OBJECTIVE: To investigate the relationship between the weight-adjusted waist index (WWI) and acute, subacute pain or chronic pain among American adults. METHODS: There was a cross-sectional study. Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) concerning waist circumference, weight, pain status and covariates (age, gender, race, marital status, education level and income, physical activity, alcohol consumption, smoking status, and diabetes) were extracted for analysis. Multinomial Logistic regression was conducted across the three models to investigate the associations between WWI and acute, subacute and chronic pain. Model 1 did not involve any adjustments. Model 2 involved adjustments for age, gender, race, marital status, education level, and income. Model 3 was further adjusted for physical activity, alcohol consumption, smoking, and diabetes status. RESULTS: This study involved 12 694 participants with an average age of (50.6±18.7) years. Among all the participants, 9 614 people (75.74%) had no pain, 870 people (6.85%) experienced acute pain, 354 people (2.79%) suffered from subacute pain, and 1 856 people (14.62%) experienced chronic pain. The WWI of all the participants was (10.95±0.85) cm/$\sqrt{\mathrm{kg}}$, divided into four groups based on quartiles: Group Q1 (7.90-10.36) cm/$\sqrt{\mathrm{kg}}$, group Q2 (10.37-10.94) cm/$\sqrt{\mathrm{kg}}$, group Q3 (10.95-11.53) cm/$\sqrt{\mathrm{kg}}$ and group Q4 (11.54-15.20) cm/$\sqrt{\mathrm{kg}}$. With the increase of WWI, the analysis revealed a significant statistical difference in the participants' acute and chronic pain status (all P < 0.001). In Model 1, the prevalence of acute pain was lower in group Q2 and group Q4 compared with group Q1 (group Q2: OR=0.765, 95%CI: 0.615-0.953, P=0.017; group Q4: OR= 0.648, 95%CI: 0.503-0.835, P < 0.001). Compared with group Q1, the prevalence of chronic pain increased in group Q2, group Q3, and group Q4 (group Q2: OR =1.365, 95%CI: 1.149-1.622, P < 0.001; group Q3: OR=1.291, 95%CI: 1.082-1.541, P=0.005; group Q4: OR=1.874, 95%CI: 1.579-2.224, P < 0.001). In Model 2, compared with group Q1, an increase in chronic pain prevalence was still associated with an increase in WWI in other three groups (group Q2: OR=1.359, 95%CI: 1.137-1.624, P=0.001; group Q3: OR=1.260, 95%CI: 1.039-1.528, P=0.019; group Q4: OR=1.735, 95%CI: 1.413-2.132, P < 0.001). In Model 3, group Q4 had a 49.2% increased prevalence of chronic pain compared to group Q1 (OR = 1.492, 95%CI: 1.208-1.842, P < 0.001). However, in Models 2 and 3, no significant relationship was observed between acute pain and WWI (all P>0.05). And none of the three models identified a significant association between subacute pain and WWI (all P>0.05). CONCLUSION For American adults, there was no significant correlation between WWI and acute pain or subacute pain. However, as WWI increases, so does the prevalence of chronic pain. Further validation of this conclusion through large-scale prospective studies is warranted.
Humans ; Cross-Sectional Studies ; Middle Aged ; Male ; Female ; Adult ; Waist Circumference ; Chronic Pain/epidemiology* ; Aged ; Nutrition Surveys ; Pain/epidemiology* ; Body Weight ; Logistic Models ; Body Mass Index

BACKGROUND: The aim of this study was to investigate the clinical characteristics of complex regional pain syndrome (CRPS) in young male patients in South Korea, especially focusing on the association with military service. METHODS: From January 2007 to May 2017, we investigated the electronic medical records of 430 consecutive patients, aged 18 to 30 years, who visited Seoul National University Hospital Pain Center, with a suspected diagnosis of CRPS at the initial visit. The following patient details were available for analysis: demographic and disease-related variables, relevance to military service, medications, and the treatment modalities received. RESULTS: Out of 430 patients, 245 (57.0%) were diagnosed with CRPS, of which, 200 were male patients and 45 were female patients. Of the male patients, 95 (47.5%) developed CRPS during military service. CRPS during military service was more likely to result from sprain/strain, and the incidence of CRPS was significantly higher in the lower extremities in patients from the military service group than in those from the non-military service group. During the follow-up period, 37.9% of male CRPS patients (n = 61/161) were treated successfully. Patients with moderate to severe initial pain intensity, and diagnosed during their military service, showed better outcomes. CONCLUSIONS: Our results demonstrated that manifestation of CRPS in the young Korean population was more common in male and among those male CRPS patients, about half the cases developed during the military service period.
Chronic Pain ; Diagnosis ; Electronic Health Records ; Epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Military Medicine ; Military Personnel ; Neuralgia ; Pain Clinics ; Retrospective Studies ; Seoul ; Stress, Psychological

PURPOSE: The aims of this study was to evaluate the effects of acceptance and commitment therapy (ACT) for chronic pain patients. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched the Cochrane Library, CINAHL, EMBASE, OVID, PubMed and Korean databases to identify randomized controlled trials published through May 2019. To estimate the effect size, a meta-analysis of the studies was performed using the R program, and the risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies. RESULTS: A total of 11 studies were included in this study. Studies were heterogeneous, and random effects models were used in the analyses. ACT was effective for improving pain (g=−0.40, 95%CI:−0.69~−1.12, p<.001, I2=80%), pain acceptance (g=1.24, 95% CI:0.41~2.05, p<.001, I²=95%), anxiety (g=−0.47, 95% CI:−0.81~−0.13, p<.001, I²=84%), depression (g=−0.52, 95% CI:−0.85~−0.19, p<.001, I²=85%), and quality of life (g=1.14, 95% CI:0.11~2.17, p<.001, I²=95%). CONCLUSION: Our study findings of the ACT seems to be effective for improving pain, pain acceptance, anxiety, depression, and quality of life in patients with chronic pain. Additionally, ACT may be useful for reducing barriers to therapy, and various studies should be attempted.
Acceptance and Commitment Therapy ; Anxiety ; Bias (Epidemiology) ; Chronic Pain ; Depression ; Humans ; Quality of Life

BACKGROUND: Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer. METHODS: Data of 232 patients who underwent single port -VATS (n=131) or triple port VATS (n=101) for non-small cell lung cancer (NSCLC) on January 1, 2016 to June 30, 2017 in our hospital were analyzed. The clinical and operative data were assessed, numeric rating scale (NRS) was used to evaluate the mean pain score on the 1th, 2th, 3th, 7th, 14th days, 3th months and 6th months postoperative. RESULTS: Both groups were similar in clinical characteristics, there were no perioperative death in two groups. In the 1th, 2th, 7th, 14th days and 3th, 6th months postoperative, the NRS score of the single port group was superior, and the difference was significant compared with the triple port (P<0.05). There was no statistically significant difference between the two groups in operative time, blood loss, postoperative hospitalization time, duration of chest tube, the NRS scores in the 3 d (P>0.05). Univariate and multivariate analysis of the occurrence on the chronic pain showed that the operation time, surgical procedure and the 14th NRS score were risk factors for chronic pain (P<0.05). CONCLUSIONS The single port thoracoscopic surgery has an advantage in the incidence of acute and chronic pain in patients with non-small cell lung cancer. Shorter operative time can reduce the occurrence of chronic pain. The 14th day NRS score is a risk factor for chronic pain postoperative.
Acute Pain ; epidemiology ; etiology ; Aged ; China ; Chronic Pain ; epidemiology ; etiology ; Female ; Humans ; Lung Neoplasms ; complications ; surgery ; Male ; Middle Aged ; Pain, Postoperative ; epidemiology ; etiology ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; methods

INTRODUCTIONAnxiety sensitivity has been proposed as a psychological vulnerability factor for post-traumatic stress disorder (PTSD). Studies have also supported the protective role of resilience for overcoming the negative effects of trauma exposure. Given the linkages between anxiety sensitivity, resilience, trauma exposure and post-traumatic stress, this study explored the potential moderating roles of anxiety sensitivity and resilience on the association between trauma history and PTSD symptoms in a sample of individuals with chronic pain.

MATERIALS AND METHODSA total of 100 patients with chronic pain were recruited from a large public hospital. Patients who had pain lasting for more than 3 months and a pain intensity rating of at least 4/10 were included. The study participants were administered measures of PTSD symptoms (PTSD Checklist - Civilian Version), resilience (Brief Resilient Coping Scale) and anxiety sensitivity (Anxiety Sensitivity Index).

RESULTSAn analysis of outcome measures indicated that anxiety sensitivity and resilience were independently associated with PTSD symptoms, where βs were 0.57 and -0.23, respectively. The relationship between trauma and PTSD symptom severity was also moderated by anxiety sensitivity. Trauma history was associated with higher PTSD symptom severity only in those with high anxiety sensitivity. However, contrary to the hypotheses, resilience did not serve as a moderator.

CONCLUSIONThere are potential benefits of PTSD interventions that increase resilience and decrease anxiety sensitivity in individuals with chronic pain, especially for those who have experienced a traumatic event. Given that the presence of PTSD symptomatology in chronic pain populations negatively impact patient well-being, it would be important for clinicians to assess, monitor and treat PTSD in individuals with chronic pain.

Anxiety ; epidemiology ; psychology ; Chronic Pain ; epidemiology ; psychology ; Humans ; Psychological Trauma ; epidemiology ; psychology ; Resilience, Psychological ; Risk Factors ; Severity of Illness Index ; Singapore ; epidemiology ; Stress Disorders, Post-Traumatic ; epidemiology ; psychology

INTRODUCTIONBrucellosis is a public health problem that is prevalent in several developing countries.

METHODSThe clinical and laboratory characteristics of 164 cases of brucellosis in Bursa, Turkey, were retrospectively evaluated.

RESULTSThe ages of the 164 patients ranged from 15-85 years. All of the patients underwent the Rose Bengal test and 163 (99.4%) patients tested positive. 122 (74.4%) patients were diagnosed with acute brucellosis, 31 (18.9%) with subacute brucellosis and 11 (6.7%) with chronic brucellosis. Focal involvement was found in 101 (61.6%) patients. Although patients with focal involvement had a higher white blood cell count (p = 0.002), those without focal involvement had higher aspartate transaminase and alanine transaminase values, and lower platelet values (p = 0.005, 0.007 and 0.039, respectively). Spondylodiscitis was observed on imaging in 58 (66.7%) of the 87 patients who presented with back pain. Among the 118 patients who were examined within the first month of treatment, 79 (66.9%) responded to treatment. The relapse rate was 11.6% among all 164 patients.

CONCLUSIONBrucellosis should be considered as a differential diagnosis among patients who present with fever, and joint or back pain. Focal involvement should be investigated in the presence of leucocytosis, and subacute or chronic forms of brucellosis. To identify cases of spondylodiscitis, radiography should be performed in patients who present with back pain.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Back Pain ; diagnosis ; Brucellosis ; diagnosis ; epidemiology ; therapy ; Chronic Disease ; Diagnosis, Differential ; Female ; Fever ; Humans ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Risk Factors ; Turkey

PURPOSE: This descriptive study aims to describe the levels of mobility in community-dwelling older Koreans with chronic illnesses, and to examine the associations of their mobility with sleep patterns, physical activity and physical symptoms including fatigue and pain. METHODS: The participants were a total of 384 community-dwelling older adults recruited from three senior centers in Seoul, Korea. Measures included mobility assessed using 6-minute walk test (6MWT), physical activity behavior, sleep profiles, fatigue and pain. Data were collected from July to December 2012. RESULTS: The mean 6MWT distance was 212.68 meters. Over 90% of the study participants (n = 373) were classified as having impaired mobility using 400 meters as the cutoff point diagnostic criteria of normal mobility in 6MWT. The 6MWT distance was 246.68 meters for participants in their 60s, 212.32 meters for those in their 70s, and 175.54 meters for those in their 80s. Significant predictors of mobility included younger age, taking mediation, regular physical activity, female gender, higher income, higher fatigue and better perception on sleep duration, which explained 18% of the total variance of mobility. CONCLUSION: A high-risk group for mobility limitation includes low income, sedentary older men who are at risk for increased fatigue and sleep deficit. Further research should incorporate other psychological and lifestyle factors such as depression, smoking, drinking behavior, and/or obesity into the prediction model of mobility to generate specific intervention strategies for mobility enhancement recommendations for older adults.
Aged ; Aged, 80 and over ; Chronic Disease/*epidemiology ; Cross-Sectional Studies ; Fatigue/epidemiology ; Female ; Humans ; Independent Living/*statistics & numerical data ; Male ; *Mobility Limitation ; Motor Activity ; Pain/epidemiology ; Risk Factors ; Seoul/epidemiology ; Sleep ; Surveys and Questionnaires

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.
Antidepressive Agents ; Chronic Pain ; Citalopram ; Dopamine ; Epidemiology* ; Fibromyalgia ; Fluvoxamine ; Headache ; Humans ; Nausea* ; Norepinephrine ; Psychiatry ; Psychophysiologic Disorders ; Serotonin ; Sertraline ; Treatment Failure ; Vomiting* ; Weight Gain*

BACKGROUNDIn clinical practice, the mechanisms underlying chronic post-surgical pain (CPSP) remain insufficiently understood. The primary goals of this study were to determine the incidence of chronic pain after thoracic surgery and to identify possible risk factors associated with the development of chronic post-thoracotomy pain in Chinese patients. The secondary goal was to determine whether the difference between pre- and post-operative white blood cell (WBC) counts could predict the prevalence of CPSP after thoracotomy. The impact of chronic pain on daily life was also investigated.

METHODSWe contacted by phone 607 patients who had undergone thoracotomy at our hospital during the period February 2009 to May 2010. Statistical comparisons were made between patients with or without CPSP.

RESULTS

RESULTSwere ultimately analyzed from 466 qualified patients. The overall incidence of CPSP was 64.5%. Difference between pre- and post-operative WBC counts differed significantly between patients with or without CPSP (P < 0.001) and was considered as an independent risk factor for the development of CPSP following thoracotomy (P < 0.001). Other predictive factors for chronic pain included younger age (< 60 years, P < 0.001), diabetes mellitus (P = 0.023), acute post-operative pain (P = 0.005) and the duration of chest tube drainage (P < 0.001). At the time of interviews, the pain resulted in at least moderate restriction of daily activities in 15% of the patients, of which only 16 patients had paid a visit to the doctor and only three of them were satisfied with the therapeutic effects.

CONCLUSIONSChronic pain is common after thoracotomy. WBC count may be a new independent risk factoring surgical patients during peri-operative period. Besides, age, diabetes mellitus, acute post-operative pain, and duration of chest tube drainage may also play a role in chronic post-surgical pain occurrence.

Adult ; Aged ; Chronic Pain ; epidemiology ; etiology ; Drainage ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Pain, Postoperative ; epidemiology ; etiology ; Prevalence ; Risk Factors ; Thoracotomy ; adverse effects

OBJECTIVETo compare the advantages and disadvantages of laparoscopic versus open appendectomy in patients with chronic appendicitis.

METHODSTwo hundred twenty- four patients were divided into laparoscopic group (n=98) and open appendectomy group (n=126) according to individual willing. Prospective non- randomized study was performed to compare the operative time, operative bleeding, hospitalization time, the discovery and management concerned in operation. Abdominal pain in these chronic appendicitis cases was followed up.

RESULTSThe operative time was (54.8+/-21.8) min in open group and (51.8+/-18.0) min in laparoscopic group (t=0.80,P > 0.05). The operative bleeding was (18.6+/-23.3) ml in open group and (9.8+/-4.7) ml in laparoscopic group (t=3.13, P < 0.05). The hospitalization time was (8.9+/-5.3) d in open group and (6.8+/-3.0) d in laparoscopic group (t=2.66,P < 0.05). Twenty- five cases had abdominal adhesion in laparoscopic group, including 9 cases of adhesion around appendix, 6 cases of adhesion between ileocecum and anterior or lateral abdominal wall, 4 cases of adhesion between epiploon and abdominal wall or intestines, 6 cases of adhesion around colon and others. All adhesion had been dissected. Fourteen cases adhesion around appendix had been discovered in 126 cases of open group and dissected (chi(2) =7.95,P < 0.05). In follow- up research, 24 cases still had chronic abdominal pain in 98 case of open group, and 9 cases had chronic abdominal pain in 87 of laparoscopic group, the difference was significant (chi(2)=6.29,P < 0.05).

CONCLUSIONThe laparoscopic appendectomy possesses more advantages in treating chronic appendicitis and can decrease the incidence of chronic abdominal pain after operation.

Abdominal Pain ; etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendectomy ; adverse effects ; methods ; Appendicitis ; surgery ; Child ; Chronic Disease ; Female ; Humans ; Incidence ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Prospective Studies ; Treatment Outcome ; Young Adult