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Journal Der Deutschen Dermatologischen... Jul 2024Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged...
BACKGROUND
Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged procedures under local anesthesia. The purpose of this study was to assess pain during dermatologic surgery, describe perioperative pain management, and identify factors that influence pain perception.
PATIENTS AND METHODS
This prospective, monocentric study included inpatients undergoing dermatologic surgery under local anesthesia from April to December 2021. Preoperative demographic data, a pain questionnaire, and four psychometric questionnaires (PCS, LOT-R, SFQ, PHQ-9) were collected. Postoperative pain and analgesic use during the first 24 hours were recorded.
RESULTS
A total of 120 patients (with a total of 191 interventions) were included in the study. Mean postoperative pain was reported to be very low (NRS < 2). Preoperative pain and expected postoperative pain were found to be predictive of postoperative pain. There was a strong correlation between catastrophizing and preoperative anxiety (r = 0.65) and a moderate correlation between depression and preoperative anxiety (r = 0.46).
CONCLUSIONS
Dermatologic surgery under local anesthesia is generally considered painless. During preoperative counseling and assessment, attention should be paid to patients who fear surgery, report pain, or anticipate postoperative pain, as they have an increased risk of experiencing postoperative pain.
PubMed: 38958392
DOI: 10.1111/ddg.15435 -
Brazilian Journal of Medical and... 2024This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted...
This study explored the association between loneliness and mental health among nurses in China during the COVID-19 pandemic. This cross-sectional study was conducted from March to April 2022. We enrolled 2,811 nurses from a tertiary hospital in China. Demographic characteristics, lifestyle factors, work-related factors, and psychological characteristics were collected from participants via a self-reported questionnaire. Loneliness was measured with the three-item short form of the Revised UCLA Loneliness Scale, and the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7) scale were used to measure mental health. Adjusted odds ratios (ORs) and 95% confidence intervals (CI) were determined using binary logistic regression. Among participants in this study, 12.0% (337) experienced loneliness, and 7.8% (219) and 6.7% (189) reported depression and anxiety, respectively. The loneliness scores were categorized into three levels (3, 4-6, and 7-9). For depression, compared with the lowest reference, the ORs and 95% CI across the tertile were 1.31 (0.69-1.84) and 2.53 (1.11-5.76) after adjustment, respectively, and the P-value for trend was 0.045. For anxiety, compared with the lowest reference, the ORs and 95%CI across the tertile were 1.84 (1.28-2.63) and 2.52 (1.57-4.10) after adjustment, respectively; the P-value for trend was 0.004. This study showed that loneliness was significantly associated with poor mental health among nurses during the COVID-19 pandemic. These findings suggested that medical establishments should offer interventions for nurses to prevent mental health problems by targeting this modifiable risk factor.
Topics: Humans; Loneliness; Cross-Sectional Studies; Female; China; COVID-19; Adult; Male; Mental Health; Depression; Nurses; Middle Aged; SARS-CoV-2; Anxiety; Surveys and Questionnaires; Risk Factors; Pandemics
PubMed: 38958366
DOI: 10.1590/1414-431X2024e13408 -
Journal of Clinical Sleep Medicine :... Jul 2024Sleep disturbances are common in neurodevelopmental disorders (NDDs), affecting patients and caregivers' quality of life. -associated syndrome, a rare NDD, is marked by...
STUDY OBJECTIVES
Sleep disturbances are common in neurodevelopmental disorders (NDDs), affecting patients and caregivers' quality of life. -associated syndrome, a rare NDD, is marked by intellectual disability, developmental delay, epilepsy, and sleep issues. However, research on sleep quality in these individuals is limited. This study aimed to evaluate genetic variants, epilepsy, and sleep patterns in -associated syndrome patients and their caregivers.
METHODS
An online survey was applied to 11 caregivers of individuals diagnosed with SYNGAP1-associated syndrome. Specific clinical inquiries were included, addressing childbirth, previous surgeries, and medication use. Inquiries about epilepsy included type of epilepsy, type and frequency of seizures, anti-seizure medications, and complementary non-pharmacological treatments. Children's Sleep Habits Questionnaire (CSHQ) was applied to assess the patients' sleep profile. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of caregivers.
RESULTS
Genetic analysis showed heterozygous mutations in , often leading to loss of function. Epilepsy was present in 82% of participants, with 77.8% having drug-resistant seizures. Using the Children's Sleep Habits Questionnaire (CSHQ), 81.8% of patients exhibited poor sleep habits, including bedtime resistance, anxiety, night awakenings, parasomnias, and daytime sleepiness. Caregivers also reported poor sleep quality according to the Pittsburgh Sleep Quality Index (PSQI).
CONCLUSIONS
This study highlights the high prevalence of epilepsy and sleep problems in -associated syndrome, impacting both patients and caregivers. Further research is crucial to understand the syndrome's effects on sleep disturbances, emphasizing the need for targeted interventions to improve sleep quality in individuals with rare genetic syndromes and their caregivers.
PubMed: 38958060
DOI: 10.5664/jcsm.11246 -
The Laryngoscope Jul 2024Tympanostomy tube insertion (TTI) under local anesthesia (LA) is gaining popularity but literature comparing long-term outcomes for children undergoing TTI under LA...
OBJECTIVES
Tympanostomy tube insertion (TTI) under local anesthesia (LA) is gaining popularity but literature comparing long-term outcomes for children undergoing TTI under LA versus general anesthesia (GA) is limited. This study compares the long-term quality of life (QoL) between LA and GA in children undergoing TTI. Secondary objectives included long-term behavioral changes, parental satisfaction, tube durability, and postoperative complications.
METHODS
We prospectively followed children aged under 6 who underwent TTI, under LA or GA, 2 years prior. We assessed QoL using validated scales (OM6, PedsQL), analyzed behavioral changes and parental satisfaction through qualitative scales, and retrieved data on tube durability and non-immediate complications.
RESULTS
A total of 84 children (LA = 42; GA = 42) had complete data and a minimum of 1 year of follow-up. Demographic data were similar, except for younger patients in the LA group (1.4 vs. 1.9 years, p = 0.02). LA group exhibited increased fear of health care professionals following TTI (LA: Likert scale 2.1/5, GA: 1.5/5, p = 0.04). Tube retention rate was shorter in the LA group (at 15 months: GA:72%, LA:50%, p = 0.039). Two years post-TTI, there were no differences regarding QoL (OM-6 score; LA: 15.2/100, GA: 21.4/100, p = 0.18, and PedsQL score; LA: 84.3/100, GA: 83.8/100, p = 0.90), parental satisfaction with anesthesia (GA: 4.5/5, LA: 4.6/5, p = 0.56), and postoperative complications (GA: 3/42, LA: 7/42, p = 0.18).
CONCLUSIONS
TTI under LA in children is associated with an increased fear of health care professionals and shorter functionality of tympanostomy tubes as compared to GA. No difference was observed in long-term QoL, parental satisfaction, and complications rate.
LEVEL OF EVIDENCE
Level 3 Laryngoscope, 2024.
PubMed: 38958053
DOI: 10.1002/lary.31611 -
Aesthetic Surgery Journal Jul 2024An important factor which underlines the clinical significance of vaginal laxity presence is the association of the latter with the female sexual function. Male...
BACKROUND
An important factor which underlines the clinical significance of vaginal laxity presence is the association of the latter with the female sexual function. Male sexuality can also be affected by vaginal laxity.
OBJECTIVES
We aimed to investigate the effect of vaginoplasty on a cohort of women, who underwent the respective procedure under the indication of vaginal laxity/impaired sexual function. At the same time, it is very important to evaluate the sexual satisfaction of partners after vaginal tightening.
METHODS
Fifty women who underwent vaginoplasty and their male partners (n=50) were included in the study. State-Trait Anxiety Inventory (STAI) and Female Sexual Function Index (FSFI) were performed to female patients three months before and after the treatment. Also, male partners were asked for their sexual functions by International Index of Erectile Function-5 (IIEF-5) three months before and after the treatment. A 5-question questionnaire inquiring about pleasure status was administered to the male partners using a four-point Likert scale.
RESULTS
Post-treatment STAI THE STATE and STAI THE TRAIT scores of the female patients were statistically significantly lower than their pre-treatment scores (52.5 vs 32, p<0.001; 56 vs 44, p<0.001, respectively). The post-treatment FSFI score of the female patients was significantly higher than their pre-treatment score (19.2 vs 29.7, p<0.001).
CONCLUSIONS
Our results demonstrated significant improvement in the sexual function of males and females and additionally, a significant decrease in the indices of the temporary anxiety levels and the inherent predisposition for anxiety disorders after vaginoplasty.
PubMed: 38957918
DOI: 10.1093/asj/sjae144 -
Journal of the Indian Society of... Apr 2024Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial.
BACKGROUND
Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments.
AIM
The aim of this study was to compare 1 m/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects.
MATERIALS AND METHODS
In this cross-over trial, 15 children aged 6-8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week.
RESULTS
All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment.
CONCLUSION
0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.
Topics: Humans; Nitrous Oxide; Midazolam; Child; Administration, Intranasal; Cross-Over Studies; Hypnotics and Sedatives; Dexmedetomidine; Conscious Sedation; Male; Female; Dental Anxiety; Anesthesia, Dental; Anesthetics, Inhalation; Dental Care for Children; Child Behavior; Pulpectomy
PubMed: 38957912
DOI: 10.4103/jisppd.jisppd_104_24 -
Journal of the Indian Society of... Apr 2024Both precooling the site and injecting a warm anesthetic solution have proven to be efficient in reducing pain individually. However, there is insufficient data on... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
A comparative evaluation of the efficiency of warm local anesthetic solution delivered on precooled injection sites with the conventional local anesthetic technique in 7-9-year-old children: A randomized split-mouth cross-over trial.
BACKGROUND
Both precooling the site and injecting a warm anesthetic solution have proven to be efficient in reducing pain individually. However, there is insufficient data on evaluating the efficiency of precooling the site of injection along with the simultaneous administration of a warm local anesthetic solution on the same site in a single patient.
AIM
The aim of this study was to evaluate and compare the efficacy, pain perception, hemodynamic changes, and adverse effects of a warm local anesthetic solution injected on precooled injection sites using 2% lignocaine with the conventional local anesthetic technique during inferior alveolar nerve block in 7-9-year-old children.
METHODS
A split-mouth, double-blinded, randomized clinical trial was conducted on 70 children who received 2% lignocaine with either technique A or B during the first or second appointment of the treatment procedure. The pain perception, anesthetic efficacy, pulse rate, oxygen saturation levels, and adverse events were evaluated.
RESULTS
Pain during injection and treatment after administration of the warm local anesthesia (LA) technique was less as compared to the conventional block technique. Anesthetic success was observed with a faster onset of action (212.57 ± 32.51 s) and shorter duration of LA (165.16 ± 33.09 min) in the warm local technique as compared to the conventional technique. No significant differences were found with regard to heart rate and oxygen saturation levels between the two techniques. Administrating warm LA solutions at precooled injection sites revealed fewer adverse events.
CONCLUSION
Injecting warm LA solution on precooled injection sites causes less discomfort and anxiety in children, which makes it more suitable for the child as well as the pediatric dentist.
Topics: Humans; Child; Anesthetics, Local; Double-Blind Method; Anesthesia, Dental; Female; Male; Lidocaine; Cross-Over Studies; Anesthesia, Local; Injections; Nerve Block; Pain Measurement; Hot Temperature; Pain Perception; Mandibular Nerve
PubMed: 38957910
DOI: 10.4103/jisppd.jisppd_52_24 -
Journal of the Indian Society of... Apr 2024Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam.
METHODOLOGY
Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05.
RESULTS
Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05).
CONCLUSIONS
The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.
Topics: Humans; Pit and Fissure Sealants; Child; Rubber Dams; Dental Anxiety; Male; Female; Child Behavior; Pain Measurement; Heart Rate; Dental Caries
PubMed: 38957909
DOI: 10.4103/jisppd.jisppd_127_24 -
Journal of the Indian Society of... Apr 2024The escalating concern over Internet gaming disorder (IGD) among children underscores the urgency of comprehending its determinants and links to mental health,...
BACKGROUND
The escalating concern over Internet gaming disorder (IGD) among children underscores the urgency of comprehending its determinants and links to mental health, particularly for interventions targeting school-aged children.
AIM
This study aimed to evaluate the prevalence and determinants of IGD and its association with depression, anxiety, and behavior among 8-12-year-old children attending private schools in Salem city.
SETTINGS AND DESIGN
A cross-sectional study involving 780 children aged 8-12 years from Salem district was conducted. Schools were randomly sampled, and data were collected through a self-administered questionnaire.
MATERIALS AND METHODS
Data were gathered from children without genetic, systemic, or mental disorders and brain trauma. The questionnaire, adapted from Alhamoud M A et al. (2022), encompassed sections on sociodemographic characteristics, gaming behavior, and scales for assessing IGD, depression, and anxiety. Administration occurred during school hours with a 30-35 min completion time.
STATISTICAL ANALYSIS USED
Data analysis utilized SPSS v23.0, including descriptive statistics, ANOVA, Chi-square tests for intergroup comparisons, and Pearson's correlation coefficient to determine associations.
RESULTS
The prevalence of IGD in Salem district was 1.2%, with higher rates of anxiety and depression observed among older children, particularly males.
CONCLUSIONS
A positive correlation was evident between IGD, anxiety, and depression. Urgent preventive measures have to be warranted to curb the rising trend of IGD, such as limiting screen time and promoting outdoor activities to enhance children's overall health.
Topics: Humans; Child; India; Male; Cross-Sectional Studies; Prevalence; Female; Depression; Internet Addiction Disorder; Anxiety; Surveys and Questionnaires; Schools; Video Games; Behavior, Addictive
PubMed: 38957906
DOI: 10.4103/jisppd.jisppd_27_24 -
Frontiers in Psychology 2024As a topic of widespread concern in the fields of mental health and public health, social anxiety has many negative impacts on the physical and mental health of...
OBJECTIVE
As a topic of widespread concern in the fields of mental health and public health, social anxiety has many negative impacts on the physical and mental health of contemporary college students. Therefore, this study aims to provide new ideas for solving the problem of social anxiety among college students by exploring the potential mediating role of social support and psychological capital in the relationship between physical activity and social anxiety.
METHODS
A cross-sectional survey was conducted on 874 college students from five universities in Shandong Province. Various self-report tools such as physical activity rating scale, social support scale, positive psychological capital scale, and social anxiety scale were used to collect information needed for this study. Related data. Use this to conduct descriptive statistical analysis, correlation analysis, and mediation effect analysis.
RESULTS
The results showed that physical activity was significantly positively correlated with college students' social support ( = 0.354, < 0.01) and psychological capital ( = 0.448, < 0.01), and social support was significantly positively correlated with psychological capital ( = 0.556, < 0.01), the above three are significantly negatively correlated with social anxiety ( = -0.326, -0.381, -0.432, < 0.01); the mediation effect analysis shows that physical activity has a significant direct effect on college students' social anxiety The effect value is -0.136, accounting for 43.31% of the total effect; social support and psychological capital both play a separate mediating role between physical activity and social anxiety among college students, with effect values of -0.064 and -0.073 respectively, accounting for the total effect. 20.38, 23.25%, and also played a chain intermediary role, with an effect value of -0.041, accounting for 13.05% of the total effect.
CONCLUSION
Current research shows that physical activity can not only directly reduce social anxiety among college students, but also indirectly alleviate social anxiety among college students by increasing the level of social support and psychological capital. This has important reference significance for helping college students in China and even around the world overcome social anxiety.
PubMed: 38957885
DOI: 10.3389/fpsyg.2024.1406452