Articles: adult.
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Randomized Controlled Trial
Effect of a Non-pharmacological Intervention on Vaccine-related Pain: Randomized Clinical Trial.
Acute pain during vaccine administration is an expected event; however, some strategies, such as the use of high frequency vibration devices associated with cryotherapy, may minimize it. ⋯ The use of high frequency vibration associated with cryotherapy has been shown to be a viable non-pharmacological intervention for the reduction of pain associated with influenza vaccination in adults.
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Mayo Clinic proceedings · Feb 2025
Randomized Controlled TrialA Randomized, Controlled Trial of In-Hospital Use of Virtual Reality to Reduce Preoperative Anxiety Prior to Cardiac Surgery.
To study the effectiveness of virtual reality (VR) in reducing anxiety levels in patients undergoing first-time sternotomy for cardiac surgery. ⋯ Overall, the findings suggest that treatment of older adults with an immersive VR experience before cardiac surgery can significantly reduce overall anxiety. Further investigation determining how such interventions can be optimally implemented in surgical practices and whether such interventions reduce the need for anxiolytic medications and improve the overall patient experience is needed.
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Observational Study
Adolescent predictors of substance use in young adulthood among individuals with childhood-onset chronic pain: A follow-up study.
Adolescent chronic pain is a substantial public health problem, and pain symptoms often persist into adulthood. Young adults with chronic pain are at elevated risk for more frequent tobacco, alcohol and cannabis use, and cross-sectional research highlights the importance of psychosocial vulnerability factors. Limited research has examined how adolescent predictors, including mental health symptoms, pain, sleep and family functioning, impact later, young adult substance use. ⋯ This prospective observational study of young adults with childhood-onset chronic pain identified adolescent depression and sleep quality as vulnerability factors associated with substance use. Given the increasing risk for substance use during adolescence and young adulthood, these findings highlight the potential importance of early intervention to reduce substance use among young adults with childhood-onset chronic pain.
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Previous studies in adults admitted to pediatric hospitals primarily investigated associations between complex chronic condition characteristics and patient outcomes. Our study explored the association of age with length of stay (LOS) and total cost in these adults, accounting for other patient factors. ⋯ There was a significant positive association between age and total cost, with adults 18-20 years having 13% higher total cost (95% confidence interval [CI]: 12%-15%), 21-25 years with 25% higher total cost (95% CI: 22%-29%), and 25-99 years having 72% higher total cost (95% CI: 66%-79%) than 1-17 years. Our findings suggest expanding upon the existing status quo to identify the most appropriate environment to care for this unique and growing population, especially given the anticipated reduction in pediatric beds and subspecialty expertise.
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Observational Study
Fluid Overload Modifies Hemodynamic Impact of CRRT: Evidence of a Covert Cardiorenal Syndrome?
Background: Fluid overload (FO) in critically ill children correlates with higher morbidity and mortality rates. Continuous renal replacement therapy (CRRT) is commonly employed to manage FO. In adults, both FO and CRRT adversely affect myocardial function. ⋯ Differences were noted in systemic vascular resistance index (1,277 [IQR 1088-1,666] vs. 1,030 [IQR 868-1,181] dynes/s/cm 5 /m 2 , P < 0.01), and cardiac index (3.90 [IQR 3.23-4.75] vs. 5.68 [IQR 4.65-6.32] L/min/m 2 , P < 0.01), with no differences in heart rate or mean arterial pressure between children with and without FO. Conclusion: FO affects the hemodynamic profile of children on CRRT, with those having FO >15% showing higher systemic vascular resistance index and lower cardiac index, despite heart rate and mean arterial pressure remaining unchanged. Our study illustrates the feasibility and utility of electrocardiometry in these patients, suggesting future research employ this technology to further explore the hemodynamic effects of dialysis in children.