163 research outputs found
Subjective outcome related to donor site morbidity after sural nerve graft harvesting: a survey in 41 patients
Gender differences in nerve regeneration after sciatic nerve injury and repair in healthy and in type 2 diabetic Goto-Kakizaki rats
Torsion of an accessory spleen: a rare case preoperatively diagnosed and cured by single-port surgery
Eliciting health state utilities for Dupuytren's contracture using a discrete choice experiment
Background and purpose An internet-based discrete choice
experiment (DCE) was conducted to elicit preferences for a wide
range of Dupuytren’s contracture (DC)-related health states. An
algorithm was subsequently developed to convert these preferences
into health state utilities that can be used to assess DC’s
impact on quality of life and the value of its treatments.
Methods Health state preferences for varying levels of DC
hand severity were elicited via an internet survey from a sample
of the UK adult population. Severity levels were deined using a
combination of contractures (0, 45, or 90 degrees) in 8 proximal
interphalangeal and metacarpophalangeal joints of the index,
middle, ring, and little ingers. Right-handed, left-handed, and
ambidextrous respondents indicated which hand was preferable
in each of the 10 randomly-selected hand-pairings comparing
different DC severity levels. For consistency across comparisons,
anatomically precise digital hand drawings were used. To anchor
preferences onto the traditional 0–1 utility scale used in health
economic evaluations, unaffected hands were assigned a utility
of 1.0 whereas the utility for a maximally affected hand (i.e., all
8 joints set at 90 degrees of contracture) was derived by asking
respondents to indicate what combination of attributes and levels
of the EQ-5D-5L proile most accurately relects the impact of
living with such hand. Conditional logistic models were used to
estimate indirect utilities, then rescaled to the anchor points on
the EQ-5D-5L.
Results Estimated utilities based on the responses of 1,745
qualiied respondents were 0.49, 0.57, and 0.63 for completely
affected dominant hands, non-dominant hands, or ambidextrous
hands, respectively. Utility for a dominant hand with 90-degree
contracture in t h e metacarpophalangeal joints of the ring and
little ingers was estimated to be 0.89. Separately, reducing the
contracture of metacarpophalangeal joint for a little inger from
50 to 12 degrees would improve utility by 0.02.
Interpretation DC is associated with substantial utility decrements.
The algorithms presented herein provide a robust and lexible
framework to assess utility for varying degrees of DC severity
Depression in medical students: insights from a longitudinal study
Background: Factors associated with depression of medical students are poorly understood. The purpose of this study is to determine the prevalence of depression in medical students, its change during the course, if depression persists for affected students, what are the factors associated with depression and how these factors change over time.
Methods: A prospective, longitudinal observational study was conducted at the Medical School of the University of Minho, Portugal, between academic years 2009-2010 to 2012-2013. We included students who maintained their participation by annually completing a questionnaire including Beck Depression Inventory (BDI). Anxiety and burnout were assessed using the State Trait Anxiety Inventory and Maslach Burnout Inventory. Surveys on socio-demographic variables were applied to evaluate potential predictors, personal and academic characteristics and perceived difficulties. ANOVA with multiple comparisons were used to compare means of BDI score. The medical students were organized into subgroups by K-means cluster analyses. ANOVA mixed-design repeated measurement was performed to assess a possible interaction between variables associated with depression.
Results: The response rate was 84, 92, 88 and 81% for academic years 2009-2010, 2010-2011,2011-2012 and 2012/2013, respectively. Two hundred thirty-eight medical students were evaluated longitudinally. For depression the prevalence ranged from 21.5 to 12.7% (academic years 2009/2010 and 2012/2013). BDI scores decreased during medical school. 19.7% of students recorded sustained high BDI over time. These students had high levels of trait-anxiety and choose medicine for anticipated income and prestige, reported more relationship issues, cynicism, and decreased satisfaction with social activities. Students with high BDI scores at initial evaluation with low levels of trait-anxiety and a primary interest in medicine as a career tended to improve their mood and reported reduced burnout, low perceived learning problems and increased satisfaction with social activities at last evaluation. No difference was detected between men and women in the median BDI score over time.
Conclusions: Our findings suggest that personal factors (anxiety traits, medicine choice factors, relationship patterns and academic burnout) are relevant for persistence of high levels of BDI during medical training. Medical schools need to identity students who experience depression and support then, as early as possible, particularly when depression has been present over time.info:eu-repo/semantics/publishedVersio
A new analgesic method, two-minute sciatic nerve press, for immediate pain relief: a randomized trial
<p>Abstract</p> <p>Background</p> <p>Current analgesics have drawbacks such as delays in acquisition, lag-times for effect, and side effects. We recently presented a preliminary report of a new analgesic method involving a two-minute sciatic nerve press, which resulted in immediate short-term relief of pain associated with dental and renal diseases. The present study investigated whether this technique was effective for pain associated with other disease types, and whether the relief was effective for up to one hour.</p> <p>Methods</p> <p>This randomized, placebo-controlled, parallel-group trial was conducted in four hospitals in Anhui Province, China. Patients with pain were sequentially recruited by participating physicians during clinic visits, and 135 patients aged 15 – 80 years were enrolled. Dental disease patients included those with acute pulpitis and periapical abscesses. Renal disease patients included those with kidney infections and/or stones. Tumor patients included those with nose, breast, stomach and liver cancers, while Emergency Room patients had various pathologies. Patients were randomly assigned to receive a "sciatic nerve press" in which pressure was applied simultaneously to the sciatic nerves at the back of both thighs, or a "placebo press" in which pressure was applied to a parallel region on the front of the thighs. Each fist applied a pressure of 11 – 20 kg for 2 minutes. Patients rated their level of pain before and after the procedure.</p> <p>Results</p> <p>The "sciatic nerve press" produced immediate relief of pain in all patient groups. Emergency patients reported a 43.5% reduction in pain (p < 0.001). Significant pain relief for dental, renal and tumor patients lasted for 60 minutes (p < 0.001). The peak pain relief occurred at the 10 – 20<sup>th </sup>minutes, and the relief decreased 47% by the 60<sup>th </sup>minutes.</p> <p>Conclusion</p> <p>Two minutes of pressure on both sciatic nerves produced immediate significant short-term conduction analgesia. This technique is a convenient, safe and powerful method for the short-term treatment of clinical pain associated with a diverse range of pathologies.</p> <p>Trial registration</p> <p>Current Controlled Trials ACTRN012606000439549</p
Psychosocial health risk factors and resources of medical students and physicians: a cross-sectional study
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