M.Tech. / The purpose of this unblinded controlled study was to determine the effective of dry needling of the Vastus Medialis Oblique muscle when utilised in conjunction with conservative chiropractic management for Patellofemoral Pain Syndrome (PFPS). The subjects of the trial were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty patients suffering from chronic Patellofemoral Pain Syndrome were chosen for the study and they were divided into two groups of fifteen. The first group received conservative chiropractic care which consisted of manipulation of the sacroiliac joint, mobilisation of the knee and patella joints and stretching and strengthening exercises consisting of Quadriceps standing self stretch and Quadriceps setting as the strengthening exercise. The second group received the above treatment but also underwent dry needling of the Vastus Medialis Oblique muscle. The objective data for this research was recorded using a lower limb isometric dynamometer and the subjective data was recorded with a pain scale. Both sets of data were recorded on the first, third and fifth treatments. The results of the trial showed that there was a significant increase in strength with a reduction in pain levels for both groups but there was no statistically significant difference when comparing the two groups. The dry needling group did however improve at a faster rate than the other group but it did even out after the five treatments. What was noteworthy is that the males of the study improved their strength by a much greater extent than the females which is uncommon for PFPS. The end result of this study is that overall, dry needling of the Vastus Medialis Oblique muscle is not highly beneficial in the long term management of PFPS but does have its benefits in the early stages of the treatment in order to relieve the acute pain and increase the Quadriceps muscle strength rapidly.

<p>Syftet med denna litteraturstudie var att beskriva äldre människors upplevelser av smärta och vilken smärtbehandling de fick. Metoden var en beskrivande litteraturstudie och för att besvara frågeställningarna genomfördes en litteratursökning i databaserna Cinahl, Science Direct och Medline (Pubmed). Resultatet visade att många av de äldre upplevde smärta på något sätt och ansåg att det var något de måste lära sig leva med. Aktiviteter i hemmet ökade ofta smärtan. Smärtan medförde att den fysiska aktiviteten minskade. Muskuloskeletal smärta var vanligast med smärta i rygg, ben, knän, fötter och höfter. Smärtan ledde till att livskvaliteten minskade och att de äldre blev mer beroende av hjälp. Kvinnor hade mer långvarig smärta och kände sig också mer deprimerade än männen. Äldre var ofta underbehandlade mot smärta och många med svår smärta använde inte smärtstillande läkemedel eller endast en låg dos. En bra läkemedelsbehandling förbättrade aktivitet och sömn. Många var intresserade av icke farmakologisk behandling och att delta i tränings- och avslappningsprogram för att hantera smärtan.</p> / <p>The aim of this study was to describe elderly people's experiences of pain and which treatment of pain they received. To answer the questions a descriptive literature review was made. The literature search was done in the following databases; Cinahl, Science Direct and Medline (Pubmed). The result showed that several of the elderly experienced pain in some way and believed it was something they had to live with. Most of the time activities at home increased the pain there the pain often decreased the physical activity.  The results showed also that musculoskeletal pain in back, legs, knees, feet and hips was most common. Pain resulted in reduced quality of life and the elderly became more dependent of support. Women experienced more chronic pain and were more depressed than men. The elderly was often undertreated against pain and many with difficult pain not used analgesics or only a low dose. A good pharmacological treatment improved activity and sleep. Majority of the elderly was interested of non-pharmacological treatment and to attend relaxation- and training's programs in order to handle the pain.</p>

Syftet med denna litteraturstudie var att beskriva äldre människors upplevelser av smärta och vilken smärtbehandling de fick. Metoden var en beskrivande litteraturstudie och för att besvara frågeställningarna genomfördes en litteratursökning i databaserna Cinahl, Science Direct och Medline (Pubmed). Resultatet visade att många av de äldre upplevde smärta på något sätt och ansåg att det var något de måste lära sig leva med. Aktiviteter i hemmet ökade ofta smärtan. Smärtan medförde att den fysiska aktiviteten minskade. Muskuloskeletal smärta var vanligast med smärta i rygg, ben, knän, fötter och höfter. Smärtan ledde till att livskvaliteten minskade och att de äldre blev mer beroende av hjälp. Kvinnor hade mer långvarig smärta och kände sig också mer deprimerade än männen. Äldre var ofta underbehandlade mot smärta och många med svår smärta använde inte smärtstillande läkemedel eller endast en låg dos. En bra läkemedelsbehandling förbättrade aktivitet och sömn. Många var intresserade av icke farmakologisk behandling och att delta i tränings- och avslappningsprogram för att hantera smärtan. / The aim of this study was to describe elderly people's experiences of pain and which treatment of pain they received. To answer the questions a descriptive literature review was made. The literature search was done in the following databases; Cinahl, Science Direct and Medline (Pubmed). The result showed that several of the elderly experienced pain in some way and believed it was something they had to live with. Most of the time activities at home increased the pain there the pain often decreased the physical activity.  The results showed also that musculoskeletal pain in back, legs, knees, feet and hips was most common. Pain resulted in reduced quality of life and the elderly became more dependent of support. Women experienced more chronic pain and were more depressed than men. The elderly was often undertreated against pain and many with difficult pain not used analgesics or only a low dose. A good pharmacological treatment improved activity and sleep. Majority of the elderly was interested of non-pharmacological treatment and to attend relaxation- and training's programs in order to handle the pain.

M.Tech. / This study compared the effectiveness of two different Chiropractic treatment protocols in the treatment of patellofemoral pain syndrome. This was done in order to establish whether or not core stabilisation exercises play a role in the treatment of patellofemoral pain syndrome. Thirty participants were used for this study. They were randomly placed into two groups namely; group 1 and group 2. Group 1 received strengthening exercises of the quadriceps muscle group and stretching exercises of the hamstring muscles. Group 2 received strengthening of the quadriceps muscle group, stretching of the hamstring muscles and core stabilisation exercises. Six treatments were administered over a period of three weeks with each participant receiving two treatments per week. Prior to the commencement of treatments one, three and six; each participant was objectively measured for quadriceps strength using the isometric dynamometer. The subjective measurements used in this study were the Numerical Pain Rating Scale and the Patellofemoral Joint Evaluation Scale, these were also completed prior to the first, third and sixth treatments. All the collected data was statistically analysed using the one-way Anova test, the Independent-t test and the Paired-t test. The statistical analysis revealed statistical differences on intra-group analysis for both groups involved especially between treatment 3 and treatment 6 for both the objective and subjective measurements. On Inter-group analysis group 2’s subjective and objective measurements improved by a larger amount than group 1’s. It was thus concluded that a combined treatment of quadriceps strengthening, hamstring stretching and core stabilisation exercises was the most effective treatment protocol in individuals suffering from patellofemoral pain syndrome.

The topic of this diploma thesis is ?The Nurse?s Contribution to the Management of Pain Treatment of Patients with a Malignant Disease?. The first objective is to ascertain whether nurses know the specifics of care of patients suffering from a cancer pain. The second objective is to ascertain whether nurses use an analogue score to assess the cancer pain. The third objective is to ascertain whether nurses document the pain intensity. The fourth objective is to ascertain whether nurses use non-pharmacological techniques to relieve cancer pains. The fifth objective is to ascertain whether nurses know the strategy of the WHO?s pain relief ladder. The research was conducted in the form of questioning while using the technique of anonymous structured questionnaires completed by the research set consisting of nurses in selected clinical wards with a high probability of occurrence of patients with an oncologic diagnosis. The total of 360 questionnaires was distributed, of which 198 completed questionnaires were returned. 105 questionnaires (53 %) came from the regional hospital in České Budějovice, 51 (26 %) from the St. Anne?s University Hospital in Brno and 42 (21 %) from the district hospital in Tábor. The research took place in March 2012. The results were assessed under the criteria preset by the author of the thesis. Hypothesis 1: Nurses are able to provide specific nursing care to patients suffering from a cancer pain, was confirmed. Hypothesis 2: Nurses assess the pain under the available analogue scores, was confirmed. Hypothesis 3: Nurses document the pain intensity, was disconfirmed. Hypothesis 4: Nurses use non-pharmacological techniques, especially physical ones, was confirmed. Hypothesis 5: Nurses know the strategy of the WHO?s pain relief ladder, was confirmed. In connection with the addressed issue, an educational leaflet about pain monitoring was drawn up for non-medical healthcare workers. This material describes the most frequently used methods of pain assessment and will serve as an overview of individual procedures including their specifics and application possibilities. The diploma thesis may serve for extending the knowledge of nurses in the field of pain treatment management.

No description available.

<p>U savremenoj hirurgiji imperativ je da hirur&scaron;ka procedura bude efikasna, ali i da obezbedi kvalitetan i brz oporavak. Najbitniji segment operativnog lečenja je obezbediti maksimalan učinak kako bi se osobi omogućio brz i potpun povratak aktivnostima dnevnog života. Posebno je pojačano&nbsp;&nbsp; interesovanje za rekonstrukciju prednjeg ukr&scaron;tenog ligamenta kod mlađe i sporsko aktivne populacije. Trendovi u medicini kao i u ortopedskoj hirurgiji idu u pravcu smanjenja postoperativnog krvarenja, bola i skraćenja postoperativnog oporavka. Supstancija sa antifibrinolitičkim delovanjem, kao &scaron;to je traneksamična kiselina, svakako je na&scaron;la svoje mesto u smanjenju postoperativnog krvarenja. Ciljevi istraživanja su se odnosili na utvrđivanje uticaja lokalno aplikovane traneksamične kiseline tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena na postoperativno krvarenje, posmatrane laboratorijske parametre, mere obima kolena, učestalosti postoperativnih komplikacija i kvaliteta postoperativnog oporavka između dve grupe ispitanika (ispitivana i kontrolna grupa). Studija je bila eksprimentalnog karaktera i sprovedena je u Kliničkom centru Vojvodine u Novom Sadu uz odobrenje etičke komisije. U istraživanje, metodom slučajnog izbora, bila su uključena 124 ispitanika oba pola raspoređena u dve grupe (ispitivana i kontrolna), a kod kojih je indikovana operativno zbrinjavanje prekida prednjeg ukr&scaron;tenog ligamenta kolena i koji su dali pristanak da budu uključeni u studiju. Svi prikupljeni podaci su beleženi u protokol, koji je za ovo istraživanje posebno dizajniran. Ispitanici su bili podvrgnuti operativnom zahvatu, uz primenu op&scaron;te ili spinalne anestezije, sa postavljenom pneumatskom poveskom na operisanom ekstremitetu. Ispitivanoj grupi bilo je lokalno aplikovano 20 ml traneksamične kiseline, dok je u kontolnoj grupi na isti način aplikovano 20 ml NaCl 0,9 % rastvora. Postoperativni gubici krvi su praćeni i beleženi tokom 24 h od operacije, dok su laboratorijki nalazi uzorkovani preoperativno i sedmog postoperativnog dana. U posmatranom periodu (preoperativno, sedmog postoperativnog dana, treće i &scaron;este postoperativne nedelje) kod ispitanika je praćen obim kolena i pojava komplikacija (hematom, hemartroza). Nakon sprovedenog istraživanje, prikupljeni podaci su dokumentovani i statistički obrađeni. Rezultati istraživanja jasno ukazuju da postoji statistički značajna razlika (t=7.181, p&lt;0.001) u količni postoperativnog krvarenja između grupa. Prosečno postoperativno krvarenje u ispitivanoj grupi je bilo 71.29&plusmn;40.76 ml, u odnosu na kontrolnu grupu gde je postoperativno krvarenje iznosilo 154.35&plusmn;81.45 ml. U kontrolnoj grupi, postoperativno se beleže niže vrednosti hemoglobina (t=9.608, p&lt;0.001) i hematokrita (t=8.325, p&lt;0.001), i vi&scaron;e vrednosti trombocita (t=2.201, p=0.032) nego u ispitivanoj grupi. Podaci o postoperativnom bolu ispitanika govore u prilog statistički značajnoj razlici u jačini bola prve nedelje nakon operacije između ispitivane i kontrolne grupe (t=2.405, p=0.018) i treće nedelje nakon operacije (t=3.700, p&lt;0.001). U ispitivanoj grupi zabeležena je ređa pojava hematoma 6.45% (n=4), dok je u kontrolnoj grupi 19.35% (n=12). Svi pacijenti u uzorku su popunili upitnik o postoperativnom kvalitetu oporavka. Nije zabeležena statistički značajna razlika u kvalitetu postoperativnog oporavka nakon operacije između dve analizirane grupe ispitanika. Dobijeni rezultati o postoperativnom krvarenju, nakon aplikovane traneksamične kiseline, ukazuju na efikasnost leka i pri lokalnoj primeni tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena. S obzirom na insuficijentnost podataka, ovo ispitivanje stvara &scaron;iru osnovu za dalja istraživanja.</p> / <p>In modern surgery, we need an effective surgical procedure, which provides quality and rapid recovery. The most important segment of surgical treatment is to provide maximum impact to allow a person to return quickly and fully to the activities of daily living. There has been particular interest in the reconstruction of the anterior cruciate ligament in the younger and sport active population. Trends in medicine, as well as in orthopedic surgery, are heading towards reducing postoperative bleeding, pain, and postoperative recovery. A substance with antifibrinolytic activity, such as tranexamic acid, has certainly found its place in reducing postoperative bleeding. The objectives of the study were to determine the effect of locally applied tranexamic acid during the reconstruction of the anterior cruciate knee ligament on postoperative bleeding, observed laboratory parameters, measures of knee circumference, frequency of postoperative complications, and quality of postoperative recovery between the two groups of subjects (study and control group). The study was prospective, conducted at the Clinical Center of Vojvodina in Novi Sad with the approval of the ethics committee. The study, by random selection method, included 124 subjects of both sexes, divided into two groups (tested and control), which indicated operative management of the anterior cruciate ligament rupture and gave informed consent for inclusion in the study. All data collected were recorded in a protocol, which was specifically designed for this research. Subjects underwent surgery, with general or spinal anesthesia, with pneumatic attachment placed on the extremity undergoing surgery. The test group was given topically 20 ml of tranexamic acid, while the control group was administered 20 ml in the same way. NaCl 0.9% solution. Postoperative blood losses were monitored and recorded within 24 h of surgery, while laboratory findings were sampled preoperatively and on the seventh postoperative day. During the observed period (preoperatively, on the seventh postoperative day, on the third and sixth postoperative weeks), the knee volume and the occurrence of complications (hematoma, hemarthrosis) were monitored in the subjects. Following the survey, the data collected were documented and statistically processed. The study results indicate that there was a statistically significant difference (t = 7.181, p &lt;0.001) in the amount of postoperative bleeding between groups. The mean postoperative bleeding in the study group was 71.29 &plusmn; 40.76 ml, compared to the control group where postoperative bleeding was 154.35 &plusmn; 81.45ml. In the control group, lower hemoglobin values (t = 9.608, p &lt;0.001) and hematocrit (t = 8.325, p &lt;0.001) were observed postoperatively, and higher platelet counts (t = 2.201, p = 0.032) than in the study group. The data on the postoperative pain of the respondents support a statistically significant difference in the severity of pain on the first week after surgery between the study and the control group (t = 2.405, p = 0.018) and the third week after surgery (t = 3.700, p &lt;0.001). In the study group, the incidence of hematoma was less than 6.45% (n = 4), while in the control group it was 19.35% (n = 12). All patients in the sample completed a questionnaire on postoperative quality of recovery. There was no statistically significant difference in the quality of postoperative recovery after surgery between the two analyzed groups of subjects. The results of post-operative bleeding, after administrated tranexamic acid, indicate the efficacy of the drug and at a local application during the reconstruction of the anterior cruciate ligament. Due to the insufficiency of data, this study creates a broad basis for further research.</p>

This research was executed as three separate studies. Study 1 focused on the perception of pain and the semantic aspects of pain. Study 2 focused on the measurement of acute pain and mood states. Study 3 focused on the psychological treatment of cancer pain. In Study 1 a group of 66 Setswana-speaking adults were required to describe what they saw, what happened, and what would be the outcome with respect to three visually presented pain scenes using The Pain Apperception Test (PAT) A qualitative analysis of their responses shows that pain is experienced as an all encompassing experience affecting all aspects of their lives, such as the physical, emotional, social, and economic. This was found to be true, irrespective of gender and age with the exception of economic issues. A qualitative analysis of their responses to the Pain Eliciting Incidents Questionnaire (PEIQ) reveals that the Setswana pain descriptors are classifiable according to the three dimensions of pain namely, the sensory-discriminative, affective-motivational, and cognitive-evaluative. Sludy 2 applied the Profile of Mood States (POMS) preoperatively to a group of 58 female laparotomy (gynaecological) patients. These patients were also tested post-operatively with the Visual Analogue Scale (VAS) and the Wisconsin Brief Pain Questionnaire (WBPQ) as pain measures. The pain measures were taken at no medication and at the peak of medication. Factor analysis could not confirm the validity of the six POMS scales. These scales also did not show correlations with post-operative pain. Correlations between the pain measures showed acceptable reliability and validity of the VAS and the WBPQ. In Study 3 three groups of 15 cancer patients each, suffering from chronic pain, were treated over a period of two weeks with either cognitive behavioural therapy plus medication, reassurance therapy plus medication, or medication only. Comparison of before and after treatment pain measures showed that both cognitive behavioural therapy and reassurance therapy had a beneficial effect. Follow-up results three months later showed that the beneficial effect of reassurance therapy did not persist. Patients treated with cognitive behavioral therapy still showed the beneficial effects thereof. / Psychology / D. Litt. et Phil. (Psychology)

This research was executed as three separate studies. Study 1 focused on the perception of pain and the semantic aspects of pain. Study 2 focused on the measurement of acute pain and mood states. Study 3 focused on the psychological treatment of cancer pain. In Study 1 a group of 66 Setswana-speaking adults were required to describe what they saw, what happened, and what would be the outcome with respect to three visually presented pain scenes using The Pain Apperception Test (PAT) A qualitative analysis of their responses shows that pain is experienced as an all encompassing experience affecting all aspects of their lives, such as the physical, emotional, social, and economic. This was found to be true, irrespective of gender and age with the exception of economic issues. A qualitative analysis of their responses to the Pain Eliciting Incidents Questionnaire (PEIQ) reveals that the Setswana pain descriptors are classifiable according to the three dimensions of pain namely, the sensory-discriminative, affective-motivational, and cognitive-evaluative. Sludy 2 applied the Profile of Mood States (POMS) preoperatively to a group of 58 female laparotomy (gynaecological) patients. These patients were also tested post-operatively with the Visual Analogue Scale (VAS) and the Wisconsin Brief Pain Questionnaire (WBPQ) as pain measures. The pain measures were taken at no medication and at the peak of medication. Factor analysis could not confirm the validity of the six POMS scales. These scales also did not show correlations with post-operative pain. Correlations between the pain measures showed acceptable reliability and validity of the VAS and the WBPQ. In Study 3 three groups of 15 cancer patients each, suffering from chronic pain, were treated over a period of two weeks with either cognitive behavioural therapy plus medication, reassurance therapy plus medication, or medication only. Comparison of before and after treatment pain measures showed that both cognitive behavioural therapy and reassurance therapy had a beneficial effect. Follow-up results three months later showed that the beneficial effect of reassurance therapy did not persist. Patients treated with cognitive behavioral therapy still showed the beneficial effects thereof. / Psychology / D. Litt. et Phil. (Psychology)