Showing papers on "Visual analogue scale published in 1994"
TL;DR: It is hoped that adoption of this instrument toMeasure shoulder function will facilitate communication between investigators, stimulate multicenter studies, and encourage validity testing of this and other available instruments to measure shoulder function and outcome.
1,424 citations
TL;DR: In this paper, a prospective, randomized, double-blind, and controlled clinical study was conducted to assess the efficacy of laser laparoscopic surgery in the treatment of pain associated with minimal, mild, and moderate endometriosis.
437 citations
TL;DR: It was concluded that there were strong relations between ratings of sleepiness and performance, that the ATS rating scale was at least as good as the other scales and that the ratings were affected by type of task.
Abstract: The present study validated the nine-point Karolinska Sleepiness Scale (KSS) and the new Accumulated Time with Sleepiness (ATS) scale against performance of laboratory tasks. The ATS scale was designed as a method for integrating subjective sleepiness over longer time periods. The subjects were asked if certain symptoms of sleepiness had occurred and, if so, for how long. Six subjects participated twice. Each time they were kept awake during the night (except for a short nap occurring during one of the nights in a counterbalanced order) and were tested at 2200, 0200, 0400 and 0600 hours. The tests included a 10-minute rest period, a 28-minute visual vigilance task and an 11-minute single reaction time task. KSS and visual analogue scale (VAS) ratings were given before each test, and ATS ratings were given after. Performance deteriorated clearly, and all three rating scales reflected increased sleepiness with time of night. Scores on the KSS and VAS showed high correlations with performance tasks (mean intraindividual correlations were between 0.49 and 0.71). Performance correlated even higher with the ATS ratings (r = 0.73-0.79). Intercorrelations between rating scales were also high (r = 0.65-0.86). It was concluded that there were strong relations between ratings of sleepiness and performance, that the ATS rating scale was at least as good as the other scales and that the ratings were affected by type of task.
410 citations
Journal Article•
TL;DR: PEMF has therapeutic benefit in painful OA of the knee or cervical spine and differences reached statistical significance at one or more observation points for pain, pain on motion, and tenderness.
Abstract: Objective We conducted a randomized, double blind clinical trial to determine the effectiveness of pulsed electromagnetic fields (PEMF) in the treatment of osteoarthritis (OA) of the knee and cervical spine. Methods A controlled trial of 18 half-hour active or placebo treatments was conducted in 86 patients with OA of the knee and 81 patients with OA of the cervical spine, in which pain was evaluated using a 10 cm visual analog scale, activities of daily living using a series of questions (answered by the patient as never, sometimes, most of the time, or always), pain on passive motion (recorded as none, slight, moderate, or severe), and joint tenderness (recorded using a modified Ritchie scale). Global evaluations of improvement were made by the patient and examining physician. Evaluations were made at baseline, midway, end of treatment, and one month after completion of treatment. Results Matched pair t tests showed extremely significant changes from baseline for the treated patients in both knee and cervical spine studies at the end of treatment and the one month followup observations, whereas the changes in the placebo patients showed lesser degrees of significance at the end of treatment, and had lost significance for most variables at the one month followup. Means of the treated group of patients with OA of the knee showed greater improvement from baseline values than the placebo group by the end of treatment and at the one month followup observation. Using the 2-tailed t test, at the end of treatment the differences in the means of the 2 groups reached statistical significance for pain, pain on motion, and both the patient overall assessment and the physician global assessment. The means of the treated patients with OA of the cervical spine showed greater improvement from baseline than the placebo group for most variables at the end of treatment and one month followup observations; these differences reached statistical significance at one or more observation points for pain, pain on motion, and tenderness. Conclusion PEMF has therapeutic benefit in painful OA of the knee or cervical spine.
280 citations
TL;DR: This interval level handicap measurement scale will be useful in assessing both specific therapies and health services, in clinical trials, in analyses of cost effectiveness, and in assessments of quality assurance.
Abstract: OBJECTIVE--To develop a handicap measurement scale in a self completion questionnaire format, with scale weights allowing quantification of handicap at an interval level of measurement. DESIGN--Adaptation of the International Classification of Impairments, Disabilities and handicaps into a practical questionnaire incorporating the dimensions of handicap mobility, occupation, physical independence, social integration, orientation, and economic self sufficiency and scale weights derived from interviews with a general population sample, with the technique of conjoint analysis. SETTING--Two general practices in different areas of London. SUBJECTS--240 adults aged 55-74 years randomly selected from the practices, 101 (42%) of whom agreed to be interviewed, and 79 (78%) of whom completed the exercise. MAIN MEASURES--Rating of severity of handicap associated with 30 hypothetical health scenarios on a visual analogue scale, from which was derived a matrix of scale weights ("part utilities") relating to different levels of disadvantage on each dimension, with a formula for combining them into an overall handicap score. Severity scores measured directly for five scenarios not used to derive the scale weights were compared with those calculated from the formula to validate the model. RESULTS--The part utilities obtained conformed with the expected hierarchy for each dimension, confirming the validity of the method. The measured severities and those calculated from the formula for the five scenarios used to validate the model agreed closely (Pearson's r = 0.98, p = 0.0009; Kendall's tau = 1.00, p = 0.007). CONCLUSIONS--This interval level handicap measurement scale will be useful in assessing both specific therapies and health services, in clinical trials, in analyses of cost effectiveness, and in assessments of quality assurance.
266 citations
TL;DR: The reproducibility of evidence in favour of homoeopathy proof of its activity or proof of the clinical trial's capacity to produce false-positive results is tested.
224 citations
TL;DR: A multiple comparison of the effectiveness of various medications and placebo on patients in moderate and severe preoperative pain showed that ibuprofen, ketoprofen and methylprednisolone plus penicillin were more effective than placebo within the first 48 h following complete instrumentation.
188 citations
TL;DR: Evaluation of covariates, including gender, age, education, generation in the United States, and difficulty of the surgical extraction, demonstrated that gender was significant, with men reporting less pain than women regardless of ancestry.
153 citations
TL;DR: A logistic regression analysis showed that VAS, VRS were more strongly associated with IRS than PRI and IPS, and a single factor clearly emerged explaining most of the different scales variability.
Abstract: A consecutive sample of 53 chronic cancer pain patients were administered 5 different pain intensity scales: a visual analogue scale (VAS), a numerical rating scale from 0 to 10 (NRS), a verbal rating scale (VRS), the Italian Pain Questionnaire (Italian version of the McGill Pain Questionnaire) (PRI), and the Integrated Pain Score (IPS) which is an instrument designed at the Pain Therapy and Palliative Care Division of the National Cancer Institute of Milan to integrate pain intensity and duration in a single measure. These scales were administered before and after a definite therapy change. At the time of the second evaluation the patients were also administered a pain relief scale (IRS). A factor analysis of the scoring properties of these instruments revealed a high degree of association between the variables. A single factor clearly emerged explaining most of the different scales variability. A logistic regression analysis showed that VAS, NRS, VRS were more strongly associated with IRS than PRI and IPS.
151 citations
TL;DR: Dogs undergoing a variety of orthopaedic surgical procedures were randomly assigned to one of two analgesic protocols, and a statistical analysis of the visual analogue scores showed that carprofen provided slightly better pain relief than pethidine and produced less sedation.
Abstract: Forty dogs undergoing a variety of orthopaedic surgical procedures were randomly assigned to one of two analgesic protocols, receiving either pethidine at 2 mg/kg pre-operatively and 3 mg/kg postoperatively, or carprofen, a new non-steroidal anti-inflammatory drug at 4 mg/kg pre-operatively Analgesia and sedation were assessed after the operations under double blind conditions using a discontinuous scoring system and a visual analogue scale There was good agreement between the two scoring systems, and a statistical analysis of the visual analogue scores showed that carprofen provided slightly better pain relief than pethidine and produced less sedation Carprofen provided good analgesia during the 18 hours the dogs were in hospital and no adverse side effects were observed
145 citations
Journal Article•
TL;DR: In this article, concordance between self-report measures and clinical observations of functional disability in ankylosing spondylitis (AS), rheumatoid arthritis (RA), and fibromyalgia (FM) was studied.
Abstract: OBJECTIVE To study concordance between self-report measures and clinical observations of functional disability in ankylosing spondylitis (AS), rheumatoid arthritis (RA), and fibromyalgia (FM). METHODS 35 patients with AS completed 9 selected items of the Functional Index questionnaire, whereas 12 patients with RA and 13 with FM completed 7 selected items of the Arthritis Impact Measurement Scales. Five days later, all 60 patients and 4 controls actually performed the selected activities, which were recorded on video. The tapes were assessed in random order by 12 observers (6 occupational therapists and 6 physicians). Both patients and observers indicated functional disability on a 10 cm visual analog scale (VAS). RESULTS Interobserver agreement was high (Cronbach's alpha 0.98). All observers scored the 4 healthy controls as having no disability at all. Mean discordance scores (VAS patients minus VAS observers) for the selected items were negligible in AS [-0.17 cm (p = 0.30)], moderate in RA [+1.10 cm (p = 0.06)] and high in FM [+2.44 cm (p < 0.01)]. CONCLUSION Discordance between self-report questionnaires and observed functional disability is a feature most striking in FM. In validation of self-report questionnaires of functional disability the appropriate spectrum of rheumatological diagnoses should be considered.
TL;DR: In this article, the authors examined the extent to which preoperative state and trait anxiety, general need for control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of post-operative pain.
Abstract: Objective We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors. Design Preoperative and outcome variables were analyzed using Pearson product-moment correlations and forward stepwise multiple linear regression. Setting This study was conducted at a university hospital in preoperative and postoperative settings. Patients Ninety-nine consecutively consenting ASA physical status I-II women (age 46 +/- 11 years, 70% caucasian, 28% Afro-American, 2% Hispanic) undergoing simple hysterectomy procedures with no known cancer were included in the study. Interventions Standardized general anesthesia, surgery, and PCA therapy was conducted. Outcome measures The McGill Pain Questionnaire (MPQ), patient requests and delivered analgesic medication, visual analog scales (VAS) for pain and anxiety, time to oral medications and hospital discharge, and Likert scale measurements of overall pain and discomfort were utilized. Results Older patients generally reported less pain, but used the same amount of analgesic medication as younger patients. Preoperative trait anxiety correlated with increased PCA requests, but not with postoperative pain. In contrast, preoperative state anxiety correlated positively with postoperative pain and with shorter time to hospital discharge. The patients' need for control was positively correlated with the Present Plan Index scale of the MPQ, with morphine requirement, and with PCA requests. Conclusions Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.
TL;DR: It is suggested that quadriceps rehabilitation is worth trying for every patient (70% experienced complete recovery) regardless patient's age, sex, body composition, athletic level, duration of symptoms, or biomechanical malalignments in the lower extremities.
Abstract: This study determined prospectively the outcome-predictive role of 22 background variables in the nonoperative treatment of chronic patellofemoral pain syndrome. The general variables registered age, sex, body composition, athletic activity, and duration of symptoms. The remaining variables measured clinically and radiologically the biomechanical malalignments in the lower extremities. In 49 consecutive patients, these variables were measured at the entry of the 6-wk treatment protocol (rest, NSAIDs, and intense isometric quadriceps exercises), and the outcome was determined at 6 wk and 6 months using improvements in the 100-mm Visual Analog Scale and the Lysholm and Tegner knee scores as outcome criteria. A multiple stepwise regression analysis indicated that age was the only factor which significantly (P < 0.05 to 0.005) but not very strongly associated with the outcome: the younger the patient the better the outcome (r = -0.34 to -0.41 at 6 wk, and -0.25 to -0.41 at 6 months). Inclusion of any of the other predictive variables in the analytic model did not significantly improve the prediction. This result suggests that quadriceps rehabilitation is worth trying for every patient (70% experienced complete recovery) regardless patient's age, sex, body composition, athletic level, duration of symptoms, or biomechanical malalignments in the lower extremities.
TL;DR: The data suggest that the administration of 20 ml of local anaesthetics i.p. is not effective in reducing postoperative pain, improving lung function, or attenuating the metabolic endocrine response after laparoscopic cholecystectomy.
Abstract: We have compared the efficacy of 0.9% NaCI 20 ml (n = 15), 0.25% bupivacaine 20ml (n = 15) and 0.5% lignocaine 20 ml (n = 15), administered i.p., in reducing postoperative pain and opioid requirements, and modifying the metabolic response to surgery and postoperative lung function after laparoscopic cholecystectomy. There were no differences in postoperative pain scores (visual analogue scale and verbal rating scale) between the three groups in the first 4 h after operation and in analgesic requirements during the first 24 h. In all groups, forced vital capacity, peak expiratory flow and forced expiratory volume in 1 s decreased 2h after surgery (P
TL;DR: It is concluded that laparoscopic cholecystectomy did cause significant postoperative pain in one-third of patients only up to the first postoperative day and as predictors for high intensity of pain were not identified, pain should be monitored and analgesics should be delivered liberally.
Abstract: It is postulated that laparoscopic cholecystectomy as "patient-friendly surgery" leads to more comfort and in particular to less pain. A prospective study on pain was performed on all patients undergoing the operation over the period of 1 year (n = 382) out of a series of more than 1,000 patients who have undergone the operation in our clinic. Pain was measured by a 100-point visual analogue scale (VAS), by a five-point verbal rating scale, and by the consumption of analgesics. Pain was the most frequent symptom, both before and after the operation. The mean level of pain was 37 VAS points 5 h after the operation and declined to 16 points on the third day. In 106 patients (27.8%) the intensity of pain was higher than 50 VAS points. Analgesics were used by 282 patients (73.8%), opioids by 112 (29.3%). Pain was significantly higher in female than male patients (P 50 VAS points (n = 138) had higher preoperative pain levels (P = 0.018) and preoperatively complained more frequently about nausea, vomiting, bloating, and a feeling of abdominal pressure (P = 0.003-0.031). However, predictive values of these variables were too small to be of clinical benefit.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: It is possible that 24-h post-injection rest will result in a prolonged duration of clinical response and reduce the need for frequent steroid injections and the risk of complications.
Abstract: In order to assess the effect of 24 h observed bed rest following intra-articular steroid injection of the knee joint in patients with an inflammatory arthritis such as RA, AS or colitic arthropathy, 91 patients with inflammatory arthritis of one knee joint were randomized to receive 24 h bed rest in hospital following intra-articular steroid injection or were injected in outpatients. The clinical and laboratory assessments such as pain and stiffness on a 10-cm visual analogue scale, knee circumference (cm), 50 ft walking time (s), CRP and ESR were measured before receiving the steroid injection and at 3, 6, 12 and 24 weeks. Both groups of patients improved clinically and serologically at 3 weeks. By 12 weeks the degree of improvement in the pain score, stiffness score, knee circumference, 50 ft walking time and CRP was better in the rest group and these differences persisted to 24 weeks. For each outcome variable the summary measure of response was significantly better in the rest group compared to the no rest group. Intra-articular steroid injection of the knee joint followed by strict i inpatient bed rest for 24 h results in a greater degree of clinical and serological improvement, compared to routine outpatient injections for up to 6 months. It is therefore possible that 24-h post-injection rest will result in a prolonged duration of clinical response and reduce the need for frequent steroid injections and the risk of complications.
Journal Article•
TL;DR: The effects of group gymnastics on neck pain were studied among 44 women in a printing company and suggested a seasonal variation in neck symptoms which has to be considered when planning or evaluating intervention studies.
Abstract: The effects of group gymnastics on neck pain were studied among 44 women in a printing company A randomized cross-over design was used with two groups matched according to the work task, frequency of symptoms, and age The treatment consisted of gymnastics for 45 min once a week for 10 weeks Neck pain was rated by visual analogue scale and pressure pain sensitivity of the neck muscles was measured with an algometer The results showed no clear effects of the group gymnastics program An equal and significant reduction in pain ratings was seen in both groups after the first intervention in the spring Recurrence of symptoms was seen in both groups in September, and no significant reduction in pain occurred during the second intervention in the autumn The results suggest a seasonal variation in neck symptoms which has to be considered when planning or evaluating intervention studies
TL;DR: The findings tend to indicate that, even after long-term treatment, zolpidem does not induce rebound insomnia or daytime anxiety.
Abstract: In a parallel-group, placebo-controlled, polysomnographic study with randomization, the possible occurrence of rebound insomnia was evaluated in 24 patients suffering from moderate to severe chronic insomnia and receiving either triazolam 0.5 mg, zolpidem 10 mg, or placebo. Treatment duration was 27 nights, followed by three placebo-controlled withdrawal nights. Both drugs showed significant efficacy compared to placebo during the active treatment period. A trend toward tolerance was noted in the triazolam group but not in the zolpidem one. The increase in total sleep time in the zolpidem group was accompanied by an increase in the number of sleep cycles. When active treatment was discontinued, clear rebound insomnia was present in the triazolam group while it was not possible to observe any rebound in the placebo and zolpidem groups. Subjective feelings of the patients, which were assessed by means of visual analog scales, correlated well with polysomnographic data. Our findings tend to indicate that, even after long-term treatment, zolpidem does not induce rebound insomnia or daytime anxiety.
TL;DR: The difference in mean pain score for thewarm buffered solution, compared with those for the warm, buffered, and room-temperature solutions, suggests that warming and buffering have a synergistic effect.
TL;DR: Psychophysical principles can be applied to quantitate the severity of dyspnea during cardiopulmonary exercise testing and studies demonstrate that the slope and/or intercept of the power production-breathlessness relationship provide a valid, reliable, and responsive approach for measurement.
Abstract: The perception of breathlessness during physical activities is a frequent and disturbing complaint for patients with chronic respiratory disease. Psychophysical principles can be applied to quantitate the severity of dyspnea during cardiopulmonary exercise testing. Power production (or work) appears to be the most appropriate stimulus for measuring the dyspnea response. The 0-10 category-ratio (CR-10) scale and the visual analog scale (VAS) are two instruments for measuring the intensity of breathlessness. Studies demonstrate that the slope and/or intercept of the power production-breathlessness relationship provide a valid, reliable, and responsive approach for measurement. Ratings of dyspnea during exercise are useful to determine the severity of breathing difficulty and to assess the efficacy of therapy.
TL;DR: Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects.
Abstract: Background Little research was found to indicate that pain is managed well in hospitalized patients and few studies were found regarding pain management for critical care patients. Objective To determine the extent to which nurses manage pain effectively without side effects related to narcotic analgesics in an intensive care and a surgical unit. Methods The sample consisted of 44 patients, 20 from an intensive care unit and 24 from a surgical unit. Patients completed a Visual Analogue Scale to measure pain intensity three times in 24 hours. The narcotic side effects of constipation and sedation were measured using the Constipation Assessment Scale and a sedation scale. Documentation was assessed using the Chart Audit for Pain. Results Patients in both units continued to experience pain even with pain management interventions. The critical care nurses administered an average of 30% of the maximum narcotic dose ordered and the surgical unit nurses, 36.8%. Documentation of the effect of the pain medication was scant on both units. Although sedation was not a problem in either unit, the majority of patients reported symptoms of constipation. Documentation of this problem was scant in both units. Conclusions Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects. Patients who experience pain expect to have their pain controlled. Efforts must be made to change nurses' pain management behaviors.
TL;DR: In both groups a correlation was found between pain score and psychometric scoring, and in both groups the fibromyalgia patients scored significantly higher on pain than the controls.
Abstract: The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. Fibromyalgia patients scored significantly higher than the controls on the Bech-Rafaelsen Melancholia Scale, the Atypical Depression Scale and the Hamilton Anxiety Rating Scale. On the Newcastle Depression Scale there was no difference. In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.
TL;DR: A multicentric study on the treatment of nonmalignant chronic pain with epidural spinal cord stimulation (SCS) has been carried out in 32 Italian centers devoted to pain therapy, with favorable results for patients with previous pharmacological therapy which was not always discontinued when SCS took place.
Abstract: A multicentric study on the treatment of nonmalignant chronic pain with epidural spinal cord stimulation (SCS) has been carried out in 32 Italian centers devoted to pain therapy. Neurosurgical and anesthesiology units participated in this retrospective study. 410 of the eligible patients were enrolled in the protocol: 48% were male, 52% female. All patients underwent a screening test period (average 21 days) and 74% underwent the definitive implant. The diagnosis was failed back surgery syndrome in 45%, reflex sympathetic dystrophy in 15%, phantom limb pain in 14%, postherpetic neuralgia in 8%, peripheral nerve injury in 5%, others 13%. 84% received noninvasive unsuccessful treatment (10 tensor acupuncture). All had previous pharmacological therapy which was not always discontinued when SCS took place. Pain assessment had been done with the visual analog scale and verbal scale both subjectively and by the physician and nurses. Neuropsychological profile with minimal mental test or MMPI was obtained in 68% of the patients. These results were favorable (i.e. excellent or good; more than 50% reduction of pain) in 87% of the patients at the 3-month follow-up, 75% at the 6-month follow-up, 69% at the 1-year follow-up, and 58% at the 2-year follow-up. Complication rate was: dislocation of the electrocatheter 4%, technical problems 3%, infections of the system 2%. The results will be discussed in correlation with the different etiologies of the nonmalignant chronic pain syndrome.
TL;DR: It is concluded that 1 mg of intra‐articular morphine provides effective pain relief following arthroscopic knee surgery and that the addition of bupivacaine is of no benefit.
Abstract: Summary
We assessed the effectiveness of intra-articular solutions of morphine, bupivacaine with adrenaline and a combination of both, compared with placebo in facilitating mobilisation and reducing postoperative pain and analgesic requirements for 24 h after operation. Forty patients undergoing arthroscopic knee surgery were studied in a double-blind, randomised, controlled trial. All treatments proved more effective than placebo in facilitating earlier mobilisation and in decreasing postoperative pain as measured by visual analogue scale. Morphine alone provided the best analgesia and significantly decreased analgesic consumption for 24 h after surgery. We conclude that 1 mg of intra-articular morphine provides effective pain relief following arthroscopic knee surgery and that the addition of bupivacaine is of no benefit.
TL;DR: Data analysis showed significant reductions in subjective pain ratings by subjects receiving relaxation training, and a significant reduction in non-opiate p.r.n. analgesic intake which suggested a reduced incidence of breakthrough pain.
Abstract: The efficacy of a relaxation technique involving deep breathing, muscle relaxation, and imagery was tested as a nursing intervention for the promotion of comfort and pain relief in hospitalized oncology patients. The intervention was implemented in accordance with Orem's self-care approach to nursing practice. Sixty-seven new admissions to an oncology ward were randomly assigned to receive relaxation training by audio tapes, live relaxation training by nurses, or no relaxation training. Relaxation training was conducted twice weekly over a period of three weeks. All subjects were pretested and post-tested with the McGill Pain Questionnaire and Visual Analogue Scale for pain. Analgesic medication was monitored throughout the study. Data analysis showed significant reductions in subjective pain ratings by subjects receiving relaxation training. There was also a significant reduction in non-opiate p.r.n. analgesic intake which suggested a reduced incidence of breakthrough pain.
TL;DR: It is shown that 2% lignocaine gel offers no advantage over plain lubricating gel in providing analgesia for flexible cystoscopy and in this situation good lubrication may be a more important factor than topical anaesthesia.
Abstract: OBJECTIVE The value of 2% lignocaine gel as a topical anaesthetic for flexible cystoscopy in men was tested in a prospective, randomized, double-blind, placebo controlled trial. PATIENTS AND METHODS A total of 138 patients were entered into the study. Group A patients (n = 75) received 10 ml of 2% lignocaine gel intraurethrally whilst 10 ml of plain lubricating gel was instilled in the remaining 63 patients (Group B). Patient discomfort was recorded by means of a four-point descriptive pain scale (completed by both surgeon and patient) and a 100 mm non-graphic rating visual analogue scale (patient only). RESULTS The results showed no significant difference between the two treatments irrespective of the method of recording. CONCLUSION This study shows that 2% lignocaine gel offers no advantage over plain lubricating gel in providing analgesia for flexible cystoscopy. In this situation good lubrication may be a more important factor than topical anaesthesia.
TL;DR: There was an overall and progressive reduction in all sensitivity parameters in the 3 groups with no significant differences between the treatments and there is perhaps the need for further evaluations of desensitizing formulations using conventional fluoride products as controls rather than minus active or placebo formulations.
Abstract: A considerable number of varied agents are apparently effective in the treatment of dentine hypersensitivity. In particular, the literature supports the efficacy of fluoride and strontium containing formulations. Despite this, comparisons between strontium products are relatively few in number and surprisingly there are almost no evaluations of these products against "bench mark," conventional commercial fluoride toothpastes. This study was a double-blind parallel group comparison of two strontium-based desensitizing toothpaste products and a conventional fluoride product in the treatment of dentine hypersensitivity. A total of 119 patients completed the 12-week study and from them, sensitivity gradings were obtained at baseline, 1, 4, 8, and 12 weeks. Sensitivity was scored in response to cold air, a thermal probe at 0 degree C, and scratching with a dental probe. Patients also graded their overall sensitivity at each visit, using a visual analogue scale and the effects of treatment on completion. Plaque and gingivitis indices were recorded at each visit. There was an overall and progressive reduction in all sensitivity parameters in the 3 groups with no significant differences between the treatments. Plaque and gingivitis scores were already relatively low in this patient group at baseline but improved further as the study continued. The improvements, however, were comparable in the 3 groups. Under the conditions of this clinical trial the 2 desensitizing toothpastes showed similar reductions, but no greater than that observed in the conventional fluoride toothpaste. There is perhaps the need for further evaluations of desensitizing formulations using conventional fluoride products as controls rather than minus active or placebo formulations.
TL;DR: It is concluded that loratadine may be tried as an adjuvant therapy in the management of severe and moderate atopic dermatitis, in patients complaining of pruritus.
Abstract: The aim of the study was to assess the therapeutic efficacy of loratadine on pruritus in patients with atopic dermatitis, considering the patients' sensation of itch. Sixteen patients, mean age 24.8 years, with moderate or severe atopic dermatitis were included in a double-blind and placebo-controlled study with a six-period, multi-crossover design. The patients were given 10 mg loratadine or placebo every day, alternating between loratadine and placebo every 2 weeks. The degree of pruritus during the day and during the night was recorded by the patients every morning and every evening, respectively, on a 10-cm visual analog scale. The study detected a significant effect of loratadine, as compared with placebo, on pruritus during the day, pruritus during the night, and severity of rash. At least nine of the 16 patients included were classified as responders and only one as a nonresponder to loratadine treatment. It is concluded that loratadine may be tried as an adjuvant therapy in the management of severe and moderate atopic dermatitis, in patients complaining of pruritus.
TL;DR: Topical mepivacaine reduced the pain experienced during and after hysteroscopy and endometrial biopsy.
Abstract: Study Objective. To determine whether the pain and discomfort of routine hysteroscopy with endometrial biopsy to diagnose infertility and endometrial pathology can be minimized by topical application of mepivacaine. Design. Prospective, randomized, double-blind study. Setting. The Department of Obstetrics and Gynecology at a teaching hospital in Rome, Italy. Patients. Enghteen women undergoing diagnostic hysteroscopy. Interventions. Hysteroscopy and endometrial biopsy were performed after transcervical injection of 5 ml 2% mepivacaine or 5 ml saline solution into the uterine cavity. Measurements and Main Results. Difficulty introducing the hysteroscope was rated by the operator on a scale of 1 to 3. an observer scored visible signs of each woman's distress using a three-point scale. The patients reported their pain 15, 30, 60 and 120 minutes after the procedure on a visual analog scale. Mepivacaine was more effective than placebo according to all measurements. Conclusions. Topical mepivacaine reduced the pain experienced during and after hysteroscopy and endometrial biopsy.
TL;DR: 4-aminopyridine was more effective than 3,4-diaminopyrazine, especially for ambulation, fatigue, and overall daily functioning, in the treatment of patients with multiple sclerosis.
Abstract: Objective: To compare the efficacy and toxicity of 4-aminopyridine and 3,4-diaminopyridine in patients with multiple sclerosis. Design: Intervention study with a before-after design and a randomized, double-blind, crossover design. Setting: University referral center. Patients: Twenty-four patients with definite multiple sclerosis who had been treated in a previous clinical trial with 4-aminopyridine. Interventions: Nonresponders to treatment with 4-aminopyridine (14 patients) were treated with 3,4-diaminopyridine in a 4-week, open-label trial with doses up to 1.0 mg/kg of body weight (before-after design). Responders to treatment with 4-aminopyridine (10 patients) participated in a comparative study of 6 weeks' duration with 4-aminopyridine and 3,4-diaminopyridine according to a randomized, double-blind, double-crossover design. Main Outcome Measures: Neurophysiologic variables for nonresponders, neurologic functions and symptoms on a visual analogue scale for responders, and side effects for both groups. Results: Toxicity profiles of 4-aminopyridine and 3,4-diaminopyridine were different, and systemic tolerability was reduced for 3,4-diaminopyridine. 4-Aminopyridine was more effective than 3,4-diaminopyridine, especially for ambulation, fatigue, and overall daily functioning. Conclusion: Our data suggest that, concerning both efficacy and side effects, 4-aminopyridine is superior to 3,4-diaminopyridine in the treatment of patients with multiple sclerosis.