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Major Clinical Features and Epidemic Characteristics of Erosive Vulvar Lichen Planus: A Retrospective Analysis

International Journal of Dermatology And Venereology 2024年第2期7卷 94-98页

作者： Shao Ya-Kun Sun Kai-Lyu Yang Min Liu Wan Fu Yu Chang Jian-Min Department of Dermatology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing China.

Objective: Vulvar lichen planus (VLP), especially erosive VLP (EVLP), seriously affects women’s physiological function and quality of life. A retrospective analysis of erosive vulvar lichen planus (EVLP) was performed to raise awareness on this chronic, deforming, and painful vulvar disease.Methods: This observational retrospective study involved 40 patients with EVLP among 1,368 patients with vulvar disease from 2017 to 2020. The patients’ vulvar clinical features and extravulvar mucosal involvement were investigated. The patients’ pain and quality of life were evaluated with the numeric rating scale and the Dermatology Life Quality Index (DLQI), respectively. Clinical characteristics were reported using frequencies and proportions for categorical variables. Continuous variables are expressed as mean ± standard deviation. The association between NRS score for pain and DLQI score was analyzed by Pearson’s correlation test.Results: EVLP accounted for 2.9% (40/1,368) of all cases of vulvar disease, and the median age at onset was 42 years. Erosion mostly occurred on the labia minora and introitus. Half (20/40) of the patients had extravulvar mucosal involvement. Seventeen (42.5%) patients had oral lichen planus, and seven (17.5%) patients were diagnosed with vulvovaginal-gingival syndrome. The numeric rating scale score showed that 47.5% (19/40) of patients experienced mild pain, whereas 12.5% (5/40) described the pain as severe. Thirty-one patients (77.5%, 31/40) had dyspareunia, and nine patients had aggravated pain after sexual intercourse. The mean DLQI score was 9.1 ± 6.0, with 37.5% (15/40) of patients indicating that EVLP had severely affected their lives. The numeric rating scale score for pain was significantly correlated with the DLQI score (P = 0.007).Conclusion: EVLP can affect the quality of women’s lives and cause severe deformations and painful architectural changes. The description of the characteristics of EVLP in this report will benefit the diagnosis and early treatment of this disease.

关键词： erosive vulvar lichen planus multiple mucosal involvement pain assessment quality of life Dermatology Life Quality Index numeric rating scale

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Effect of Verbal Instructions in pain assessment during a Passive Straight Leg Raise Test in People with Chronic Low Back pain

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Open Journal of Therapy and Rehabilitation 2022年第4期10卷 189-197页

作者： Masae Ikeya Takumi Jiroumaru Hitomi Bunki Michio Wachi Noriyuki Kida Teruo Nomura Department of Physical Therapy Biwako Professional University of Rehabilitation Higashiomi Japan Department of Applied Biology Graduate School of Science and Technology Kyoto Institute of Technology Kyoto Japan Department of Physical Therapy Bukkyo University Kyoto Japan Kanazawa Orthopedic & Sports Medicine Clinic Ritto Japan

The most prevalent issue in physical therapy is pain. Due to the subjective nature of pain, assessment tools are essential in understanding it as objective data. However, assessment of pain may result in distress for the patient. A physical therapist (PT) should conduct these tests as quickly and accurately as possible. Straightforward instructions are vital in such cases. This study aimed to clarify the effect of verbal instructions for pain assessment during a passive straight leg raise (PSLR) test for participants with chronic low back pain (CLBP). This study included 22 participants who provided informed consent and received three consecutive PSLR tests with measurement of the hip flexion range of motion (HFROM) and were instructed to cease the test at submaximal pain before the first test. Following the second and third tests, participants were given specific verbal instructions to remember pain intensity, quality, and location. After each test, participants were to circle the pain location on the body chart and rate their pain intensity on a numeric rating scale (NRS) and pain quality. All participants were then interviewed about the differences between having and not having specific verbal instructions. The results of HFROM, NRS, and pain extent were not significantly different between the first and second tests or between the second and third tests using a paired t-test. Eleven changes in pain location were found in the second test compared to those in the first test. In the third test, only three participants circled a different area than in the second test. Ten participants showed similar changes with pain location in pain quality in the three PSLR tests. This study revealed the effect of specific verbal instructions prior to PSLR tests. Particularly, participants could notice exact pain location. Our findings may help PT to understand pain cause and reduce patients’ stress during pain assessment in clinical settings.

关键词： Chronic Low Back pain pain assessment Passive Straight Leg Raise Test Verbal Instructions

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pain assessment Using Facial Action Units and Bayesian Network

Pain Assessment Using Facial Action Units and Bayesian Netwo...

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第40届中国控制会议

作者： Wenqiang Guo Ziwei Xu Zhigao Guo Lingling Mao Yongyan Hou Zixuan Huang School of Information Engineering & Artificial Intelligence Shaanxi University of Science & Technology School of Electrical & Control Engineering Shaanxi University of Science & Technology School of Electronic Engineering and Computer Science Queen Mary University

Automatic pain assessment systems based on facial videos are consistently studied due to the demand of robust and cost-effective pain management.In order to improve the assessment accuracy under the dynamic and uncertain pain assessment environment,we propose a novel pain assessment method,AUBN,based on facial action units(AUs) and Bayesian network(BN).Firstly,the key feature points of pain expression are extracted through constrained local neural field(CLNF) model,and then AUs with a large amount of pain information are identified.The AUs are labeled to form the sample data set,and the constraints on BN conditional probabilities are constructed from the qualitative expert knowledge.Then,the sample data set is fused with the constraint extended parameter set using the variable weight method.Finally,BN reasoning method is applied to achieve the recognition of facial pain expression.Experimental results show that the proposed method outperforms SLPM+MCSVM,TDSBP+SVM and LBV+CNN methods on recognition accuracy and can significantly improve the recognition performance of facial pain expression.

关键词： pain assessment action unit Bayesian network varying weight fusion parameter estimation

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Distress assessment and Response Systems in Patients With Cancer pain

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Journal of Nutritional Oncology 2019年第3期4卷 132-137页

作者： Hong Wei Li Guang Yang Xiao Hui Ma Dong Sheng Xu Ling Ling Zhao Jiu Wei Cui Nan Ya Wang Cancer Center the First Hospital of Jilin UniversityChangchun 130021China

Objective This study used the Distress assessment and Response Tool(DART)to screen,evaluate,and explore physical symptoms,psychological problems,and social support in patients with cancer pain,with an aim to provide data for the comprehensive care of these patients to improve their quality of life.Methods The DART was used to survey 497 patients with cancer pain who were admitted to the Cancer Center of the First Hospital of Jilin University from June 2014 to March 2017.All patients were diagnosed with malignant tumors by clinical,radiological and/or cytological examinations,and were experiencing tumor-related pain.This study recorded the patient’s somatic symptoms,psychological problems and social support in detail.After the data were collected,the SPSS 21.0 software was used to perform the statistical analysis,with the significance level set at Ppain(NRS≤3);of these,29.7%and 15.8%reported depression and anxiety,respectively.In addition,17.3%of patients were experiencing moderate or severe pain(NRS≥4);of these,53.5%and 40.7%reported depression and anxiety,respectively.There was a statistically significant difference in the incidence of anxiety and depression between the two groups.Conclusion Patients with cancer pain,particularly those with moderate-to-severe pain,showed a high incidence of distress.In addition,they were likely to report physical symptoms,were conscious of poor health conditions,and were prone to have anxiety and depression.In terms of social support,patients with moderate-to-severe cancer pain should receive substantial support,as they experience work-related and economic concerns and report difficulties in family life and social activities.

关键词： Cancer pain Distress pain assessment Distress assessment and Response Tool(DART) Anxiety

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Effect of Specific Verbal Instructions on the Identification of pain Location during a Passive Straight Leg Raise Test

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Open Journal of Therapy and Rehabilitation 2023年第2期11卷 45-53页

作者： Masae Ikeya Takumi Jiroumaru Hitomi Bunki Noriyuki Kida Teruo Nomura Department of Physical Therapy Biwako Professional University of Rehabilitation Higashiomi City Japan Department of Applied Biology Graduate School of Science and Technology Kyoto Institute of Technology Kyoto City Japan Department of Physical Therapy Bukkyo University Kyoto City Japan Kanazawa Orthopedic & Sports Medicine Clinic Ritto City Japan

Musculoskeletal pain is common. Because pain is subjective, objectively describing it is crucial. However, pain assessment may cause distress in patients;therefore, physical therapists (PTs) should conduct these tests quickly and accurately. Simple and clear instructions are recommended for pain assessment. However, few studies have provided evidence to support this hypothesis. Correspondingly, this study aimed to confirm the effectiveness of specific verbal instructions for pain location during five consecutive Passive Straight Leg Raise (PSLR) tests. The 28 asymptomatic participants (age 27.4 ± 9.6 years) who provided informed consent received five consecutive PSLR tests: three without and two with specific verbal instructions to ascertain pain intensity, quality, and location. The participants drew pain locations on a body chart and described the pain intensity and quality after each test. All participants were interviewed regarding the differences they noted in the presence and absence of specific verbal instructions. Each pain location was classified into one of ten areas for statistical analysis. The proportion of participants who changed the pain location was compared between the tests using McNemar’s test, and the kappa coefficient was confirmed for consistency of pain location. There was a significant difference in the proportion of participants who changed their pain location between the second and third tests and from the third to the fourth test (McNemar’s test: p = 0.003). Kappa coefficients had low consistency (κ = 0.28) just after receiving the specific verbal instructions in the fourth test compared to the third test. Consistency improved in the fifth test (κ = 0.57);93% of the participants answered that the pain location had become clearer. This study revealed the effects of specific verbal instructions in identifying pain locations. This detailed information may help PTs provide appropriate treatment and contribute to reducing pain in clinical settings.

关键词： Specific Verbal Instructions pain Location pain assessment Passive Straight Leg Raise Test

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Evaluation of the Effectiveness and Nature of Analgesia in the Medical-Surgical Emergency Department of CHU-Donka

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Open Journal of Emergency Medicine 2023年第4期11卷 155-161页

作者： Amadou Yalla Camara Abdoulaye Touré Almamy Bangoura M’mah Lamine Camara Thierno Sadou Diallo Boubacar Atigou Dramé Joseph Donamou Department of Medical and Surgical Emergency CHU-Donka National Hospital Conakry Guinea Anesthesia and Intensive Care Unit Ignace Deen National Hospital Conakry Guinea Department of Anaesthesia and Intensive Care Donka National Hospital Conakry Guinea

Introduction: pain assessment is an essential step towards pain relief. In our context, however, it is insufficient in emergency departments. The aim was to assess the nature and effectiveness of the analgesia used in the emergency department of the CHU-Donka. Method: This was a single-centre prospective observational study conducted over one month (November 2020) in the medical-surgical emergency department of CHU-Donka. All patients aged 18 or over admitted to the emergency department with moderate to severe acute pain were included. Results: We enrolled 880 patients, 615 of whom (69.88%) were in pain. Males predominated (65.2%), with a sex ratio of 1.87. The average age was 44.78 ± 16.41 years, with extremes ranging from 18 to 85 years. The most represented age group was 18 - 34 years, with 66.18%. Initial assessment of pain by nursing staff in 3 cases. Initial assessment of pain by the investigator was 100%, 74% moderate and 26% severe. No reassessment of pain by nursing staff. Reassessment by the interviewer was 100% and found 5% no pain, 61% mild pain, 24% moderate pain and 10% severe pain. With an average numerical scale of 3.77 ± 2.61 and extremes from 0 to 10. Average length of stay was 2.85 ± 1.48 hours, with extremes ranging from 45 minutes to 8 hours. Analgesia was administered with paracetamol alone (43.58%), combined with tramadol or nefopam. No patient received morphine. Conclusion: This study revealed a lack of pain assessment in our department.

关键词： pain assessment Emergencies Numerical Scale CHU-Donka

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Post-Marketing Surveillance of Qishe Pill(芪麝丸)Use for Management of Neck pain in a Chinese Patient Cohort to Determine Its Safety,Tolerability and Effectiveness

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Chinese Journal of Integrative Medicine 2021年第6期27卷 408-416页

作者： CUI Xue-jun SUN Yue-li ZHANG Chang-qing WU Tao TAN Jun ZHU Zhen-an CHEN Yong-qiang WANG Qiu-gen LI Ming WANG Yong-jun Spine Research Institute Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai(200032)China Department of Orthopedics Shanghai Sixth People's HospitalShanghai Jiao Tong University School of MedicineShanghai(200233)China Department of Orthopedics Huadong HospitalFudan UniversityShanghai(200040)China Department of Orthopedics Shanghai East HospitalTongji UniversityShanghai(200120)China Department of Orthopedics Shanghai Ninth People's HospitalShanghai(200011)China Department of Orthopedics Shanghai Hospital of Traditional Chinese MedicineShanghai University of Traditional Chinese MedicineShanghai(200071)China Department of Orthopedics Shanghai First HospitalShanghai(200080)China Department of Orthopedics Shanqhai Chanqhai HospitalNavy Medical UniversityShanghai(200435)China

Objective:To evaluate the safety and effectiveness of Qishe Pill(芪麝丸)on neck pain in realworld clinical practice.Methods:A multi-center,prospective,observational surveillance in 8 hospitals across Shanghai was conducted.During patients receiving 4-week Qishe Pill medication,Visual Analogue Scale(VAS)and Neck Disability Index(NDI)assessments have been used to assess their pain and function,while safety monitoring have been observed after 2 and 4 weeks.Results:Results from 2,023 patients(mean age 54.5 years)suggest that the drug exposure per unit of body mass was estimated at 3.41±0.62 g/kg.About 8.5%(172/2,023)of all participants experienced adverse events(AEs),while 3.8%(78/2,023)of all participants experienced adverse reaction.The most common AEs were gastrointestinal events and respiratory events.The VAS score(pain)and NDI score(function)significantly decreased after 4-week treatment.An effect-quantitative analysis was also conducted to show that the normal clinical dosage may be consider as 3–4 g/kg,at which dosage the satisfactory pain-relief effect may achieve by 40-mm reduction in VAS.Conclusion:These findings showed that patients with cervical radiculopathy who received Qishe Pill experienced significant improvement on pain and function.(Registration No.NCT01875562).

关键词： neck pain pain assessment post-marketing surveillance Qishe Pill Chinese medicine complementary and alternative medicine

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A Modified CNN Network for Automatic pain Identification Using Facial Expressions

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Journal of Software Engineering and Applications 2021年第8期14卷 400-417页

作者： Ioannis Karamitsos IIham Seladji Sanjay Modak Rochester Institute of Technology Dubai UAE

pain is a strong symptom of diseases. Being an involuntary unpleasant feeling, it can be considered a reliable indicator of health issues. pain has always been expressed verbally, but in some cases, traditional patient self-reporting is not efficient. On one side, there are patients who have neurological disorders and cannot express themselves accurately, as well as patients who suddenly lose consciousness due to an abrupt faintness. On another side, medical staff working in crowded hospitals need to focus on emergencies and would opt for the automation of the task of looking after hospitalized patients during their entire stay, in order to notice any pain-related emergency. These issues can be tackled with deep learning. Knowing that pain is generally followed by spontaneous facial behaviors, facial expressions can be used as a substitute to verbal reporting, to express pain. In this paper, a convolutional neural network (CNN) model was built and trained to detect pain through patients’ facial expressions, using the UNBC-McMaster Shoulder pain dataset. First, faces were detected from images using the Haarcascade Frontal Face Detector provided by OpenCV, and preprocessed through gray scaling, histogram equalization, face detection, image cropping, mean filtering, and normalization. Next, preprocessed images were fed into a CNN model which was built based on a modified version of the VGG16 architecture. The model was finally evaluated and fine-tuned in a continuous way based on its accuracy, which reached 92.5%.

关键词： CNN Computer Vision Facial Expressions Image Processing pain assessment

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