Fear of needles can significantly limit professional and social functioning of a person, and is highly prevalent in general population (4%). The aim of our study was to reveal risk factors that are associated with fear of needles among healthy university students of medicine and pharmacy. The study was of a cross-sectional type. In total, 301 students of medicine or pharmacy (82% female and 18% male) attending from 1st to 5th year of study were surveyed at the Faculty of Medical Sciences, University of Kragujevac, Serbia. The students were surveyed using a questionnaires (scales) for assessing the fear of needless, a visual analog scale for self-assessment intensity of the fear of needless, and a general questionnaire with questions about socio-demographic characteristics of the participants. Using a score on the scales as out-come variables, multiple regressions were employed to reveal factors that may influence the fear of needles. Average values of Blood/Injection Fear Scale, Injection Phobia Scale-Anxiety and Medical Avoidance Survey scores were 7.89 ± 9.48, 4.46 ± 5.18 and 89.95 ± 12.73, respectively. The following factors affected significantly the score of the scales: course of study, chronic disease in the family, fear of a dentist, smell of the room phobia, sound phobia, score on the Beck’s anxiety scale and fear of a situation when medical staff give an injection. The presence of chronic disease in the family was a protective factor, while the other six factors were contributing to the fear of needles. Fear of needles is more prevalent among the students of pharmacy than among the students of medicine. It is less frequent among students with chronic disease in their family, while fear of dentist, smell of the room phobia, sound phobia, general anxiety and fear from the situation when medical staff give an injection are all factors that predispose students of medicine or pharmacy to develop fear of needles.
Aim: We aimed to single out admission predictors of acute respiratory distress syndrome (ARDS) in hospitalized COVID-19 patients and investigate the role of bioelectrical impedance (BIA) measurements in ARDS development. Method: An observational, prospective cohort study was conducted on 407 consecutive COVID-19 patients hospitalized at the University Clinical Center Kragujevac between September 2021 and March 2022. Patients were followed during the hospitalization, and ARDS was observed as a primary endpoint. Body composition was assessed using the BMI, body fat percentage (BF%), and visceral fat (VF) via BIA. Within 24 h of admission, patients were sampled for blood gas and laboratory analysis. Results: Patients with BMI above 30 kg/m2, very high BF%, and/or very high VF levels were at a significantly higher risk of developing ARDS compared to nonobese patients (OR: 4.568, 8.892, and 2.448, respectively). In addition, after performing multiple regression analysis, six admission predictors of ARDS were singled out: (1) very high BF (aOR 8.059), (2) SaO2 < 87.5 (aOR 5.120), (3) IL-6 > 59.75 (aOR 4.089), (4) low lymphocyte count (aOR 2.880), (5) female sex (aOR 2.290), and (6) age < 68.5 (aOR 1.976). Conclusion: Obesity is an important risk factor for the clinical deterioration of hospitalized COVID-19 patients. BF%, assessed through BIA measuring, was the strongest independent predictor of ARDS in hospitalized COVID-19 patients.
Background/Aim. Neuropathy represents the most frequent complication in the patients with diabetes mellitus (DM). Symmetric distal sensorimotor polyneuropathy (DSP), which represents the most frequent type of diabetic neuropathy, is present in 30% of hospitalized diabetic patients. The aim of our study was to compare the effects of physical therapy (PT) and alpha-lipoic acid (ALA) supplementation on pain reduction and quality of life improvement in the DSP patients. Methods. The study was performed on 60 adult patients with DM type 2 and DSP. The patients were randomly divided into 2 groups: group A (n = 30) was treated by PT and group B (n = 30) was treated by ALA. The study lasted 6 months during which 3 diagnostictherapeutic cycles were performed. To asses their pain before and after every of 3 cycles, we used visual analog scale (VAS). We also evaluated quality of life before the 1st and after the 3rd cycle with the European Quality of Life Questionnaire (EQ-5D-3L). To analyze results between groups we used mixed between-within subjects ANOVA and statistical significance was set on p < 0.05. Results. Pain intensity showed statistically significant influence of both PT and ALA (? = 0.028; p < 0.001). A statistically significant difference between the effects of those two therapy modalities was observed (F = 4.78; p < 0.05): PT reduced pain to the greater extent than ALA. A statistically significant improvement was found in the domain of pain/discomfort both in the group A (? = 0.54, p < 0.001) and group B (? = 0.57, p < 0.001), as well as anxiety/depression (group A: ? = 0.32, p = 0.008; group B: ? = 0.22, p < 0.019) and EQ-VAS (both groups, p < 0.05). Conclusion. Our research showed that physical therapy had a greater influence in pain reduction than alpha-lipoic acid in the patients with DSP.
1 January 2019 in Srpski arhiv za celokupno lekarstvo
Introduction/Objective. Pain, stiffness and limited mobility are the main factors that lead to difficulties in performing daily activities and are also responsible for the decline in the quality of life in people with knee osteoarthritis (OA). The aim of this study was to evaluate the functional capacity and health related quality of life (HRQoL) compared to pain in patients with knee OA, as well as to determine the correlation between these three clinical variables. Methods. The study involved 931 patients diagnosed with knee OA. In all patients, pain was evaluated by a short form of the McGill pain questionnaire (SFMPQ), functional status was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC), while life quality was evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Results. The average age of patients was 61.21±4.62 years, while 71.3% of them were women. The quality of life in patients with knee OA and all pain parameters contained in the SF-MPQ were highly statistically positively associated (p≤0.01). In addition, the physical functioning was mostly affected by emotional pain (rho=-0.585). A high statistical correlation (p≤0.01) was noted between stiffness and physical functioning from the WOMAC questionnaire and all of the parameters from the SF-MPQ. The physical functioning from the WOMAC questionnaire had the strongest correlation with total pain incorporated into the McGill questionnaire (rho=0.530). Conclusion. Knee pain has a significant impact on functional capacity and HRQoL in patients with knee OA. Therefore, one of the main therapy goals for OA of the knee should be the reduction of pain in the affected knee, which can help to improve the functionality and HRQoL of these patients.
29 May 2017 in Serbian Journal of Experimental and Clinical Research
Hip osteoarthritis (OA) is a degenerative, progressive musculoskeletal system disease in adult individuals. Both genders demonstrate a similar prevalence at 11.5% for men and 11.6% for women. During the initial stage of hip OA, conservative treatments may significantly decrease pain, provide functional improvement and enhance health related quality of life (HRQoL).The aims of the study were to evaluate the quality of life of patients with hip osteoarthritis and to estimate the impact of a comprehensive rehabilitation intervention on their HRQoL.This was a prospective, observational study of 50 consecutive patients with hip osteoarthritis who were referred to an outpatient rehabilitation intervention. To assess their HRQoL before and after rehabilitation, we used the SF-36 and the Lequesne index for hip OA.The mean age was 61.7±8.3 years, and 56% of the patients were women. After rehabilitation, the SF-36 RE and RP subscales and the Lequesne pain subscale showed the most significant improvement, although all of the SF-36 and Lequesne domains showed significant improvement. Before rehabilitation, the Lequesne ADL subscale was most correlated with the SF-36 PF subscale (rho=−0.908). After rehabilitation, the total Lequesne score was highly correlated with the SF-36 PF subscale (rho=−0.895). Age, education and the duration of disease were significantly correlated with all of the Lequesne subscales before and after rehabilitation.This study showed that patients with hip osteoarthritis had a substantially low HRQoL, but all health dimensions showed statistically significant improvements after outpatient rehabilitation intervention.