Seventy-seven diagnostic suspect indicators of LBP conditions were consensuated. These may facilitate conservative or interventional pain management decision-making.

Chronic pain is a serious problem in Spain. This multicenter, epidemiological 3-month follow-up study investigates pain management efficacy in Spanish centers using patient satisfaction criteria. 3,414 eligible adult patients (65,6% female) with moderate to severe chronic pain from 146 pain centers were included. Patient satisfaction was assessed based onto question 18 of Spanish healthcare barometer-CSI. Pain evolution (Brief Pain Inventory-Short Form (BPI-SF) and visual analog scale (VAS)), quality of life/EuroQol-5, and pain control expectations fulfillment were also assessed. Mean age was 61.3 years. 64.4% of participating centers employed multidisciplinary pain management approach. After 3 months, mean patient satisfaction was 7.8 (1–10) on the CIS barometer. Medical staff received the highest scores, whereas waiting for tests, appointment request to appointment date time, and waiting times at the center the lowest. Mean pain decreased from 7.4 to 4.0; BPI-SF intensity decreased from 6.5 to 3.8; pain control expectations were met in 78.7% of patients; EuroQoL-5D utility index increased from 0.37 to 0.62, p < 0.001, and health status (VAS) from 40.6 to 61.9, p < 0.001. Chronic pain patients (90%) are satisfied with Spanish centers care; 80% had their pain control expectations met. Quality of life improved remarkably: 71% felt moderately to significantly better. However, waiting times need improvement.

Background SF-36 is a questionnaire used in clinical practice to measure subjective patient health. It includes 8 scales: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health. Purpose To describe Pain Unit patients' pharmacotherapy and evaluate its influence on SF-36 responses. Materials and methods Retrospective study that included patients attended in the pain management unit between October 2009 and May 2010. Patients completed at least two SF-36 questionnaires. The electronic history was used to collect demographic (sex, age) and treatment information (diagnosis, pain pharmacotherapy before and after the first clinical visit). Scores obtained in the two questionnaires were compared and The authors calculated the number of patients with improved SF-36 scores. Results 173 patients were attended during the study period, but only 47 were included. Sex distribution: 61.7% female and 38.3% male. Mean age was 56.3 (22-82) years. Chronic lower back pain and postsurgical neuralgia were the main diagnoses. On the first clinical visit NSAIDs (36.2%) and analgesics (34%) were the most prescribed groups followed by weak opioids, antidepressants, anticonvulsants and strong opioids. On the second visit anticonvulsants, antidepressants and strong opioids were the most frequently-prescribed groups. There were no changes between the two questionnaires on role-physical and role-emotional scales and very little difference on bodily pain measures. More than half of patients reported improved results on physical functioning, general health, vitality and mental health scales. The combination of anticonvulsants and antidepressants was associated with an improvement on these scales. Better results were observed if opioids were added to treatment. Conclusions Pharmacotherapy changes after the clinical visits improved physical functioning, general health, vitality and mental health. Antidepressants and anticonvulsants alone or in combination with opioids were the main groups involved. It is interesting to know the drugs used in a Pain Unit, their impact on SF-36, and to evaluate whether the goal of pain relief was really reached and whether patients received optimal pharmacotherapy.

Background As a respiratory disease, the transmission of Coronavirus disease (COVID-19) is mainly caused by small droplets and aerosols. Healthcare personnel are particularly exposed during otologic surgery given the continuity with the nasopharynx, where the viral load is high, and the use of high-speed instruments. The purpose of the present study is to test a model of droplet dispersion produced in the performance of a drilling procedure on human bone to provide information about its distribution and size of the deposit in similar conditions to those of an operating theatre, to design different preventive measures. Material and method A mastoidectomy and trans -labyrinthine approach were performed on an embalmed human corpse using for irrigation during drilling methylene blue dye in physiological saline solution (pss) at a concentration of 0.324 mg/mL. The distribution of the drops was stablished using semi-absorbent papers of size 52 cm × 42 cm covering the area around the dissection field to a radius of 150 cm and on the corpse at different heights to check vertical dispersion. The collected deposit material was analysed with the microscope at different magnification objectives. Results Droplets between 2 μm and 2.6 cm were obtained. The visualization of the coloured droplets in the horizontal plane at a magnification of 1.5 was detected at 150 cm from the focus of emission of milling particles. Discussion According to our study, bone drilling with high speed motors under continuous saline irrigation in a haemorrhagic surgical field increases the amount of aerosols exposing healthcare personnel to additional airbone particles. This risk does not end in the operating rooms as particles smaller than 2 μm can be suspended in the air for hours and could exit the operating theatre due to the use of positive pressure systems. Thus, the use of N95, FFP2, FFP3 or PAPRS should be considered and the development of hood systems to prevent the dispersion of aerosols during these procedures should be considered.