaviour time >4.5 hours group, the risk of CLBP was increased as BMI elevation, indicating sedentary behaviour time >4.5 hours played a modulatory role in the relationship between obesity and CLBP. CONCLUSION: Obesity was significantly associated with an increased risk of CLBP, and sedentary behaviour time modulated the association between obesity and CLBP. The findings might provide a reference for the lifestyle modifications among individuals with obesity and reducing sedentary behaviour is recommended for this population.
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Índice de Masa Corporal , Dolor de la Región Lumbar , Encuestas Nutricionales , Obesidad , Conducta Sedentaria , Humanos , Estudios Transversales , Dolor de la Región Lumbar/epidemiología , Obesidad/epidemiología , Obesidad/complicaciones , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto , Estados Unidos/epidemiología , Dolor Crónico/epidemiología , Factores de Riesgo , Sobrepeso/epidemiología , AncianoRESUMEN
OBJECTIVE: To assess the effectiveness of a modified Lichtenstein Repair combined with Herniorrhaphy in reducing postoperative chronic pain and enhancing recovery and quality of life in inguinal hernia patients. METHODS: This retrospective study, conducted at the Taleghani training center between January 2021 and February 2023, retrospectively examined 289 hernia surgeries, of which 130 employed a modified Lichtenstein technique. The investigation encompassed a detailed analysis of patient demographics, employed surgical techniques, operative methods with a focus on minimal dissection, and an evaluation of postoperative outcomes. RESULTS: In this study of 289 participants, primarily males aged 60-80 years, the modified technique group demonstrated a notably lower incidence of hernia recurrence (1.5%) compared to the Lichtenstein group (3.1%). Additionally, the modified technique was more effective in reducing postoperative pain, with a significantly lower mean Visual Analogue Scale (VAS) score of 0.15, compared to 0.31 in the Lichtenstein group. This suggests enhanced patient comfort and a potentially quicker recovery in the modified technique group. CONCLUSION: The modified Lichtenstein hernioplasty technique, characterized by minimal tissue trauma and precise mesh placement, emerges as an effective approach in inguinal hernia repair. It offers significant benefits in reducing postoperative discomfort and chronic pain, thereby enhancing patient recovery and overall quality of life. This method aligns with current surgical trends towards patient-centric and minimally invasive procedures.
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Dolor Crónico , Hernia Inguinal , Herniorrafia , Dolor Postoperatorio , Calidad de Vida , Mallas Quirúrgicas , Humanos , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Herniorrafia/métodos , Hernia Inguinal/cirugía , Femenino , Dolor Crónico/etiología , Dolor Crónico/epidemiología , Dolor Crónico/prevención & control , Anciano de 80 o más Años , Dolor Postoperatorio/etiología , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/epidemiología , Adulto , Resultado del Tratamiento , Recurrencia , Dimensión del DolorRESUMEN
BACKGROUND: Pediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years. METHODS: Available longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child's pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models. RESULTS: Gut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11. CONCLUSIONS: Some, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.
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Dolor Crónico , Humanos , Dolor Crónico/epidemiología , Dolor Crónico/psicología , Dolor Crónico/etiología , Niño , Factores de Riesgo , Femenino , Masculino , Estudios Longitudinales , Preescolar , Lactante , Estudios ProspectivosRESUMEN
Insomnia can coexist with chronic pain and is a major cause of rapidly increasing medical expenses. However, insomnia has not been fully evaluated in patients with chronic pain. This retrospective study aimed to identify the risk factors for insomnia in patients with chronic non-cancer pain. A total of 301 patients with chronic non-cancer pain were enrolled. Patients with the Athens insomnia scale scoresâ ≥â 6 andâ <â 6 were classified into insomnia (+) and insomnia (-) groups, respectively. All patients completed self-report questionnaires as part of their chronic pain treatment approach. Univariate and multivariate analyses were performed to predict insomnia. We found that 219 of 301 (72.8%) patients met the AIS criteria for insomnia. Significant differences were depicted between patients with and without insomnia in terms of body mass index, numeric rating scale, pain catastrophizing scale, hospital anxiety, and depression scale (HADS), pain disability assessment scale, EuroQol 5 dimension (EQ5D), and pain self-efficacy questionnaire. Multiple regression analysis identified the numeric rating scale, HADS, and EQ5D scores as factors related to insomnia in patients with chronic non-cancer pain. Anxiety, depression, and disability were associated with a greater tendency toward insomnia. HADS and EQ5D scores are useful screening tools for preventing insomnia in patients with chronic non-cancer pain.
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Dolor Crónico , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Masculino , Estudios Retrospectivos , Femenino , Dolor Crónico/psicología , Dolor Crónico/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Adulto , Anciano , Dimensión del Dolor/métodos , Depresión/epidemiología , Encuestas y Cuestionarios , Ansiedad/epidemiología , Catastrofización/psicologíaRESUMEN
BACKGROUND: Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain. METHODS: Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled. A diagnosis of sarcopenia was established based on the criteria outlined by the Asian Working Group for Sarcopenia in 2019. Patient demographics, pain-related factors, clinical factors, and sarcopenia-related measurements were compared between non-sarcopenic and sarcopenic patients. Linear regression analysis was used to evaluate the correlation of calf circumference with muscle mass, strength, and physical performance. Also, a receiver operating characteristic curve analysis for calf circumference in predicting sarcopenia was conducted; and area under the curve (AUC) values, along with their corresponding 95% confidence intervals (CI), were calculated. RESULTS: Data from 592 patients were included in the analysis. Eighty-five patients were diagnosed with sarcopenia (14.3%), 71 of whom had severe sarcopenia (11.9%). A higher prevalence of sarcopenia was observed in female patients (9.0% vs. 16.7%, p = 0.016). After adjusting for age, BMI, and comorbidities, calf circumference correlated positively with muscle mass but not with muscle strength and physical performance. The AUC values for sarcopenia were 0.754 (95% CI = 0.636-0.871, p = 0.001) in males and 0.721 (95% CI = 0.657-0.786, p < 0.001) in females. The cut-offs for calf circumference in predicting sarcopenia were 34 cm (sensitivity 67.1%, specificity 70.6%) in males, and 31 cm (sensitivity 82.5%, specificity 51.5%) in females. CONCLUSIONS: Even though sex differences in its predictive value for sarcopenia should be considered, our findings suggest that calf circumference can be used as an indicator for predicting muscle mass and may serve as a potential marker for identifying sarcopenia in older patients with chronic low back pain.
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Pierna , Dolor de la Región Lumbar , Sarcopenia , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Masculino , Femenino , Anciano , Estudios Transversales , Estudios Retrospectivos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/epidemiología , Dolor Crónico/diagnóstico , Dolor Crónico/epidemiología , Fuerza Muscular/fisiología , Anciano de 80 o más Años , Valor Predictivo de las Pruebas , Músculo Esquelético/patología , Músculo Esquelético/fisiopatologíaRESUMEN
BACKGROUND: Problematic anger, characterized by excessive frequency, intensity, and duration of anger which causes substantial emotional distress and functional interference, poses a marked challenge in military populations. Despite its importance, research on this topic is limited. This study contributes to the literature by exploring problematic anger in a large sample of Norwegian military personnel who served in NATO missions in Afghanistan. METHODS: All Norwegian military personnel who deployed to Afghanistan between 2001 and 2020 were sent a link to a cross-sectional web-based survey by the Joint Medical Services of the Norwegian Armed Forces in 2020. A total of 6205 individuals (response rate: 67.7%) participated. The cross-sectional survey assessed problematic anger, mental and physical health, war zone stressor exposure, and quality of life. RESULTS: Overall, 8.4% of participants reported problematic anger. Mental health disorders, deployment-related shame and guilt, chronic pain, and challenges with the military-to-civilian transition were independently associated with problematic anger. Both staying in service and maintaining a part-time connection with the military as a reservist mitigated the risk of problematic anger after deployment, compared to complete separation from military service. CONCLUSION: Findings demonstrate a sizeable prevalence of problematic anger among veterans of combat deployments. Given the associations between problematic anger and mental health disorders, chronic pain, and transition challenges, interventions designed to mitigate problematic anger need to be multi-faceted, including the possibility of maintaining an ongoing connection to military service. By reducing the risk of problematic anger, occupational, interpersonal and health outcomes may be improved for service members. Future research should examine the impact of problematic anger on adjustment over time, prevention strategies, and problematic anger in other high-risk occupations.
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Campaña Afgana 2001- , Ira , Despliegue Militar , Personal Militar , Humanos , Masculino , Personal Militar/psicología , Personal Militar/estadística & datos numéricos , Adulto , Femenino , Estudios Transversales , Prevalencia , Noruega/epidemiología , Factores de Riesgo , Despliegue Militar/psicología , Despliegue Militar/estadística & datos numéricos , Adulto Joven , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Calidad de Vida/psicología , Culpa , Dolor Crónico/psicología , Dolor Crónico/epidemiología , Vergüenza , Persona de Mediana EdadRESUMEN
The COVID-19 pandemic has increased germ aversion, an aversive affective response to a high likelihood of pathogen transmission. While psychological factors are associated with chronic pain, the relationship between germ aversion and chronic pain remains unexplored. This study aimed to examine the relationship between germ aversion and new-onset and prognosis of chronic pain using longitudinal data collected during the COVID-19 pandemic. We conducted web-based surveys of full-time workers at baseline and after three months. Data were collected on demographic characteristics, psychological factors, and chronic pain. Germ aversion was assessed using a modified Perceived Vulnerability to Disease scale. We analyzed responses from 1265 panelists who completed the survey twice. The prevalence of chronic low back pain (CLBP) and chronic neck and shoulder pain (CNSP) was associated with sex, short sleep duration, psychological distress, loneliness, and germ aversion. Stratified analyses showed that germ aversion was a risk factor for CLBP at three months in both individuals with and without CLBP at baseline, and for CNSP at three months in those with CNSP at baseline, even after adjustment for confounders. In conclusion, this preliminary study suggests that high germ aversion is a risk factor for CLBP and CNSP in young and middle-aged workers.
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COVID-19 , Dolor de la Región Lumbar , Dolor de Hombro , Humanos , COVID-19/psicología , COVID-19/epidemiología , Masculino , Femenino , Dolor de la Región Lumbar/psicología , Dolor de la Región Lumbar/epidemiología , Adulto , Factores de Riesgo , Persona de Mediana Edad , Dolor de Hombro/epidemiología , Dolor de Hombro/psicología , Dolor Crónico/psicología , Dolor Crónico/epidemiología , Internet , SARS-CoV-2/aislamiento & purificación , Encuestas y Cuestionarios , Pandemias , Estudios Longitudinales , Prevalencia , Adulto JovenRESUMEN
AIMS: Post mastectomy pain syndrome (PMPS) can have significant negative effects on patients' quality of life after mastectomy. The estimated prevalence of PMPS varies widely and there is little data from a New Zealand population. This limits clinicians' ability to meaningfully describe and discuss pain-related complications of mastectomy peri-operatively. METHOD: We designed a single-centre, retrospective study to describe acute post-operative analgesic requirements after mastectomy, to describe the prevalence of PMPS at least 1 year after surgery, and to identify associated risk factors for this complication. RESULTS: One hundred and thirty mastectomy patients met inclusion criteria and 59 were willing and able to participate in 12-month follow-up. Acute post-operative pain was generally well managed with modest doses of oral analgesics. Sixty-six percent (n=39) of women reported some form of persistent pain symptoms post-mastectomy; this was associated with younger age, axillary surgery and chemotherapy. Only 5% of patients (n=3) met consensus criteria for PMPS, which limited identification of risk factors for this more severe complication. CONCLUSION: Despite PMPS occurring infrequently, post-operative pain of a less severe nature after mastectomy occurs commonly. Clinicians should remain vigilant to possible risk factors for this post-operative complication and counsel patients appropriately.
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Neoplasias de la Mama , Mastectomía , Dolor Postoperatorio , Centros de Atención Terciaria , Humanos , Femenino , Dolor Postoperatorio/tratamiento farmacológico , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/etiología , Mastectomía/efectos adversos , Persona de Mediana Edad , Estudios Retrospectivos , Adulto , Anciano , Neoplasias de la Mama/cirugía , Factores de Riesgo , Analgésicos/uso terapéutico , Nueva Zelanda/epidemiología , Dolor Agudo/etiología , Dolor Agudo/tratamiento farmacológico , Dolor Agudo/epidemiología , Prevalencia , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Dolor Crónico/tratamiento farmacológico , Dimensión del DolorRESUMEN
Pain, substance use, and mental health conditions are common among people living with HIV (PLWH), and avoidance and rumination may influence the co-occurrence of these conditions. The present study examined longitudinal associations between avoidance/rumination and pain outcomes, anxiety, anger, and substance use among PLWH. Participants (Nâ¯=â¯187) with chronic pain and depressive symptoms completed self-report assessments over a 1-year period. Greater avoidance/rumination was positively associated with mental health outcomes (anxiety, anger), pain interference, and alcohol use across participants after controlling for depression severity. At time points with greater avoidance/rumination than average, participants also reported increased pain severity and interference, anxiety and anger symptoms, and alcohol use. No associations were found between avoidance/rumination and cannabis use. Results suggest a mechanistic effect of avoidance/rumination, such that increases in avoidance/rumination correspond with poorer health outcomes among PLWH over time. Targeting avoidance/rumination through intervention approaches may be beneficial for addressing comorbid health conditions among PLWH. Additional research is necessary to investigate this possibility and further characterize the effects of avoidance/rumination on health outcomes for PLWH.
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Ansiedad , Depresión , Infecciones por VIH , Salud Mental , Rumiación Cognitiva , Trastornos Relacionados con Sustancias , Humanos , Masculino , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/complicaciones , Persona de Mediana Edad , Depresión/psicología , Depresión/epidemiología , Depresión/complicaciones , Adulto , Ansiedad/psicología , Ansiedad/epidemiología , Salud Mental/estadística & datos numéricos , Dolor Crónico/psicología , Dolor Crónico/epidemiología , Ira , Reacción de Prevención , AutoinformeRESUMEN
OBJECTIVE: Thoracic surgery is associated with one of the highest rates of chronic postsurgical pain (CPSP) among all surgical subtypes. Chronic postsurgical pain carries significant medical, psychological, and economic consequences, and further interventions are needed to prevent its development. This study aimed to determine the prevalence, characteristics, and risk factors associated with CPSP after thoracic surgery. DESIGN: A prospective cohort study. SETTING: Single-center tertiary care hospital. PARTICIPANTS: This study included 285 adult patients who underwent thoracic surgery at Toronto General Hospital in Toronto, Canada, between 2012 and 2020. MEASUREMENTS AND MAIN RESULTS: Demographic, psychological, and clinical data were collected perioperatively, and follow-up evaluations were administered at 3, 6, and 12 months after surgery to assess CPSP. Chronic postsurgical pain was reported in 32.4%, 25.4%, and 18.2% of patients at 3, 6, and 12 months postoperatively, respectively. Average CPSP pain intensity was rated to be 3.37 (SD 1.82) at 3 months. Features of neuropathic pain were present in 48.7% of patients with CPSP at 3 months and 71% at 1 year. Multivariate logistic regression models indicated that independent predictors for CPSP at 3 months were scores on the Hospital Anxiety and Depression Scale (adjusted odds ratio [aOR] of 1.07, 95% CI of 1.02 to 1.14, p = 0.012) and acute postoperative pain (aOR of 2.75, 95% CI of 1.19 to 6.36, p = 0.018). INTERVENTIONS: None. CONCLUSIONS: Approximately 1 in 3 patients will continue to have pain at 3 months after surgery, with a large proportion reporting neuropathic features. Risk factors for pain at 3 months may include preoperative anxiety and depression and acute postoperative pain.
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Dolor Crónico , Dolor Postoperatorio , Procedimientos Quirúrgicos Torácicos , Humanos , Masculino , Femenino , Estudios Prospectivos , Dolor Postoperatorio/epidemiología , Dolor Postoperatorio/psicología , Dolor Postoperatorio/etiología , Dolor Postoperatorio/diagnóstico , Factores de Riesgo , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Dolor Crónico/psicología , Persona de Mediana Edad , Prevalencia , Procedimientos Quirúrgicos Torácicos/efectos adversos , Anciano , Estudios de Cohortes , Adulto , Estudios de SeguimientoRESUMEN
INTRODUCTION: Multiple Canadian jurisdictions have reported a pattern of chronic pain among people who died from substance-related acute toxicity. This study examined the prevalence and characteristics of those with chronic pain using data from a national study of people who died of accidental acute toxicity. METHODS: A cross-sectional analysis of accidental substance-related acute toxicity deaths that occurred in Canada between 1 January 2016 and 31 December 2017 was conducted. The prevalence of pain and pain-related conditions were summarized as counts and percentages of the overall sample. Subgroups of people with and without a documented history of chronic pain were compared across sociodemographic characteristics, health history, contextual factors and substances involved. RESULTS: From the overall sample (n = 7902), 1056 (13%) people had a history of chronic pain while 6366 (81%) had no documented history. Those with chronic pain tended to be older (40 years and older), unemployed, retired and/or receiving disability supports around the time of death. History of mental health conditions, trauma and surgery or injury was significantly more prevalent among people with chronic pain. Of the substances that most frequently contributed to death, opioids typically prescribed for pain (hydromorphone and oxycodone) were detected in toxicology more often among those with chronic pain than those without. CONCLUSION: Findings underscore the cross-cutting role of multiple comorbidities and unmanaged pain, which could compound the risk of acute toxicity death. Continued prioritization of harm reduction and regular patient engagement to assess ongoing needs are among the various opportunities for intervention.
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Dolor Crónico , Humanos , Canadá/epidemiología , Masculino , Femenino , Dolor Crónico/epidemiología , Estudios Transversales , Persona de Mediana Edad , Adulto , Anciano , Prevalencia , Analgésicos Opioides/envenenamiento , Adolescente , Adulto Joven , Factores de Edad , Sobredosis de Droga/mortalidad , Sobredosis de Droga/epidemiología , Factores SociodemográficosRESUMEN
BACKGROUND: Chikungunya fever (CF) is a viral disease, transmitted by alphavirus through Aedes aegypti, and albopictus mosquitoes, affecting several people, mainly in tropical countries, when its transmitter is not under control, and the main symptom of the chronic phase of CF is joint pain. OBJECTIVES: The primary objective of this study was to observe the prevalence, most affected joints, and intensity of chronic joint pain in individuals affected by CF, and also identify the factors associated with chronic joint pain in these individuals. METHODS: Cross-sectional study that evaluated one hundred and thirty volunteers, of both sexes, aged between 20-65 years, with a clinical and/or laboratory diagnosis of CF. The presence of joint pain was investigated using the Brazilian version of the Nordic Questionnaire of Musculoskeletal Symptoms and the intensity of pain using the Visual Analogue Scale. RESULTS: Of the 130 volunteers evaluated, n = 112 (86%) reported currently experiencing chronic joint pain, persistent, for approximately 38.6 ± 1.73 months, with the greatest predominance in the morning (58%). The joints most affected by pain were: the ankles (65.5%), interphalangeal joints of the hands (59.2%), and knees (59.2%). The joints that presented the greatest intensity of pain were: the ankles (5.13 ± 0.34), interphalangeal joints of the hands (4.63 ± 0.34), and knees (4.33 ± 0.33). Sedentary behavior (p = 0.037), increasing age (p = 0.000), and overweight/obesity (p = 0.002) were factors associated with chronic joint pain. CONCLUSION: A high prevalence of chronic, persistent joint pain was observed, with a greater prevalence in the morning. The joints most affected by chronic pain and with the greatest pain intensity were the ankles, and interphalangeal joints of the hands and knees. Sedentary behavior, increasing age, and overweight/obesity were the factors associated with chronic joint pain in individuals affected by CF in this study. Key Points ⢠Individuals affected by CF had a high prevalence of chronic joint pain, persistent and more prevalent in the mornings ⢠The ankles and interphalangeal joints of the hands and knees were the joints with the highest prevalence of pain ⢠The ankles and interphalangeal joints of the hands and knees were the joints with the greatest pain intensity ⢠Sedentary behavior, increasing age, and overweight/obesity were factors associated with chronic joint pain in individuals affected by CF.
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Artralgia , Fiebre Chikungunya , Dolor Crónico , Obesidad , Sobrepeso , Conducta Sedentaria , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Fiebre Chikungunya/complicaciones , Fiebre Chikungunya/epidemiología , Estudios Transversales , Artralgia/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Anciano , Adulto Joven , Dolor Crónico/epidemiología , Factores de Edad , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Brasil/epidemiología , Prevalencia , Dimensión del DolorRESUMEN
INTRODUCTION: Evidence about the advantage of Lichtenstein's repair, the guidelines' recommended technique, is scarce regarding postoperative chronic inguinal pain (CPIP). The primary aim of this study was to compare CPIP in patients undergoing Lichtenstein versus other techniques. METHODS: Prospective multicentric cohort study including consecutive adults undergoing elective inguinal hernia repair in Portuguese hospitals (October - December 2019). Laparoscopic and mesh-free hernia repairs were excluded. The primary outcome was postoperative pain at three months, defined as a score of ≥ 3/10 in the European Hernia Society Quality of Life score pain domain. The secondary outcome was 30-day postoperative complications. RESULTS: Eight hundred and sixty-nine patients from 33 hospitals were included. Most were men (90.4%) and had unilateral hernias (88.6%). Overall, 53.6% (466/869) underwent Lichtenstein's repair, and 46.4% (403/869) were treated with other techniques, of which 83.9% (338/403) were plug and patch. The overall rate of CPIP was 16.6% and 12.2% of patients had surgical complications. The unadjusted risk was similar for CPIP (OR 0.76, p = 0.166, CI 0.51 - 1.12) and postoperative complications (OR 1.06, p = 0.801, CI 0.69 - 1.60) between Lichtenstein and other techniques. After adjustment, the risk was also similar for CPIP (OR 0.83, p = 0.455, CI 0.51 - 1.34) and postoperative complications (OR 1.14, p = 0.584, CI 0.71 - 1.84). CONCLUSION: The Lichtenstein technique was not associated with lower CPIP and showed comparable surgical complications. Further investigation as- sessing long term outcomes is necessary to fully assess the benefits of the Lichtenstein technique regarding CPIP.
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Dolor Crónico , Hernia Inguinal , Herniorrafia , Dolor Postoperatorio , Humanos , Masculino , Hernia Inguinal/cirugía , Dolor Postoperatorio/etiología , Herniorrafia/efectos adversos , Herniorrafia/métodos , Estudios Prospectivos , Portugal , Femenino , Persona de Mediana Edad , Dolor Crónico/etiología , Dolor Crónico/epidemiología , Anciano , Adulto , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiologíaRESUMEN
BACKGROUND/OBJECTIVES: Long-term consequences of opioid consumption, such as misuse, have been a major concern in patients with chronic non-cancer pain. Potentially opioid misuse may also be a consequence in patients with cancer in opioid treatment which encouraged us to undertake this systematic review assessing the frequency of opioid misuse in this population. MATERIALS/METHODS: The search strategy comprised words related to cancer, opioid misuse, and frequency. PubMed, Embase, PsycInfo, and Cinahl were searched from inception to July 2023. Prospective studies were selected and analysed regarding frequency, study characteristics, and quality. A meta-analysis was possible to carry out for a sub-group (opioid misuse risk). RESULTS: From 585 abstracts screened, six articles were included. Only prevalence data were found. The prevalence of opioid misuse ranged from 5.7% to 84%, while the prevalence of opioid misuse risk varied from 2.4% to 35.4%. The pooled prevalence of opioid misuse risk was 12.3% (95% CI: 0.8-36.3; I2 = 98.4%, 95% CI: 97.2-99.1). The studies differed regarding, e.g., methods, misuse definitions, and assessment instruments. CONCLUSIONS: Few studies were identified and large differences in prevalence for opioid misuse and opioid misuse risk were observed. Methodological disparities and the studies quality underscore the importance of improved studies in the future.
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Analgésicos Opioides , Neoplasias , Trastornos Relacionados con Opioides , Humanos , Prevalencia , Trastornos Relacionados con Opioides/epidemiología , Analgésicos Opioides/efectos adversos , Neoplasias/epidemiología , Neoplasias/tratamiento farmacológico , Dolor en Cáncer/tratamiento farmacológico , Dolor en Cáncer/epidemiología , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiologíaRESUMEN
OBJECTIVES: The study aimed to analyze the risk factors and etiological profile of lower back pain (LBP) among patients attending a neurology outpatient department at a tertiary care center. MATERIALS AND METHODS: A cross-sectional observational study was conducted, involving 170 patients, aged over 18, presenting with LBP between March and August 2023. Sociodemographic and lifestyle data were collected, and diagnostic investigations, including X-ray and magnetic resonance imaging (MRI), were performed. Patients were categorized into acute and chronic LBP groups for analysis. RESULTS: Age-acute LBP was more prevalent in younger patients (<35 years), while chronic LBP was predominant in older age-groups (≥55 years). Gender-females showed a higher prevalence of LBP compared to males, with chronic LBP more common among females. Triggering events-heavy weightlifting was a significant trigger for chronic LBP, while coughing/sneezing was common in acute LBP. Occupation-patients with physically exerting jobs were more prone to acute LBP, while chronic LBP was prevalent among homemakers and those with no work. Body mass index (BMI)-obesity and overweight were associated with chronic LBP. Medication-chronic LBP patients were more likely to be on medication compared to acute LBP patients. MRI findings-prolapsed intervertebral disk (PIVD) was the most prevalent etiology, more common in chronic LBP patients. Other etiologies included vertebral fracture, tumor, tuberculosis, and various spinal conditions. CONCLUSION: Lower back pain is a multifaceted condition influenced by age, gender, BMI, and lifestyle factors. Effective management and prevention strategies should consider these risk factors to improve patients' quality of life. A comprehensive approach is essential to address the complex etiology of LBP.
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Dolor de la Región Lumbar , Centros de Atención Terciaria , Humanos , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiología , Masculino , Femenino , Factores de Riesgo , Estudios Transversales , Adulto , Persona de Mediana Edad , Imagen por Resonancia Magnética , Prevalencia , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Factores de Edad , Factores Sexuales , Índice de Masa Corporal , Adulto Joven , AncianoRESUMEN
Importance: The incidence of chronic pain has been increasing over the last decades and may be associated with the stress of deployment in active-duty servicewomen (ADSW) as well as women civilian dependents whose spouse or partner served on active duty. Objective: To assess incidence of chronic pain among active-duty servicewomen and women civilian dependents with service during 2006 to 2013 compared with incidence among like individuals at a time of reduced combat exposure and deployment intensity (2014-2020). Design, Setting, and Participants: This cohort study used claims data from the Military Health System data repository to identify ADSW and dependents who were diagnosed with chronic pain. The incidence of chronic pain among individuals associated with service during 2006 to 2013 was compared with 2014 to 2020 incidence. Data were analyzed from September 2023 to April 2024. Main Outcomes and Measures: The primary outcome was the diagnosis of chronic pain. Multivariable logistic regression analyses were used to adjust for confounding, and secondary analyses were performed to account for interactions between time period and proxies for socioeconomic status and combat exposure. Results: A total of 3â¯473â¯401 individuals (median [IQR] age, 29.0 [22.0-46.0] years) were included, with 644â¯478 ADSW (18.6%). Compared with ADSW in 2014 to 2020, ADSW in 2006 to 2013 had significantly increased odds of chronic pain (odds ratio [OR], 1.53; 95% CI, 1.48-1.58). The odds of chronic pain among dependents in 2006 to 2013 was also significantly higher compared with dependents from 2014 to 2020 (OR, 1.96; 95% CI, 1.93-1.99). The proxy for socioeconomic status was significantly associated with an increased odds of chronic pain (2006-2013 junior enlisted ADSWs: OR, 1.95; 95% CI, 1.83-2.09; 2006-2013 junior enlisted dependents: OR, 3.05; 95% CI, 2.87-3.25). Conclusions and Relevance: This cohort study found significant increases in the diagnosis of chronic pain among ADSW and civilian dependents affiliated with the military during a period of heightened deployment intensity (2006-2013). The effects of disparate support structures, coping strategies, stress regulation, and exposure to military sexual trauma may apply to both women veterans and civilian dependents.
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Dolor Crónico , Personal Militar , Humanos , Femenino , Dolor Crónico/epidemiología , Adulto , Personal Militar/estadística & datos numéricos , Personal Militar/psicología , Incidencia , Estados Unidos/epidemiología , Adulto Joven , Estudios de Cohortes , Persona de Mediana EdadRESUMEN
BACKGROUND: Chronic pelvic pain is a common disease that affects approximately 4% of women of reproductive age in developed countries. This number is estimated to be higher in developing countries, with a significant negative personal and socioeconomic impact on women. The lack of data on this condition in several countries, particularly those in development and in socially and biologically vulnerable populations such as the indigenous, makes it difficult to guide public policies. OBJECTIVES: To evaluate the prevalence of chronic pelvic pain (dysmenorrhea, dyspareunia, non-cyclical pain) and identify which variables are independently associated with the presence of the condition in indigenous women from Otavalo-Ecuador. DESIGN: A cross-sectional study was carried out including a sample of 2429 women of reproductive age between 14 and 49 years old, obtained from April 2022 to March 2023. A directed questionnaire was used, collected by bilingual interviewers (Kichwa and Spanish) belonging to the community itself; the number of patients was selected by random sampling proportional to the number of women estimated by sample calculation. Data are presented as case prevalence, odds ratio, and 95% confidence interval, with p < 0.05. RESULTS: The prevalence of primary dysmenorrhea, non-cyclic pelvic pain, and dyspareunia was, respectively, 26.6%, 8.9%, and 3.9%.all forms of chronic pain were independently associated with each other. Additionally, dysmenorrhoea was independently associated with hypertension, intestinal symptoms, miscegenation, long cycles, previous pregnancy, use of contraceptives and pear body shape. Pain in other sites, late menarche, exercise, and pear body shape were associated with non-cyclic pelvic pain. And, urinary symptoms, previous pregnancy loss, miscegenation, and pear body shape were associated with dyspareunia. CONCLUSION: The prevalence of primary dysmenorrhea and non-cyclical chronic pelvic pain was notably high, in contrast with the frequency of reported dyspareunia. Briefly, our results suggest an association between dysmenorrhoea and conditions related to inflammatory and/or systemic metabolic disorders, including a potential causal relationship with other manifestations of pelvic pain, and between non-cyclical pelvic pain and signs/symptoms suggesting central sensitization. The report of dyspareunia may be influenced by local cultural values and beliefs.