Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled fro...Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.展开更多
Objectives: Low back pain is a major occupational problem especially among nursing staff. The objectives of our study are to evaluate the prevalence of low back pain among nurses and to look for physical and psychosoc...Objectives: Low back pain is a major occupational problem especially among nursing staff. The objectives of our study are to evaluate the prevalence of low back pain among nurses and to look for physical and psychosocial risk factors. Methods: It is a cross-sectional study based on a self-administered questionnaire destined for all nurses working in Farhat Hached Teaching hospital of Sousse (Tunisia). Results: Our study included 203 nurses with an average age of 39.8 years. The prevalence of low back pain over the last twelve months was 58.1%. The factors that are significantly associated to low back pain were: high BMI, number of pregnancies, arthritis, poor physical condition, daily frequency of inappropriate posture for the activity being performed, and the layout of materials in the workplace. Conclusion: Our study evidenced the high prevalence of LBP among nurses and allowed bringing to light the role of individual and ergonomic physical factors in the genesis of LBP. Such identification permits to undertake targeted preventive actions. The association between psychosocial factors and LBP was not emphasized.展开更多
Background: A large number of studies have addressed whiplash injury, and many meta-analyses have sought to highlight chronicity factors;the implicated processes, however, remain a matter of debate. The present study ...Background: A large number of studies have addressed whiplash injury, and many meta-analyses have sought to highlight chronicity factors;the implicated processes, however, remain a matter of debate. The present study used data from the ESPARR cohort (an on-going prospective study of a representative cohort of road accident victims in the Rh?ne administrative département of France). The objectives were to describe the consequences of whiplash injury and to determine prognostic factors for poor recovery and persistent pain at 1 year post-accident. Methods: The cohort included 255 “pure” whiplash victims, 173 of whom responded to the 1-year follow-up questionnaire. Correlations between explanatory variables and health and pain status were explored by modified Poisson regression to provide adjusted relative risk (RR) values. Results: Half of the victims had not fully recovered health status by 1 year. The main factor associated with non-recovery was pain (RR = 1.3;1.0-1.7). A birth in the family preceding the accident emerged as another factor (RR=1.5;1.2-1.9). Victims responsible for their accident were twice as likely to report being free of pain as those not responsible (RR = 0.5;0.3-0.8). No correlation emerged with accident-related characteristics or PTSD. Conclusions: The present results extend our understand- ing of whiplash injury. Residual pain is the fundamental factor causing whiplash victims to feel that they have not recovered good health. Our findings suggest this may be bound up with physical factors (gender susceptibility);external factors such as having to carry weights (such as a baby) and with perceiving oneself as a victim are not incompatible with this hypothesis.展开更多
Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS ...Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS infected patients and submitted to rheumatologic consultation in the National Hospital University of Cotonou. Results: 73 out of 17,342 patients examined (0.42%) were suffering from CRPS. Those 73 patients (40 women, 54.8% and 33 men, 45.2%) were in average 54.66 years old and enjoyed an average duration of evolution of 5.79 months. The trauma (41 cases, 56.1%), the stroke (19 cases, 25%), the diabetes (8 cases, 11.3), were the main risk factors that were observed. CRPS was preferably located at the shoulder-hand (34.2%), shoulder (28.8%), wrist-hand (16.4%) and knee (11%). Inflammatory pain was observed in 55 cases. The treatment was dominated by griseofulvina (41 cases, 56.1%), antiinflammatory drugs (38 cases, 52%), analgesic (20 cases, 27, 3%), joint injection by betamethasone (17 cases, 27%). Conclusion: CRPS is not rare in our country. The first risk factor remains the trauma in rheumatologic consultation in Cotonou.展开更多
Neuropathic pain is a chronic syndrome caused by direct damage to or disease of the somatosensory nervous system. The lack of safe, adequate and sustained pain relief offered by present analgesic treatments is most al...Neuropathic pain is a chronic syndrome caused by direct damage to or disease of the somatosensory nervous system. The lack of safe, adequate and sustained pain relief offered by present analgesic treatments is most alarming. While many treatment options are available to manage chronic pain, such as antidepressants, nonsteroidal anti-inflammatory agents, opioids, and anticonvulsants, chronic neuropathic pain remains largely unmanaged. Compounding the dilemma of ineffective chronic pain treatments is the need to provide relief from suffering and yet not contribute to the scourge of drug abuse. A recent epidemic of addiction and accidental drug prescription overdoses parallel the increased use of opioid treatment, even though opioids are rarely an effective treatment of relieving chronic pain. To make matters worse, opioids may contribute to exacerbating pain, and side-effects such as cognitive impairment, nausea, constipation, development of tolerance, as well as their potential for addiction and overdose deaths exist. Clearly, there is an urgent need for alternative, nonopiate treatment of chronic pain. Innovative discoveries of pertinent brain mechanisms and functions are key to developing effective, safe treatments. Pioneering work has revealed the essential effects of the pleiotropic mediator tumor necrosis factor(TNF) on brain functioning. These studies establish that TNF inhibits norepinephrine release from hippocampal neurons, and show that excess TNF production within the hippocampus occurs during neuropathic pain, which mobilizes additional mechanisms that further inhibit norepinephrine release. Significantly, it has been verified that elevated levels of TNF in the brain are actually required for neuropathic pain development. Since TNF decreases norepinephrine release in the brain, enhanced TNF levels would prevent engagement of the norepinephrine descending inhibitory neuronal pain pathways. Increased levels of TNF in the brain are therefore critical to the development of neuropathic pain. Therefore, strategies that decrease this enhanced TNF expression in the brain will have superior analgesic efficacy. We propose this novel approach of targeting the pathologically high levels of brain TNF as an effective strategy in the treatment of the devastating syndrome of chronic pain.展开更多
Introduction: Low back pain is nowadays a real public health problem in companies. The objective of the study was to determine the prevalence and factors associated with chronic low back pain among workers of a mining...Introduction: Low back pain is nowadays a real public health problem in companies. The objective of the study was to determine the prevalence and factors associated with chronic low back pain among workers of a mining company in Burkina Faso. Material and Methods: This was a descriptive and analytical cross-sectional study with a retrospective collection that took place from August 1, 2021 to March 16, 2022 in a gold mine in Burkina Faso. It focused on mine workers who participated in the 2019 annual medical visit. Results: Out of a total workforce of 880 workers who took part in the annual medical visit in 2019, 165 had chronic common low back pain, i.e. a prevalence of 18.75%. The average age of low back pain workers was 37.21 ± 7.5 years. Among the workers suffering from low back pain, 62 (37.58%) held the position of machine operator. Clinically, mechanical pain was found in 113 low back pain workers (76%) and twenty-nine (17.58%) had radicular pain. Standard radiography of the lumbar spine was abnormal in 129 workers (78.18%. In the univariate analysis, the factors associated with the pathology were sex, level of study, work station and seniority in the position. After a logistic regression, the factors associated with its occurrence were whole-body vibration (Fisher’s test = 12.7541;P = 0.000), male sex (Fisher’s test = 8.363;P = 0.004), and seniority for 4 to 5 years (Chi2 = 4.0234;p = 0.046). Conclusion: The study reveals the existence of chronic low back pain cases among the workers of the mining company. There is a predominance of the pathology in men, workers exposed to vibrations and those with a seniority of 4 to 5 years. It is necessary to establish a policy of prevention of low back pain for the benefit of workers, in particular those exposed to vibrations.展开更多
BACKGROUND： Inflammatory responses in injured nerves have been recognized as important factors for initially sensitizing nociceptive neurons. Cyclooxygenase （COX） is the rate-limiting enzyme in prostaglandin synthe...BACKGROUND： Inflammatory responses in injured nerves have been recognized as important factors for initially sensitizing nociceptive neurons. Cyclooxygenase （COX） is the rate-limiting enzyme in prostaglandin synthesis, and COX-2 inhibitor is involved in mechanisms of analgesia and anti-inflammation. OBJECTIVE： To investigate the effects of COX-2 inhibitor on thermal and mechanical hyperalgesia, as well as expression of growth associated protein 43 （GAP-43） and nerve growth factor （NGF） in dorsal root ganglion, in a rat model of neuropathic pain due to chronic constriction injury. DESIGN, TIME AND SETTING： A randomized, controlled, comparison study that was performed at the Surgical Department and Pathological Laboratory, Second Affiliated Hospital of Shantou University Medical College from September 2006 to September 2007. MATERIALS： COX-2 inhibitor, Iornoxicam, was purchased from Nycomed Pharmaceutical （Austria）; rabbit anti-GAP-43, and rabbit anti-NGF polyclonal antibodies were purchased from Boster, Wuhan, China. METHODS： A total of 50 adult, Wistar rats were randomly assigned to four groups： normal control （n = 5）, model （n = 15）, normal saline control （n = 15）, and Iornoxicam treatment （n =15）. With exception of the control group, the sciatic nerve of all rats was loosely ligated to establish a model of chronic constriction injury. The model rats were divided into three subgroups according to varying post-operative survival periods： 3, 7 and 14 days （n = 5）, respectively. Rats in the Iornoxicam treatment group were intraperitoneally injected with 1.3 mg/kg lornoxicam every 12 hours throughout the entire experimental procedure. Rats in the normal saline control group were intraperitoneally injected with 1.3 mL/kg saline. MAIN OUTCOME MEASURES： Immunohistochemistry revealed expression of GAP-43 and NGF in the L5 dorsal root ganglions. Mechanical withdrawal threshold and thermal withdrawal latency were used to observe neurological behavioral changes in rats. RESULTS： The relative gray values of GAP-43- and NGF-positive neurons in the model group were remarkably increased compared with the normal control rats （P 〈 0.01）, while the relative gray values in the Iomoxicam treatment group were significantly less than the model and normal saline control groups （P 〈 0.01）. Mechanical withdrawal threshold and thermal withdrawal latency gradually decreased with increasing injury time in the model, normal saline control, and Iornoxicam treatment groups, and were significantly less than the normal control group （P 〈 0.05）. In addition, mechanical withdrawal threshold and thermal withdrawal latency were significantly greater in the Iornoxicam treatment group compared with the model and normal saline control groups （P 〈 0.05）. CONCLUSION： Intraperitoneal injection of the COX-2 inhibitor Iornoxicam attenuated mechanical and thermal hyperalgesia induced by sciatic nerve chronic constriction injury and inhibited the increased expression of GAP-43 and NGF.展开更多
Background: Low back pain (LBP) is a very common health problem amongst the general population and a major cause of disability that affects work performance and well-being. Healthcare workers (HCWs) are especially at ...Background: Low back pain (LBP) is a very common health problem amongst the general population and a major cause of disability that affects work performance and well-being. Healthcare workers (HCWs) are especially at risk of developing LBP because of physical and emotional factors. Little is known about the burden of LBP in Cameroon. Objective: To determine the prevalence of low back pain and identify its associated factors among healthcare workers. Methods: A cross-sectional study using a self-administered questionnaire was conducted among healthcare workers in the Yaound Central Hospital and the Yaound University Teaching Hospital. The questionnaire collected data regarding recent, past year and lifetime occurrences of LBP, socio-demographics and work conditions. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 26. Results: A total number of 268 HCWs participated in the study, including 197 (73.5%) females and 71 (26.5%) males. The mean age of the study participants was 40.60 8.38 years (extremes of 20 and 65 years). The lifetime, annual, and point prevalences of LBP among the participants were 67.5% (CI: 61.6 - 73.1), 61.5% (CI: 55.6 - 67.1) and 35.7% (CI: 29.7 - 41.5) respectively. Multivariate analysis confirmed a moderate stress level, a sedentary lifestyle, working in the medicine and specialities department, lifting heavy objects and bending to work as associated factors to LBP. Most sufferers had a minimal functional disability (65.7%) while 34.3% had a moderate to severe disability. Conclusions: Healthcare providers have a considerably high prevalence of low back pain. Factors associated with LBP found in this study were similar to those widely recognized in the literature. A substantial proportion of healthcare providers are suffering from functional disability associated with low back pain, affecting their social and work lives. There is a need for multilevel interventions to prevent and control low back pain in this highly vulnerable occupational group.展开更多
Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the q...Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.展开更多
<strong><span style="font-family:Verdana;">Background:</span></strong><span style="font-family:Verdana;"> Low back pain is one of the important patients’ presenting&l...<strong><span style="font-family:Verdana;">Background:</span></strong><span style="font-family:Verdana;"> Low back pain is one of the important patients’ presenting</span><span style="font-family:Verdana;"> complain that requires expert management from the physiotherapists. Yet no work was available for reference on the use of outcome measures for its e</span><span style="font-family:;" "=""><span style="font-family:Verdana;">valuation by Nigeria physiotherapists. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study, therefore, investigated the outcome measures used by Nigerian physiotherapists</span></span><span style="font-family:Verdana;"> to </span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">valuate patients with Low Back Pain and the fac</span><span style="font-family:Verdana;">tors that influenced their use. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A survey questionnaire was posted to 306 randomly selected mem</span></span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">bers</span><span> </span><span style="font-family:Verdana;">of the Nigeria Society of Physiotherapy (NSP). Data were analyzed using f</span><span style="font-family:Verdana;">requency, percentages, mean, ANOVA, and Pearson’s Chi</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">square. P</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">val</span><span style="font-family:;" "=""><span style="font-family:Verdana;">ue was placed at 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 52.9% of the respondents (221) used a pain visual analog scale. Only 36.1% used LBP</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">specific clinical outcome measures. The factors that influenced their use were belief, attitude, knowledge, and choice. There was no significant difference between the majority of the factors and the use of clinical outcome measures. The </span><span style="font-family:Verdana;">P-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">values were 0.960, 0.648, 0.760 </span><span style="font-family:Verdana;">for belief, attitude and knowledge respectively. The only factor that had a </span><span style="font-family:Verdana;">significant difference (</span></span><span style="font-family:Verdana;">P </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.029) with the use of clinical outcome measures </span><span style="font-family:Verdana;">w</span><span style="font-family:Verdana;">as choice. Gender and postgraduate qualification had no significant influ</span></span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">nce on the use of clinical outcome measures at the </span></span><span style="font-family:Verdana;">P-</span><span style="font-family:Verdana;">value </span><span style="font-family:;" "=""><span style="font-family:Verdana;">of 0.117 and 0.510 respe</span><span><span style="font-family:Verdana;">ctively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Pain visual analog scale is the outcome measure frequently used by Nigeria Physiotherapists to evaluate patien</span></span><span style="font-family:Verdana;">ts with Low Back Pain. Belief, attitude, knowledge, and choice are the factors that influ</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">enced the use. There is a need to incorporate the use of LBP</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">specific outcome measures by Nigerian physiotherapists while treating patients with LBP.</span></span>展开更多
BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion an...BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.展开更多
基金supported by the Research Fund from National Science and Technology Infrastructure Program of the People's Republic of China, 2006BA106B08
文摘Objective To explore the risk factors of low back pain among the Chinese occupational population in several major industries. Methods A total of 7200 subjects （3600 cases and 3600 controls） were randomly sampled from a cross-sectional study, and they were investigated for individual and occupational factors of low back pain. The potential risk factors were first selected by using chi-square tests. Secondly, collinearity diagnosis proceeded by using the Kendall＇s rank correlation. Finally, binary logistic regression model was used for multi-factor analysis. Results Collinearity diagnosis showed that there was a severe collinearity problem among the potential risk factors of low back pain. Logistic regression model included 20 variables with statistical significance. Bending neck forward or holding neck in a forward posturefor long periods （0R=1.408） was the most important risk factor inducing low back pain in this study, followed by bending heavily with the trunk （0R=1.402）, carrying out identical work almost for the whole day （0R=1.340）. Additionally, suHicient normal break was a protective factor of low back pain. Conclusion Low back pain among the Chinese occupational population was associated with body height, occupation, work organization, physical work, working posture, and others. All these risk factors could be regarded as the indicators of low back pain, and some relevant preventive measures should be taken to reduce low back pain risk.
文摘Objectives: Low back pain is a major occupational problem especially among nursing staff. The objectives of our study are to evaluate the prevalence of low back pain among nurses and to look for physical and psychosocial risk factors. Methods: It is a cross-sectional study based on a self-administered questionnaire destined for all nurses working in Farhat Hached Teaching hospital of Sousse (Tunisia). Results: Our study included 203 nurses with an average age of 39.8 years. The prevalence of low back pain over the last twelve months was 58.1%. The factors that are significantly associated to low back pain were: high BMI, number of pregnancies, arthritis, poor physical condition, daily frequency of inappropriate posture for the activity being performed, and the layout of materials in the workplace. Conclusion: Our study evidenced the high prevalence of LBP among nurses and allowed bringing to light the role of individual and ergonomic physical factors in the genesis of LBP. Such identification permits to undertake targeted preventive actions. The association between psychosocial factors and LBP was not emphasized.
文摘Background: A large number of studies have addressed whiplash injury, and many meta-analyses have sought to highlight chronicity factors;the implicated processes, however, remain a matter of debate. The present study used data from the ESPARR cohort (an on-going prospective study of a representative cohort of road accident victims in the Rh?ne administrative département of France). The objectives were to describe the consequences of whiplash injury and to determine prognostic factors for poor recovery and persistent pain at 1 year post-accident. Methods: The cohort included 255 “pure” whiplash victims, 173 of whom responded to the 1-year follow-up questionnaire. Correlations between explanatory variables and health and pain status were explored by modified Poisson regression to provide adjusted relative risk (RR) values. Results: Half of the victims had not fully recovered health status by 1 year. The main factor associated with non-recovery was pain (RR = 1.3;1.0-1.7). A birth in the family preceding the accident emerged as another factor (RR=1.5;1.2-1.9). Victims responsible for their accident were twice as likely to report being free of pain as those not responsible (RR = 0.5;0.3-0.8). No correlation emerged with accident-related characteristics or PTSD. Conclusions: The present results extend our understand- ing of whiplash injury. Residual pain is the fundamental factor causing whiplash victims to feel that they have not recovered good health. Our findings suggest this may be bound up with physical factors (gender susceptibility);external factors such as having to carry weights (such as a baby) and with perceiving oneself as a victim are not incompatible with this hypothesis.
文摘Aim: To determine the frequency and the risk factors of Complex Regional Pain syndrome (CRPS) in Cotonou (Benin). Patients and Méthod: This has been a transversal study carried out over 22 years on files of CRPS infected patients and submitted to rheumatologic consultation in the National Hospital University of Cotonou. Results: 73 out of 17,342 patients examined (0.42%) were suffering from CRPS. Those 73 patients (40 women, 54.8% and 33 men, 45.2%) were in average 54.66 years old and enjoyed an average duration of evolution of 5.79 months. The trauma (41 cases, 56.1%), the stroke (19 cases, 25%), the diabetes (8 cases, 11.3), were the main risk factors that were observed. CRPS was preferably located at the shoulder-hand (34.2%), shoulder (28.8%), wrist-hand (16.4%) and knee (11%). Inflammatory pain was observed in 55 cases. The treatment was dominated by griseofulvina (41 cases, 56.1%), antiinflammatory drugs (38 cases, 52%), analgesic (20 cases, 27, 3%), joint injection by betamethasone (17 cases, 27%). Conclusion: CRPS is not rare in our country. The first risk factor remains the trauma in rheumatologic consultation in Cotonou.
文摘Neuropathic pain is a chronic syndrome caused by direct damage to or disease of the somatosensory nervous system. The lack of safe, adequate and sustained pain relief offered by present analgesic treatments is most alarming. While many treatment options are available to manage chronic pain, such as antidepressants, nonsteroidal anti-inflammatory agents, opioids, and anticonvulsants, chronic neuropathic pain remains largely unmanaged. Compounding the dilemma of ineffective chronic pain treatments is the need to provide relief from suffering and yet not contribute to the scourge of drug abuse. A recent epidemic of addiction and accidental drug prescription overdoses parallel the increased use of opioid treatment, even though opioids are rarely an effective treatment of relieving chronic pain. To make matters worse, opioids may contribute to exacerbating pain, and side-effects such as cognitive impairment, nausea, constipation, development of tolerance, as well as their potential for addiction and overdose deaths exist. Clearly, there is an urgent need for alternative, nonopiate treatment of chronic pain. Innovative discoveries of pertinent brain mechanisms and functions are key to developing effective, safe treatments. Pioneering work has revealed the essential effects of the pleiotropic mediator tumor necrosis factor(TNF) on brain functioning. These studies establish that TNF inhibits norepinephrine release from hippocampal neurons, and show that excess TNF production within the hippocampus occurs during neuropathic pain, which mobilizes additional mechanisms that further inhibit norepinephrine release. Significantly, it has been verified that elevated levels of TNF in the brain are actually required for neuropathic pain development. Since TNF decreases norepinephrine release in the brain, enhanced TNF levels would prevent engagement of the norepinephrine descending inhibitory neuronal pain pathways. Increased levels of TNF in the brain are therefore critical to the development of neuropathic pain. Therefore, strategies that decrease this enhanced TNF expression in the brain will have superior analgesic efficacy. We propose this novel approach of targeting the pathologically high levels of brain TNF as an effective strategy in the treatment of the devastating syndrome of chronic pain.
文摘Introduction: Low back pain is nowadays a real public health problem in companies. The objective of the study was to determine the prevalence and factors associated with chronic low back pain among workers of a mining company in Burkina Faso. Material and Methods: This was a descriptive and analytical cross-sectional study with a retrospective collection that took place from August 1, 2021 to March 16, 2022 in a gold mine in Burkina Faso. It focused on mine workers who participated in the 2019 annual medical visit. Results: Out of a total workforce of 880 workers who took part in the annual medical visit in 2019, 165 had chronic common low back pain, i.e. a prevalence of 18.75%. The average age of low back pain workers was 37.21 ± 7.5 years. Among the workers suffering from low back pain, 62 (37.58%) held the position of machine operator. Clinically, mechanical pain was found in 113 low back pain workers (76%) and twenty-nine (17.58%) had radicular pain. Standard radiography of the lumbar spine was abnormal in 129 workers (78.18%. In the univariate analysis, the factors associated with the pathology were sex, level of study, work station and seniority in the position. After a logistic regression, the factors associated with its occurrence were whole-body vibration (Fisher’s test = 12.7541;P = 0.000), male sex (Fisher’s test = 8.363;P = 0.004), and seniority for 4 to 5 years (Chi2 = 4.0234;p = 0.046). Conclusion: The study reveals the existence of chronic low back pain cases among the workers of the mining company. There is a predominance of the pathology in men, workers exposed to vibrations and those with a seniority of 4 to 5 years. It is necessary to establish a policy of prevention of low back pain for the benefit of workers, in particular those exposed to vibrations.
基金Supported by:the Scientific Research Program of Xiamen Science and Technology Bureau,No. 3502Z20077074
文摘BACKGROUND： Inflammatory responses in injured nerves have been recognized as important factors for initially sensitizing nociceptive neurons. Cyclooxygenase （COX） is the rate-limiting enzyme in prostaglandin synthesis, and COX-2 inhibitor is involved in mechanisms of analgesia and anti-inflammation. OBJECTIVE： To investigate the effects of COX-2 inhibitor on thermal and mechanical hyperalgesia, as well as expression of growth associated protein 43 （GAP-43） and nerve growth factor （NGF） in dorsal root ganglion, in a rat model of neuropathic pain due to chronic constriction injury. DESIGN, TIME AND SETTING： A randomized, controlled, comparison study that was performed at the Surgical Department and Pathological Laboratory, Second Affiliated Hospital of Shantou University Medical College from September 2006 to September 2007. MATERIALS： COX-2 inhibitor, Iornoxicam, was purchased from Nycomed Pharmaceutical （Austria）; rabbit anti-GAP-43, and rabbit anti-NGF polyclonal antibodies were purchased from Boster, Wuhan, China. METHODS： A total of 50 adult, Wistar rats were randomly assigned to four groups： normal control （n = 5）, model （n = 15）, normal saline control （n = 15）, and Iornoxicam treatment （n =15）. With exception of the control group, the sciatic nerve of all rats was loosely ligated to establish a model of chronic constriction injury. The model rats were divided into three subgroups according to varying post-operative survival periods： 3, 7 and 14 days （n = 5）, respectively. Rats in the Iornoxicam treatment group were intraperitoneally injected with 1.3 mg/kg lornoxicam every 12 hours throughout the entire experimental procedure. Rats in the normal saline control group were intraperitoneally injected with 1.3 mL/kg saline. MAIN OUTCOME MEASURES： Immunohistochemistry revealed expression of GAP-43 and NGF in the L5 dorsal root ganglions. Mechanical withdrawal threshold and thermal withdrawal latency were used to observe neurological behavioral changes in rats. RESULTS： The relative gray values of GAP-43- and NGF-positive neurons in the model group were remarkably increased compared with the normal control rats （P 〈 0.01）, while the relative gray values in the Iomoxicam treatment group were significantly less than the model and normal saline control groups （P 〈 0.01）. Mechanical withdrawal threshold and thermal withdrawal latency gradually decreased with increasing injury time in the model, normal saline control, and Iornoxicam treatment groups, and were significantly less than the normal control group （P 〈 0.05）. In addition, mechanical withdrawal threshold and thermal withdrawal latency were significantly greater in the Iornoxicam treatment group compared with the model and normal saline control groups （P 〈 0.05）. CONCLUSION： Intraperitoneal injection of the COX-2 inhibitor Iornoxicam attenuated mechanical and thermal hyperalgesia induced by sciatic nerve chronic constriction injury and inhibited the increased expression of GAP-43 and NGF.
文摘Background: Low back pain (LBP) is a very common health problem amongst the general population and a major cause of disability that affects work performance and well-being. Healthcare workers (HCWs) are especially at risk of developing LBP because of physical and emotional factors. Little is known about the burden of LBP in Cameroon. Objective: To determine the prevalence of low back pain and identify its associated factors among healthcare workers. Methods: A cross-sectional study using a self-administered questionnaire was conducted among healthcare workers in the Yaound Central Hospital and the Yaound University Teaching Hospital. The questionnaire collected data regarding recent, past year and lifetime occurrences of LBP, socio-demographics and work conditions. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 26. Results: A total number of 268 HCWs participated in the study, including 197 (73.5%) females and 71 (26.5%) males. The mean age of the study participants was 40.60 8.38 years (extremes of 20 and 65 years). The lifetime, annual, and point prevalences of LBP among the participants were 67.5% (CI: 61.6 - 73.1), 61.5% (CI: 55.6 - 67.1) and 35.7% (CI: 29.7 - 41.5) respectively. Multivariate analysis confirmed a moderate stress level, a sedentary lifestyle, working in the medicine and specialities department, lifting heavy objects and bending to work as associated factors to LBP. Most sufferers had a minimal functional disability (65.7%) while 34.3% had a moderate to severe disability. Conclusions: Healthcare providers have a considerably high prevalence of low back pain. Factors associated with LBP found in this study were similar to those widely recognized in the literature. A substantial proportion of healthcare providers are suffering from functional disability associated with low back pain, affecting their social and work lives. There is a need for multilevel interventions to prevent and control low back pain in this highly vulnerable occupational group.
文摘Background and Aims: The treatment of patients with advanced cancer pain is mainly concentrated in the outpatient department, and most of the time in their family, these patients are easy to be ignored, To study the quality of life and its influencing factors of cancer pain patients at home is of great significance to improve the quality of life of patients. Meanwhile, it provides theoretical and practical basis for medical personnel to develop and implement individualized comprehensive intervention programs. Patients and Methods: According to the inclusion and exclusion criteria, 200 patients with cancer pain at home are selected to treat, and their quality of life conditions are observed before treatment, 1 week after treatment and 1 month after treatment, and their influencing factors are analyzed. Results: The patients’ scores of body function, emotional function, cognitive function and social function exist significant difference before and after treatment (p scores of role function and the overall evaluation scores before and after treatment, two stages after treatment exist significant difference (p < 0.01), the symptoms scores of fatigue, pain, diarrhea, nausea and vomiting are significant differences before and after treatment (p appetite loss score before a month and a week after treatment and treatment exists significant difference (p the scores of constipation symptom before treatment and a month after treatment exist significant difference (p < 0.01), only gender on cognitive function before treatment has significant difference (p . One week after treatment, tumor staging and metastasis have impact on overall health evaluation, role function, cognitive function and emotional function (p The location of metastasis and the type of pain affect the role function and emotional function respectively (p . One month after treatment, age, metastasis, metastasis site and pain type have influence on cognitive function, emotional function, overall health evaluation and role function respectively (p The overall health status, body function, role function, emotional function, cognitive function and social function of the patients are lower than those of the Norwegian norm (p < 0.001). The symptoms of pain, appetite, constipation, nausea and vomiting are higher than those of the Norwegian norm before and after treatment (p There was a significant positive correlation between quality of life and total score of social support (p < 0.01). Objective support and subjective support were positively correlated with quality of life (p Conclusion: Cognitive interventions should be individualized. The effectiveness of cancer treatment and the control of cancer recurrence and metastasis have influence on the quality of life of patients with cancer pain at home. Although the patients’ function indexes have been improved after treatment, there exist differences in the improvement after treatment. The symptoms of nausea, vomiting, pain and appetite should be intervened promptly. The management of symptoms such as dyspnea, fatigue, constipation should be focused persistently. Objective support and subjective support were the influencing factors of patients’ quality of life, the construction of social support system should be strengthened, we should help them to overcome negative emotions, return to normal family and social roles, seek help in a positive manner and use support to improve the quality of life.
文摘<strong><span style="font-family:Verdana;">Background:</span></strong><span style="font-family:Verdana;"> Low back pain is one of the important patients’ presenting</span><span style="font-family:Verdana;"> complain that requires expert management from the physiotherapists. Yet no work was available for reference on the use of outcome measures for its e</span><span style="font-family:;" "=""><span style="font-family:Verdana;">valuation by Nigeria physiotherapists. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> This study, therefore, investigated the outcome measures used by Nigerian physiotherapists</span></span><span style="font-family:Verdana;"> to </span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">valuate patients with Low Back Pain and the fac</span><span style="font-family:Verdana;">tors that influenced their use. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> A survey questionnaire was posted to 306 randomly selected mem</span></span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">bers</span><span> </span><span style="font-family:Verdana;">of the Nigeria Society of Physiotherapy (NSP). Data were analyzed using f</span><span style="font-family:Verdana;">requency, percentages, mean, ANOVA, and Pearson’s Chi</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">square. P</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">val</span><span style="font-family:;" "=""><span style="font-family:Verdana;">ue was placed at 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 52.9% of the respondents (221) used a pain visual analog scale. Only 36.1% used LBP</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">specific clinical outcome measures. The factors that influenced their use were belief, attitude, knowledge, and choice. There was no significant difference between the majority of the factors and the use of clinical outcome measures. The </span><span style="font-family:Verdana;">P-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">values were 0.960, 0.648, 0.760 </span><span style="font-family:Verdana;">for belief, attitude and knowledge respectively. The only factor that had a </span><span style="font-family:Verdana;">significant difference (</span></span><span style="font-family:Verdana;">P </span><span style="font-family:Verdana;">=</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">0.029) with the use of clinical outcome measures </span><span style="font-family:Verdana;">w</span><span style="font-family:Verdana;">as choice. Gender and postgraduate qualification had no significant influ</span></span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">nce on the use of clinical outcome measures at the </span></span><span style="font-family:Verdana;">P-</span><span style="font-family:Verdana;">value </span><span style="font-family:;" "=""><span style="font-family:Verdana;">of 0.117 and 0.510 respe</span><span><span style="font-family:Verdana;">ctively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Pain visual analog scale is the outcome measure frequently used by Nigeria Physiotherapists to evaluate patien</span></span><span style="font-family:Verdana;">ts with Low Back Pain. Belief, attitude, knowledge, and choice are the factors that influ</span></span><span style="font-family:Verdana;">- </span><span style="font-family:Verdana;">enced the use. There is a need to incorporate the use of LBP</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">specific outcome measures by Nigerian physiotherapists while treating patients with LBP.</span></span>
文摘BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual process.The main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function.However,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training.Staged limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and contents.This method helps patients gradually restore limb function.Nevertheless,some patients still exhibit poor limb function after standardized exercise.Therefore,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery.AIM To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture.METHODS A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital.Univariate and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)groups.Univariate analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle fracture(P<0.05);Multiple linear regression analysis showed that the functional exercise compliance scale score,SSRS,BK,PGE2,and 5-HT were independent risk factors affecting functional performance after staged functional exercise(P<0.05).CONCLUSION Exercise compliance,SSRS,and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery.Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.
