• Title/Summary/Keyword: Symptom Distress

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Chronic postsurgical pain: current evidence for prevention and management

  • Thapa, Parineeta;Euasobhon, Pramote
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.155-173
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    • 2018
  • Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

A Case of Mediastinal Teratoma Complicated by Spontaneous Rupture into Pleural Cavity (종격동 기형종의 흉막강내로의 자연 파열 1예)

  • Lee, Tae-Hoon;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.265-271
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    • 1999
  • Patients with mediastinal teratoma are usually asymptomatic, but may develop symptoms by rupture into adjacent structures which result in pneumonia, hemoptysis, pleural effusion, pericardial effusion, or pneumothorax. Rarely, life-threatening acute respiratory distress require a emergency surgery. Rupture into pleural cavity may result in pleuritis and pleural effusion with severe anterior chest or back pain. The symptom must be differentiated from other common intrathoracic distress diseases. Clinical, cytologic and radiologic examinations of pleural effusion, and moreover, measurement of enzymes such as amylase or insulin, which is secreted from pancreatic tissues, in pleural effusion and cystic fluid enabled us to make the diagnosis of rupture of mediastinal teratoma preoperatively.

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Changes in the Laterality of Functional Connectivity Associated with Tinnitus: Resting-State fMRI Study

  • Shin, Yeji;Ryu, Chang-Woo;Jahng, Geon-Ho;Park, Moon Suh;Byun, Jae Yong
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.1
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    • pp.55-64
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    • 2019
  • Purpose: One of the suggested potential mechanisms of tinnitus is an alteration in perception in the neural auditory pathway. The aim of this study was to investigate the difference in laterality in functional connectivity between tinnitus patients and healthy controls using resting state functional MRI (rs-fMRI). Materials and Methods: Thirty-eight chronic tinnitus subjects and 45 age-matched healthy controls were enrolled in this study. Connectivity was investigated using independent component analysis, and the laterality index map was calculated based on auditory (AN) and dorsal attention (DAN), default mode (DMN), sensorimotor, salience (SalN), and visual networks (VNs). The laterality index (LI) of tinnitus subjects was compared with that of normal controls using region-of-interest (ROI) and voxel-based methods and a two-sample unpaired t-test. Pearson correlation was conducted to assess the associations between the LI in each network and clinical variables. Results: The AN and VN showed significant differences in LI between the two groups in ROI analysis (P < 0.05), and the tinnitus group had clusters with significantly decreased laterality of AN, SalN, and VN in voxel-based comparisons. The AN was positively correlated with tinnitus distress (tinnitus handicap inventory), and the SalN was negatively correlated with symptom duration (P < 0.05). Conclusion: The results of this study suggest that various functional networks related to psychological distress can be modified by tinnitus, and that this interrelation can present differently on the right and left sides, according to the dominance of the network.

Risk Factors of the Masticatory Function in Patients with Temporomandibular Disorders: A Cross-Sectional Cohort Study

  • Kim, Keon-Hyung;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.92-102
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    • 2019
  • Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

Lateral Thoracic Expansion Surgery for Jeune's Syndrome (Jeune 증후군 환아에게 시행한 외측 흉벽 확장술)

  • Kim Joon Bum;Moon Il Hong;Choi Byung Min;Lee Kee Hyoung;Choi In Cheol;Park Seung Il
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.873-877
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    • 2005
  • Jeune's asphyxiating thoracic dystrophy is a rare, complex malformation with a broad spectrum of clinical expression. The degree of chest wall deformity is the most important prognostic factor and the only part which is correctable. A 11 month-old male infant was diagnosed as having Jeune's syndrome and received right side lateral thoracic expansion surgery. But because respiratory distress symptom was sustained postoperatively, we performed left side procedure 3 months after the initial operation. Respiratory distress symptom got worse after fracturing the left titanium plate which was inserted to fix the expanded thoracic wall and reimplantation was performed. The patient was discharged 6 months after the initial operation. He was readmitted and received ventilator care for respiratory failure and died 10 months after the initial operation.

Effects of Telephone Counseling on Health and Service Satisfaction after Discharge in Gynecologic Cancer Women (퇴원 후 전화상담중재가 부인암환자의 지각된 건강상태, 심리적 안녕과 간호만족도에 미치는 효과)

  • Park, Young-Sook;Han, Kyung-Ja;Ha, Yang-Sook;Song, Mi-Soon;Kim, Sung-Jae;Chung, Chae-Weon;Park, Yeon-Hwan;Koh, Chin-Kang;Kwon, Won-Kyung;Lee, Joo-Young;Hwang, Shin-Woo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.2
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    • pp.294-304
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    • 2008
  • Purpose: Cancer patients experience a range of physical and psychological sequelae. Consistent nursing support should be provided along the cancer treatment path. This study aimed to i)examine the effects of a telephone counseling program after discharge on perceived health, psychological well-being, and satisfaction with nursing services, and ii)describe symptom distress and their coping methods. Method: The study was a quasi-experimental design with a non-equivalent pre-post test. The sample included 20 women with gynecologic cancer in the experimental group and the same in the control group from a university hospital in Seoul. The telephone intervention was given once from 5 to 7 days after the chemotherapy. The General Well-Being Schedule and Symptom Distress Scale were used. Result: An effect from telephone counseling was found only in the vitality subscale of psychological well-being. Other subscores, perceived health, or satisfaction with nursing services did not differ between the two groups. Pain, skin change, decreased appetite, and constipation were the major symptoms and a relatively few coping strategies were utilized. Conclusion: Protocol of telephone counseling led by a nurse needs to be further developed in regard to best timing, amount, and target effects for follow-up care of gynecologic cancer patients.

Medical-and-Psychosocial Factors Influencing on the Quality of Life in Patients with Cervix Cancer (자궁경부암환자의 삶의 질에 영향을 미치는 치료관련 및 심리사회적 요인)

  • Chun, Mi-Son;Lee, Eun-Hyun;Moon, Seong-Mi;Kang, Seung-Hee;Ryu, Hee-Sug
    • Radiation Oncology Journal
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    • v.23 no.4
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    • pp.201-210
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    • 2005
  • Purpose: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. Materials and Methods: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. Results: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life ($R^2=0.633$ F:16.959, p=.000). Cancer stage, symptom distress, mood disturbance, social support(family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. Conclusion: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

Distribution of Pattern Identification According to BMI in Functional Dyspepsia Patients and Analysis of Frequently Used Herbal Medicines: A Retrospective Chart Review (기능성소화불량 환자의 BMI에 따른 변증 유형 분포 및 다빈도 처방 분석 : 후향적 차트 리뷰)

  • Chae-Rim Yoon;Chang-Yul Keum;Aram Han;Su-Hyun Choi;Su-Hyun Choi;Dahee Jeong;Hae-in Jeong;Na-Yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.645-660
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    • 2023
  • Objectives: This study analyzed the clinical characteristics of patients with functional dyspepsia (FD) who received Korean medicine treatment. Methods: A retrospective chart review was conducted to investigate sociodemographic characteristics, clinical characteristics, and prescribed treatments. The clinical records of 192 patients who visited Kyung Hee University Korean Medicine Hospital for FD from May 1, 2022, to May 31, 2023, were analyzed. In addition, the distribution of pattern identification and symptom type according to body mass index (BMI), as well as prescription history, were analyzed. Results: As the degree of obesity increased, the proportion of Spleen-Qi deficiency pattern patients decreased (p=0.012), and the proportion of damp-phlegm pattern patients increased (p=0.000). Additionally, as the degree of obesity increased, the proportion of patients with excess differentiation increased (p=0.002). The PDS (Postprandial distress syndrome) symptom type was significantly more frequent in the underweight and normal groups than in the overweight and obese groups, and the EPS (Epigastric pain syndrome) symptom type was more frequent in the overweight and obese groups. Regardless of the type of pattern identification, the most frequently used prescriptions were Naesowhajung-tang, Hanshin Naeso-san, and Sojeokgunbi-hwan granule. Conclusion: This study analyzed the medical records of patients with FD to elucidate the use of Korean medicine treatments. Our study is meaningful in that we found that the distribution of pattern identification and symptom patterns are linked to the degree of obesity in FD patients and identified the tendency for herbal medicine treatments to be prescribed in clinical practice.

Comparison of Clinical Courses According to the Existence of Patent Ductus Arteriosus in Respiratory Distress Syndrome (신생아 호흡곤란 증후군에서 동맥관 개존 동반유무에 따른 임상적 경과 비교)

  • Seong, Ju Hee;Lee, Hyeon Joo;Hong, Hyun Kee;Bae, Chong-Woo;Choi, Yong-Mook
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1080-1084
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    • 2003
  • Purpose : To compare perinatal characteristics, clinical courses, and overall morbidity between respiratory distress syndrome(RDS) with patent ductus arteriosus(PDA) and RDS without PDA in neonates. Methods : Eighty-three neonates who were diagnosed and treated for RDS in the neonatal intensive care unit(NICU) from Jan. 2000 to Dec. 2002 were included in this study. RDS was complicated with PDA(group A) in 17 patients and not complicated in 66(group B). PDA was diagnosed by echocardiogram in neonates with congestive heart failure symptom, cardiac murmur or chest X-ray findings of cardiomegaly or pulmonary edema. A retrospective study was undertaken of the perinatal characteristics and overall morbidity in group A and group B. Results : The birth weight and gestational periods of group A were less compared with group B. There was more perinatal asphyxia in group A. Incidence of overall morbidity such as bronchopulmonary dysplasia, intraventricular hemorrhage and death was higher in group A. Intravenous indomethacin was administered in 17 PDA infants. Conclusion : The perinatal characteristics in the two groups showed a significant difference. Incidence of overall morbidity in the two groups showed significant differences, however, there is no simple conclusion to draw because we didn't do multifactorial analyses to rule out other many risk factors affecting morbidity, such as gestational weeks or birth weight.

The Prevalence, Subtypes and Risk Factors of Irritable Bowel Syndrome by ROME III among Korean University Students (ROME III에 의한 국내 대학생의 과민성 장 증후군의 유병률, 증상유형 및 위험요인)

  • Park, Mi-Jung;Lee, Kyung-Sook;Jeong, Jae-Sim;Kim, Joo-Hyun;Choi, Jung-An;Shin, Gi-Soo;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.13 no.1
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    • pp.61-71
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    • 2011
  • Purpose: The purpose of the present study was to investigate the prevalence, subtypes and risk factors of irritable bowel syndrome by ROME-III among Korean university students. Methods: This study was descriptive survey research. The sampls were 796 and variables were measured by structured questionaire. Rome-III criteria was used for diagnosis of IBS. The gathered data were analyzed with %, $x^2$-test, t-test, logistic regression by SPSS win 17.0. Results: The students with IBS were 61 (7.7%) and the most of the subtype was IBS-M (42.6%). Meal (times/day), breakfast, stress, quality of sleep, neuroticism, bodily pain, general health, social function, role emotional restriction, mental health, somatization, obcessive-compulsive state, depression, anxiety, hostility, global severity index, positive symptom distress index, positive symptom were significantly different between IBS group and non-IBS group. The prevalence of IBS was low in the higher score of role emotional in general health state. There were more 2 times students who had score of the obsessive-compulsive in psychological health over the 50 than below the 50 in IBS group. Conclusion: 7.7% of students were diagnosed by Rome-III criteria and the most of the sybtype was IBS-M. The risk factors of IBS were role emotional restriction, obsessive-compulsive state.