The Effects of Self–Pain Management on the Intensity of Pain and Pain Management Methods in Arthritic Patients

The aims of this study were to investigate the effects of pain management education on the intensity of pain and frequency of utilization of pain management methods in two groups of patients with arthritis of different pathogenesis and clinical features, and to compare whether a significant difference existed between the two groups. The study was carried out between September 2007 and June 2008 on 30 female patients with gonarthrosis and 30 female patients with rheumatoid arthritis (RA) followed at the rheumatology outpatient clinic of a university hospital. Data on sociodemographic characteristics and those related with the illness were collected using a special survey. Each patient was given information about the features, causes, and treatment of the arthritis and how to cope with pain, emphasizing the importance of pain management methods. The intensity of pain and efficacy of pain management methods were assessed using the McGill Pain Questionnaire and the Pain Management Inventory at baseline and the second and sixth weeks after the education. The SPSS (v15.0) statistical package was used for statistical analysis. After education, significant improvements in pain intensity scores compared with baseline scores were observed in both groups (p < .05), and there was no significant difference between the RA and gonarthrosis groups. Among the various pain management methods, the education program led to significantly more utilization of massaging the painful area, exercising, and using complementary methods to control stress in both groups of patients, and there was no significant difference between the groups. In conclusion, the pain management education given in this study alleviated the intensity of pain and significantly increased the use of some pain management methods in both gonarthrosis and RA cases.     

Invited Commentary on “The Report to Congress on the Management of Traumatic Brain Injury in Children”

The Centers for Disease Control and Prevention (CDC) published “The Report to Congress on the Management of Traumatic Brain Injury in Children” in the spring of 2018. The report is a call to action for professionals providing care for children with traumatic brain injury in the health, social, and educational sectors and for researchers, administrators, and agencies to develop strategies to improve outcomes. For pediatric rehabilitation providers there are clear opportunities to improve service delivery for individual patients and for the population of children after traumatic brain injury more generally. Notably there is a workforce shortage, and fragmentation exists among the various systems that serve children with traumatic brain injuries and their families.     

Opioids for the Management of Dyspnea in Cancer Patients: Evidence of the Last 15 Years—A Systematic Review

The objective of this study was to review the evidence on the use of opioids for treatment of the dyspnea in adult cancer patients. A systematic literature review was conducted in the databases MEDLINE, CINAHL (EBSCO), ScienceDirect, and Cochrane Library of trials testing the effect of opioids in relieving dyspnea in cancer patients. Fourteen trials met the criteria for inclusion in the review. Eight randomized trials and six nonrandomized trials. All randomized clinical trials analyzed present risks of bias. Morphine has been the most studied strong opioid showing efficacy in alleviating dyspnea when administered, either orally or subcutaneously, in cancer patients. The potential benefit of the strong opioids in the alleviation of dyspnea in cancer patients is modest and limited to some opioids. More studies are needed to sufficiently support the role of opioids in dyspnea at rest, at exertion, and for breakthrough dyspnea and to clarify the safety issues.     

The Unique Management of Cystic Fibrosis–Related Diabetes and the Importance of Glycemic Control

Cystic fibrosis (CF) is a rare autosomal recessive lung disease that decreases the ability of chloride channels to function properly, leading to complications such as salt loss and mucus accumulation in different organs. Mucus accumulation leads to lung infections and decreased pancreatic function, nutrition, and sperm production. Treatment developments have prolonged the median life expectancy, but, with increasing age, a condition known as CF-related diabetes (CFRD) is more likely to develop. CFRD is a distinct condition that is different from type 1 and type 2 diabetes in key ways, including its pathophysiology, diagnosis, and management. It is essential for nurse practitioners in the primary-care setting to recognize these differences, because CFRD is becoming more common in CF patients. Obtaining glycemic control and recognizing its importance in patients with CFRD is especially significant, because glycemic control is correlated with lung function. This review focuses on recognizing CFRD and the rationale behind treatment differences.     

Management of dyspepsia—The role of the ED Observation unit to optimize patient outcomes

Background

Dyspepsia is a common complaint that can confer significant burden on one's quality of life and may also be associated with serious underlying conditions. The objective of this study was to determine if patients admitted to the emergency department observation unit (EDOU) for severe or persistent dyspepsia would have cost effective management in terms of investigations performed, length and cost of hospital stay. The secondary objective was to determine if any patient characteristics could predict a need for admission to the inpatient unit.

The effectiveness of “Protex” for disinfection of the ultrasound probe

The aim of this study was to evaluate the effectiveness of “Protex” (Parker; Fairfield, NJ, USA) for disinfection of ultrasound probes. We examined bacterial contamination on ultrasound probes that were wiped with a plain paper towel, with a plain and an ethanol-soaked paper towel, or with a plain and Protex-soaked paper towel. The plain paper towel was used to remove the gel, and was contaminated by large numbers of bacteria, but the use of ethanol-soaked paper towels and that of paper towels soaked in Protex? broad-spectrum disinfectant (Parker: Fairfield, NJ, USA) reduced those numbers markedly.