This document summarizes and comments on a study that measured markers of oxidative stress in newborns undergoing heel lancing procedures. The summary is:
1) The study found that newborns who exhibited higher pain scores during heel lancing saw increases in markers of oxidative stress between blood samples taken before and after the procedure.
2) However, the document notes that the increases were relatively small and their clinical significance is unknown. It also offers an alternative hypothesis that the increases could reflect local rather than systemic oxidative responses to the tissue injury of heel lancing.
3) The document recommends using established non-pharmacological interventions like sucrose to reduce pain from heel lancing when possible, as currently available analgesic medications
This document discusses chronic pain from a physical therapy perspective. It outlines how acute pain becomes chronic, risk factors for chronic pain, and models for treating tendinopathies and chronic pain. Treatment approaches discussed include manual therapy, Tai Chi, graded exposure, and eccentric exercise programs like the Alfredson model. The document emphasizes examining for movement dysfunctions, addressing both physical and psychological factors, and finding the right balance between rest and progressive loading over time to reduce chronic pain.
This document provides guidelines for the management of acute low back pain. It recommends starting with acetaminophen or NSAIDs for two to four weeks. Physical therapy modalities like heat, cold packs, and massage can provide relief for the first two to four weeks. Bed rest is not generally recommended except for two to three days for acute radiculopathy; otherwise, activity modification is preferred. Exercise programs focusing on weight loss, trunk strengthening, and stretching can help alleviate back pain. Patient education on back protection and lifestyle changes is important. Surgery is only recommended for select groups with complications like cauda equina lesions or worsening/resistant neurologic symptoms.
The document discusses the physiological changes that occur with aging and their impact. As people age, they experience changes in various body systems like sensory, cardiovascular, musculoskeletal, and neurological systems. These changes can affect functional abilities and independence with daily activities unless addressed through occupational therapy interventions.
Common Brain Mechanisms Between Pain & AddictionPaul Coelho, MD
This document summarizes a perspective on common brain mechanisms of chronic pain and addiction. It proposes that chronic pain involves neuroadaptations similar to those seen in addiction, including reward deficiency, impaired inhibitory control, incentive sensitization, aberrant learning, and anti-reward allostatic neuroadaptations. The document provides epidemiological context on the prevalence and costs of chronic pain. It then reviews models of reward and addiction neurobiology and discusses how chronic pain may disrupt normal hedonic homeostasis in a manner analogous to addiction through an allostatic load. The perspective aims to inform improved chronic pain treatment by drawing parallels to addiction theories and interventions.
The Hawaii Center for Regenerative Medicine offers advanced non-surgical pain relief treatments such as prolotherapy, platelet rich plasma therapy, stem cell therapy, and neural prolotherapy. The center is led by Dr. Liza Smigel, who is highly trained and experienced in regenerative medicine treatments, and the first to offer these innovative procedures in Hawaii for musculoskeletal injuries and pain.
Physical therapy exercises for low back painHealthQuest
Physical therapy exercises are highly acclaimed solutions for low back pain. Under proper guidance, you can undertake various physical therapy exercises to reduce pain and bring back muscle strength.
The document discusses how the magazine addresses and attracts its target audience. It uses a colorful layout with a simple, clean design to appeal to female readers. The front page uses various fonts and includes a photo of smiling characters to seem informal yet recognizable and associate the magazine with happiness. Photos in different styles and locations throughout portray different feelings and appeal to a wide range of readers. The color scheme and overall clean, organized look aim to attract the target audience of teenage girls.
Los alumnos de 7°B visitaron el Museo Quinquela Martín en 2013 como parte de un proyecto sobre agua y arte, donde disfrutaron de música y tango interpretado por su guía con violín. El museo alberga cuadros y mascarones de proa que decoran la casa y le dan belleza al paisaje del río.
This document discusses chronic pain from a physical therapy perspective. It outlines how acute pain becomes chronic, risk factors for chronic pain, and models for treating tendinopathies and chronic pain. Treatment approaches discussed include manual therapy, Tai Chi, graded exposure, and eccentric exercise programs like the Alfredson model. The document emphasizes examining for movement dysfunctions, addressing both physical and psychological factors, and finding the right balance between rest and progressive loading over time to reduce chronic pain.
This document provides guidelines for the management of acute low back pain. It recommends starting with acetaminophen or NSAIDs for two to four weeks. Physical therapy modalities like heat, cold packs, and massage can provide relief for the first two to four weeks. Bed rest is not generally recommended except for two to three days for acute radiculopathy; otherwise, activity modification is preferred. Exercise programs focusing on weight loss, trunk strengthening, and stretching can help alleviate back pain. Patient education on back protection and lifestyle changes is important. Surgery is only recommended for select groups with complications like cauda equina lesions or worsening/resistant neurologic symptoms.
The document discusses the physiological changes that occur with aging and their impact. As people age, they experience changes in various body systems like sensory, cardiovascular, musculoskeletal, and neurological systems. These changes can affect functional abilities and independence with daily activities unless addressed through occupational therapy interventions.
Common Brain Mechanisms Between Pain & AddictionPaul Coelho, MD
This document summarizes a perspective on common brain mechanisms of chronic pain and addiction. It proposes that chronic pain involves neuroadaptations similar to those seen in addiction, including reward deficiency, impaired inhibitory control, incentive sensitization, aberrant learning, and anti-reward allostatic neuroadaptations. The document provides epidemiological context on the prevalence and costs of chronic pain. It then reviews models of reward and addiction neurobiology and discusses how chronic pain may disrupt normal hedonic homeostasis in a manner analogous to addiction through an allostatic load. The perspective aims to inform improved chronic pain treatment by drawing parallels to addiction theories and interventions.
The Hawaii Center for Regenerative Medicine offers advanced non-surgical pain relief treatments such as prolotherapy, platelet rich plasma therapy, stem cell therapy, and neural prolotherapy. The center is led by Dr. Liza Smigel, who is highly trained and experienced in regenerative medicine treatments, and the first to offer these innovative procedures in Hawaii for musculoskeletal injuries and pain.
Physical therapy exercises for low back painHealthQuest
Physical therapy exercises are highly acclaimed solutions for low back pain. Under proper guidance, you can undertake various physical therapy exercises to reduce pain and bring back muscle strength.
The document discusses how the magazine addresses and attracts its target audience. It uses a colorful layout with a simple, clean design to appeal to female readers. The front page uses various fonts and includes a photo of smiling characters to seem informal yet recognizable and associate the magazine with happiness. Photos in different styles and locations throughout portray different feelings and appeal to a wide range of readers. The color scheme and overall clean, organized look aim to attract the target audience of teenage girls.
Los alumnos de 7°B visitaron el Museo Quinquela Martín en 2013 como parte de un proyecto sobre agua y arte, donde disfrutaron de música y tango interpretado por su guía con violín. El museo alberga cuadros y mascarones de proa que decoran la casa y le dan belleza al paisaje del río.
The document contains a list of 50 URLs for BitTorrent trackers. The URLs are for announcing torrents to various public trackers across the internet in order to help people find and download the torrent files.
The document discusses how the magazine addressed its target audience of male teenagers ages 15-19 interested in rap music. It used bold gold coloring throughout to draw attention while appealing to different age groups. The language and tone was casual yet sharp enough for different audiences. Social media platforms were utilized to provide an expanded musical experience for audiences. Unique imagery, buzzwords about exclusives and competitions, and adherence to rap genre conventions in areas like color and font styles were meant to attract the target audience.
Participar en obras de teatro ofrece numerosos beneficios para los estudiantes como mejorar las calificaciones en español, hacer nuevos amigos, desarrollar habilidades del lenguaje y ser creativo; también ayuda a promover buenas relaciones entre compañeros y fortalecer las habilidades sociales a través de la interacción, lo que aumenta la autoestima y reduce el estrés.
Conrado Reyes, the department head, discussed Eddie's performance with the company owner, Mr. Alex Sandoval. While Conrado did not think Eddie was ready for promotion or deserved demotion, Mr. Sandoval saw potential in Eddie. They decided to transfer Eddie to a new department instead of promoting or demoting him. Conrado learned that others may see potential in employees where he does not, and that placing employees where their skills are best suited benefits both the employee and company. He also learned not to view others evaluating his employees as a threat, and to focus on developing his employees' skills so they can advance their careers.
Islamic law prescribes cutting off the hands of convicted robbers as a punishment according to a verse in the Quran. The verse from Surah Maidah states that the hands of male and female thieves should be cut off as an exemplary punishment from God that is meant to demonstrate His power and wisdom.
THIS PRESENTATION ENCASES A EFFECTIVE AND EFFICIENT PROBLEM SOLVING TECHNIQUE THROUGH FISH BONE DIAGRAM
TEAM MEMBER 1:
GARIMA SRIVASTAVA
TEAM MEMBER 2:
TRINA GHOSH
Este documento describe las condiciones para que dos triángulos sean congruentes y resuelve problemas aplicando estas condiciones. Existen tres casos suficientes para la congruencia de triángulos: 1) ángulo-lado-ángulo, 2) lado-ángulo-lado, y 3) lado-lado-lado. El documento también explica conceptos como bisectriz, mediatriz y base media, y cómo aplicarlos para resolver problemas geométricos.
El documento presenta datos sobre el promedio industrial Dow Jones (DJIA) y el índice Standard & Poor's 500 (S&P 500) durante nueve días. El coeficiente de correlación muestral entre el DJIA y el S&P 500 calculado a partir de los datos es 0,93, lo que indica una fuerte asociación positiva entre las dos medidas del mercado de valores.
En este documento hablo de las lecturas sobre los recursos y propuestas metodológicas en la enseñanza de la historia, asi como del tiempo y lugares en ella.
Este documento describe diferentes tipos de intereses y ganancias relacionadas con préstamos e inversiones. Explica que los intereses simples no se acumulan, mientras que los intereses compuestos sí se acumulan periódicamente. También define la tasa de capitalización como la relación entre los ingresos netos de una inversión y su precio de compra. Finalmente, describe la tasa nominal como la tasa de interés por período multiplicada por el número de períodos, y cómo se usa para comparar tasas de interés anuales bajo diferentes
El documento presenta información sobre varias playas y destinos turísticos populares. Se describe Playa del Carmen como una de las playas más famosas de México ubicada en la Riviera Maya. También se mencionan Playa Cristal en el Parque Nacional Tayrona y Duke Kahanamoku Beach en Waikiki, Honolulu. Se incluyen breves descripciones de varias cadenas hoteleras como Holiday Inn, Hoteles City e Inn at Mazatlán. Finalmente, se presenta información sobre el restaurante El Rincón Gaucho en León, Guana
Dokumen tersebut merangkum rencana pelaksanaan orientasi organisasi kemahasiswaan Badan Eksekutif Mahasiswa Fakultas Ilmu Agama Islam Universitas Islam Indragiri tahun 2014, yang bertujuan untuk memperkenalkan peran mahasiswa sebagai kekuatan moral, agen perubahan, dan kontrol sosial serta memberikan pembekalan manajemen organisasi dan administrasi kesekretariatan kepada mahasiswa baru. Kegiatan ini akan diselenggarakan pada tanggal 13 September 2014 di
Basílica de nuestra señora del rosario de chiquinquira10cristian12u
La basílica de Nuestra Señora del Rosario de Chiquinquirá es una iglesia católica en Colombia dedicada a la Virgen María. Alberga el cuadro original de la Virgen de Chiquinquirá, la santa patrona de la ciudad. La basílica conmemora el milagro de la renovación de la imagen de la Virgen y ha sufrido daños por terremotos, pero sigue siendo un importante centro religioso y turístico de la región.
El documento presenta un juego de rimas para niños en el que se propone revolver el cajón de las vocales para encontrar palabras que comiencen con la misma letra. A modo de ejemplo, se presentan varias palabras que comienzan con la letra E, como elefante, escobilla, enfermera y edificio.
Gaturro se despierta después de una pesadilla y escucha a Ágatha pedir ayuda. Va a buscarla y encuentra una tortuga que lo lleva a una isla, donde descubre que Ágatha está bajo un hechizo. Para romperlo, debe encontrar cinco palabras con la ayuda de varios animales. Finalmente descubre que las palabras son "NO", "oído", "NEGAR", "voz" y "ODIO" y pronunciándolas juntas rompe el hechizo. Encuentra a la verdadera Á
El documento proporciona instrucciones para realizar una copia de seguridad de los cursos en la plataforma EVAGD antes de actualizarla a una nueva versión. Explica los pasos para acceder al bloque de administración dentro de cada curso, seleccionar "Copia de seguridad", elegir los elementos a incluir, hacer clic en continuar para ver la lista de elementos copiados, y guardar el archivo de copia de seguridad fuera de la plataforma.
El documento describe la necesidad de asesoría para mejorar el sistema educativo mexicano a través de proyectos educativos diseñados por expertos comprometidos con la educación del país. Estos proyectos buscan transformar la educación mediante currículas actualizadas y relevantes.
El documento habla sobre el compromiso municipalista del PSOE. Expresa que los alcaldes se identifican con un manifiesto que promueve la participación interna en el partido y la apertura a la sociedad. Argumenta que el PSOE necesita adaptarse a las nuevas formas de organización social, ser crítico, estar en sintonía con la sociedad y que sus políticas sean coherentes con sus valores para recuperar la confianza de los votantes. Defiende que el nuevo proyecto socialista debe ser municipalista, de proximidad y participativo más allá
Nocebo hyperalgesia partial reinforcement and extinction Paul Coelho, MD
This study investigated whether partial reinforcement (PRF) can induce nocebo hyperalgesia, and whether nocebo hyperalgesia extinguishes after conditioning. 135 participants received electrocutaneous stimulation and were told a device could increase pain sensitivity. Those in the continuous reinforcement (CRF) group always felt increased pain with the device, while the PRF group felt it 62.5% of the time. Both CRF and PRF induced nocebo hyperalgesia, but it was weaker under PRF. Nocebo hyperalgesia failed to extinguish for either group. This suggests PRF may reduce nocebo hyperalgesia intensity in clinical settings, and that once established, no
1) The document discusses a scientific workshop focused on changing paradigms for understanding chronic pelvic pain.
2) It notes that the traditional biomedical model of focusing only on medical/surgical therapies has failed many patients, and the workshop aimed to develop alternative conceptual frameworks.
3) A key topic was the role of the nervous system in pain perception and the potential for central and peripheral sensitization to chronic pain independent of the initial cause. Alterations in nerve receptors and neuroendocrine mediators noted in sensitization might provide treatment targets.
The document contains a list of 50 URLs for BitTorrent trackers. The URLs are for announcing torrents to various public trackers across the internet in order to help people find and download the torrent files.
The document discusses how the magazine addressed its target audience of male teenagers ages 15-19 interested in rap music. It used bold gold coloring throughout to draw attention while appealing to different age groups. The language and tone was casual yet sharp enough for different audiences. Social media platforms were utilized to provide an expanded musical experience for audiences. Unique imagery, buzzwords about exclusives and competitions, and adherence to rap genre conventions in areas like color and font styles were meant to attract the target audience.
Participar en obras de teatro ofrece numerosos beneficios para los estudiantes como mejorar las calificaciones en español, hacer nuevos amigos, desarrollar habilidades del lenguaje y ser creativo; también ayuda a promover buenas relaciones entre compañeros y fortalecer las habilidades sociales a través de la interacción, lo que aumenta la autoestima y reduce el estrés.
Conrado Reyes, the department head, discussed Eddie's performance with the company owner, Mr. Alex Sandoval. While Conrado did not think Eddie was ready for promotion or deserved demotion, Mr. Sandoval saw potential in Eddie. They decided to transfer Eddie to a new department instead of promoting or demoting him. Conrado learned that others may see potential in employees where he does not, and that placing employees where their skills are best suited benefits both the employee and company. He also learned not to view others evaluating his employees as a threat, and to focus on developing his employees' skills so they can advance their careers.
Islamic law prescribes cutting off the hands of convicted robbers as a punishment according to a verse in the Quran. The verse from Surah Maidah states that the hands of male and female thieves should be cut off as an exemplary punishment from God that is meant to demonstrate His power and wisdom.
THIS PRESENTATION ENCASES A EFFECTIVE AND EFFICIENT PROBLEM SOLVING TECHNIQUE THROUGH FISH BONE DIAGRAM
TEAM MEMBER 1:
GARIMA SRIVASTAVA
TEAM MEMBER 2:
TRINA GHOSH
Este documento describe las condiciones para que dos triángulos sean congruentes y resuelve problemas aplicando estas condiciones. Existen tres casos suficientes para la congruencia de triángulos: 1) ángulo-lado-ángulo, 2) lado-ángulo-lado, y 3) lado-lado-lado. El documento también explica conceptos como bisectriz, mediatriz y base media, y cómo aplicarlos para resolver problemas geométricos.
El documento presenta datos sobre el promedio industrial Dow Jones (DJIA) y el índice Standard & Poor's 500 (S&P 500) durante nueve días. El coeficiente de correlación muestral entre el DJIA y el S&P 500 calculado a partir de los datos es 0,93, lo que indica una fuerte asociación positiva entre las dos medidas del mercado de valores.
En este documento hablo de las lecturas sobre los recursos y propuestas metodológicas en la enseñanza de la historia, asi como del tiempo y lugares en ella.
Este documento describe diferentes tipos de intereses y ganancias relacionadas con préstamos e inversiones. Explica que los intereses simples no se acumulan, mientras que los intereses compuestos sí se acumulan periódicamente. También define la tasa de capitalización como la relación entre los ingresos netos de una inversión y su precio de compra. Finalmente, describe la tasa nominal como la tasa de interés por período multiplicada por el número de períodos, y cómo se usa para comparar tasas de interés anuales bajo diferentes
El documento presenta información sobre varias playas y destinos turísticos populares. Se describe Playa del Carmen como una de las playas más famosas de México ubicada en la Riviera Maya. También se mencionan Playa Cristal en el Parque Nacional Tayrona y Duke Kahanamoku Beach en Waikiki, Honolulu. Se incluyen breves descripciones de varias cadenas hoteleras como Holiday Inn, Hoteles City e Inn at Mazatlán. Finalmente, se presenta información sobre el restaurante El Rincón Gaucho en León, Guana
Dokumen tersebut merangkum rencana pelaksanaan orientasi organisasi kemahasiswaan Badan Eksekutif Mahasiswa Fakultas Ilmu Agama Islam Universitas Islam Indragiri tahun 2014, yang bertujuan untuk memperkenalkan peran mahasiswa sebagai kekuatan moral, agen perubahan, dan kontrol sosial serta memberikan pembekalan manajemen organisasi dan administrasi kesekretariatan kepada mahasiswa baru. Kegiatan ini akan diselenggarakan pada tanggal 13 September 2014 di
Basílica de nuestra señora del rosario de chiquinquira10cristian12u
La basílica de Nuestra Señora del Rosario de Chiquinquirá es una iglesia católica en Colombia dedicada a la Virgen María. Alberga el cuadro original de la Virgen de Chiquinquirá, la santa patrona de la ciudad. La basílica conmemora el milagro de la renovación de la imagen de la Virgen y ha sufrido daños por terremotos, pero sigue siendo un importante centro religioso y turístico de la región.
El documento presenta un juego de rimas para niños en el que se propone revolver el cajón de las vocales para encontrar palabras que comiencen con la misma letra. A modo de ejemplo, se presentan varias palabras que comienzan con la letra E, como elefante, escobilla, enfermera y edificio.
Gaturro se despierta después de una pesadilla y escucha a Ágatha pedir ayuda. Va a buscarla y encuentra una tortuga que lo lleva a una isla, donde descubre que Ágatha está bajo un hechizo. Para romperlo, debe encontrar cinco palabras con la ayuda de varios animales. Finalmente descubre que las palabras son "NO", "oído", "NEGAR", "voz" y "ODIO" y pronunciándolas juntas rompe el hechizo. Encuentra a la verdadera Á
El documento proporciona instrucciones para realizar una copia de seguridad de los cursos en la plataforma EVAGD antes de actualizarla a una nueva versión. Explica los pasos para acceder al bloque de administración dentro de cada curso, seleccionar "Copia de seguridad", elegir los elementos a incluir, hacer clic en continuar para ver la lista de elementos copiados, y guardar el archivo de copia de seguridad fuera de la plataforma.
El documento describe la necesidad de asesoría para mejorar el sistema educativo mexicano a través de proyectos educativos diseñados por expertos comprometidos con la educación del país. Estos proyectos buscan transformar la educación mediante currículas actualizadas y relevantes.
El documento habla sobre el compromiso municipalista del PSOE. Expresa que los alcaldes se identifican con un manifiesto que promueve la participación interna en el partido y la apertura a la sociedad. Argumenta que el PSOE necesita adaptarse a las nuevas formas de organización social, ser crítico, estar en sintonía con la sociedad y que sus políticas sean coherentes con sus valores para recuperar la confianza de los votantes. Defiende que el nuevo proyecto socialista debe ser municipalista, de proximidad y participativo más allá
Nocebo hyperalgesia partial reinforcement and extinction Paul Coelho, MD
This study investigated whether partial reinforcement (PRF) can induce nocebo hyperalgesia, and whether nocebo hyperalgesia extinguishes after conditioning. 135 participants received electrocutaneous stimulation and were told a device could increase pain sensitivity. Those in the continuous reinforcement (CRF) group always felt increased pain with the device, while the PRF group felt it 62.5% of the time. Both CRF and PRF induced nocebo hyperalgesia, but it was weaker under PRF. Nocebo hyperalgesia failed to extinguish for either group. This suggests PRF may reduce nocebo hyperalgesia intensity in clinical settings, and that once established, no
1) The document discusses a scientific workshop focused on changing paradigms for understanding chronic pelvic pain.
2) It notes that the traditional biomedical model of focusing only on medical/surgical therapies has failed many patients, and the workshop aimed to develop alternative conceptual frameworks.
3) A key topic was the role of the nervous system in pain perception and the potential for central and peripheral sensitization to chronic pain independent of the initial cause. Alterations in nerve receptors and neuroendocrine mediators noted in sensitization might provide treatment targets.
BESTIPP study assessed the effects of bio-electric stimulation therapy (BEST) in postpolio patients. 25 patients were recruited and assessed on fatigue, endurance, and pain at baseline and over 24 weeks. BEST significantly improved all three endpoints: fatigue scores decreased 34% on average, endurance increased 40%, and pain decreased 34%. Benefits were maintained during a 12-week extension with maintenance therapy. The study demonstrated that BEST is an effective treatment for symptoms in postpolio patients.
Chronic pelvic pain is a complex condition with no single cause. It often involves both physical and psychological factors. The document discusses the evaluation and treatment of chronic pelvic pain. It describes how understanding of the condition has evolved over time to recognize that visible pathology often does not fully explain a patient's pain. A multidisciplinary approach is needed that considers potential contributors beyond just organic findings, such as muscle tension, trauma history, and central sensitization. A thorough history and physical exam aim to identify all potential pain generators that can be addressed through treatment.
This document discusses 3 common myths about fetal pain and the use of fetal analgesia during procedures:
1) That fetuses do not feel pain or remember pain. However, research shows fetuses may feel pain as early as 20 weeks and have stress responses to invasive procedures.
2) That fetal analgesia is not possible or safe and there is no data to support it. Some studies have shown fetal analgesia is possible and safe in short term use and reduces stress responses.
3) That maternal analgesia is sufficient to cover fetal pain needs. However, not all maternal analgesia crosses the placenta and individual variation exists, so direct fetal analgesia should be considered.
The document argues
Se revisa las técnicas para evaluar el dolor, como varios sistemas de puntuación del dolor específicos por edad. Se discute el manejo farmacológico del dolor, incluyendo el uso de agentes que inhiben la formación de prostaglandinas, AINES y el acetaminofeno, así como los opioides débiles usados comúnmente, cuando la administración oral es factible, para el tratamiento del dolor leve a moderado.
Medical Management of Chronic Pelvic Pain: The Evidence.Alex Swanton
Chronic pelvic pain (CPP) is a significant problem for both general practitioners in the primary care setting and gynaecologists alike. The incidence of CPP has often been overlooked due, partially, to an inappropriate referral pattern, but also due to the inherent difficulty in correctly diagnosing the condition.
Properties of the brain's emotional learning circuitry predict the transition to chronic pain. In a longitudinal study, individuals with acute back pain were scanned over a year-long period. The strength of functional connectivity between the medial prefrontal cortex and nucleus accumbens at the initial scan predicted whether the individual would transition to chronic pain with over 80% accuracy. Future studies are needed to understand the mechanisms driving pain chronicity, with the goal of developing novel therapies to prevent the transition to chronic pain.
This document provides guidelines for the initial management of chronic pelvic pain in women. It discusses conducting a thorough history and assessment to identify potential contributing factors to the pain, which are often multifactorial. These factors can include endometriosis, adhesions, irritable bowel syndrome, musculoskeletal issues, nerve entrapment, and psychological or social issues. It emphasizes the importance of allowing adequate time, actively listening to the patient's experience, and taking a collaborative approach to developing a management plan that addresses both physical and non-physical contributors to the pain.
This study examined the diagnostic value of five clinical tests for patellofemoral pain syndrome (PFPS): the vastus medialis coordination test, patellar apprehension test, Waldron's test, Clarke's test, and eccentric step test. Forty-five knee pain patients were divided into a PFPS group or non-PFPS control group based on established diagnostic criteria for PFPS. A blinded investigator performed the five tests. The vastus medialis coordination test, patellar apprehension test, and eccentric step test had positive likelihood ratios above 2, indicating they provide a small increase in diagnosing PFPS when positive. The other tests had positive likelihood ratios below 2, questioning their diagnostic value. All tests had negative likelihood ratios
MSN 5300 MRU Structure of Empirical Research Articles Table of.pdfbkbk37
This study examined predictive factors of postoperative pain and anxiety in 301 children who underwent elective circumcision. The researchers found that predictive factors of postoperative pain included the type of surgical technique used, not having siblings, and experiencing postoperative complications. Predictive factors of postoperative anxiety included the type of surgical technique, the mother's level of education, preoperative anxiety levels, and a history of previous surgery. The study aimed to expand knowledge on predictive factors, but the researchers noted that randomized controlled trials are still needed to confirm the findings.
Reflexology involves applying pressure to specific points on the feet, hands and ears to relieve pain and stress in other parts of the body. While its history dates back thousands of years, modern reflexology was developed in the early 20th century. Several systematic reviews have found insufficient evidence that reflexology is effective for any medical condition due to methodological flaws in studies. However, some studies have found positive results for conditions like urinary symptoms, pain, anxiety and constipation when using more rigorous study designs with controls. Overall, more high-quality research is still needed to determine if reflexology is effective.
Nursing Research MarchApril 2002 Vol 51, No 2 125 Back.docxcherishwinsland
Nursing Research March/April 2002 Vol 51, No 2 125
� Background: The mechanisms for postoperative nausea and
vomiting are numerous and pathways not well elucidated.
Although many medications have been developed to help
prevent postoperative nausea and vomiting, the search for
better approaches to recovery treatment continues.
� Objective: The purpose of this study was to evaluate the effec-
tiveness of isopropyl alcohol (IPA) inhalation for treatment of
postoperative nausea and vomiting for patients who have
general anesthesia for a surgical procedure.
� Method: Participants were recruited from an urban hospital on
the East Coast of the United States. Participants were
assigned to an experimental or control group and IPA inhala-
tion was compared to the standard anti-emetic treatment for
rescue treatment in the immediate postoperative period.
Postoperative nausea and vomiting was rated using a
descriptive ordinal scale.
� Results: The results of this study show IPA to be effective and
that there was no significant difference between the stan-
dard treatment protocol and treatment with IPA. Treatment
with IPA was significantly more cost effective than standard
drug treatment.
� Discussion: Further research is recommended to evaluate the
length of effectiveness, standard dose needed, most effec-
tive mode of inhalation, and factors blocking IPA effective-
ness.
� Key Words: alternative treatment • IPA • nausea • postopera-
tive • vomiting
oday’s healthcare concerns center on decreasing
costs, shortening hospital stays, and facilitating a
quick return to normal activity for patients. Post-operative
nausea and vomiting (PONV) is a major concern for
patients having same-day surgery under general anesthesia
as it causes increased complications and delays in dis-
charge from the hospital (Hirsch, 1994).
Approximately one-third of the 11 million patients under-
going outpatient surgery under general anesthesia will
experience significant nausea or emesis in the postopera-
tive period (Claybon, 1994). The mechanisms for PONV
are numerous and the causative pathways not well eluci-
dated. Many factors may play a role in an episode of nau-
sea and vomiting, and despite advances in new drug thera-
pies in minimizing the incidence, no ideal drug has been
found to prevent all the causes of PONV.
Aromatherapy is a relatively new and under-researched
alternative treatment that might hold promise in treating
PONV. Isopropyl alcohol (IPA) is among several aromas
displaying possible anti-emetic properties. Isopropyl alco-
hol inhalation is a new treatment with only limited inves-
tigations to date (Langevin & Brown, 1997).
Literature Review
Current PONV treatment strategies are based on the
understanding of the vomiting reflex; however, the lack of
well-elucidated pathways in the control of PONV has con-
tributed to the problems with these treatment strategies
and medications. It has been well documented that some
patients are more susceptible to P.
Efectos fetales de la anestesia espinal maternaAnestesia Dolor
1. Spinal anesthesia is commonly used for cesarean sections due to advantages for the mother such as remaining awake for the birth and facilitating post-op pain relief. However, hypotension is a common side effect that can pose risks to both mother and baby if severe or prolonged.
2. The review found that no single method completely prevents hypotension during spinal anesthesia for c-section but the risk can be reduced through IV fluids, vasopressors like ephedrine or phenylephrine, and leg compression. Even minor hypotension may cause issues for the baby like transient carbon dioxide retention.
3. Fetal oxygenation is dependent on several factors like placental function, uterine and umbilical blood
This document summarizes a letter to the editor in response to a recent systematic review comparing pigtail catheters and chest tubes for treating pneumothorax. The letter notes that while drainage success and recurrence were similar, drainage duration was longer for chest tubes. It questions whether this difference reflects hospital practices in removing tubes rather than time to close bronchopleural fistulas. The letter suggests factors like treatment team and physician specialty could influence removal decisions. It concludes pigtail catheters result in less pain and allow alternative placements, making them a reasonable initial treatment option.
The document discusses neonatal pain, including that babies can feel and react to pain, validated scales exist to measure neonatal pain, and developmental aspects of pain perception in newborns. It also outlines non-pharmacological and pharmacological approaches to treating pain in newborns, emphasizing the need for comprehensive pain management strategies that minimize unnecessary pain in neonates.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
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ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
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Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
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Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
Pengantar Penggunaan Flutter - Dart programming language1.pptx
experiencia
1. ARTICLE IN PRESS
PAINÒ xxx (2009) xxx–xxx
www.elsevier.com/locate/pain
Commentary
Blood sampling and other needle procedures – The Achilles heel of newborn
intensive care
Critical illness and trauma can accelerate the generation of reac- Then, it is plausible that babies who required more heel massage
tive oxygen free radicals (FR), which can harm many tissues. The experienced more severe pain, had more local tissue trauma, and
newborn may be particularly vulnerable to oxidative injury. In had greater increases in AOPP and TH due to local, rather than sys-
the current issue of Pain, Bellieni et al. [1] measured advanced oxy- temic, generation of FR. It would support the ‘‘local oxidation”
gen protein products (AOPP) and total hydroperoxides (TH) as sur- hypothesis if a post hoc review showed a correlation between
rogate measures of FR generation in blood samples at the potassium measurements and either baseline values or heel mas-
beginning and end of diagnostic heel lancing procedures in new- sage-evoked increases in AOPP and TH.
borns. For the subset of babies with the highest behavioral pain These two interpretations could be tested by further experi-
scores, concentrations of AOPP and TH increased between blood ments involving simultaneous central venous sampling from ba-
samples taken at the end, compared to the beginning, of the heel bies with indwelling lines who nevertheless require heelstick
lance. Their two primary conclusions are: (1) pain can accelerate sampling or who could have repeated sampling of drops of blood
FR generation in newborns, and (2) since FR can harm organs, cli- from operative sites during surgery. Anti-inflammatory effects of
nicians should consider ‘‘use of effective analgesic procedures for local anesthetics are complex, and could confound these
every type of potentially painful event, in order to avoid the dan- measurements.
gerous effects of oxidative stress” [1]. In this Commentary, we con- Although Bellieni et al. [1] showed statistically significant in-
sider aspects of the design, results, and conclusions of the Bellieni creases in the values for AOPP and TH for this subgroup, the effect
et al. study [1] and some general problems with physiologic sizes for these increases are relatively small, and of unknown clin-
parameters as sole indicators of pain in critically ill neonates [2]. ical significance.
Newborns in Neonatal Intensive Care Units (NICUs) are sub- Effect sizes and clinical significance are pertinent to the authors’
jected to repeated noxious events, including, but not limited to, re- second conclusion; namely, that analgesics should be provided for
peated needle procedures. In sick newborns, frequent laboratory every potentially painful procedure. Interventions such as posi-
tests provide crucial information to guide physiologic interven- tioning and nesting, use of non-nutritive sucking (e.g. pacifiers),
tions. Blood sampling is, therefore, a necessary, though noxious, as- kangaroo mother care [5], breastfeeding [8] and oral sucrose [10]
pect of newborn intensive care. Heel lancing has long been used for have been shown to have clearly measurable (although often
blood sampling for babies who lack vascular access. While heel incomplete) efficacy and minimal risk. Our recommendation is to
lancing is technically simple, it produces tissue trauma, hyperalge- use these non-pharmacologic interventions to ameliorate the ef-
sia [12], and behavioral and physiologic activation indicative of fects of heel lances whenever possible.
pain especially with repeated heel lances, which produce bruising Conversely, topical local anesthetics, acetaminophen, and mor-
and inflammation. phine have been ineffective as analgesics in clinical trials for heel
Blood sampling relies on the assumption that the sample re- lancing [4,6,9], and we were unable to identify published NSAID
flects systemic physiology. For example, measured serum or plasma trials. Infant rats show diminished analgesic responses to cycloox-
sodium concentrations are similar from arterial, venous or heel- ygenase inhibition compared to older animals [7]. Opioid tolerance
lance sources. Other measurements (e.g. the partial pressure of proceeds more rapidly in younger animals and humans compared
oxygen) differ markedly from different sites. Heel lancing is irre- to older ones. It remains unclear whether any currently-available
producible, and squeezing the heel repeatedly is often required analgesic medication has a definable risk–benefit ratio for reducing
to get sufficient blood for sampling. Heel lance blood samples, pain or oxidative stress from heel lancing in neonates. Future study
therefore, can be influenced by local injury and hemolysis. For of both pharmacologic and non-pharmacologic interventions
example, heel lancing is notorious for generating falsely elevated should evaluate effects of interventions on immediate behaviors,
potassium measurements. stress responses, and hyperalgesia [12].
Bellieni et al. [1] regard the observed increases in AOPP and TH Nevertheless, heel lancing is clearly painful and stressful, and
as markers for a systemic oxidative response to pain. While they alternatives to this procedure should be sought. Non-invasive
may be correct, an alternative hypothesis is that these increases methods for physiologic measurement, most notably pulse oxime-
could reflect local oxidative responses to the injury of heel lancing. try and exhaled breath capnometry have clearly reduced pain and
Suppose that, in general, heel lancings that require more massag- distress for countless infants, and have greatly refined mechanical
ing of the heel are more traumatic to tissues and more painful. ventilation and adjustment of inspired oxygen concentrations.
Breath analysis has a growing range of applications, including
DOI of original article: 10.1016/j.pain.2009.08.025 metabolic studies.
0304-3959/$36.00 Ó 2009 Published by Elsevier B.V. on behalf of International Association for the Study of Pain.
doi:10.1016/j.pain.2009.09.005
2. ARTICLE IN PRESS
2 Commentary / PAINÒ xxx (2009) xxx–xxx
Physiologic indicators are problematic as sole measures of acute [4] Carbajal R, Lenclen R, Jugie M, Paupe A, Barton BA, Anand KJS. Morphine does
not provide adequate analgesia for acute procedural pain among preterm
pain in infants; many other nonpainful processes evoke sympa-
neonates. Pediatrics 2005;115:1494–500.
thetic activation and stress responses [2]. Conversely, repetitive [5] Johnston CC, Filion F, Campbell-Yeo M, Goulet C, Bell L, McNaughton K, Byron J.
stress can be harmful per se, independent of subjective distress. Enhanced kangaroo mother care for heel lance in preterm neonates: a
It is therefore appropriate to assess physiological indicators along crossover trial. J Perinatol 2009;29:51–6.
[6] O’Brien L, Taddio A, Lyszliewicz DA, Koren G. A critical review of the topical
with behavioral indicators in response to noxious events such as local anesthetic amethocaine (Ametop) for pediatric pain. Pediatric Drugs
heel lance. This approach underlies the ever-expanding repository 2005;7:41–5.
of composite infant pain measures such as the PIPP [11] which de- [7] Ririe DG, Prout HM, Eisenach JC. Effect of cyclooxygenase-1 inhibition in
postoperative pain is developmentally regulated. Anesthesiology
tect multiple dimensions of pain and contextual factors that affect 2004;101:1031–5.
expression of pain. [8] Shah PS, Aliwalas LL, Shah VS. Breastfeeding or breast milk for procedural pain
There is a lack of high quality evidence for the efficacy, effec- in neonates. Cochrane Database Syst Rev 2006;3:CD00495.
[9] Shah V, Taddio A, Ohlsson A. Randomised controlled trial of paracetamol for
tiveness or cost–benefit of standardized pain assessment in rela- heel prick pain in neonates. Arch Dis Child Fetal Neonatal Ed
tion to clinical or process outcomes in pediatrics. 1998;79:209F–11F.
In the NICU, where neonates undergo an average of approxi- [10] Stevens B, Yamada J, Ohlsson A. Sucrose for analgesia in newborn infants
undergoing painful procedures. Cochrane Database Syst Rev
mately 10 painful procedures per day [3], clinicians and research- 2004;3:CD001069.
ers must work simultaneously on implementing evidence-based [11] Stevens B, Johnston C, Petryshen P, Taddio A. Premature infant pain profile:
management strategies [13] while seeking more objective physio- development and initial validation. Clin J Pain 1996;12:13–22.
[12] Taddio A, Shah V, Atenafu E, Katz J. Influence of repeated painful procedures
logic or behavioral pain indicators. System-wide approaches aimed
and sucrose analgesia on the development of hyperalgesia in newborn infants.
at pain prevention should include optimal use of non-invasive Pain 2009;144:43–8.
methods of physiologic monitoring, improved clinical decision pro- [13] Yamada J, Stinson J, Lamba J, Dickson A, McGrath PJ, Stevens B. A review of
cedures to prevent unnecessary or redundant blood sampling, and systematic reviews on pain interventions in hospitalized infants. Pain Res
Manag 2008;13:413–20.
avoidance of heel lancing when alternative sampling methods are
available.
Charles B. Berde
Harvard Medical School, Boston, MA, USA
Acknowledgments Division of Pain Medicine, Department of Anesthesiology, Perioperative
and Pain Medicine, Children’s Hospital Boston, 333 Longwood Avenue,
Supported by the Sara Page Mayo Endowment for Pediatric Pain Room 555, Boston, MA 02115, USA
Research and Treatment. Tel.: +1 617 355 7040; fax: +1 617 812 3089.
Ms. Elizabeth Carpino provided expert assistance in the prepa- E-mail address: charles.berde@childrens.harvard.edu
ration of this manuscript.
Bonnie Stevens
Lawrence S. Bloomberg Faculty of Nursing & Faculty of Medicine,
References University of Toronto, Toronto, Ont., Canada
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[2] Berde CB, McGrath PJ. Pain measurement and Beecher’s challenge, 50 years
E-mail addresses: b.stevens@utoronto.ca
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Epidemiology and treatment of painful procedures in neonates in intensive
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