Medicine and Health Sciences Commons^™

Efficacy Of Low Level Laser Therapy In The Treatment Of Postherpetic Neuralgia, Lili Legiawati, Marsha Bianti

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and defined as pain that persists for more than 90 days after the onset of HZ rash. The chronic pain of PHN is debilitating and often associated with significant morbidity. It is a neuropathic pain and manifests as allodynia, hyperalgesia, or spontaneous pain. Although it is not considered to be life-threatening, sometime HZ is inadequately treated and may result in more severe PHN. Various treatment protocols for PHN are available; however, the result remains unsatisfactorily. The use of low level laser therapy (LLLT) in pain management …

Immersive Virtual Reality For The Management Of Pain In Community-Dwelling Older Adults., Sara Benham, Minhee Kang, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members (n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS^®) depression scale, World Health Organization Quality of Life …

Characterization Of G-Protein Coupled Receptors In Pain, Depression And Anxiety, Neil Lax

Electronic Theses and Dissertations

Chronic pain and major depressive disorder are widespread conditions in the world. Interestingly, these conditions often occur comorbidly, with each individual disease amplifying the symptoms of the other. A significant amount of preclinical research in pain and depression focuses on G-protein coupled receptors (GPCRs), implying that GPCRs may be useful in treating this comorbidity. Our efforts have sought to characterize several poorly understood GPCRs, including the serotonin receptor subtypes 2C and 7 (5-HT2CR and 5-HT7R) and metabotropic glutamate receptor 5 (mGluR5), along with more well-known GPCRs such as the mu opioid receptor (MOR), and the role that they play in …

Art In The Stages Of Suffering And Death, Joanna Aramini

Visual Arts Department Student Scholarship

There has always been a strong link between art and the study of science and medicine, and one of the most iconic images of suffering and death in history to date is Christ suffering on the cross. In this thesis, I examine if and how art can make it possible to transcend human pain and overcome suffering, especially in our modern society where pain is seen as something we cannot deal with, and where we look to medicine and prescriptions to diminish it. I argue that art in the states of suffering and death, closely examining Michelangelo’s La Pieta and …

Opioid-Prescribing Practices For Post-Operative Patients In Otolaryngology: A Multiphasic Quality Improvement Project In A Single Large Institution, Zachary Gandee, Sophia Dang, Alexander N. Duffy, Jonathan C. Li, Tanvi Rana, Brittany Gunville, Tingting Zhan, Elizabeth Cottrill, Md, David Cognetti, Md

Phase 1

Objectives:

In otolaryngology, postoperative pain management lacks evidence-based guidelines. We investigated opioid prescription and consumption for common procedures to develop prescribing guidelines at our institution.

Study Design:

Prospective, survey study.

Methods:

Patients who underwent surgery between July and September were given surveys upon discharge and at first follow-up visit. We assessed opioid usage and pain using the visual analog scale and opioid consumption throughout the postoperative period. Opioid prescriptions were converted to a standardized unit of 5 mg Oxycodone pills for reporting. Four procedures (transoral robotic surgery resection [TORS], sialendoscopy, parathyroidectomy/thyroidectomy, and parotidectomy) were selected for isolated analysis.

Results: …

Patient Perceptions And Expectations About Postoperative Analgesia, Carrie Mok, Nirmal Shah, Do, Stephen F. Goldberg, Md, Amir C. Dayan, Md, Marc Torjman, Phd, Jaime L. Baratta, Md

Phase 1

Introduction

Opioid overdose deaths have nearly quadrupled since 1999. Nearly 2 out of 3 persons being prescribed medications are prescribed an opioid. Physicians may be prescribing opioids for more than what is required for postoperative pain control, leading to increased risk for opioid abuse and addiction. Patient perceptions of perioperative pain medications are poorly understood.

Objective

This survey aims to understand patient expectations of perioperative analgesics.

Methods

Following IRB approval, patients 18 years of age or older, were given a 13-question survey prior to their surgery at Thomas Jefferson University Hospital, to evaluate the perception of pain medications, medication efficacy, …

Abdominal-Pelvic Pain In Female Patients With Endometriosis - A Review Of The Literature, Cristinel Dumitru Badiu, Marina Romina Sima, Claudia Mehedintu, Bogdan Mastalier, Mihaela Mandu, Liliana Florina Andronache, Dan Nicolae Paduraru, Anca Mihaela Pantea Stoian, Valentin Titus Grigorean

Journal of Mind and Medical Sciences

Abdominal-pelvic pain is the dominant symptom in endometriosis, one of the most common pathologies that affect women, being also a multifactorial disorder. Exploratory laparoscopy allows the correct assessment of the location as well as severity and extent of the lesions, thus representing the current gold standard in diagnosis. The correlation of pain intensity with the evolutionary stage of endometriosis is inconstant. Surgical treatment, preferably performed laparoscopically, includes the excision of the ectopic endometrium, having as a primary objective the control of persistent pain and the removal of all endometriotic foci. This procedure helps to improve the life quality of the …

Promis Pain Interference Is Superior Vs Numeric Pain Rating Scale For Pain Assessment In Foot And Ankle Patients, David N. Bernstein, Meghan Kelly, Jeff Houck, John P. Ketz, Samuel Flemister, Benedict F. Digiovanni, Judith F. Baumhauer, Irvin Oh

Faculty Publications - College of Physical Therapy

Background: The Numeric Pain Rating Scale (NPRS) is a popular method to assess pain. Recently, the Patient-Reported Outcomes Measurement Information System (PROMIS) has been suggested to be more accurate in measuring pain. This study aimed to compare NPRS and PROMIS Pain Interference (PI) scores in a population of foot and ankle patients to determine which method demonstrated a stronger correlation with preoperative and postoperative function, as measured by PROMIS Physical Function (PF).

Methods: Prospective PROMIS PF and PI and NPRS data were obtained for 8 common elective foot and ankle surgical procedures. Data were collected preoperatively and postoperatively at a …

Use Of A Vietnamese Pain Scale And Report Of Pain Or Discomfort In Vietnamese Patients With Limited English Proficiency During The Post-Operative Period, Kristine Ho

Doctoral Projects

Language and the ability to communicate with the patient are foundational for effective anesthesia/patient relationships (Rosse, Bruijne, Suurmond, Essink-Bot, &Wagner, 2015). The burgeoning population of Vietnamese people in the United States demands implementation of procedures to ensure adequate communication and safe care. The present project sought to determine if the Wong-BakerVietnamese Pain Rating® Scale assisted Vietnamese patients with limited English proficiency to adequately report pain or discomfort relief during the post-operative period. A convenience sample of adults (N = 25) that meet inclusion criteria constituted the sample. Inclusive criteria were patients who were Vietnamese, between the ages of 30 …

Improving Analgesia Administration For Pediatric Patients In A Rural Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

When a child is in pain, parents often seek out treatment at an emergency department. After a detailed chart review it was determined that only 32.53% of the pediatric patients who present to a rural, northern California, ED in pain receive any documented form of analgesia during their time in the ED. A review of the literature revealed that triage nurse-initiated protocols can successfully manage to provide consistent and efficient analgesia to patients who present to an ED with pain. Therefore, a practice improvement project was undertaken to increase of the consistency and efficiency of analgesia administration for pediatric patients …

"Current Anesthesia Education Practices Regarding Music As An Adjunct For Analgesia And Anxiolysis ", Taylor Hull

College of Science and Health Theses and Dissertations

Background: Music has been proven as an effective complementary and alternative medicine, and can be an important tool for nurse anesthetist.

Objectives: The purpose of this project was to assess if nurse anesthesia programs are including music as a part of the complementary and alternative medicine (CAM) curriculum for anxiety and pain in the perioperative setting.

Method: A descriptive survey was sent to program directors of nurse anesthesia programs in the United States to assess the current level of awareness and education regarding music as an alternative medicine as well as barriers to the addition of music into curriculum. …

Cannabis Shenanigans: Advocating For The Restoration Of An Effective Treatment Of Pain Following Spinal Cord Injury., Daniel E. Graves, Phd

Department of Rehabilitation Medicine Faculty Papers

Cannabis is an effective treatment for pain following spinal cord injury that should be available to patients and researchers. The major argument against the rescheduling of cannabis is that the published research is not convincing. This argument is disingenuous at best, given that the evidence has been presented and rejected at many points during the political dialog. Moreover, the original decision to criminalize cannabis did not utilize scientific or medical data. There is tension between the needs of a society to protect the vulnerable by restricting the rights of others to live well and with less pain. It is clear …

A-Type Kv Channels In Dorsal Root Ganglion Neurons: Diversity, Function, And Dysfunction, Benjamin M. Zemel, David M. Ritter, Manuel Covarrubias, Tanziyah Muqeem

Department of Neuroscience Faculty Papers

A-type voltage-gated potassium (Kv) channels are major regulators of neuronal excitability that have been mainly characterized in the central nervous system. By contrast, there is a paucity of knowledge about the molecular physiology of these Kv channels in the peripheral nervous system, including highly specialized and heterogenous dorsal root ganglion (DRG) neurons. Although all A-type Kv channels display pore-forming subunits with similar structural properties and fast inactivation, their voltage-, and time-dependent properties and modulation are significantly different. These differences ultimately determine distinct physiological roles of diverse A-type Kv channels, and how their dysfunction might contribute to neurological disorders. The importance …

Patient-Centered Pain Management Communication From The Patient Perspective, Marie Haverfield, Karleen Giannitrapani, Christine Timko, Karl Lorenz

Faculty Publications

BackgroundPain management discussions between patient and provider can be stressful to navigate and greatly impact the care received. Because of the complexity, emotional color, and sensitivity of pain management, such discussions require a high degree of skill.ObjectiveTo identify patients’ perspectives of patient-centered care communication within the context of pain management discussions.DesignWe conducted semi-structured interviews (25–65 min) with patients regarding their experiences with pain assessment and management.Participants: 36 patients (29 males, 7 females), from 3 Veteran Affairs healthcare locations. Participant age ranged from 28 to 94 with pain intensity ranging from 0 to 10, based on the “pain now” numeric rating …

Current Evidence For Pediatric Triage Pain Protocols In The Emergency Department, Alvin R. Walters

DNP Qualifying Manuscripts

Only 50% of pediatric patients presenting with significant pain receive any form of analgesia while in the emergency department (ED). The American College of Emergency Physicians endorses the use of triage protocols to improve the speed and consistency of analgesia in the ED. However, given the unique needs of the pediatric population insufficient evidence exists, if any, to support the use of triage protocols for their treatment in the ED. After a review of the literature it is concluded that triage pain protocols are a safe and effective method for providing pediatric analgesia in the ED. However, the variability in …

Systemic Lidocaine As An Analgesic Technique In The Perioperative Setting, Joe J. Lennon

Nursing Capstones

No abstract provided.

Genetic Moderation Of Pain And Fatigue Symptoms Resulting From The Mindfulness-Based Stress Reduction For Breast Cancer Program, Carissa Bea Alinat

USF Tampa Graduate Theses and Dissertations

Breast cancer survivors (BCS) account for the largest group of cancer survivors living in the United States and they often experience lingering physical symptoms that may affect quality of life, with fatigue and pain the most commonly reported. This genetic research study was conducted within a parent R01 study, with the purpose of exploring associations between genetic variants and fatigue and pain symptoms and the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program. The aims of this study were to: 1) identify specific genotypes involved in fatigue and pain symptoms, and 2) explore whether single nucleotide polymorphism (SNP) rs1800795 in …

Using A Kindle To Improve Parental Perceptions Of Pain In Their Children: A Dnp Scholarly Project, Andrew Gearhart

DNP Scholarly Projects

Patient satisfaction is an important goal for health care providers, as it is associated with treatment success, and patients are more likely to adhere to medical treatments when they are satisfied. Emergency departments are among the lowest ranked healthcare settings nationwide in terms of patient satisfaction. Pediatric patients often experience pain and/or anxiety while in the hospital setting and are at an increased risk of having unpleasant experiences while receiving care. The purpose of this DNP scholarly project is to determine whether the introduction of a Kindle Fire tablet was effective in decreasing parental perceptions of pain while their child …

Cold Pressor Pain Response In Children With Cancer, Brooke N. Jenkins, Ryan J. Roemer, Ariana Martinez, Tara K. Torres, Michelle A. Fortier

Psychology Faculty Articles and Research

Objective:

The goal of this study was to examine pain responses in pediatric patients with cancer.

Method:

Children (ages 6 to 18) undergoing treatment for cancer (N=68) completed the cold pressor task.

Results:

Average pain tolerance was 118.22 seconds (SD=101.18) and 40% of the children kept their hand in the water the entire 4-minute ceiling. On a 0 to 10 numeric rating scale, children reported a pain severity of 5.07 (SD=3.47) at their first report of pain, a pain severity of 5.94 (SD=3.54) at their maximum report of pain, and a pain severity of 5.33 (SD=3.72) at the time they …

Identification Of Nurse-Controlled Predictors Of Pain In Patients Undergoing A Total Hip Or Total Knee Arthroplasty, Melodie Ruth Daniels

Dissertations

Objectives: The purpose of this study was to examine relationships among nursing interventions and pain status during hospitalization in orthopedic surgical patients receiving total hip or knee arthroplasty in one of four community hospitals in San Diego, California.

Background: The epidemic of opioid-related adverse events creates a need for opioid sparing approaches to pain management. Pain management practices have been studied in relation to medicine; however, the relationship between pain and opioid sparing, nurse-specific interventions is not clear.

Methods: The retrospective descriptive study examined Electronic Health Record (EHR) data of patients (N = 1657) discharged after a total hip …

An Evaluation Of The Treatment Modality And Management Of Acute And Chronic Low Back Pain Individuals In Rural Southeast Kansas, Michele R. Carey

Doctor of Nursing Practice Scholarly Project

Roughly 25 million American adults experience pain, and 23 million others withstand severe assiduous pain that is disabling and results in decrease work productivity, loss of quality of life and diminished health (Meldrum, 2016). Treatment of pain, including chronic and acute low back pain includes a multidisciplinary approach merging cognitive-behavioral, psychological and physical therapies, respite, pain coping management and self-hypnosis (Meldrum, 2016). In 1999, pharmaceutical companies reassured physicians that opioid pain relievers were not addictive, and the prescribing rate began to increase (NIH, 2017). The quantity of opioids being prescribed has quadrupled since 1999 which has led to an increase …

Having Healing Conversations, Lucille Marchand Md, Bsn, Faahpm

Palliative Care Institute

How do we have conversations about pain that are in and of themselves healing? Often, clinicians dread having conversations about pain. This session will introduce a map of how to have healing conversations about this challenging topic. Empathy and responding to emotion are key in healing conversations.

Fascia Iliaca Compartment Block Protocol For Hip Fracture, M. Ray Nordyke

Doctor of Nursing Practice Projects

Fascia iliaca compartment block (FICB) is a volume based block used to treat pain associated with hip fractures. An anesthesia group at a central Illinois hospital expressed interest in the creation of an evidenced-based protocol for FICB. After an extensive literature search an evidence-based protocol was designed. The initial implementation of the protocol was a presentation of an informational PowerPoint which discussed the aspects of the protocol presented to the anesthesia staff and the registered nursing staff who assist the anesthesia providers. The protocol was then evaluated with a Likert scale survey completed by the staff. The results from the …

Neural Mechanisms Of The Rejection-Aggression Link, David S. Chester, Donald R. Lynam, Richard Milich, C. Nathan Dewall

Psychology Faculty Publications

Social rejection is a painful event that often increases aggression. However, the neural mechanisms of this rejection–aggression link remain unclear. A potential clue may be that rejected people often recruit the ventrolateral prefrontal cortex’s (VLPFC) self-regulatory processes to manage the pain of rejection. Using functional MRI, we replicated previous links between rejection and activity in the brain’s mentalizing network, social pain network and VLPFC. VLPFC recruitment during rejection was associated with greater activity in the brain’s reward network (i.e. the ventral striatum) when individuals were given an opportunity to retaliate. This retaliation-related striatal response was associated with greater levels of …

Protocol Development In The Or: Lessons Learned, Megan Sims

Doctor of Nursing Practice Projects

The management of pain in those undergoing a laparoscopic cholecystectomy is complex and challenging. There have been advances in the understanding of the physiology of pain and a wide variety of treatment options are now available. Establishing a preventative multi-modal protocol with different types of pain medications that work on a variety of receptors along the pain pathway is imperative. Through an exhaustive literature review, a preventative multi-modal approach was established and introduced at a small hospital in Central Illinois available for all laparoscopic cholecystectomy patients undergoing surgery over a 10 week implementation period. There was only one completed case …

The Association Between Physiologic Sources Of Pain And Sleep Quality In Older Adults And People With Dementia, Crystal-Rae Evans

Theses and Dissertations

The association between physiologic sources of pain and sleep quality in older adults and people with dementia was examined in this dissertation. Previous research illustrates multiple factors contribute to sleep quality outcomes. Musculoskeletal pain, respiratory distress, gastrointestinal discomfort, and genitourinary pain were examined in relation to sleep quality in older adults and people with dementia. No theory currently exists to guide this nursing research, therefore an illustration of pain and sleep quality in older adults and people with dementia was utilized. Descriptive data analysis and logistic regression were used to address the study aims. The findings from this research illustrate …

The Gift Of Pain With Transformative Possibilities, Richard B. Hovey

Patient Experience Journal

This personal narrative explores the experiences of pain metaphorically as a gift. The intention of this article is to offer alternative ways to reflect on pain, life and taking risks to move from health literacy toward health agency with help. I describe my approach to decision making using the hermeneutic wager which provides a means to imagine possibilities while mindfully assessing risk. Learning to manage pain and learning to live well with pain is a gift that we are not always aware is within our grasp.

Systemic Exercise-Induced Hypoalgesia Following Isometric Exercise Reduces Conditioned Pain Modulation, Ali Alsouhibani, Henrik Bjarke Vaegter, Marie K. Hoeger Bement

Physical Therapy Faculty Research and Publications

Objective

Physically active individuals show greater conditioned pain modulation (CPM) compared with less active individuals. Understanding the effects of acute exercise on CPM may allow for a more targeted use of exercise in the management of pain. This study investigated the effects of acute isometric exercise on CPM. In addition, the between-session and within-session reliability of CPM was investigated.

Design

Experimental, randomized crossover study.

Setting

Laboratory at Marquette University.

Subjects

Thirty healthy adults (19.3±1.5 years, 15 males).

Methods

Subjects underwent CPM testing before and after isometric exercise (knee extension, 30% maximum voluntary contraction for three minutes) and quiet rest in …

Effect On Opioid Use Following The Implementation Of Evidence-Based Pain Management, Kathryn L. Ellens

Doctoral Projects

Pain is the most common reason people seek healthcare. Initiatives to prevent the undertreatment of pain have resulted in overreliance on opioids to treat pain. Despite significant increases in opioid use, pain is more prevalent than ever. Additionally, devastating consequences from opioid use have resulted, such as dependence, addiction, and increasing opioid-related deaths. Research demonstrates multimodal analgesic therapy is an effective alternative to the overreliance on opioids to treat pain. Multimodal analgesia is the synergistic use of two or more analgesics with different mechanisms of action. Multimodal analgesia produces significantly more effective and efficient pain management than opioid-only therapy. This …

Gender And Posture Are Significant Risk Factors To Musculoskeletal Symptoms During Touchscreen Tablet Computer Use, Szu-Ping Lee, Ya-Ting Hsu, Betina Bair, Marissa Toberman, Lung-Chang Chien

Physical Therapy Faculty Publications

[Purpose] To investigate the prevalence of neck and shoulder symptoms during the use of tablet computer, and to identify the risk factors associated with these symptoms. [Subjects and Methods] A cross-sectional survey was conducted to study tablet computer usage, posture during use, and neck and shoulder symptoms in 412 participants in a school setting. Significant risk factors for musculoskeletal symptoms during tablet computer use were identified. [Results] Overall prevalence of musculoskeletal symptoms during tablet computer use was 67.9% with greater prevalence of neck symptoms (neck: 84.6%; shoulder/upper extremity: 65.4%). Significant risk factors associated with symptoms during use were: current musculoskeletal …