Micronized palmitoylethanolamide/trans-polydatin treatment of endometriosis-related pain: a meta-analysis

Aim. To demonstrate clinical effectiveness of micronized palmitoylethanolamide-transpolydatin combination in reducing endometriotic chronic pelvic pain. Other endometriotic- pains were also assessed. Methods. Systematic reviews of PubMed, SCIELO, Scopus, and AJOL. Randomized trials and observational studies reporting a visual analogue scale for pain or similar in endometriotic patients were reviewed. A mean improvement of visual analogue scale (or visual analogue scale-like) scores at enrollment and at a three-month follow-up was assessed and interpreted clinically. Results. Four studies of poor quality were available. In a heterogeneous sample of endometriotic patients with pain, the administration of micronized palmitoylethanolamide/ trans-polydatin (400 mg/40 mg) twice a day for three months provided a clinically relevant improvement of chronic pelvic pain and dysmenorrhea while improving deep dyspareunia to a limited degree. No clinically relevant improvement was found for dyschezia. Conclusion. More studies are warranted for assessing the drugs-related efficacy

A comparative study of aesthetic perceptions of malocclusion among general practice dentists, orthodontists and the public using a visual analogue scale (VAS) and the IOTN-AC

Perception of malocclusion varies among individuals and among patients and practitioners. Although several indices that tend to coincide in many aspects and unify criteria, no single index has been recognised as the most suitable for assessing orthodontic treatment need. Moreover, orthodontists are not always aware of the differences in perception of malocclusion between patients and practitioners. To examine the perception of dental anaesthetics amongst dentists, orthodontists and the general population, study the relationship between the perception of dental aesthetics and the severity of the malocclusion, using the visual analogue scale and the IOTN-AC, and investigate relationships among the resulting data. Frontal intraoral photographs of 24 cases were classified by the severity of their malocclusion according to the DAI index. The photographs were examined by 150 individuals (30 orthodontists, 30 general dental practitioners and 90 members of the general population), who assessed them on a visual analogue scale and according to the IOTN-AC. The orthodontists gave the lowest scores on the visual analogue scale, although the differences between the three groups were not significant. For DAI grades 1, 3 and 4, significant differences were found in the IOTN-AC assessments. Here too, the orthodontist group was the most critical. In general, in all three groups, both the visual analogue scale and IOTN-AC scores increased or decreased in line with the severity of the malocclusion according to the DAI. However, the correlation between these scores was low. The orthodontists scored the malocclusions more critically than the general dentists or the general population with the IOTN-AC, but this difference was not found with the visual analogue scale

Interval-level measurement with visual analogue scales in Internet-based research: VAS Generator

The present article describes VAS Generator (www.vasgenerator.net), a free Web service for creating a wide range of visual analogue scales that can be used as measurement devices in Web surveys and Web experimentation, as well as for local computerized assessment. A step-by-step example for creating and implementing a visual analogue scale with visual feedback is given. VAS Generator and the scales it generates work independently of platforms and use the underlying languages HTML and JavaScript. Results from a validation study with 355 participants are reported and show that the scales generated with VAS Generator approximate an interval-scale level. In light of previous research on visual analogue versus categorical (e.g., radio button) scales in Internet-based research, we conclude that categorical scales only reach ordinal-scale level, and thus visual analogue scales are to be preferred whenever possibl

Pengaruh Calf Stretching Terhadap Penurunan Nyeri Plantar Fascia Pada Pasien Plantar Fasciitis di RSUD Dr. Moewardi Surakarta

Background: Plantar fasciitis is a condition of a strong tissue is supporting the arch of the foot becomes irritated or inflamed. This strong tissue is named plantar fascia, a thick bundle of tissue extending along the soles of the feet from the heel to the bottom of the five toes. One of the problems that usually arise due to plantar fasciitis is tightness and limitation of motion in the calf muscle and ankle which can cause increased pressure on the plantar fascia. Objective: To determine the benefits of calf stretching in reducing plantar fascia pain in plantar fasciitis patients. Research Method: This type of research is quasi experiment, which is using Single-Case Research approach to evaluate the effect of the treatment with single or case-study. The research design used was ABA, the first A is A1 which is the initial state where the measurement of pain with Visual Analogue Scale (VAS), B is the treatment of calf stretching and second A is A2, a measurement of pain using Visual Analogue Scale (VAS) after giving calf stretching exercise. Results: A measurement used Visual Analogue Scale (VAS) and Foot Function Index (FFI) showed a decrease in pain scale between pre-test and post-test in calf stretching group, and no decrease in pain scale in non-calf stretching group. Conclusion: Calf stretching can reduce plantar fascia pain in plantar fasciitis patients. Keywords: plantar fascia, plantar fasciitis, Visual Analogue Scale, Foot Function Index, calf stretching

Is there a case for using Visual Analogue Scale valuations in Cost-Utility Analysis?

This paper critically reviews theoretical and empirical propositions regarding visual analogue scale (VAS) valuations of health states and their use in Cost Utility Analysis. An oft-repeated conclusion in the economic evaluation literature is the inferiority, on theoretical grounds, of VAS valuations. Common criticisms are that VAS lacks a theoretical foundation; that VAS values are not ‘choice based’; that VAS values are not consistent with utility-under-uncertainty requirements; and that context and range effects observed in VAS valuation data mean that they cannot even be considered to represent measurable value functions. We address each of the above points, critically reviewing the economic and psychometric literature relating to theories of utility and theories of utility measurement, and the welfarist and non-welfarist literature relating to social choices and QALYs. We conclude that there are strong grounds, both theoretical and empirical, for challenging the apparently emerging consensus that VAS valuations should not be used in economic assessments. The theoretical appeal of alternatives such as the standard gamble is valid only at the level of individuals, rather than social decision-making. Further, the non-welfarist foundations of CUA do not require health state valuations to be grounded in any particular theory of utility, suggesting that the selection of the appropriate valuation method should be based on empirical performance. The VAS has important advantages over rival techniques such as standard gamble and time trade-off. However, we identify a number of areas in which further research is required to establish and consolidate the potential of VAS as a valuation method

The Comparison of Gabapentin and Amitriptilin Effectivity as Pain Therapy in Herniated Nucleus Pulposus

Herniated nucleus pulposus (HNP) is one of peripheral neuropathic pain. Although concensus guidelines for the treatment of neuropathic pain are based on the results of the RCT studies, there are still gaps in the literatures. This study aimed to compare the effectiveness and quality of life of gabapentin and amitriptyline for the treatment of pain in HNP. The method used a quasi experimental with consequtive sampling. This study included 30 patients in the gabapentin group and 26 patients in the amitriptyline group, and each group was evaluated for 1 month. Effectiveness was assessed using Visual Analogue Scale (VAS) every 2 weeks then analized by independent and paired sample t test. The results showed that the use of gabapentin and amitriptilin in 4 weeks showed the decrease of pain score measured by visual analog scale 3.70 ± 0.349 and 3.500 ± 0.34 although there was no statistical difference (p value = 0.704). To sum up, effectiveness of gabapentin and amitriptyline in the treatment of neuropathic pain did not have statistical difference

Improved quality of life in patients with refractory or recidivant ascites after insertion of transjugular intrahepatic portosystemic shunts

Background. We have recently shown that the transjugular intrahepatic portosystemic shunt (TIPS) is more effective than paracentesis in the treatment of cirrhotic patients with severe ascites and can prolong survival in selected patients. Although an improved quality of life (QOL) has been suggested in these patients after the TIPS procedure, so far there are no data available to substantiate this assumption. Therefore, the aim of this study was to determine the effect of TIPS on the QOL in cirrhotic patients with refractory or recidivant ascites. Methods: 21 cirrhotic patients who underwent TIPS for refractory or recidivant ascites were investigated. All patients were pretreated with repeated paracentesis for at least 1 year. Before the procedure and at 3 and 6 months during follow-up, the patients themselves rated QOL, fatigue and physical performance on a visual analogue scale (range 0-100). Furthermore, QOL was determined by the QOL index (range 0-10) according to Spitzer. Results: Patients' rating of the QOL on the visual analogue scale significantly increased from 35 +/- 25 (baseline) to 64 +/- 28 (3 months), and 66 +/- 24 (6 months; p = 0.02). Similarly, the QOL index significantly increased from 6.9 +/- 2.0 (baseline) to 8.3 +/- 2.1 (3 months), and 8.6 +/- 1.7 (6 months; p < 0.001). The increase of QOL was more pronounced in patients with complete response to TIPS. Conclusions: We demonstrate that TIPS for refractory or recidivant ascites improves the QOL in patients with cirrhosis. Our data indicates that this improvement is dependent on the response to therapy. Copyright (C) 2002 S. Karger AG, Basel

Visual analogue scales for pain assessment in Alzheimer's disease

Background: In earlier studies, pain assessment in patients with Alzheimer’s disease (AD) was conducted by interview, for which reliability is questionable considering the decline in expressive and receptive language abilities in AD. As similar language problems occur in young children, the reliability of pain assessment in this latter population is increased by employing visual analogue scales. Objective: By employing visual analogue scales, the current study investigated whether (1) nondemented elderly persons and AD patients comprehend the purpose of the scales and (2) AD patients, compared to nondemented elderly persons, report suffering less pain intensity and pain affect. Methods: Three visual analogue scales, i.e. the Colored Analogue Scale (CAS), the Faces Pain Scale (FPS), and the Facial Affective Scale (FAS) were administered to patients in an early and midstage of AD and to nondemented elderly persons. Results: The results show that the percentage of subjects who comprehended the CAS, FAS and FPS was for the nondemented elderly persons 100, 75 and 100%, respectively, for the early AD group 100, 50 and 60%, respectively, and for the midstage AD group 80, 20 and 30%, respectively. Furthermore, elderly persons without dementia reported experiencing more intense pain and pain affect than the early and midstage AD group. Interestingly, the early and midstage AD patients did not differ in reporting pain affect. Conclusion: Visual analogue scales may improve pain assessment in those AD patients who fully comprehend the meaning of the scales. As only the minority of midstage AD patients understood the purpose of the FAS and FPS, the search for tools, particularly to assess pain affect in this population, must continue

Assessing acute itch intensity : general labelled magnitude scale is more reliable than classic visual analogue scale

The reliable measurement of itch intensity is crucial, both in research as well as clinical contexts. For example, when the reliability of a measurement scale is unknown, it is impossible to determine whether a patient has changed sufficiently to be confident that the change is beyond that which could be attributed to measurement error (1). One factor that might influence the reliability of measurements is the type of rating scale used to assess itch intensity. Previous research (2-4) has documented the retest reliability of different rating scales for assessing chronic itch intensity. However, a retest reliability analysis of rating scales for acute experimental itch, induced using substances such as histamine or cowhage, is currently lacking. Here, we compare the test-retest reliability of three rating scales commonly used for this purpose. First, we considered the visual analogue scale in its classic form (cVAS), where participants indicate itch intensity on a line ranging from 0 (no itch) to 100 (the most intense itch imaginable). Second, we included a variant of the VAS, where an additional ‘Scratch Threshold’ marker is set at 33% (tVAS,5), defined as itching strong enough to be scratched (6). Finally, we considered the general Labelled Magnitude Scale (gLMS,7), where participants judge the magnitude of itch on a line with quasilogarithmically placed labels of “no sensation” at 0, “barely detectable” at 1, “weak” at 6, “moderate” at 17, “strong” at 35, “very strong” at 53 and “strongest imaginable sensation” at 100. Thus, all three scales have an identical range, but differ in the type and number of verbal labels provided

Quality of life with ivabradine in patients with angina pectoris

Background—To explore the effect of ivabradine on angina-related quality of life (QoL) in patients participating in the Study Assessing the Morbidity–Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) QoL substudy. Methods and Results—QoL was evaluated in a prespecified subgroup of SIGNIFY patients with angina (Canadian Cardiovascular Society class score, ≥2 at baseline) using the Seattle Angina Questionnaire and a generic visual analogue scale on health status. Data were available for 4187 patients (2084 ivabradine and 2103 placebo). There were improvements in QoL in both treatment groups. The primary outcome of change in physical limitation score at 12 months was 4.56 points for ivabradine versus 3.40 points for placebo (E, 0.96; 95% confidence interval, –0.14 to 2.05; P=0.085). The ivabradine−placebo difference in physical limitation score was significant at 6 months (P=0.048). At 12 months, the visual analogue scale and the other Seattle Angina Questionnaire dimensions were higher among ivabradine-treated patients, notably angina frequency (P&#60;0.001) and disease perception (P=0.006). Patients with the worst QoL at baseline (ie, those in the lowest tertile of score) had the best improvement in QoL for 12 months, with improvements in physical limitation and a significant reduction in angina frequency (P=0.034). The effect on QoL was maintained over the study duration, and ivabradine patients had better scores on angina frequency at every visit to 36 months. Conclusions—Treatment with ivabradine did not affect the primary outcome of change in physical limitation score at 12 months. It did produce consistent improvements in other self-reported QoL parameters related to angina pectoris, notably in terms of angina frequency and disease perception