Browsing by Subject "Pain"

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Now showing items 21-29 of 29
  • Tarjanne, Satu; Härkki, Päivi (2017)
    Syvää endometrioosia esiintyy noin 1 %:lla hedelmällisessä iässä olevista naisista. Yksi sen tavallisimmista esiintymispaikoista on emättimen pohjukan ja peräsuolen välinen tila, ja silloin taudista käytetään nimitystä rektovaginaalinen endometrioosi. Tauti voi ulottua myös suolen seinämään. Syvä endometrioosi aiheuttaa vaikeita kuukautiskipuja, yhdyntä- sekä vatsakipuja ja rektovaginaalinen muoto myös ulostuskipuja. Tautia hoidetaan ensisijaisesti yhdistelmäehkäisyvalmisteilla tai keltarauhashormoneilla. Mikäli ne eivät lievitä kipuja riittävästi, tarvitaan kirurgiaa. Kirurginen hoito parantaa merkittävästi potilaiden elämänlaatua. Se on kuitenkin vaativaa, ja myös vakavia komplikaatioita esiintyy.
  • Kalso, Eija (2016)
  • Ivaska, Lauri; Kuitunen, Mikael (2020)
    Kun teinitytön kurkkukipu ei alkanut helpottua antibioottikuurilla, hänet ohjattiin erikoissairaanhoidon päivystykseen.
  • Heikkilä, Helka M.; Hielm-Björkman, Anna K.; Innes, John F.; Laitinen-Vapaavuori, Outi M. (2017)
    Background: Recently, intra-articular botulinum toxin A (IA BoNT A) has been shown to reduce joint pain in osteoarthritic dogs. Similar results have been reported in human patients with arthritis. However, the mechanism of the antinociceptive action of IA BoNT A is currently not known. The aim of this study was to explore this mechanism of action by investigating the effect of IA BoNT A on synovial fluid (SF) and serum substance P (SP), prostaglandin E-2 (PGE(2)), and tumor necrosis factor alpha (TNF-alpha) in osteoarthritic dogs. Additionally, the aim was to compare SF SP and PGE(2) between osteoarthritic and non-osteoarthritic joints, and investigate associations between SP, PGE(2), osteoarthritic pain, and the signalment of dogs. Thirty-five dogs with chronic naturally occurring osteoarthritis and 13 non-osteoarthritic control dogs were included in the study. Osteoarthritic dogs received either IA BoNT A (n = 19) or IA placebo (n = 16). Serum and SF samples were collected and osteoarthritic pain was evaluated before (baseline) and 2 and 8 weeks after treatment. Osteoarthritic pain was assessed with force platform, Helsinki Chronic Pain Index, and joint palpation. Synovial fluid samples were obtained from control dogs after euthanasia. The change from baseline in SP and PGE(2) concentration was compared between the IA BoNT A and placebo groups. The synovial fluid SP and PGE(2) concentration was compared between osteoarthritic and control joints. Associations between SP, PGE(2), osteoarthritic pain, and the signalment of dogs were evaluated. Results: There was no significant change from baseline in SP or PGE(2) after IA BoNT A. Synovial fluid PGE(2) was significantly higher in osteoarthritic compared to control joints. Synovial fluid PGE(2) correlated with osteoarthritic pain. No associations were found between SP or PGE2 and the signalment of dogs. The concentration of TNF-alpha remained under the detection limit of the assay in all samples. Conclusions: The results suggest that the antinociceptive effect of IA BoNT A in the joint might not be related to the inhibition of SP nor PGE(2). Synovial fluid PGE(2,) but not SP, could be a marker for chronic osteoarthritis and pain in dogs.
  • Heikkilä, Helka M; Hielm-Björkman, Anna K; Innes, John F; Laitinen-Vapaavuori, Outi M (BioMed Central, 2017)
    Abstract Background Recently, intra-articular botulinum toxin A (IA BoNT A) has been shown to reduce joint pain in osteoarthritic dogs. Similar results have been reported in human patients with arthritis. However, the mechanism of the antinociceptive action of IA BoNT A is currently not known. The aim of this study was to explore this mechanism of action by investigating the effect of IA BoNT A on synovial fluid (SF) and serum substance P (SP), prostaglandin E2 (PGE2), and tumor necrosis factor alpha (TNF-α) in osteoarthritic dogs. Additionally, the aim was to compare SF SP and PGE2 between osteoarthritic and non-osteoarthritic joints, and investigate associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs. Thirty-five dogs with chronic naturally occurring osteoarthritis and 13 non-osteoarthritic control dogs were included in the study. Osteoarthritic dogs received either IA BoNT A (n = 19) or IA placebo (n = 16). Serum and SF samples were collected and osteoarthritic pain was evaluated before (baseline) and 2 and 8 weeks after treatment. Osteoarthritic pain was assessed with force platform, Helsinki Chronic Pain Index, and joint palpation. Synovial fluid samples were obtained from control dogs after euthanasia. The change from baseline in SP and PGE2 concentration was compared between the IA BoNT A and placebo groups. The synovial fluid SP and PGE2 concentration was compared between osteoarthritic and control joints. Associations between SP, PGE2, osteoarthritic pain, and the signalment of dogs were evaluated. Results There was no significant change from baseline in SP or PGE2 after IA BoNT A. Synovial fluid PGE2 was significantly higher in osteoarthritic compared to control joints. Synovial fluid PGE2 correlated with osteoarthritic pain. No associations were found between SP or PGE2 and the signalment of dogs. The concentration of TNF-α remained under the detection limit of the assay in all samples. Conclusions The results suggest that the antinociceptive effect of IA BoNT A in the joint might not be related to the inhibition of SP nor PGE2. Synovial fluid PGE2, but not SP, could be a marker for chronic osteoarthritis and pain in dogs.
  • Kumaradev, Sushmithadev; Fayosse, Aurore; Dugravot, Aline; Dumurgier, Julien; Roux, Christian; Kivimäki, Mika; Singh-Manoux, Archana; Sabia, Severine (2021)
    This study examines the importance of length of follow-up on the association between pain and incident dementia. Further objective was to characterize pain trajectories in the 27 years preceding dementia diagnosis and compare them with those among persons free of dementia during the same period. Pain intensity and pain interference (averaged as total pain) were measured on 9 occasions (1991-2016) using the Short-Form 36 Questionnaire amongst 9046 (women = 31.4%) dementia-free adults aged 40 to 64 years in 1991; 567 dementia cases were recorded between 1991 and 2019. Cox regression was used to assess the association between pain measures at different time points and incident dementia and mixed models to assess pain trajectories preceding dementia diagnosis or end point for dementia-free participants. Results from Cox regression showed moderate/severe compared with mild/no total pain, pain intensity, and pain interference not to be associated with dementia when the mean follow-up was 25.0, 19.6, 14.5, or 10.0 years. These associations were evident for a mean follow-up of 6.2 years: for total pain (hazard ratio = 1.72; 95% confidence intervals = 1.28-2.33), pain intensity (1.41; 1.04-1.92), and pain interference (1.80; 1.30-2.49). These associations were stronger when the mean follow-up for incidence of dementia was 3.2 years. Twenty-seven-year pain trajectories differed between dementia cases and noncases with small differences in total pain and pain interference evident 16 years before dementia diagnosis (difference in the total pain score = 1.4, 95% confidence intervals = 0.1-2.7) and rapidly increasing closer to diagnosis. In conclusion, these findings suggest that pain is a correlate or prodromal symptom rather than a cause of dementia.
  • Kausto, Johanna; Kaila-Kangas, Leena; Lallukka, Tea; Leino-Arjas, Päivi (2020)
    Joissakin maissa on laadittu vaihdevuosiin liittyviä ohjeistuksia työnantajille ja ¬työntekijöille.
  • Hynynen, Pia; Sainio, Susanna; Räisänen-Sokolowski, Anne; Kaartinen, Kati (2019)
    Punasolusiirtojen tunnetuin haitta on välitön hemolyyttinen verensiirtoreaktio. Sen oireet alkavat usein jo verensiirron aikana. Viivästyneen reaktion oireet ovat yleensä lievempiä ja jäävät usein kokonaan toteamatta. Kuvaamme potilaan, jolla viivästynyt hemolyyttinen verensiirtoreaktio johti dialyysihoitoja vaatineeseen mu¬¬nuaisvaurioon. Koska oireiden yhteyttä äskettäiseen verensiirtoon ei heti osattu epäillä, diagnoosi viivästyi, aiheutui invasiivisia tutkimuksia ja munuaisten toipuminen vaarantui.
  • Paavonen, Jorma (2020)
    Vulvovaginaaliset ongelmat, etenkin emätintulehdus, ovat varsin yleisiä lääkärin vastaanotolle hakeutumisen syitä. Vahvaan tutkimusnäyttöön perustuvaa hoito-ohjeistusta ei usein ole tai siitä ei ole apua. Kokemusperäisen osaamisen merkitys korostuu kliinisessä työssä.