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Diagnosis and medical treatment of neuropathic pain in leprosy

Overview of attention for article published in Revista Latino-Americana de Enfermagem, January 2016
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Title
Diagnosis and medical treatment of neuropathic pain in leprosy
Published in
Revista Latino-Americana de Enfermagem, January 2016
DOI 10.1590/1518-8345.0676.2731
Pubmed ID
Authors

Rogerio Del Arco, Susilene Maria Tonelli Nardi, Thiago Gasperini Bassi, Vania Del Arco Paschoal

Abstract

to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Out of the 37 patients that experienced pain, 22 (59.5%) had neuropathic pain (or a mixture of this pain and their existing pain) and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5%) of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12) for neuropathic pain, 5 (41.6%) responded that they became better. For the other 7 (58.4%) there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12) and those that were not, showed significant differences (value p=0.020). we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture. identificar as dificuldades em diagnosticar e tratar a dor neuropática causada pela hanseníase, bem como determinar as características principais dessa situação. examinaram-se 85 pacientes tratados no ambulatório de referência para hanseníase e referiam dor. Aplicou-se questionário, o teste Douleur Neuropathic 4, e criterioso exame neurológico pelo qual excluíram-se 42 pacientes por não se comprovar dor. dos 37 pacientes com dor, 22 (59,5%) tinham Douleur Neuropathic ou mista e, desses, 90,8% caracterizavam essa dor como de intensidade moderada ou severa, sendo que 81,8% sofriam por mais de 6 meses. Apenas 12 (54,5%) pacientes haviam sido diagnosticados com Douleur Neuropathic e quase metade dos casos (45,5%) estava sem reconhecimento. Quanto ao tratamento medicamentoso (n=12) para a Douleur Neuropathic, 5 (41,6%) responderam que tiveram melhora, nos outros 7 (58,4%) não houve alteração da dor ou pioraram quando se comparou ao quadro inicial. A análise estatística, comparando a melhora da dor entre os pacientes tratados (n=12) e aqueles não tratados (n=10), foi significante (valor-p=0,020). identificou-se dificuldade em diagnosticar a dor neuropática em hanseníase, haja vista que quase metade dos pacientes estudados estava sem reconhecimento desse quadro. Atribuíram-se, como fatores associados, a não adoção de protocolo apropriado para efetivo diagnóstico e tratamentos inadequados que podem mascarar o quadro. identificar las dificultades de diagnosticar y tratar el dolor neuropático causado por la lepra, así como determinar las características principales de esa situación. se examinaron 85 pacientes tratados en ambulatorio de referencia para lepra y que refirieron dolor. Se aplicó el cuestionario test Douleur Neuropathic 4, y se hizo un minucioso examen neurológico a través del cual se excluyeron 42 pacientes por no haberse comprobado dolor. de los 37 pacientes con dolor, 22 (59,5%) tenían dolor neuropático o mixto y, de esos, 90,8% caracterizaban ese dolor como de intensidad moderada o severa, siendo que 81,8% sufrían de él hace más de 6 meses. Apenas 12 (54,5%) pacientes habían sido diagnosticados con dolor neuropático y casi mitad de los casos (45,5%) estaba sin reconocimiento. En cuanto al tratamiento medicamentoso (n=12) para el dolor neuropático, 5 (41,6%) respondieron que tuvieron mejoría; en los otros 7 (58,4%) no hubo alteración del dolor o empeoraron cuando se comparó con el cuadro inicial. El análisis estadístico, comparando la mejoría del dolor entre los pacientes tratados (n=12) y aquellos no tratados (n=10), fue significativa (valor-p=0,020). se identificó dificultad en diagnosticar el dolor neuropático en la lepra, considerando que casi la mitad de los pacientes estudiados estaban sin reconocimiento de ese cuadro. Se atribuyeron como factores asociados la no adopción de protocolo apropiado para un efectivo diagnóstico y tratamientos inadecuados que pudieron haber enmascarar el cuadro.

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 54 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 18 33%
Student > Master 9 17%
Student > Doctoral Student 3 6%
Professor 3 6%
Librarian 2 4%
Other 8 15%
Unknown 11 20%
Readers by discipline Count As %
Medicine and Dentistry 20 37%
Nursing and Health Professions 10 19%
Biochemistry, Genetics and Molecular Biology 2 4%
Pharmacology, Toxicology and Pharmaceutical Science 2 4%
Agricultural and Biological Sciences 2 4%
Other 5 9%
Unknown 13 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2016.
All research outputs
#11,153,157
of 12,537,534 outputs
Outputs from Revista Latino-Americana de Enfermagem
#335
of 417 outputs
Outputs of similar age
#219,664
of 261,742 outputs
Outputs of similar age from Revista Latino-Americana de Enfermagem
#4
of 4 outputs
Altmetric has tracked 12,537,534 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 417 research outputs from this source. They receive a mean Attention Score of 1.9. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 261,742 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one.