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Scrutinizing the Profile and Risk Factors of Suicide: A Perspective from a Case-Control Study Focused on a Northern Region of Spain.

Suicide is a major public health problem the prevention of which has become a priority, and, to this end, knowledge of its risk factors is essential. This study aims to evaluate the impact of some social, medico-legal, and clinical issues on suicide deaths. A total of 135 cases were identified as suicides that occurred in a region of northern Spain between 2018 and 2020. Controls (three for each case) were matched by age, sex, and urban-rural areas. The information was collected retrospectively through electronic health record systems. A binary logistic regression analysis was performed to study the association between individual risk factors and suicide. Being male (78.5%), between 40 and 60 years of age, unmarried (70.9%), and unemployed (85%) were associated with suicide deaths. Although the existence of a previous self-harm attempt is presented as the most robust risk factor (OR 22.121 [8.997-54.389]), the presence of a psychiatric diagnosis (OR 12.583 [7.686-20.601]) and cancer (OR 3.729 [1.845-7.536]) also showed a significant relationship with suicide ( < 0.05). Defining and knowing the risk factors for suicide helps to better understand the profiles of those individuals who are vulnerable, and enables prevention actions to be taken in both social and medical spheres.

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Health-Related Quality of Life in Migraine: EQ-5D-5L-Based Study in Routine Clinical Practice.

Migraine leads to moderate to severe disabilities and disrupts family life, interpersonal relationships, and professional life, and is the second leading cause of disability worldwide. Many people with migraine suffer prolonged headaches and frequent migraine attacks, transition to having chronic migraine, and have the highest number of disability-adjusted life-years. The aim of this study is to measure the quality of life in migraineurs based on the EQ-5D-5L questionnaire.

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Long Term Effectiveness of ESWT in Plantar Fasciitis in Amateur Runners.

Shock wave therapy is one of the modern methods of treatment used to treat diseases of muscles, tendons, and entheses in orthopedics, as well as in sports medicine. The therapy is increasingly used in the treatment of plantar fasciitis-a disease that is very difficult and burdensome to treat. Where basic conservative treatment for heel spurs fails, the only alternative consists of excision of the bone outgrowth, and shock wave therapy: a modern, minimally invasive, and relatively safe method. The aim of the study was to determine the long-term effectiveness of extracorporeal shock wave therapy in the treatment of painful ailments occurring in the course of plantar fasciitis in amateur runners.

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Does the Intensity of the Headache Differ According to the Level of Neck Disability in Chronic Migraine Patients?

Chronic migraine (CM) patients who report a high frequency and intensity of headaches also report neck pain (NP) and neck disability (ND) in neck activities that require stability. In this context, CM patients may report different headache intensities at different levels of ND. Our aim in this study is to investigate whether the intensity of headaches differs according to the level of ND in CM patients. Headache intensity and NP intensity were evaluated with the Visual Analog Scale (VAS), and ND was evaluated with the Neck Disability Index (NDI). A total of 142 patients who met the inclusion criteria were included in the study. The mean age was 53.24 ± 12.08 years. The median number of monthly headache days was 20. According to VAS, the median headache intensity was 10(4-10) cm and the median of NP intensity was 9(1-10) cm. The mean NDI was 28.45 ± 10.28. There was a difference in headache intensity between mild and severe disability levels ( = 0.007, Z = -3.289); headache intensity between mild and complete disability levels ( = 0.000, Z = -4.421); and headache intensity between moderate and complete disability levels ( = 0.004, Z = -2.212). Although the difference in headache intensity between ND levels is small, a median increase of 2 cm in headache intensity at mild ND levels may result in complete ND. A median increase of 1 cm in headache intensity at the moderate ND level may cause complete disability in the neck. According to our results, the intensity of headaches of CM patients differed according to the level of ND. We consider our results to be clinically important in this context.

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Efficacy of Serotonin Type 3 Receptor Antagonist Ramosetron on Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D)-Like Symptoms in Patients with Quiescent Inflammatory Bowel Disease: A Randomized, Double-Blind, Placebo-Controlled Trial.

Patients with quiescent inflammatory bowel disease (IBD) frequently suffer diarrhea-predominant irritable bowel syndrome (IBS-D)-like symptoms, such as abdominal pain or stool irregularities. Here, we assessed the effect of ramosetron, a serotonin type 3 (5-HT) receptor antagonist, on IBS-D-like symptoms in patients with quiescent IBD. Seventy patients with quiescent IBD, who met the Rome III diagnostic criteria for IBS-D, were randomly assigned to receive either ramosetron (5 μg; n = 35) or a placebo (n = 35) orally once daily for 4 weeks. The primary endpoint was the responder rate for global assessment of relief from overall IBS-D-like symptoms. The responder rates for relief of abdominal pain/discomfort and improvement of bowel habits were also evaluated. The responder rate for relief from overall IBS-D-like symptoms at the final evaluation point was significantly higher in the ramosetron group (35.5%) than in the placebo group (11.4%) ( = 0.037). The responder rate for improvement of bowel habits was significantly higher in the ramosetron group (38.7%) than in the placebo group (14.3%) ( = 0.028). The reduction of stool frequency was significantly greater in the ramosetron group than in the placebo group ( = 0.044). Ramosetron is effective for relief of overall IBS-D-like symptoms in patients with quiescent IBD.

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Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study.

This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician's instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician's instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients' decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale-NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant ( = 40.0, < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.

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Effect of Acute Self-Myofascial Release on Pain and Exercise Performance for Cycling Club Members with Iliotibial Band Friction Syndrome.

Cycling is a popular sport, and the cycling population and prevalence of related injuries and diseases increase simultaneously. Iliotibial band friction syndrome is a common chronic overuse injury caused by repetitive knee use in cycling. Self-myofascial release using foam rollers is an effective intervention for this syndrome; however, studies reporting positive results on self-myofascial release in cycling are limited. Therefore, this study investigated the effect of self-myofascial release on pain and iliotibial band flexibility, heart rate, and exercise performance (cadence, power, and record) in adult male cyclists with iliotibial band friction syndrome. We evaluated the pain and exercise ability of the control ( = 11) and self-myofascial release ( = 11) groups before and after cycling twice. Significant differences were observed in the pain scale, the iliotibial band flexibility, and cycling pain and power. The posterior cadence of the self-myofascial release group was 3.2% higher than that of the control group. The control group's record time increased by 74.64 s in the second cycling session compared to the first cycling session, while that of the self-myofascial release group decreased by 30.91 s in the second cycling session compared to the first cycling session. Self-myofascial release is effective in relieving pain and may improve cycling performance by increasing the iliotibial band flexibility.

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Conservative Therapies for TMJ Closed Lock: A Randomized Controlled Trial.

Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal appliances (OA) are among the therapies of choice.

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Spontaneous Osteonecrosis of the Knee: State of the Art.

Osteonecrosis is a terrible condition that can cause advanced arthritis in a number of joints, including the knee. The three types of osteonecrosis that can affect the knee are secondary, post-arthroscopic, and spontaneous osteonecrosis of the knee (SPONK). Regardless of osteonecrosis classification, treatment for this condition seeks to prevent further development or postpone the onset of knee end-stage arthritis. Joint arthroplasty is the best course of action whenever there is significant joint surface collapse or there are signs of degenerative arthritis. The non-operative options for treatment at the moment include observation, nonsteroidal anti-inflammatory medications (NSAIDs), protective weight bearing, and analgesia if needed. Depending on the severity and type of the condition, operational procedures may include unilateral knee arthroplasty (UKA), total knee arthroplasty (TKA), or joint preservation surgery. Joint preservation techniques, such as arthroscopy, core decompression, osteochondral autograft, and bone grafting, are frequently used in precollapse and some postcollapse lesions, when the articular cartilage is typically unaffected and only the underlying subchondral bone is affected. In contrast, operations that try to save the joint following significant subchondral collapse are rarely successful and joint replacement is required to ease discomfort. This article's goal is to summarise the most recent research on evaluations, clinical examinations, imaging and various therapeutic strategies for osteonecrosis of the knee, including lesion surveillance, medicines, joint preservation methods, and total joint arthroplasty.

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Time Trends and Sex Differences in the Association between Diabetes and Chronic Neck Pain, Chronic Low Back Pain, and Migraine. Analysis of Population-Based National Surveys in Spain (2014-2020).

(1) Background: To assess the time trend in the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine or frequent headache (MFH) among people with diabetes in Spain from 2014 to 2020, this study identified sex differences and compared the prevalence of these pain sites between people with diabetes and age-sex-matched non-diabetic subjects. (2) Methods: The study design included a cross-sectional and a case-control study. The data were obtained from the European Health Interview Surveys for Spain conducted in 2014 and 2020. The presence of diabetes, CNP, CLBP, and MFH was self-reported. Study covariates included sociodemographic characteristics, comorbidities, lifestyles, and pain-related variables. (3) Results: Among people with diabetes, the prevalence of CNP, CLBP, and MFH did not improve from 2014 to 2020. Women with diabetes had a significantly higher prevalence of all the pain sites analyzed than men with diabetes. After matching by sex and age, the prevalence of CNP (26.0% vs. 21.1%; < 0.001), CLBP (31.2% vs. 25.0%; < 0.001), and MFH (7.7% vs. 6.5%; = 0.028) was higher for people with diabetes than for those without diabetes. Self-reported mental disease was independently associated with reporting the three pain sites analyzed in people with diabetes. (4) Conclusions: The prevalence of CNP, CLBP, and MFH has remained stable over time. Remarkable sex differences were found, with a higher prevalence among women than men with diabetes. Diabetes was associated with reporting in all the pain sites analyzed. Self-reported mental disease was associated with reporting CNP, CLBP, and MFH.

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