Pain medicine https://painmedicine.org.ua/index.php/pnmdcn <p>"Medicina bolu" is a science-and-practice periodical for medical professionals. The main highlighting issue is pain, but not the only one, because in medicine there are no situations where a phenomenon is strictly isolated. Sign up for a print edition and follow up on the site to keep up with important and useful information.</p> <p>Thematic interests of the journal<br>Fundamental aspects of pain (clinical physiology, pathophysiology, pharmacology).<br>Applied aspects of pain (epidemiology, pain assessment, innovative methods of diagnosis and treatment, clinical pharmacology).<br>Clinical aspects of pain (acute pain, chronic pain, perioperative pain, posthumous pain, neuropathic pain, dysfunctional pain).<br>Clinical and anatomical approach to pain (headache, orofacial pain, neck and back pain, toothache, musculoskeletal pain, myofascial pain, fibromyalgia, visceral pain, pelvic pain, cardialgia, etc.).<br>Interdisciplinary approach to pain (in anesthesiology, in surgery, in pediatrics, neurology, vertebrology, in the clinic of internal diseases, oncology, rheumatology, gerontology, gastroenterology, traumatology and orthopedics, otorhinolaryngology, dentistry, obstetrics, gynecology and urology, in the palliative and hospice medicine).<br>Treatment and rehabilitation of patients suffering from pain (pharmacotherapy, physical rehabilitation, medical rehabilitation, alternative methods of treatment, means of psychological and psychotherapeutic influence, invasive methods of pain relief, organization of pain relief).<br>Separate clinical cases and their clinical examination.</p> en-US <p><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="http://creativecommons.org/licenses/by/4.0/" rel="license"><img style="border-width: 0px;" src="https://i.creativecommons.org/l/by/4.0/88x31.png" alt="Creative Commons License"></a><br style="background-color: transparent; color: #000000; cursor: text; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; outline-color: #2d8ac7; outline-style: solid; outline-width: 2px; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;"><span style="display: inline !important; float: none; background-color: transparent; color: #000000; cursor: text; font-family: 'Noto Sans',Arial,Helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;">This work is licensed under a </span><a style="background-color: transparent; color: #007ab2; font-family: &amp;quot; noto sans&amp;quot;,arial,helvetica,sans-serif; font-size: 14px; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: underline; text-indent: 0px; text-transform: none; -webkit-text-stroke-width: 0px; white-space: normal; word-spacing: 0px;" href="http://creativecommons.org/licenses/by/4.0/" rel="license">Creative Commons Attribution 4.0 International License</a></p> editor@painmedicine.org.ua (Oleksandr Marchuk) vlvitkovskyi@gmail.com (Viktor Vitkovskyi) Fri, 29 Apr 2022 00:00:00 +0300 OJS 3.3.0.11 http://blogs.law.harvard.edu/tech/rss 60 Сhest pain: a modern review of pain medicine https://painmedicine.org.ua/index.php/pnmdcn/article/view/286 <p><strong>Abstract</strong>. Background. Approximately 1% of all reasons for visits to primary care physicians are chest pain, and in 2–4% of these patients pain is the cause of potentially life-threatening cardiovascular disease. For a correct and quick diagnosis, it is extremely important that the clinician and the patient speak “one language”: the described complaints should be interpreted quickly and correctly, and the doctor’s questions should be clear to the patient. It is very important to get information from the patient about any accompanying symptoms and a detailed description of chest discomfort. History taking and physical examination should take the minimum amount of time required. That is why it is necessary to understand how and why conditions develop, the manifestation of which is pain in the chest. To highlight the significant variability of clinical manifestations of thoracalgia, mechanisms of development and features of clinical and laboratory-instrumental diagnosis of the causes of chest pain is a main aim of the review. Materials and methods. Modern foreign guidelines for the management of patients with chest pain, written in English, were used.</p> <p><strong>Conclusions</strong>. After injuries, chest pain is the main reason of patients visits to the admission department for urgency care. Longstanding classification of the chest pain causes divides it into cardiac and non-cardiac, and cardialgia, in turn, can be subdivided to pain, caused by ischemic changes in the myocardium, and the one with a non-ischemic origin. Patients often do not use the term “pain” to describe their symptoms, but often use other terms such as discomfort, compression, or may associate discomfort with indigestion. When chest pain is caused by ischemia or insufficient coronary blood flow, it is called ischemic thoracalgia. Detection of angina pectoris is one of the main problems in the examination of patients with chest pain, and thoracalgia, which clinically and instrumentally correlates with acute angina pectoris, requires urgent diagnosis and treatment, as it may be a sign of acute coronary syndrome (ACS). Thoracic pain can not only affect the heart muscle, but also radiate from other anatomical areas or be felt secondarily, if it develops in an adjacent anatomical area (eg, thoracic spine, epigastric pain, etc.). Both acute and chronic chest pain should be carefully evaluated by a clinician, and further examination may be performed based on his findings. Appropriate and necessary laboratory and instrumental examination of patients, taking into account all possible risks, not only allows to quickly establish an accurate diagnosis, but also leads to more effective treatment.</p> Tetyana Anikeіeva, Anastasiya Moisieienko Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/286 Wed, 27 Apr 2022 00:00:00 +0300 Pooled analysis of central venous pressure and brain natriuretic peptide levels in patients with extubation failure https://painmedicine.org.ua/index.php/pnmdcn/article/view/287 <p><strong>Background</strong>: extubation failure is related to prolonged hospital stay, high mortality and care cost. In recent years, cardiovascular insufficiency has been considered as a common cause of failed extubation, and some studies have shown that central venous pressure (CVP) and brain natriuretic peptide (BNP) can predict the extubation outcome. Therefore, we conducted a pooled analysis to evaluate that the CVP and BNP levels in critically ill patients subjected to mechanical ventilation are predictors of extubation failure.</p> <p><strong>Methods</strong>: Three online electronic databases such as web of science, EMBASE, and Cochrane Library are systematically searched up to October 2021. All data are analyzed using Review Manager 5.4. The pooled analysis results were performed depending on standardized mean differences (SMD) with 95 % confidence intervals (CI) of the CVP and BNP levels for each study.</p> <p><strong>Results</strong>: A total of 13 studies with 47 561 participants were included in our study. Our results showed that elevated CVP levels were significantly associated with the risk of failed extubation (SMD: 0.54, 95 % CI: 0.07 to 1.02, P = 0.03). This association also appeared after extubation (SMD: 1.39, 95 % CI: 0.37 to 2.40, P = 0.008), but it did not appear before extubation (SMD: 0.04, 95 % CI: -0.50 to 0.59, P = 0.88). Similarly, Our results also showed that increased BNP levels is closely related to extubation failure (SMD: 0.72, 95 % CI: 0.48 to 0.96, P &lt; 0.00001). This relationship also occurs before (SMD: 0.60, 95 % CI: 0.29 to 0.90, P = 0.0001) and after (SMD: 0.92, 95 % CI: 0.54 to 1.30, P &lt; 0.00001) extubation.</p> <p><strong>Conclusions</strong>: This study showed that elevated CVP and BNP levels are associated with risk of extubation failure in critically ill patients. Compared with CVP level, BNP level is a more sensitive and accurate predictor of extubation failure.</p> Jianghong Cao, Beibei Wang, Lili Zhu, Lu Song Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/287 Thu, 28 Apr 2022 00:00:00 +0300 Patient’s safety during simultaneous bilateral total knee arthroplasty https://painmedicine.org.ua/index.php/pnmdcn/article/view/288 <p><strong>Abstract.</strong> As the utilization of total knee arthroplasty increases and the population ages, the number of patients who require surgical treatment of both knees is rising. These procedures may be conducted simultaneously or sequentially; the simultaneous bilateral approach is increasingly considered the preferred option because it permits a symmetric recovery while avoiding risks associated with an additional operation, anesthetic, hospitalization, and recovery period while reducing the costs associated with sequential procedures. Despite these advantages, concerns have been raised regarding increased risks for deep vein thrombosis, pulmonary embolism, cardiac complications, and mortality. Results reported in the literature with regards to the relative safety of these procedures have been conflicting; however, it is agreed upon that careful patient selection is essential for reducing risk associated with simultaneous bilateral total knee arthroplasty. A set of guidelines have been established which may be used to help guide the management of patients with bilateral degenerative joint disease seeking knee replacement surgery. Key words: bilateral total knee arthroplasty, simultaneous bilateral total knee arthroplasty, staged bilateral total knee arthroplasty, total knee arthroplasty.</p> I M Zazirnyi, A M Strokan, V V Savych, Ye A Levytskyi Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/288 Fri, 29 Apr 2022 00:00:00 +0300 Diagnosis and treatment of biliary atresia in children https://painmedicine.org.ua/index.php/pnmdcn/article/view/289 <p><strong>Abstract.</strong> There are relatively few severe liver diseases in childhood. Biliary atresia is one of the most difficult. Early diagnosis of this disease is the basis of the subsequent treatment algorithm. In this article, we want to present the main criteria for diagnosing biliary tract pathology in newborns and young children, as well as draw the attention of pediatricians and neonatologists to the difficulties that arise in their diagnosis. Despite the rarity of these diseases, biliary atresia, as well as other rare liver diseases, should always be considered in the diagnosis of longterm hyperbilirubinemia. Due to early diagnosis and subsequent Kasai operation, the possibility of liver transplantation, in the last two decades, there has been significant progress in the treatment of children with biliary atresia.</p> K Dmytriieva, K Dmytriiev, M Vidiscak, V Vidiscak Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/289 Fri, 29 Apr 2022 00:00:00 +0300 Pain management in a child with odontogenic orbital cellulitis and severe complications https://painmedicine.org.ua/index.php/pnmdcn/article/view/290 <p><strong>Introduction.</strong> Orbital cellulitis is a diffuse purulent inflammation of the orbital tissues followed by necrosis. Complications of orbital cellulitis include meningitis or cerebral vascular thrombosis leading to death.<br><strong>Background.</strong> We present the case of a 3-year-old child with orbital cellulitis and severe complications treated at the Departmentof Anesthesiology and Intensive Care, CNE “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”.<br><strong>Results.</strong> The child presented to the ophthalmology department with complaints of pronounced lid edema and hyperemia, right eye exophthalmos, massive purulent, foul-smelling discharge from the right eye, hyphema of the inner and outer corners of the eye, absent movements of the right eyeball, hyperthermia. Non-contrast computed tomography of the brain revealed osteomyelitis of the right maxilla, cellulitis of the right orbit, right-sided sinusitis, ethmoiditis. Under general anesthesia, there were performed deep orbitotomy, extraction of teeth 54, 55 with the extraction area drainage, puncture of the right maxillary sinus. Multimodal analgesia, detoxification therapy, empiric antimicrobial therapy, immune replacement therapy, protein replacement therapy, and syndromic treatment were chosen. On the 9th day, the child’s condition improved, and he was transferred to the ophthalmology department. On the 27th day of hospital stay, the child was discharged home in a satisfactory condition.<br><strong>Conclusions.</strong> The child’s recovery was achieved due to timely hospitalization and surgery, goal-directed antibiotic therapy, application of multimodal anesthesia principles and adequate pain management, immune replacement therapy, usage of non-specific detoxification methods and adequate rehydration therapy.</p> Ya V Semkovych, M Ya Semkovych, T M Melnyk, N I Gavrylyshyn , O B Synoverska Copyright (c) 2022 https://creativecommons.org/licenses/by/4.0 https://painmedicine.org.ua/index.php/pnmdcn/article/view/290 Fri, 29 Apr 2022 00:00:00 +0300