Articles: function.
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Sarcopenia is a progressive, generalized disease of skeletal muscle characterized by a loss of muscle strength and muscle mass. The combination of obesity and sarcopenia is called sarcopenic obesity. Because of the aging of the population in many countries around the world, sarcopenia and sarcopenic obesity are a challenge for global health policy. ⋯ A targeted and structured approach to the detection and treatment of sarcopenia and sarcopenic obesity can make a major contribution to the maintenance or improvement of these patients' functionality and quality of life.
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Randomized Controlled Trial
Ultrasound guided transcutaneous phrenic nerve stimulation in critically ill patients: a new method to evaluate diaphragmatic function.
Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. The diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills. This study aimed to evaluate ultrasound-guided transcutaneous phrenic nerve stimulation for daily bedside assessment of diaphragm function by targeted electrical phrenic nerve stimulation. ⋯ The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound-guided transcutaneous phrenic nerve stimulation in sedated patients with no or minimal spontaneous respiratory activity.
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Despite functional connectivity network dysfunction among individuals with headaches, no studies have examined functional connectivity neural correlates and anatomical differences in coping with headaches. ⋯ This study highlights the potential use of emerging behavioural biomarkers in headache management, such as pain acceptance, and their role in modifying the headache experience. Notably, grey matter reorganization in the cerebellum and other known brain pain networks, could indicate brain networks that can be modified from targeted behavioural interventions to help decode the nociplastic mechanisms that predominates in headaches.
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Persistent postsurgical pain (PPSP) following thoracic surgery affects 40%-60% of patients undergoing lung resection due to malignancies. Postoperative pain-related symptoms are common, leading to limitations in activities of daily living (ADL) and deterioration in physical function, which significantly impacts quality of life. Pain-related limitations are of interest, as postsurgical pain may present as a target for intervention to improve postoperative rehabilitation. This study aimed to evaluate the association between PPSP and ADL limitations during the first 12 postoperative months after surgery for lung cancer. ⋯ Surgery remains a cornerstone in the treatment of early-stage lung cancer. Despite advances in minimally invasive techniques and rehabilitation, persisting postsurgical pain and pain-related limitations in daily activities may endure. This study investigated specifically the pain-related limitations in activities of daily living and described recovery trajectories during the first 12 postoperative months. Patients with persistent postsurgical pain experienced multiple limitations compared to pain-free patients. Although partial recovery was observed, impairments remained significant for up to 12 months after surgery.
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High-impact chronic pain (HICP), defined as chronic pain with a significant impact on daily function, affects approximately 8% of the Western population. In Denmark, HICP still remains to be described at the population level. Some patients with HICP are referred to the Danish pain centres, where they are registered with a procedural code. We conducted a nationwide registry-based study of all Danish patients registered with a visit to a pain centre from January 2005 to March 2022, to explore time trends in the prescription of analgesics and sedatives in this HICP subpopulation. Furthermore, data on socioeconomics and hospital diagnoses are reported. ⋯ This nationwide study of 66,577 Danish patients with high-impact chronic pain reveals a significant decrease in filled opioid prescriptions over the past 15 years, with a simultaneous rise in gabapentinoid use before referral to pain centres. These findings suggest a shift in clinical practice towards alternative pain management strategies. The study underscores the need for continued research into the long-term effects of these changes and their impact on patient outcomes.