WorldWideScience

Sample records for medical symptom relief

  1. Menopause: Symptom Relief and Treatments

    Science.gov (United States)

    ... Submit Home > Menopause > Menopause symptom relief and treatments Menopause Menopause symptom relief and treatments Working with your doctor ... on menopause symptom relief and treatments Learning about menopause treatment options Most women do not need treatment ...

  2. Quick-Relief Medications for Lung Diseases

    Science.gov (United States)

    ... relief medications are used to treat asthma, other lung disease symptoms or an acute episode (such as an ... about the following quick-relief asthma and other lung disease medications: Anticholinergics Anticholinergics are quick-relief asthma and ...

  3. Contemporary medical management of peripheral arterial disease: a focus on risk reduction and symptom relief for intermittent claudication.

    Science.gov (United States)

    Agrawal, Kush; Eberhardt, Robert T

    2015-02-01

    Peripheral arterial disease (PAD) is primarily caused by progressive systemic atherosclerosis manifesting in the lower extremities. This review addresses the epidemiology, clinical presentation and evaluation, and medical management of PAD, with a focus on intermittent claudication. Key advances in the recognition of cardiovascular risk in asymptomatic individuals with mildly abnormal ankle-brachial index, newer reflections on exercise therapy, and a review of established and investigational agents for the treatment of symptomatic PAD, such as cilostazol, statins, and angiotensin-converting enzyme inhibitors, are highlighted.

  4. Fertility and Symptom Relief following Robot-Assisted Laparoscopic Myomectomy

    Directory of Open Access Journals (Sweden)

    Michael C. Pitter

    2015-01-01

    Full Text Available Objective. To examine success of robot-assisted laparoscopic myomectomy (RALM measured by sustained symptom relief and fertility. Methods. This is a retrospective survey of 426 women who underwent RALM for fibroids, symptom relief, or infertility at three practice sites across the US. We examined rates of symptom recurrence and pregnancy and factors associated with these outcomes. Results. Overall, 70% of women reported being symptom-free, with 62.9% free of symptoms after three years. At >3 years, 66.7% of women who underwent surgery to treat infertility and 80% who were also symptom-free reported achieving pregnancy. Factors independently associated with symptom recurrence included greater time after surgery, preoperative dyspareunia, multiple fibroid surgeries, smoking after surgery, and preexisting diabetes. Factors positively correlated with achieving pregnancy included desiring pregnancy, prior pregnancy, greater time since surgery, and Caucasian race. Factors negatively correlated with pregnancy were advanced age and symptom recurrence. Conclusions. This paper, the first to examine symptom recurrence after RALM, demonstrates both short- and long-term effectiveness in providing symptom relief. Furthermore, RALM may have the potential to improve the chance of conception, even in a population at high risk of subfertility, with greater benefits among those who remain symptom-free. These findings require prospective validation.

  5. Medications for Pain Relief during Labor and Delivery

    Science.gov (United States)

    ... FAQ086 LABOR, DELIVERY, AND POSTPARTUM CARE Medications for Pain Relief During Labor and Delivery • What are the types ... an epidural”) is the most common type of pain relief used during labor and delivery in the United ...

  6. Bilastine for the relief of allergy symptoms.

    Science.gov (United States)

    Sádaba Díaz de Rada, B; Azanza Perea, J R; Gomez-Guiu Hormigos, A

    2011-04-01

    Bilastine is a potent inhibitor of the histamine H1 receptor. It was recently approved in 28 countries of the European Union for the symptomatic treatment of allergic rhinoconjunctivitis and urticaria in adults and children older than 12 years. Data from preclinical studies confirmed its selectivity for the histamine H1 receptor over other receptors, and demonstrated antihistaminic and antiallergic properties in vivo. Studies in healthy volunteers and patients have shown that bilastine does not affect driving ability, cardiac conduction or alertness. Bilastine has demonstrated a good safety profile, without serious adverse effects or antimuscarinic effects in clinical trials. There were no significant changes in laboratory tests, electrocardiograms or vital signs. In clinical studies, oral treatment with bilastine 20 mg once daily improved allergic rhinitis with greater efficacy than placebo and comparable to cetirizine and desloratadine. Bilastine 20 mg was more effective than placebo and equivalent to levocetirizine in chronic urticaria, relieving symptoms, improving quality of life and controlling sleep disorders.

  7. Anti-Seizure Medications: Relief from Nerve Pain

    Science.gov (United States)

    Anti-seizure medications: Relief from nerve pain Anti-seizure drugs often are used to help control the type of ... by damaged nerves. By Mayo Clinic Staff Anti-seizure medications were originally designed to treat people with ...

  8. Understanding medical symptoms

    DEFF Research Database (Denmark)

    Malterud, Kirsti; Guassora, Ann Dorrit Kristiane; Graungaard, Anette Hauskov

    2015-01-01

    The aim of this article is to present a conceptual review and analysis of symptom understanding. Subjective bodily sensations occur abundantly in the normal population and dialogues about symptoms take place in a broad range of contexts, not only in the doctor’s office. Our review of symptom unde...

  9. Medical Marijuana's Pain Relief May Work Better for Men

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160603.html Medical Marijuana's Pain Relief May Work Better for Men Study ... a new study indicates. Researchers asked 42 recreational marijuana smokers to place one hand in extremely cold ...

  10. Medically Unexplained Symptoms

    Science.gov (United States)

    ... may flare up or worsen. IRRITABLE BOWEL SYNDROME Irritable Bowel Syndrome (IBS) is an MUS that interferes with the normal functioning of the large intestine. It is characterized by a group of symptoms, ...

  11. Experiences from tsunami relief activity: implications for medical training

    Directory of Open Access Journals (Sweden)

    Sudharsanam Manni Balasubramaniam

    2012-09-01

    Full Text Available A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills.

  12. Correlations among insomnia symptoms, sleep medication use and depressive symptoms

    National Research Council Canada - National Science Library

    Komada, Yoko; Nomura, Takashi; Kusumi, Masayoshi; Nakashima, Kenji; Okajima, Isa; Sasai, Taeko; Inoue, Yuichi

    2011-01-01

    Aim:  To elucidate the factors associated with insomnia symptoms and the use of sleep medication, and the correlations among insomnia symptoms, sleep medication use and depressive symptoms in the general population. Methods...

  13. Survival and Symptom Relief after Palliative Radiotherapy for Esophageal Cancer.

    Science.gov (United States)

    Welsch, Julia; Kup, Philipp Günther; Nieder, Carsten; Khosrawipour, Veria; Bühler, Helmut; Adamietz, Irenäus A; Fakhrian, Khashayar

    2016-01-01

    The aim of this study was to assess the 6-months dysphagia-free survival, improvement in swallowing function, complication rate, and overall survival in patients with incurable esophageal cancer treated with palliative radiotherapy. We retrospectively reviewed data from 139 patients (median age 72 years) with advanced/recurrent incurable esophageal cancer, who were referred to 3 German radiation oncology centers for palliative radiotherapy between 1994 and 2014. Radiotherapy consisted of external beam radiotherapy (EBRT) with 30 - 40.5 Gy/2.5 - 3 Gy per fraction, brachytherapy alone (BT) with 15 - 25 Gy/5 - 7Gy per fraction/weekly and EBRT + BT (30 - 40.5 Gy plus 10 - 14 Gy with BT) in 65, 46, and 28 patients, respectively. Dysphagia-free survival (Dy-PFS) was defined as the time to worsening of dysphagia for at least one point, a new loco-regional failure or death of any cause. Median follow-up time was 6 months (range 1-6 months). Subjective symptom relief was achieved in 72 % of patients with median response duration of 5 months. The 1-year survival rate was 30%. The 6-months Dy-PFS time for the whole group was 73 ± 4%. The 6-months Dy-PFS was 90 ± 4% after EBRT, 92 ± 5% after EBRT + BT and 37 ± 7% after BT, respectively (p<0.001). Five patients lived for more than 2 years, all of them were treated with EBRT ± BT. Ulceration, fistula and stricture developed in 3, 6 and 7 patients, respectively. Radiotherapy leads to symptom improvement in the majority of patients with advanced incurable esophageal cancer. The present results favor EBRT ± BT over BT alone. Due to the retrospective nature of this study, imbalances in baseline characteristics might have contributed to this finding, and further trials appear necessary.

  14. Effects of nicotine versus placebo e-cigarette use on symptom relief during initial tobacco abstinence.

    Science.gov (United States)

    Perkins, Kenneth A; Karelitz, Joshua L; Michael, Valerie C

    2017-08-01

    Because electronic cigarettes (e-cigs) containing nicotine may relieve smoking abstinence symptoms similar to nicotine replacement therapy medication, we used within-subjects designs to test these effects with a first-generation e-cig in nonquitting and quitting smokers. In Study 1, 28 nontreatment-seeking smokers abstained overnight prior to each of 3 sessions. Minnesota Nicotine Withdrawal Scale (MNWS) withdrawal (and craving item) relief was assessed following 4 exposures (each 10 puffs) over 2 hr to e-cigs that either did (36 mg/ml) or did not (i.e., placebo, 0 mg/ml) contain nicotine or after no e-cig. Relief was greater after nicotine versus placebo e-cig (p cig, showing relief was due to nicotine per se and not simple e-cig use behavior. Using a crossover design in Study 2, smokers preparing to quit soon engaged in 2 experimental 4-day quit periods on separate weeks. In weeks 1 and 3, all received a nicotine or placebo e-cig on Monday to use ad libitum while trying to abstain from smoking on Tuesday through Friday. (Week 2 involved resumption of ad libitum smoking.) MNWS and Questionnaire of Smoking Urges (QSU) craving were assessed at daily visits following 24-hr abstinence. Of 17 enrolled, 12 quit for ≥24 hr at least once, allowing test of relief because of e-cig use on quit days. Withdrawal and craving were reduced because of nicotine versus placebo e-cig use (both p cigs, nicotine e-cigs can relieve smoking abstinence symptoms, perhaps in a manner similar to Food and Drug Administration-approved nicotine replacement therapy products, although much more research with larger samples is needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Relief for maritime medical emergencies through telematics.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A

    1998-12-01

    MERMAID is a European Union (EU)-financed maritime telemedicine project with global reach and 24-h multilingual capability, so as to serve multinational crews working in the isolation of the world's oceans. It provides a model for the provision of healthcare services based on the electronic transmission of medical information via ISDN-based video conferencing. This model is not limited to medical diagnostics, but it encompasses all cases in which the actual delivery of healthcare services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an extensive telecommunications infrastructure that includes both satellite transmission for ship to shore communication and an extensive ground-based network for summoning expert medical help from around the world so as to meet the project's multilinguality requirements and, therefore, the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low-, medium-, and high-bandwidth data requirements) are considered, while the full range of network choices (digital land lines, cellular/wireless, satellite, and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their lifecycle. Finally, out of that, MERMAID utilizes advanced land-based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  16. Reflexology for symptom relief in patients with cancer.

    Science.gov (United States)

    Wilkinson, Susie; Lockhart, Karen; Gambles, Maureen; Storey, Lesley

    2008-01-01

    Complementary therapies are increasingly being used in hospices and hospitals alongside orthodox treatments in an attempt to improve patients' emotional, spiritual, psychological, and physical well-being. An average of 31% of UK patients with cancer use some form of complementary therapy. Many UK cancer centers, out-patient units, and hospices are providing complementary services. There is strong anecdotal evidence that complementary therapies assist in the palliation of physical and psychological symptoms. This systematic review examines the research evidence base for the effectiveness of reflexology in cancer care. The study reports the results of a systematic review following the Cochrane principles of systematic reviewing. No meta-analysis was possible. Studies were retrieved from a comprehensive search of electronic databases from their start dates. An initial search was carried out in 2003 and updated in 2005 to 2006. Eligible studies were randomized controlled trials, controlled before and after studies, and interrupted time-series studies. Participants were adults with a diagnosis of cancer, receiving care in any healthcare setting. Interventions were limited to reflexology carried out by a qualified therapist as distinguished from another healthcare professional carrying out a reflexology intervention. Outcome measures were patient-reported levels of physical and psychological indices of symptom distress and quality of life (measured using validated assessment tools).

  17. Symptom relief and the placebo effect in the trial of an anti-peptic drug.

    Science.gov (United States)

    MacDonald, A J; Peden, N R; Hayton, R; Mallinson, C N; Roberts, D; Wormsley, K G

    1981-04-01

    In order to determine some of the factors involved in the response of duodenal ulcers to placebo treatment, the following factors were studied prospectively during a double-blind, placebo-controlled trial: demographic data; duration of illness and effect of treatment; expectation of success or failure of the new drug; presence of psychiatric problems; and suggestibility. Healing (measured by endoscopy) occurred in 37 patients, 17 of whom were receiving placebo; relief of symptoms occurred in 35 patients, 16 of whom were receiving placebo. There was no significant difference between drug and placebo. Healing was significantly associated with relief of symptoms but with no other variable. Relief of symptoms was more common in male patients and in those from higher social classes, as well as in patients who expected a complete cure and those without evidence of psychiatric problems. the natural history of the disease may be different in these patients. Unexpectedly, suggestibility was not associated with healing or relief of symptoms in the patients receiving placebo.

  18. Euthanasia and relief of suffering: attitudes of medical students.

    Science.gov (United States)

    Ramírez-Rivera, J; Ramos, O

    1995-01-01

    Medical students, from the first, second and third year classes of the University of Puerto Rico School of Medicine, answered a questionnaire which included testing knowledge and attitudes about euthanasia and the relief of suffering. More than 60% of each class participated, a total of two hundred. Ninety three percent of the students knew the definition of euthanasia but 50 percent could not tell the difference between active and passive euthanasia. Students in the first year were better oriented than their counterparts in the third year (58 percent versus 44 percent). Seventy percent of the 100 students who could differentiate between active and passive euthanasia thought that active euthanasia should not be considered murder, but 69 percent were cognizant it was so considered in Puerto Rico. Eighty-three percent of first year students but only 61 percent of third year students thought that physicians should alleviate suffering of terminally ill patients. Medical schools should provide a serious, unprejudiced and complete discussion of euthanasia and other life and death issues in their curricula. A humane orientation of medical students should be given as much emphasis as other aspects of professional training.

  19. Psychosocioeconomic study of medically unexplained physical symptoms

    Directory of Open Access Journals (Sweden)

    Maju Mathew Koola

    2012-01-01

    Full Text Available Background: There is a paucity of studies done on medically unexplained physical symptoms (MUPS in Kerala, India. The objective of this study was to examine the sociodemographic and other clinical variables associated with this condition. Materials and Methods: The clinical sample was taken from the General Medicine Clinic of a tertiary care hospital, in Kerala. The referred cases meeting the criteria (N=48 for medically unexplained physical symptoms were enrolled for this cross-sectional study. The medical doctor with experience in psychiatry completed the questionnaire. Results: Most of the patients were middle-aged females from rural areas. The most common symptom reported was headache. Most of the patients had symptoms for five years or more and had seen two-to-five consultants. A majority of the patients had undergone special investigations and a few had expensive and invasive investigations. Cluster C personality disorders were the most common associated personality disorders with medically unexplained physical symptoms. Conclusions: To our knowledge this is the first psychosocioeconomic study on medically unexplained physical symptoms, done in Kerala, India. Medically unexplained physical symptoms cause loss of productivity and economic burden and are a major public health problem. Future studies are warranted focusing on non-pharmacological treatment, psycho-education on mind-body association, and medical models on specific cytokines associated with medically unexplained physical symptoms for personalized management, and to examine the effect of a combination of pharmacotherapy and cognitive behavioral therapy.

  20. Body awareness therapy: A new strategy for relief of symptoms in irritable bowel syndrome patients

    Institute of Scientific and Technical Information of China (English)

    EM Eriksson; IE M(o)ller; RH S(o)derberg; HT Eriksson; GK Kurlberg

    2007-01-01

    AIM: To compare irritable bowel syndrome (IBS) patients with apparently healthy persons and to evaluate body awareness therapy, which is a physiotherapeutic remedy focusing on normalising tensions in the body,for the treatment of IBS with the hypothesis that altered body tension is associated with the syndrome.METHODS: Twenty-one IBS patients received bodyawareness therapy two hours weekly for 24 wk. At baseline as well as after 12 and 24 wk, they underwent examinations including resource oriented body examination in combination with body awareness scale evaluation and filled in gastrointestinal and psychological symptom questionnaires. Saliva cortisol was analysed. A group of 21 apparently healthy persons underwent the same examinations once.RESULTS: Compared to the apparently healthy group,IBS patients scored higher at baseline for gastrointestinal and psychological symptoms. They showed more often alterations in normal body tension patterns, as well as deviating cortisol slopes in saliva. After 24 wk of body awareness therapy, their gastrointestinal and psychologicai symptoms were reduced overall. Somatic symptoms decreased in parallel with depressive symptoms. Whole body pain score decreased, coping ability as well as biochemical stress markers improved.CONCLUSION: IBS patients scored higher for gastrointestinal and psychological symptoms, and presented with altered biochemical stress markers. Their body tension deviated compared to healthy controls. Furthermore,body awareness therapy gave relief of both somatic complaints, psychological symptoms and normalised body tension. These findings indicate that distorted tension constitutes an important part of the symptoms in IBS.

  1. Art therapy for relief of symptoms associated with HIV/AIDS.

    Science.gov (United States)

    Rao, Deepa; Nainis, Nancy; Williams, Lisa; Langner, Daughon; Eisin, Audra; Paice, Judith

    2009-01-01

    Symptom management for persons living with HIV/AIDS is an extremely important component of care management. The importance of pharmacologic interventions for management of symptoms is well recognized, and non-pharmacologic strategies such as art therapy are gaining interest in lay and professional communities. The aim of this research project was to test the feasibility and effectiveness of art therapy for relief of symptoms experienced by people living with HIV/AIDS. In this randomized clinical trial of art therapy, the primary objective was to assess change in physical and psychological symptoms. Participants were recruited from a large urban hospital's inpatient population and outpatient HIV clinic. Seventy-nine people with a diagnosis of HIV infection provided socio-demographic information, participated in either a one-hour art therapy session or viewed a videotape about art therapy, and completed pre- and posttest measures of psychological and physical symptoms. Two separate analysis of covariance models were used to identify if the treatment condition influenced psychological and physical symptoms, after adjusting for pretest score, age, gender, and race/ethnicity. The analyses showed that physical symptom mean scores were better for those who participated in the art therapy compared to those who viewed the videotape, and this difference between conditions was statistically significant (part therapy in relation to symptoms associated with HIV/AIDS.

  2. Opioids prescription for symptoms relief and the impact on respiratory function: updated evidence.

    Science.gov (United States)

    López-Saca, José Mario; Centeno, Carlos

    2014-12-01

    Opioids are used for treating dyspnea and other symptoms in oncological and nononcological patients. The relief of respiratory fatigue and anxiety that these opioids offer is well known. One of the scarcely frequent, but very much feared, side-effects is respiratory depression. The purpose of this review is to determine whether or not the situation of an advanced-stage patient under palliative care and the use of opioids are risk factors for respiratory depression. Studies conducted on respiratory function and opioids have proliferated in the past 10 years, but there is no recent review that groups the results together and evaluates their safe use in end-stage patients. A bibliographic review found three randomized double-blinded placebo-controlled studies and five prospective studies, six of which showed that opioids significantly relieve dyspnea (P<0.001). The use of morphine for symptomatic relief does not significantly change the level of saturation of oxygen in the blood. In addition, the functional studies do not indicate that the use of opioids for dyspnea relief causes high CO2 levels in blood (P=0.05). The opioids used for treating dyspnea do not significantly compromise respiratory function; they are safe and effective.

  3. Efficacy and tolerability of a novel estradiol vaginal ring for relief of menopausal symptoms.

    Science.gov (United States)

    Speroff, Leon

    2003-10-01

    To assess the efficacy, tolerability, and acceptance of a vaginal ring delivering the equivalent of 50 or 100 microg per day of estradiol (E2), compared with placebo, for relief of moderate to severe vasomotor symptoms and urogenital symptoms in postmenopausal women. Women with moderate to severe vasomotor symptoms (seven or more per day or 56 per week average) received 13 weeks of treatment with a vaginal ring delivering 50 microg per day E2 (n = 113) or 100 microg per day E2 (n = 112), or a placebo vaginal ring (n = 108). Severity of vasomotor symptoms was assessed by a daily diary card and the Greene Climacteric Scale. Urogenital signs and symptoms were evaluated via patient and physician assessment and vaginal cytology. Participant satisfaction with the vaginal ring was evaluated via questionnaire. Vasomotor symptoms significantly improved in both treatment groups, compared with placebo (P <.05). There was a trend toward greater improvement in patient assessment of urogenital signs with active rings compared with placebo. For women with vaginal atrophy at baseline (n = 60), the maturation index improved significantly in both treatment groups compared with placebo. Total Greene Climacteric Scale scores significantly improved for both E2 vaginal ring groups (P <.05) compared with placebo. The vaginal rings were well tolerated. Most adverse events were mild or moderate and consistent with estrogen therapy. A novel vaginal ring delivering the equivalent of 50 or 100 microg per day of E2 significantly reduced the number and severity of vasomotor symptoms and improved urogenital symptoms, compared with placebo. The E2 vaginal ring was well tolerated.

  4. Medications for Pain Relief during Labor and Delivery

    Science.gov (United States)

    ... is a spinal block? • What is a combined spinal–epidural block? • What is general anesthesia? • What are the risks of general anesthesia? • Glossary ... block sensation in a region of the body. Spinal Block: A type of regional anesthesia or analgesia in which pain medications are administered ...

  5. Medical rehabilitation in disaster relief: Towards a new perspective

    Directory of Open Access Journals (Sweden)

    Bhasker Amatya

    2017-06-01

    Full Text Available With increasing frequency of natural disasters, there has been greater focus recently on the importance and role of rehabilitation services in disaster management. In past disasters, rehabilitative needs were often neglected, with emphasis on acute response plans focused on saving lives and treating acute injuries. There was a lack of, or inadequate, rehabilitation-inclusive disaster response plans and rehabilitation services in many disaster-prone developing countries. The World Health Organization (WHO Emergency Medical Team (EMT initiative recognizes rehabilitation as an integral part of medical response and patient-centred care in disaster settings. Current developments under this initiative include: the development of minimum standards for rehabilitation in emergencies to allow rapid, professional, coordinated medical response by both national and international EMTs. These guidelines ensure that EMTs deliver effective and coordinated patient care during disasters and continuum of care beyond their departure. The aim is to strengthen national capacity, foster an environment of self-empowerment of EMTs and local health services, and work in rehabilitation within defined coordination mechanisms in disaster-affected areas. A brief overview of rehabilitation in natural disasters, highlighting current developments, challenges; and gaps in the implementation of WHO guidelines for Minimum Standards for Rehabilitation in Emergencies is discussed in order to improve care for victims of future disasters.

  6. A randomized, double-blind, parallel-group, multicenter, placebo-controlled study of the safety and efficacy of extended-release guaifenesin/pseudoephedrine hydrochloride for symptom relief as an adjunctive therapy to antibiotic treatment of acute respiratory infections.

    Science.gov (United States)

    LaForce, Craig; Gentile, Deborah A; Skoner, David P

    2008-07-01

    This study assessed the efficacy and safety of guaifenesin 600 mg and pseudoephedrine hydrochloride 60 mg extended-release bilayer tablets in providing relief of acute respiratory symptoms when used as an adjunct to antibiotics in patients with an acute respiratory infection (ARI). Adult patients experiencing symptoms of ARI and meeting the physician's usual diagnostic criteria for oral antibiotic treatment were prescribed an antibiotic and randomized to adjunctive guaifenesin/pseudoephedrine hydrochloride or matching placebo twice daily for 7 days. Patients completed symptom diaries and treatment assessments twice daily and attended office visits on Days 4 and 8. The safety/intent-to-treat (ITT) population analysis included 601 patients (guaifenesin/pseudoephedrine, n = 303; placebo, n = 298). Mean symptom scores were lower with guaifenesin/pseudoephedrine from Day 3 for every symptom assessed, with statistically significant improvements in total symptom score from Day 3 (P = 0.026). The greatest effects of treatment with guaifenesin/pseudoephedrine were observed for nasal congestion and sinus headache. Time to overall relief was shorter with guaifenesin/pseudoephedrine (P = 0.038). Significantly more patients reported "the medication was helping during the day" on Day 2 with guaifenesin/pseudoephedrine (P = 0.002). Patient assessments of symptom relief showed a significant preference for guaifenesin/pseudoephedrine versus placebo (P = 0.021). Treatment with guaifenesin/pseudoephedrine was well tolerated. Insomnia (2.6%), nausea (2.3%), and headache (1.3%) were the most common treatment-related adverse effects. As adjunctive therapy for symptom relief for patients taking antibiotics for ARIs, guaifenesin/pseudoephedrine shortened time to relief and improved bothersome respiratory symptoms better than placebo, with greatest effects seen for nasal congestion and sinus headache.

  7. Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Novin Nikbakhsh

    2016-01-01

    Full Text Available Background: Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL improvement of gastric patients receiving chemotherapy. Materials and Methods: This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients received olanzapine tablets (2.5–10 mg/day a day before the beginning of chemotherapy; in the 1st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V status. Results: All the recruited patients continued the allocated interventions (no lost to follow-up. N/V decreased in the case group, but the difference was not statistically significant (P = 0.438. The patients' appetite and body mass index increased (P = 0.006. Anxiety and depression subscales of HADS had significant differences between the two groups (P 0.05. No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05. Conclusion: Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

  8. Evaluation of the suitability of emergent medical technology in earthquake relief

    Directory of Open Access Journals (Sweden)

    Rong-rong LIU

    2011-06-01

    Full Text Available In order to establish the reasonable methods to evaluate the suitability of emergent medical technology in earthquake relief,the suitability evaluation system,including 3 I-grade indexes and 8 II-grade indexes,was established by consulting specialists on the basis of systemic analysis of the influential factors.The weights of the indexes were determined by analytic hierarchy process,and the mathematical model of suitability evaluation was built up by a weighted sum of the indexes.The established evaluation method has been proved effective by an empirical study consisting of 12 common emergent medical technology.

  9. The effect of ranitidine on symptom relief and quality of life of patients with gastro-oesophageal reflux disease.

    Science.gov (United States)

    Chal, K L; Stacey, J H; Sacks, G E

    1995-01-01

    A 4-week study involving 354 patients with the symptoms of gastro-oesophageal reflux disease was conducted to assess the effect of ranitidine (as effervescent tablets) on their relief and quality of life. All patients received 150 mg bd for 2 weeks, with those responding to treatment continuing on the same dosage for a further 2-week period and 'non-responders' having the dosage increased to 150 mg qds for a further 2 weeks. Quality of life and symptom assessments were carried out at 0, 2 and 4 weeks. Two weeks' treatment with ranitidine 150 mg bd was effective at controlling the GORD symptoms in 78% of patients. A 4-week treatment with either 150 mg bd or qds controlled the symptoms in 85% of patients. All patients had significant improvements in all dimensions of their quality of life over the study period.

  10. Consultation letters for medically unexplained physical symptoms in primary care

    NARCIS (Netherlands)

    Hoedeman, Rob; Blankenstein, Annette H.; van der Feltz-Cornelis, Christina M.; Krol, Boudien; Stewart, Roy; Groothoff, Johan W.; van der Feltz-Cornelis, CM

    2010-01-01

    Background In primary care between 10% and 35% of all visits concern patients with medically unexplained physical symptoms (MUPS). MUPS are associated with high medical consumption, significant disabilities and psychiatricmorbidity. Objectives To assess the effectiveness of consultation letters (CLs

  11. Training medical specialists in communication with patients with medically unexplained physical symptoms

    NARCIS (Netherlands)

    A. Weiland (Anne)

    2015-01-01

    markdownabstractIntroduction In secondary care about 50% of newly referred patients to outpatient clinics of Neurology, Gynecology, Rheumatology or Internal Medicine present medically unexplained physical symptoms (MUPS). Medical specialists consider patients with symptoms without underlying pathol

  12. The Relationship between Symptom Relief and Psychosocial Functional Improvement during Acute Electroconvulsive Therapy for Patients with Major Depressive Disorder.

    Science.gov (United States)

    Lin, Ching-Hua; Yang, Wei-Cheng

    2017-07-01

    We aimed to compare the degree of symptom relief to psychosocial functional (abbreviated as "functional") improvement and explore the relationships between symptom relief and functional improvement during acute electroconvulsive therapy for patients with major depressive disorder. Major depressive disorder inpatients (n=130) requiring electroconvulsive therapy were recruited. Electroconvulsive therapy was generally performed for a maximum of 12 treatments. Symptom severity, using the 17-item Hamilton Depression Rating Scale, and psychosocial functioning (abbreviated as "functioning"), using the Modified Work and Social Adjustment Scale, were assessed before electroconvulsive therapy, after every 3 electroconvulsive therapy treatments, and after the final electroconvulsive therapy. Both 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale scores were converted to T-score units to compare the degrees of changes between depressive symptoms and functioning after electroconvulsive therapy. Structural equation modeling was used to test the relationships between 17-item Hamilton Depression Rating Scale and Modified Work and Social Adjustment Scale during acute electroconvulsive therapy. One hundred sixteen patients who completed at least the first 3 electroconvulsive therapy treatments entered the analysis. Reduction of 17-item Hamilton Depression Rating Scale T-scores was significantly greater than that of Modified Work and Social Adjustment Scale T-scores at assessments 2, 3, 4, and 5. The model analyzed by structural equation modeling satisfied all indices of goodness-of-fit (chi-square = 32.882, P =.107, TLI = 0.92, CFI = 0.984, RMSEA = 0.057). The 17-item Hamilton Depression Rating Scale change did not predict subsequent Modified Work and Social Adjustment Scale change. Functioning improved less than depressive symptoms during acute electroconvulsive therapy. Symptom reduction did not predict subsequent functional improvement

  13. The medical management of lower urinary tract symptoms and benign prostatic hyperplasia.

    Science.gov (United States)

    Holtgrewe, H L

    1998-11-01

    Prostatism is a widely used term assigned to the symptom complex of older men with voiding dysfunction. The cause of the syndrome has routinely been ascribed to an enlarged prostate. More recent thinking recognizes that many men with such symptoms do not, in fact, have prostate enlargement or benign prostatic hyperplasia (BPH) and that such symptoms are not a surrogate for BPH. Such recognition is essential if cost effective medical management of lower urinary tract symptoms (LUTS) is to be achieved. Prostate volume has emerged as a key factor in the selection of medical therapy of LUTS and BPH not only regarding symptom relief but also to the newer concept of the prevention of disease progression and the avoidance of future adverse events in those men with true BPH. In the United States, medical management is now first line therapy for LUTS. The proper selection of therapy based on the patient's individual pathophysiologic characteristics is now made possible by many new recent studies within the medical literature.

  14. The resource utilisation of medically unexplained physical symptoms

    Science.gov (United States)

    Lee, Kimberley; Johnson, Malcolm H; Harris, Julie; Sundram, Frederick

    2016-01-01

    Objectives: As patients with medically unexplained physical symptoms may present frequently to hospital settings and receive potentially unnecessary investigations and treatments, we aimed to assess the frequency and type of medically unexplained physical symptoms presentations to clinical services and estimate the associated direct healthcare costs. Methods: This study was undertaken at the largest district health board in New Zealand. All patients with a diagnosed presentation of medically unexplained physical symptoms in 2013 were identified using the district health board’s clinical coding system. The clinical records (medical and psychiatric) of 49 patients were examined in detail to extricate all medically unexplained physical symptoms–related secondary care activity within 6 months before or after their medically unexplained physical symptoms presentation. Standardised national costing methodology was used to calculate the associated healthcare costs. Results: In all, 49% of patients attended hospital settings at least twice during 2013. The majority of presentations were for neurological or respiratory concerns. The total cost for the sample was GBP89,636 (median: GBP1,221). Costs were most significant in the areas of inpatient admissions and emergency care. Conclusion: Medically unexplained physical symptoms result in frequent presentations to hospital settings. The costs incurred are substantial and comparable to the costs of chronic medical conditions with identifiable pathology. Improving recognition and management of medically unexplained physical symptoms has potential to offer more appropriate and cost-effective healthcare outcomes. PMID:27635250

  15. The resource utilisation of medically unexplained physical symptoms

    Directory of Open Access Journals (Sweden)

    Kimberley Lee

    2016-08-01

    Full Text Available Objectives: As patients with medically unexplained physical symptoms may present frequently to hospital settings and receive potentially unnecessary investigations and treatments, we aimed to assess the frequency and type of medically unexplained physical symptoms presentations to clinical services and estimate the associated direct healthcare costs. Methods: This study was undertaken at the largest district health board in New Zealand. All patients with a diagnosed presentation of medically unexplained physical symptoms in 2013 were identified using the district health board’s clinical coding system. The clinical records (medical and psychiatric of 49 patients were examined in detail to extricate all medically unexplained physical symptoms–related secondary care activity within 6 months before or after their medically unexplained physical symptoms presentation. Standardised national costing methodology was used to calculate the associated healthcare costs. Results: In all, 49% of patients attended hospital settings at least twice during 2013. The majority of presentations were for neurological or respiratory concerns. The total cost for the sample was GBP89,636 (median: GBP1,221. Costs were most significant in the areas of inpatient admissions and emergency care. Conclusion: Medically unexplained physical symptoms result in frequent presentations to hospital settings. The costs incurred are substantial and comparable to the costs of chronic medical conditions with identifiable pathology. Improving recognition and management of medically unexplained physical symptoms has potential to offer more appropriate and cost-effective healthcare outcomes.

  16. The prevalence of medical symptoms in military aircrew.

    Science.gov (United States)

    Gordon, Barak; Erlich, Yifat; Carmon, Erez

    2017-01-01

    The prevalence of medical symptoms in aviators has not been described in the medical literature. An anonymous questionnaire was handed to all Israeli Air Force aviators who went through the routine yearly examination. Because only two women filled the questionnaire, we excluded them. The questionnaire contained a list of 49 symptoms and the aviators were asked to mark symptoms that were present in the last month before the examination as well as age, estimated weekly flying hours, military service status (reserve or career) and type of aircraft (jet-fighter, helicopter or transport). A general linear model was used to determine the association between age, weekly flying hours, type of aircraft and type of service with the number of symptoms. Binary logistic regression analyses was used to assess the association of these factors with lack of symptoms, and the top five ranking symptoms. Data was available for 323 male aviators. 62.5% of the aviators reported at least one symptom in the previous month. 26.9% reported three or more symptoms. 25.1% reported spinal symptoms, 22% respiratory symptoms, 21.4% fatigue, 11.5% headache and 6.5% general weakness. Career service was associated with the number of symptoms, fatigue and general weakness. Age was associated with fatigue and general weakness. Aircraft type and weekly flying hours were not associated with any symptom. Medical symptoms are prevalent in military aviators. Career personnel report on medical symptoms, especially fatigue, more often than reserve personnel. Further study is warranted to examine this association.

  17. Comparative study of omeprazole, lansoprazole,pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

    Institute of Scientific and Technical Information of China (English)

    Ri-Nan Zheng

    2009-01-01

    AIM: To clarify whether there is any difference in the symptom relief in patients with reflux esophagitis following the administration of four Proton pump inhibitors (PPIs).METHODS: Two hundred and seventy-four patients with erosive reflux esophagitis were randomized to receive 8 wk of 20 mg omeprazole ( n = 68), 30 mg of lansoprazole ( n = 69), 40 mg of pantoprazole ( n= 69), 40 mg of esomeprazole ( n = 68) once a day in the morning. Daily changes in heartburn and acid reflux symptoms in the first 7 d of administration were assessed using a six-point scale (0: none; 1: mild; 2:mild-moderate; 3: moderate; 4: moderate-severe; 5:severe).RESULTS: The mean heartburn score in patients treated with esomeprazole more rapidly decreased than those receiving other PPI. Complete resolution of heartburn was also more rapid in patients treated with esomeprazole for 5 d compared with omeprazole ( P = 0.0018, P = 0.0098, P = 0.0027, P = 0.0137, P = 0.0069,respectively), lansoprazole ( P = 0.0020, P = 0.0046, P= 0.0037, P = 0.0016, P = 0.0076, respectively), and pantoprazole ( P = 0.0006, P = 0.0005, P = 0.0009, P =0.0031, P = 0.0119, respectively). There were no significant differences between the four groups in the rate of endoscopic healing of reflux esophagitis at week 8.CONCLUSION: Esomeprazole may be more effective than omeprazole, lansoprazole, and pantoprazole for the rapid relief of heartburn symptoms and acid reflux symptoms in patients with reflux esophagitis.

  18. Patients with persistent medically unexplained physical symptoms

    DEFF Research Database (Denmark)

    A, Aamland; Malterud, Kirsti; Werner, E.

    2014-01-01

    for all variables and split analysis on gender and age. RESULTS: The GPs registered 526 patients among their total of 17 688 consultations, giving a consultation prevalence of persistent MUPS of 3%. The mean age of patients was 46 years, and 399 (76%) were women. The most frequent group of symptoms...... was musculoskeletal problems, followed by asthenia/fatigue. There was no significant gender difference in symptom pattern. Almost half of the patients were currently working (45%), significantly more men. The major GP management strategy was supportive counseling. CONCLUSION: A consultation prevalence rate of 3......% implies that patients with persistent MUPS are common in general practice. Our study disclosed heterogeneity among the patients such as differences in employment status, which emphasizes the importance of personalized focus rather than unsubstantiated stereotyping of "MUPS patients" as a group....

  19. Efficacy of a new, oral estradiol acetate formulation for relief of menopause symptoms.

    Science.gov (United States)

    Speroff, Leon; Haney, Arthur F; Gilbert, Richard D; Ellman, Herman

    2006-01-01

    To determine the efficacy of three doses of a new, oral formulation of estradiol acetate (EA) for alleviation of vasomotor and urogenital symptoms in postmenopausal women. Two separate 12-week studies were undertaken in postmenopausal women with moderate to severe vasomotor symptoms. In the first study, women were randomly assigned to EA 0.9 mg/day, EA 1.8 mg/day, or placebo (study 1; N = 293), and in the second study to oral EA 0.45 mg/day or placebo (study 2; N = 259). Women recorded the frequency and severity of vasomotor symptoms daily and urogenital symptoms weekly on diary cards. Investigators assessed signs of vaginal atrophy. Frequency of moderate to severe vasomotor symptoms decreased significantly versus placebo, starting at week 2 in the EA 1.8-mg group (P = 0.005), week 3 in the EA 0.9-mg group (P = 0.003), and week 6 in the EA 0.45-mg group (P < 0.05). At week 12, mean percent reduction from baseline in vasomotor-symptom frequency was 91%, 78%, and 61%, respectively. Vasomotor-symptom severity decreased significantly versus placebo, starting at weeks 2 and 3 with EA 1.8 mg and 0.9 mg, respectively, and at week 5 with EA 0.45 mg. Vaginal pH and maturation index improved significantly in all EA groups versus placebo, and some signs and symptoms of vaginal atrophy improved at the EA 0.9- and 1.8-mg doses. Side effects were mild to moderate and consistent with estrogen therapy. Oral EA at all doses was well tolerated and significantly reduced the frequency and severity of postmenopause symptoms versus placebo.

  20. From comic relief to real understanding; how intestinal gas causes symptoms.

    LENUS (Irish Health Repository)

    Quigley, E M M

    2012-02-03

    Gas content and transit appear to conspire with the motor and sensory responses of the gut to produce gas related symptoms, both in normal individuals and especially in patients with irritable bowel syndrome (IBS). In relation to gas in IBS, two questions need to be addressed: do IBS patients produce more gas and what are the relationships between intestinal gas and symptoms? The balance of evidence seems to indicate that distension is a real phenomenon in IBS and that such distension accurately reflects gas content. More problematic is extrapolation of the observations relating symptoms to gas transit and retention.

  1. From comic relief to real understanding; how intestinal gas causes symptoms.

    Science.gov (United States)

    Quigley, E M M

    2003-12-01

    Gas content and transit appear to conspire with the motor and sensory responses of the gut to produce gas related symptoms, both in normal individuals and especially in patients with irritable bowel syndrome (IBS). In relation to gas in IBS, two questions need to be addressed: do IBS patients produce more gas and what are the relationships between intestinal gas and symptoms? The balance of evidence seems to indicate that distension is a real phenomenon in IBS and that such distension accurately reflects gas content. More problematic is extrapolation of the observations relating symptoms to gas transit and retention.

  2. Itching for Allergy Relief?

    Science.gov (United States)

    ... Home For Consumers Consumer Updates Itching for Allergy Relief? Share Tweet Linkedin Pin it More sharing options ... your ability to function, you don't find relief from OTC drugs, or you experience allergy symptoms ...

  3. Chiari I malformation with underlying pseudotumor cerebri: Poor symptom relief following posterior decompression surgery

    Directory of Open Access Journals (Sweden)

    Ahmed Alnemari

    2017-01-01

    Conclusion: This study suggests that the presence of Chiari I malformation in a patient conceals the symptoms of PTC which may become apparent following posterior decompression surgery. Other possibilities could be that the patients are misdiagnosed for Chiari I malformation when they are in fact suffering from PTC, or that PTC is a complication of surgery.

  4. The effects of implementation of guideline-directed medical therapy on relief of angina in patients with stable coronary artery disease in Serbia

    Directory of Open Access Journals (Sweden)

    Ilić Ivan

    2016-01-01

    Full Text Available Introduction. Adherence to proposed lifestyle changes and prescribed medication in patients with stable coronary artery disease (SCAD is poor. Objective. We sought to investigate the influence of adjusting guideline proposed medications on relief of angina in a large group of patients with SCAD in Serbia. Methods. The study included a total of 3,490 patients from 15 cardiology clinics with symptoms of stable angina and at least one of the following criteria: abnormal electrocardiogram (ECG, history of myocardial infarction (MI, positive stress test, significant coronary artery disease on coronary angiogram or previous revascularization. All the patients underwent comprehensive evaluation at initial visit and after two months. The relief of angina was study end-point defined as any reduction in Canadian Cardiology Society (CCS class, number of angina attacks per week and/or number of tablets of short-acting nitrates per week. Results. Most patients were included based on abnormal ECG (48.4%. At Visit 1, the average number of prescribed classes of medications to a single patient increased from 4.16 ± 1.29 to 4.63 ± 1.57 (p < 0.001. At the follow-up, the patients had significantly lower blood pressure (141 ± 19 / 85 ± 11 vs. 130 ± 12 / 80 ± 8 mmHg; p < 0.001 and most of them reported CCS class I (63.3%. The average weekly number of angina attacks was reduced from 2.82 ± 2.50 at Visit 1 to 1.72 0 ± 1.66 at Visit 2, as well as average weekly use of short-acting nitrates to treat these attacks (2.69 ± 2.53 to 1.74 ± 1.47 tablets; p < 0.001 for all. Conclusion. Adjustment of prescribed medications to guideline recommendations in a large Serbian patient population with prevalent risk factors led to significant relief of angina.

  5. A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial

    Directory of Open Access Journals (Sweden)

    Kuskowski Michael A

    2008-02-01

    Full Text Available Abstract Background This small, pilot study evaluated the impact of treatment with a natural multi-mineral supplement from seaweed (Aquamin on walking distance, pain and joint mobility in subjects with moderate to severe osteoarthritis of the knee. Methods Subjects (n = 70 with moderate to severe osteoarthritis of the knee were randomized to four double-blinded treatments for 12 weeks: (a Glucosamine sulfate (1500 mg/d; (b Aquamin (2400 mg/d; (c Combined treatment composed of Glucosamine sulfate (1500 mg/d plus Aquamin (2400 mg/d and (d Placebo. Primary outcome measures were WOMAC scores and 6 Minute Walking Distances (6 MWD. Laboratory based blood tests were used as safety measures. Results Fifty subjects completed the study and analysis of the data showed significant differences between the groups for changes in WOMAC pain scores over time (p = 0.009 ANCOVA; however, these data must be reviewed with caution since significant differences were found between the groups at baseline for WOMAC pain and stiffness scores (p = 0.0039 and p = 0.013, respectively, ANOVA. Only the Aquamin and Glucosamine groups demonstrated significant improvements in symptoms over the course of the study. The combination group (like the placebo group did not show any significant improvements in OA symptoms in this trial. Within group analysis demonstrated significant improvements over time on treatment for the WOMAC pain, activity, composite and stiffness (Aquamin only scores as well as the 6 minute walking distances for subjects in the Aquamin and Glucosamine treatment groups. The Aquamin and Glucosamine groups walked 101 feet (+7% and 56 feet (+3.5% extra respectively. All treatments were well tolerated and the adverse events profiles were not significantly different between the groups. Conclusion This small preliminary study suggested that a multi mineral supplement (Aquamin may reduce the pain and stiffness of osteoarthritis of the knee over 12 weeks of treatment and

  6. Persistent presentation of medically unexplained symptoms in general practice.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Meijer, S.A.; Visser, A.P.; Wolters, G.

    2006-01-01

    OBJECTIVES: To estimate the prevalence of persistent presentation of medically unexplained physical symptoms (MUPS) in general practice. To assess socio-demographic characteristics, health status and use of health services of patients who frequently present MUPS, compared with reference groups. DESI

  7. Rapid relief of signs/symptoms in chronic venous microangiopathy with pycnogenol: a prospective, controlled study.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Rohdewald, P; Pellegrini, L; Ledda, A; Vinciguerra, G; Ricci, A; Gizzi, G; Ippolito, E; Fano, F; Dugall, M; Acerbi, G; Cacchio, M; Di Renzo, A; Hosoi, M; Stuard, S; Corsi, M

    2006-01-01

    The aim of this study was to investigate the clinical efficacy of oral Pycnogenol (Horphag Research Ltd, UK) in patients with severe chronic venous insufficiency. Patients with severe venous hypertension (chronic venous insufficiency, ankle swelling) and history of venous ulcerations were treated with Pycnogenol. Patients received oral Pycnogenol (50 mg capsules, 3 times daily for a total of 150 mg daily) for 8 weeks. A group of 21 patients was included in the treatment group and 18 equivalent patients were observed as controls (no treatment during the observation period). All 21 patients (age 53 years; range, 42-60 years; M:F=11:10) in the treatment group completed the 8-week study. Also the 18 controls completed the follow-up period. There were no drop-outs. The average ambulatory venous pressure was 59.3 (SD 7.2; range 50-68) with a refilling time shorter than 10 seconds (average 7.6; SD 3). There were no differences in ambulatory venous pressure or refilling time between the treatment and control patients. The duration of the disease-from the first signs/symptoms-was on average 5.7 years (SD 2.1). At 4 and 8 weeks, in all Pycnogenol-treated subjects, microcirculatory and clinical evaluations indicated a progressive decrease in skin flux, indicating an improvement in the level of microangiopathy; a significant decrease in capillary filtration; a significant improvement in the symptomatic score; and a reduction in edema. There were no visible effects in controls. In conclusion, this study confirms the fast clinical efficacy of Pycnogenol in patients with chronic venous insufficiency and venous microangiopathy. The study indicates the significant clinical role of Pycnogenol in the management, treatment and control of this common clinical problem. The treatment may be also useful to prevent ulcerations by controlling the level of venous microangiopathy.

  8. Medically unexplained symptoms and pain: misunderstanding and myth.

    Science.gov (United States)

    de C Williams, Amanda C; Cella, Matteo

    2012-06-01

    The recent resurgence of the notion of psychosomatic disorders, grouping together as 'medically unexplained symptoms' all those without organic diagnosis and associated with distress, has included all chronic (persistent) pain within its remit. As pain is reasonably well explained, within an integrated biopsychosocial model, critical analysis of the position is required. Neuroscientific and translational studies of pain mechanisms have strengthened the understanding of pain, providing stronger connections between abstract psychological concepts corresponding to observation and studies of human clinical populations, neuroscientific findings in clinical and analogue studies, and animal research. This situation is contrasted with even the most recent reviews of medically unexplained symptoms providing only vague and patchily supported mechanisms, with little cognate human analogue or animal research. The implication of subsuming chronic pain under medically unexplained symptoms is that the primary care/community physician will try to persuade the patient that the symptoms indicate underlying depression, which her or she may offer to treat. When pain is instead recognized as a problem in its own right, it would be referred for specialist opinion and care, or treated directly with evidence-based pain interventions.

  9. Psychology of medically unexplained symptoms: A practical review

    Directory of Open Access Journals (Sweden)

    Sirous Mobini

    2015-12-01

    Full Text Available Medically unexplained symptoms (MUS or functional neurological symptoms (FNS are commonly seen in the medical and rehabilitation settings. Clinicians often tend to describe patients with MUS as the “most difficult to help”. This practical review discusses epidemiology, clinical presentations, assessment and diagnosis of these psychiatric and neurological conditions, and summarises psychological models that have been linked to the development and maintenance of MUS. The final purpose of the present paper was to review the current literature in the treatment on the management and treatment of MUS. It concludes that future research should focus on a more integrated treatment approach which addresses various biological, psychological and social factors contributing to the onset and maintenance of these debilitating conditions.

  10. Post-Nargis medical care: experience of a Korean Disaster Relief Team in Myanmar after the cyclone.

    Science.gov (United States)

    Kim, Hoon; Han, Seung Baik; Kim, Ji Hye; Kim, Jun Sig; Hong, EunSeog

    2010-02-01

    The objective of this study was to assess the epidemiology and clinical data of patients observed by the Korean Disaster Relief Team, during its deployment in Myanmar, from 6 to 12 June 2008. A cross-sectional, medical record-based study in the Korean Disaster Relief Team clinic, established a month after the cyclone Nargis devastated Myanmar. Data collected included demographic variables, and whether or not the problem was acute or chronic, and traumatic or medical. We included 2641 patients in the study. Of those, 57.6% presented with an acute condition, and the rest had chronic conditions. Approximately 5% of the patients presented with trauma/injury; and in 29% of the trauma cases, the problem was directly related to the cyclone. The most common diagnostic category was musculoskeletal problems (21.5%), followed by respiratory (15.3%), and digestive (14.6%) abnormalities. A little over 5% of patients had posttraumatic stress disorder, and the odds ratio was 2.62 (95% confidence interval 1.63-4.21) for women to have posttraumatic stress disorder. Most of the patients (97.5%) had minor problems and were sent home. In conclusion, a huge unmet medical need in at-risk populations and a relatively large proportion of chronic medical conditions should be considered in any future planning of a similar type of disaster.

  11. Perception of stroke symptoms and utilization of emergency medical services

    Directory of Open Access Journals (Sweden)

    Maximiliano A. Hawkes

    Full Text Available ABSTRACT Lack of stroke awareness and slow activation of emergency medical services (EMS are frequently reported reasons for delayed arrival to the hospital. We evaluated these variables in our population. Methods Review of hospital records and structured telephone interviews of 100 consecutive stroke patients. Forward stepwise logistic regression was used for the statistical analysis. Results Seventy patients (75% arrived at the hospital 4.5 hours after stroke symptoms onset. The use of EMS did not improve arrival times. Most patients who recognized their symptoms did not use EMS (p < 0.02. Nineteen patients (20% were initially misdiagnosed. Eighteen of them were first assessed by non-neurologist physicians (p < 0.001. Conclusions Our population showed a low level of stroke awareness. The use of EMS did not improve arrival times at the hospital and the non-utilization of the EMS was associated with the recognition of stroke symptoms. There was a concerning rate of misdiagnosis, mostly by non-neurologist medical providers.

  12. 抗震救灾卫勤保障的伦理学思考%Ethical Thinking about Medical Support in the Earthquake Relief

    Institute of Scientific and Technical Information of China (English)

    王剑锋

    2011-01-01

    Medical support is significantl different from daily medical work in earthquake relief.In the article, the problems were discussed related with medical ethics during executing the task according to the practice, which would be contributed to improve the construction of medical relief system.%抗震救灾行动中的卫勤保障,与日常医疗工作有显著不同.本文结合实际,对执行任务中与医学伦理学相关的问题进行思考,有助于完善灾害医疗救援体系建设.

  13. THE USE OF SUPEROXIDE DISMUTASE IN ACCELERATING SYMPTOM RELIEF IN ASTHMATIC AND HOUSE DUST MITE ALLERGIC CHILDREN RECEIVING HOUSE DUST MITE IMMUNOTHERAPY: DOUBLE BLIND RANDOMIZED CONTROLLED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Anang Endaryanto

    2015-09-01

    Full Text Available Objective: To evaluate the efficacy of superoxide dismutase (SOD in lung function (FEV1 reversibility and respiratory symptoms (drug scores, symptoms scores in asthmatic and house dust mite allergic children receiving house dust mites immunotherapy. Methods: Forty subjects aged 6–17 years old with asthma, tested positive for house dust mite allergy on skin prick test, and received immunotherapy were enrolled in this study. All subjects completed clinical based assessments and diary-based assessments for drug and symptom scores. Following a four-week baseline assessment, all subjects were randomized to receive SOD or placebo. Respiratory symptoms (drug and symptoms score and FEV1 were evaluated at the end of the 1st, 2nd, 3rd, and 4th weeks after randomization. Drug score, symptoms score, and FEV1 reversibility test results were analyzed using a Paired t test and repeated measure of ANOVA. Results: There was a significant difference in drug scores, symptoms score, and FEV1 reversibility test outcomes between SOD and placebo. SOD group showed a significant decrease in all outcome measures compared to those in placebo group. Conclusions: The use of SOD as antioxidants is effective in accelerating symptom relief for children with asthma and house dust mite allergy receiving house dust mite immunotherapy.

  14. Finding Relief from Allergy's Grip

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Finding Relief from Allergy's Grip Past Issues / Summer 2006 Table ... action for patients who have had inadequate symptom relief with antihistamines and topical nasal steroids. Through injection ...

  15. Depressive symptoms in medical students: prevalence and related factors.

    Science.gov (United States)

    Kim, Bomi; Roh, Hyerin

    2014-03-01

    This study was designed to estimate the prevalence of depression and the factors that influence it in Korean medical students. We evaluated depression in 122 first- and second-year medical students in December 2011 using the Korean Beck Depression Inventory (K-BDI). Sixteen potential factors were considered: gender, class year, grade point average, breakfast habits, residence type, leisure activity, sleep satisfaction, relationship status, a close friend or a significant other, finances, present health status, history of mood disorders, family history of mood disorders, religion, and self-esteem. The average BDI score was 8.9. There were 80 (65.6%), 16 (13.1%), 15 (12.3%), and 11 (9.0%) students with minimal, mild, moderate, and severe depression, respectively. The group with depressive symptoms comprised males with a total BDI score > or =24 and females with total BDI > or =25 and constituted 9.0% of students. Students in the depressive symptom group had lower self-esteem and lower grade point averages and were more frequently ill, less likely to be in a relationship, and more likely to have a history of mood disorders (pself-esteem score was an independent factor. The BDI scores in our study were similar to those that have been reported in other countries but slightly higher than in other Korean medical and university students. Self-esteem, grade point average, health status, history of mood disorders, family history of mood disorders, and presence of a significant other correlated significantly with depression in medical students.

  16. Symptom and Surface: Disruptive Deafness and Medieval Medical Authority.

    Science.gov (United States)

    Hsy, Jonathan

    2016-12-01

    This essay examines constructions of deafness in medieval culture, exploring how deaf experience disrupts authoritative discourses in three textual genres: medical treatise, literary fiction, and autobiographical writing. Medical manuals often present deafness as a physical defect, yet they also suggest how social conditions for deaf people can be transformed in lieu of treatment protocols. Fictional narratives tend to associate deafness with sin or social stigma, but they can also imagine deaf experience with a remarkable degree of sympathy and nuance. Autobiographical writing by deaf authors most vividly challenges diagnostic models of disability, exploring generative forms of perception that deafness can foster. In tracing the disruptive force that deaf experience exerts on perceived notions of textual authority, this essay reveals how medieval culture critiqued the diagnostic power of medical practitioners. Deafness does not simply function as a symptom of an individual problem or a metaphor for a spiritual or social condition; rather, deafness is a transformative capacity affording new modes of knowing self and other.

  17. (Gynazole-1® Compared to Fluconazole 150 mg Tablets (Diflucan® in the Time to Relief of Symptoms in Patients With Vulvovaginal Candidiasis

    Directory of Open Access Journals (Sweden)

    Larry S. Seidman

    2005-01-01

    Full Text Available Background. It is estimated that as many as 13 million cases of vulvovaginal infection occur in the United States annually, the majority of which are the result of Candida albicans infection. The symptoms of vulvovaginal infections are often painful and distressing to the patient. The objective of this study was to compare the time to symptomatic relief of vulvovaginal candidiasis (VVC with butoconazole nitrate 2% Site Release® vaginal cream (Gynazole-1® and oral fluconazole 150 mg tablets (Diflucan®.

  18. Mental health symptoms in combat medic training: a longitudinal examination.

    Science.gov (United States)

    Robinson, Michael E; Teyhen, Deydre S; Wu, Samuel S; Dugan, Jessica L; Wright, Alison C; Childs, John D; Yang, Guijun; George, Steven Z

    2009-06-01

    Mental health symptoms in military populations are rising and constitute a significant health concern. This study examined the prevalence of depression, anxiety, and suicidal ideation in soldiers (N = 3,792) undergoing combat medic training. At the start of training, 10.4%, 15.5%, and 4.1% of soldiers had clinically significant depression, anxiety, or suicidal ideation, respectfully. These percentages increased to 12.2%, 20.3%, and 5.7% at completion of training, respectfully. Worsening of depression, anxiety, and suicidal ideation occurred for 7.7%, 11.4%, and 4% of soldiers. Higher percentages of symptoms were associated with females, lower education, and lower income. Active duty personnel were more likely to worsen following training with respect to suicidal ideation (OR = 1.9, 95% CI = 1.2-2.9) compared to reservists. The identification of these significant predictors of mental health status may serve to identify individuals at risk. Additional work to examine the relative contribution of anticipatory (impending deployment) factors vs. training-related factors is warranted.

  19. The cross-sectional relation between medically unexplained physical symptoms (MUPS) and the Cortisol Awakening Response

    NARCIS (Netherlands)

    Claassen-van Dessel, Nikki; van der Wouden, Johannes C.; Dekker, Joost; Rosmalen, Judith G. M.; van der Horst, Henriette E.

    2017-01-01

    Objectives: We aimed to assess the cross-sectional relation between levels of cortisol and specific symptom clusters, symptom severity and duration of symptoms in patients with medically unexplained physical symptoms (MUPS). Methods: Baseline data of a cohort of MUPS patients were used. We chose the

  20. Cyanoacrylate medical adhesives--a new era Colgate ORABASE Soothe.N.Seal Liquid Protectant for canker sore relief.

    Science.gov (United States)

    Narang, U

    2001-01-01

    Cyanoacrylate, a synthetic adhesive, is a fast polymerizable liquid monomer. Serendipity led to the discovery of cyanoacrylate adhesives in 1951. Today, a specific cyanoacrylate monomer, 2-octyl cyanoacrylate, is being used in a topical medical adhesive formulation. The only over-the-counter cyanoacrylate-based product cleared by the Food and Drug Administration is Colgate ORABASE Soothe.N. Seal Liquid Protectant. Upon application, this liquid monomer formulation polymerizes instantly into a thin, flexible polymer film that adheres tenaciously to mucosal tissue. This polymer film creates a mechanical barrier that provides immediate and long-term pain relief of oral ulcerations and irritations, and maintains a natural healing environment for the area to heal.

  1. Children with medically unexplained pain symptoms: Categorization and effective management

    Directory of Open Access Journals (Sweden)

    Sharmishtha S Deshpande

    2011-01-01

    Full Text Available Context: Medically unexplained pain symptoms are common in children, and their incidence is on the rise. There is often a lack of clearly articulated pathophysiology in these patients. There is need to improve understanding about varied causes and presentations of these patients which would generate further insight in management of these patients. Documentation and detailed assessment of such children in Indian setting is not seen in literature. Materials and Methods: A series of 17 cases, 10 boys and 7 girls referred from pediatrics department is discussed, so as to categorize them in three different subgroups for management. Result and Discussion: Although there were often no overt anxiety or depressive features, some psychosocial stress which was mostly unnoticed by the child, the parents and the doctor, preceded such a pain. It was often an academic stress, familial separation or parental psychiatric illness. They were at times not able to verbalize their distress, which was revealed with the help of Children′s Apperception Test (C.A.T.. They mainly had anxieties about loss of love or disapproval by parents and also fear of harm or injury. They used defence mechanisms like denial, reaction formation and repression, which were ineffective in handling the overwhelming anxiety. Most of these children had either above average or borderline intelligence. Somatic expression of emotional needs and fears in these children was managed effectively by supportive therapy and antidepressant drugs.

  2. Early Relief of Upper Gastrointestinal Dyspeptic Symptoms: A Survey of Empirical Therapy with Pantoprazole in Canadian Clinical Practice

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2002-01-01

    Full Text Available BACKGROUND: Upper gastrointestinal symptoms attributable to gastroesophageal reflux disease or peptic ulcer are common, but the outcome of proton pump inhibitor therapy in clinical practice is not well documented.

  3. Prevalence and relief of pain in trauma patients in emergency medical services

    NARCIS (Netherlands)

    Berben, S.A.A.; Schoonhoven, L.; Meijs, T.H.; Vugt, A.B. van; Grunsven, P.M. van

    2011-01-01

    OBJECTIVES: The aim of this study was to give insight in the prevalence of pain, and the (effect of) pain management according to the national emergency medical services analgesia protocol in trauma patients in the Netherlands. METHODS: The retrospective document study included adult and alert traum

  4. Challenges of correlating pH change with relief of clinical symptoms in gastro esophageal reflux disease: a phase III, randomized study of Zegerid versus Losec.

    Directory of Open Access Journals (Sweden)

    Dave Walker

    Full Text Available Zegerid (on demand immediate-release omeprazole and sodium bicarbonate combination therapy has demonstrated earlier absorption and more rapid pH change compared with Losec (standard enteric coated omeprazole, suggesting more rapid clinical relief of heartburn. This Phase III, multicenter, double-blind, double-dummy, randomized study assessed the clinical superiority of Zegerid versus Losec for rapid relief of heartburn associated with gastro-esophageal reflux disease (GERD.Patients with a history of frequent (2 3 days/week uncomplicated GERD, were randomized to receive Zegerid (20 mg or Losec (20 mg with corresponding placebo. Study medication was self-administered on the first episode of heartburn, and could be taken for up to 3 days within a 14 day study period. Heartburn severity was self assessed up to 180 minutes post dose (9 point Likert scale. Primary endpoint was median time to sustained response (≥3 point reduction in heartburn severity for ≥45 minutes.Of patients randomized to Zegerid (N=122 or Losec (N=117, 228/239 had recorded ≥1 evaluable heartburn episodes and were included in the modified intent-to-treat population. No significant between-group differences were observed for median time to sustained response (60.0 vs. 52.2 minutes, Zegerid [N=117] and Losec [N=111], respectively, sustained partial response (both, 37.5 minutes and sustained total relief (both, 105 minutes. Significantly more patients treated with Zegerid reached sustained total relief within 0-30 minutes post dose in all analysis sets (p<0.05. Both treatments were well tolerated and did not raise any safety concerns.Superiority of Zegerid over Losec for rapid heartburn relief was not demonstrated; both treatments were equally effective however the rapid onset of action of Losec was unexpected. Factors, including aspects of study design may have contributed to this. This study supports previously reported difficulty in correlating intra-gastric pH change with

  5. Hippocampal volume correlates with attenuated negative psychotic symptoms irrespective of antidepressant medication

    Directory of Open Access Journals (Sweden)

    Raffaele Bernasconi

    2015-01-01

    Conclusion: Reduced GMV in the hippocampus and precuneus is associated with short-term antidepressant medication and more severe depressive symptoms. Hippocampal volume is further negatively correlated with attenuated negative psychotic symptoms. Longitudinal studies are needed to distinguish whether hippocampal volume deficits in the ARMS are related to attenuated negative psychotic symptoms or to antidepressant action.

  6. An open-label pilot study to assess the effectiveness of krill oil with added vitamins and phytonutrients in the relief of symptoms of PMS

    Directory of Open Access Journals (Sweden)

    Wakeman MP

    2013-09-01

    Full Text Available Michael P Wakeman School of Cancer Sciences, University of Birmingham, Edgbaston, Birmingham, West Midlands, UK Abstract: An open-label pilot study over 4 months to evaluate the effectiveness of a compound formulation of ingredients, which individually have been demonstrated to be implicated in the pathogenesis of premenstrual syndrome to ameliorate the most troublesome symptoms of the condition. The supplement provided thiamine, riboflavin, pyridoxine, vitamin D, soy isoflavones, rosemary extract, and krill oil and was taken each day for the 3 months of the trial. Statistically significant effect was reported by the 29 women who completed the study in relief of anxiety, bloating, mood swings, breast tenderness, skin outbreaks, food cravings, fatigue, forgetfulness, insomnia, and headache after 3 months of treatment compared with baseline. This pilot study indicates the formulation to be effective, and a larger placebo-controlled trial is now planned. Keywords: thiamine, riboflavin, pyridoxine, vitamin D, soy isoflavones, rosemary extract, premenstrual syndrome

  7. Safety and efficacy of extended-release guaifenesin/pseudoephedrine hydrochloride for adjunctive symptom relief of acute respiratory infections.

    Science.gov (United States)

    Kikano, George

    2009-05-01

    Acute bacterial respiratory infections (ABRIs) require treatment with antibiotics. Although antibiotics may address the underlying pathogenic factors, over-the-counter (OTC) agents can play an adjuvant role in relieving mucus-related symptoms. This complimentary role contributes to the healing process and is supported by current clinical guidelines.

  8. The simple query "Do you want more pain medication?" is not a reliable way to assess acute pain relief in patients in the emergency department.

    Science.gov (United States)

    Chauny, Jean-Marc; Marquis, Martin; Paquet, Jean; Lavigne, Gilles; Cournoyer, Alexis; Manzini, Christiane; Daoust, Raoul

    2017-03-15

    The management of acute pain constitutes an essential skill of emergency department (ED) physicians. However, the accurate assessment of pain intensity and relief represents a clinically challenging undertaking. Some studies have proposed to define effective pain relief as the patient's refusal for additional analgesic administration. The aim of this study was to verify whether such a refusal is effectively indicative of pain relief. This prospective cohort study included ED patients who received single or multiple doses of pain medication for an acute pain problem. Patients were evaluated for pain relief using one Likert scale and two dichotomous questions: Is your pain relieved? and Do you want more analgesics? Non-relieved patients were further analysed using a checklist as to the reasons behind their refusal for supplemental pain medication. We have recruited 378 adult patients with a mean age of 50.3 years (±19.1); 60% were women and had an initial mean pain level of 7.3 (±2.0) out of 10. We observed that 68 out of 244 patients who were adequately relieved from pain asked for more analgesics (28%), whereas 51 out of 134 patients who were not relieved from pain refused supplemental drugs (38%). Reasons for refusal included wanting to avoid side effects, feeling sufficiently relieved, and disliking the medication's effects. Over a third of ED patients in acute pain were not relieved but refused supplemental pain medication. Patients have reported legitimate reasons to decline further analgesics, and this refusal cannot be used as an indication of pain relief.

  9. Outcome assessment of the medical relief policy in Anhui province%安徽省医疗救助政策实施效果评价

    Institute of Scientific and Technical Information of China (English)

    戴卫东

    2010-01-01

    The paper covered the implementation and social outcomes of the medical relief policy benefiting urban and rural residents in Anhui province. Based on analysis of problems identified, it proposed such recommendations: Enhance government financial support; improve the "safety net"mechanism of community hospitals; build a dynamic management system for those in need of medical relief; and tighten the linkage with social medical insurance.%介绍了安徽省城乡医疗救助政策的实施情况及产生的社会效果,分析其中存在的问题,提出了完善医疗救助政策的建议:加大财政支出力度;完善社区医院"兜底"机制;建立救助对象动态管理制度;密切与社会医疗保险相结合.

  10. The cross-sectional study of anxiety levels and ratio of severity of thirteen symptoms of anxiety among medical students

    Directory of Open Access Journals (Sweden)

    Muhammad Arslan Iqbal

    2016-06-01

    Conclusions: Mild form of anxiety is much more common among medical students and majority of these medical students are females. Moreover, the symptoms of anxiety including tension, anxious mood, depressed mood, insomnia, fear and CVS symptoms appear with moderate severity in majority of medical students while on the other hand some symptoms including general somatic muscular and sensory symptoms, difficulties in concentration and memory, genitor-urinary symptoms, respiratory symptoms, GIT symptoms and other autonomic symptoms appear with least severity among majority of medical students. [Int J Res Med Sci 2016; 4(6.000: 2297-2304

  11. Contrast of Relief Effect of Tramadol and Dexmedetomidine on Shivering after General Anesthesia%Medical Recapitulate

    Institute of Scientific and Technical Information of China (English)

    王怡

    2016-01-01

    目的:比较曲马多与右美托咪定缓解全身麻醉术后寒战的临床效果。方法选取于2013年1月至2014年1月来辽宁省肿瘤医院行择期腹部手术后发生寒战的患者100例,依据随机数字表法分为右美托咪啶组(35例)、曲马多组(35例)、生理盐水组(30例)。右美托咪啶组给予右美托咪啶0.5μg/kg,曲马多组给予曲马多1 mg/kg,生理盐水组给予0.9%NaCl注射液0.05 mg/kg。观察对比三组患者的临床效果及术后寒战情况。结果右美托咪定组、曲马多组全身麻醉腹部手术患者给药后5、10 min寒战评分均较给药前呈下降趋势,右美托咪定组下降速度更快;生理盐水组给药后5、10 min寒战评分均较给药前无变化[右美托咪定组:(0.60±0.11)分、(0.22±0.03)分比(3.82±0.11)分;曲马多组:(2.01±0.41)分、(2.23±0.21)分比(3.91±0.12)分;生理盐水组:(3.71±0.13)分、(3.72±0.22)分比(3.74±0.13)分],三组寒战评分组间、时点间、组间・时点间交互效应比较差异有统计学意义( P<0.05)。右美托咪啶组给药后10 min 的镇静评分均高于曲马多、生理盐水两组[(2.89±0.23)分比(1.97±0.35)分、(1.74±0.28)分,P<0.05],差异有统计学意义;右美托咪啶组用药后恶心呕吐、心动过缓不良反应发生率为5.71%(2/35),低于曲马多组的22.86%(8/35),差异有统计学意义(P<0.05)。结论与曲马多相比,全身麻醉中静脉注射右美托咪定可有效减少术后寒战、恶心、呕吐等并发症发生,临床效果好,具有良好的临床价值。%Objective To compare the clinical effect of tramadol and dexmedetomidine for the relief of shivering after general anesthesia.Methods From Jan.2013 to Jan.2004 100 patients with postoperative shivering after elective

  12. In their own words: qualitative study of high-utilising primary care patients with medically unexplained symptoms

    Directory of Open Access Journals (Sweden)

    Frankel Richard M

    2009-09-01

    Full Text Available Abstract Background High utilising primary care patients with medically unexplained symptoms (MUS often frustrate their primary care providers. Studies that elucidate the attitudes of these patients may help to increase understanding and improve confidence of clinicians who care for them. The objective of this study was to describe and analyze perceptions and lived experiences of high utilising primary care patients with MUS. Methods A purposive sample of 19 high utilising primary care patients for whom at least 50% (69.6% in this sample of visits for two years could not be explained medically, were encouraged to talk spontaneously about themselves and answer semi-structured questions. Verbatim transcripts of interviews were analyzed using an iterative consensus building process. Results Patients with MUS almost universally described current and/or past family dysfunction and were subjected to excessive testing and ineffective empirical treatments. Three distinct groups emerged from the data. 1 Some patients, who had achieved a significant degree of psychological insight and had success in life, primarily sought explanations for their symptoms. 2 Patients who had less psychological insight were more disabled by their symptoms and felt strongly entitled to be excused from normal social obligations. Typically, these patients primarily sought symptom relief, legitimization, and support. 3 Patients who expressed worry about missed diagnoses demanded excessive care and complained when their demands were resisted. Conclusion High utilising primary care patients are a heterogeneous group with similar experiences and different perceptions, behaviours and needs. Recognizing these differences may be critical to effective treatment and reduction in utilisation.

  13. Long-term pain relief with optimized medical treatment including antioxidants and step-up interventional therapy in patients with chronic pancreatitis.

    Science.gov (United States)

    Shalimar; Midha, Shallu; Hasan, Ajmal; Dhingra, Rajan; Garg, Pramod Kumar

    2017-01-01

    Abdominal pain is difficult to treat in patients with chronic pancreatitis (CP). Medical therapy including antioxidants has been shown to relieve pain of CP in the short-term. Our aim was to study the long-term results of optimized medical and interventional therapy for pain relief in patients with CP with a step-up approach. All consecutive patients with CP were included prospectively in the study. They were treated medically with a well-balanced diet, pancreatic enzymes, and antioxidants (9000 IU beta-carotene, 0.54 g vitamin C, 270 IU vitamin E, 600 µg organic selenium, and 2 g methionine). Endoscopic therapy and/or surgery were offered if medical therapy failed. Pain relief was the primary outcome measure. A total of 313 patients (mean age 26.16 ± 12.17; 244 males) with CP were included; 288 (92%) patients had abdominal pain. The etiology of CP was idiopathic in 224 (71.6%) and alcohol in 82 (26.2%). At 1-year follow-up, significant pain relief was achieved in 84.7% of patients: 52.1% with medical therapy, 16.7% with endoscopic therapy, 7.6% with surgery, and 8.3% spontaneously. The mean pain score decreased from 6.36 ± 1.92 to 1.62 ± 2.10 (P < 0.001). Of the 288 patients, 261, 218, 112, and 51 patients were followed up for 3, 5, 10, and 15 years, respectively; 54.0%, 57.3%, 60.7%, and 68.8% of them became pain free at those follow-up periods. Significant pain relief is achieved in the majority of patients with optimized medical and interventional treatment. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  14. The association of needlestick injury with depressive symptoms among first-year medical residents in Japan.

    Science.gov (United States)

    Wada, Koji; Sakata, Yumi; Fujino, Yoshihisa; Yoshikawa, Toru; Tanaka, Katsutoshi; Miyajima, Eriko; Watanabe, Mitsuyasu; Aizawa, Yoshiharu

    2007-12-01

    Depressive symptoms among medical residents are common. The objective of this study was to determine the association of depressive symptoms with needlestick injury among first-year medical residents (so-called "intern"). We conducted a prospective cohort study among 107 medical residents in 14 training hospitals. The baseline survey was conducted in August 2005 and the follow-up survey was conducted in March 2006. Depressive symptoms were based on the Center for Epidemiological Study of Depression. Factors associated with depressive symptoms were examined using logistic regression analysis. For medical residents without depressive symptoms at the baseline survey, needlestick injury events were associated with depressive symptoms at the follow-up survey (corrected odds ratio [cOR]=2.98; 95% confidence interval [CI], 1.16-3.70). Because it was not possible to determine when the medical residents developed depressive symptoms, it is not possible to definitely determine causality between needlestick injury and depressive symptoms, although these findings are suggestive. Therefore, it would seem prudent to suggest the provision of mental health services to medical residents sustaining a needlestick injury since this may be helpful in identifying and treating depression.

  15. Training medical specialists to communicate better with patients with medically unexplained physical symptoms (MUPS): a randomized, controlled trial.

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Saase, J.L.C.M. van; Molen, H.T. van der; Jacobs, M.E.; Abels, D.C.; Köse, N; Dulmen, S. van; Vernhout, R.M.; Arends, L.R.

    2015-01-01

    Background: Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an

  16. Training medical specialists to communicate better with patients with medically unexplained physical symptoms (MUPS). A randomized, controlled trial

    NARCIS (Netherlands)

    A. Weiland (Anne); A.H. Blankenstein (Annette); J.L.C.M. van Saase (Jan); H.T. van der Molen (Henk); M.E. Jacobs (Mariël E.); D.C. Abels (Dineke C.); N. Köse (Nedim); S. Van Dulmen (Sandra); R. Vernhout (Rene); L.R. Arends (Lidia)

    2015-01-01

    textabstractBackground Patients with medically unexplained physical symptoms (MUPS) are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We

  17. Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Saase, J.L. Van; Molen, H.T. Van der; Jacobs, M.E.; Abels, D.C.; Kose, N.; Dulmen, A.M. van; Vernhout, R.M.; Arends, L.R.

    2015-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We developed an

  18. Training medical specialists to communicate better with patients with medically unexplained physical symptoms (MUPS): a randomized, controlled trial.

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Saase, J.L.C.M. van; Molen, H.T. van der; Jacobs, M.E.; Abels, D.C.; Köse, N; Dulmen, S. van; Vernhout, R.M.; Arends, L.R.

    2015-01-01

    Background: Patients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an e

  19. Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Saase, J.L. Van; Molen, H.T. Van der; Jacobs, M.E.; Abels, D.C.; Kose, N.; Dulmen, A.M. van; Vernhout, R.M.; Arends, L.R.

    2015-01-01

    BACKGROUND: Patients with medically unexplained physical symptoms (MUPS) are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We developed an e

  20. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

    Directory of Open Access Journals (Sweden)

    Jimena Fiz

    Full Text Available BACKGROUND: The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. METHODS: Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS. Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ, the Pittsburgh Sleep Quality Index (PSQI and the Short Form 36 Health Survey (SF-36. RESULTS: Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%, oral (46% and combined (43%. The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001 reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05 in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. CONCLUSIONS: The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.

  1. 抗震救灾医护人员心理干预研究进展%Research progress on psychological intervention for medical personnel of earthquake relief

    Institute of Scientific and Technical Information of China (English)

    杨馥瑜; 刘喜文

    2012-01-01

    从救灾医护人员身心健康状况、影响因素、地震心理卫生服务的一般手段、危机心理干预模式、灾后心理重建、灾后心理干预存在的问题、完善心理卫生服务系统等方面阐述了抗震救灾医护人员心理干预研究进展.%It expounded the research progress on psychological intervention for medical personnel of earthquake relief from aspects of the physical and mental health and its influencing factors of disaster relief medical personnel, general means of earthquake psychological health services, crisis psychological intervention mode,post -disaster psychological reconstruction,existing problems in post - disaster psychological intervention and perfecting mental health service system.

  2. Making sense of medically unexplained symptoms in general practice: a grounded theory study

    OpenAIRE

    Stone, Louise

    2013-01-01

    Background General practitioners often encounter patients with medically unexplained symptoms. These patients share many common features, but there is little agreement about the best diagnostic framework for describing them.

  3. [Practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders': a step in the right direction

    NARCIS (Netherlands)

    Lucassen, P.L.B.J.

    2011-01-01

    The Dutch multidisciplinary practice guideline 'Medically unexplained physical symptoms (MUPS) and somatoform disorders' provides information on non-specific somatoform complaints, hypochondriasis, conversion disorders and a limited number of specific functional syndromes. Much attention is given in

  4. Duration of symptom relief after intra-articular injection of hyaluronic acid combined with sorbitol (anti-ox-vs) in symptomatic hip osteoarthritis.

    Science.gov (United States)

    Migliore, A; Massafra, U; Bizzi, E; Tormenta, S; Cassol, M; Granata, M

    2014-01-01

    The intra-articular administration of hyaluronic acid (HA) in hip osteoarthritis (OA) has been recently increased following the use of ultrasound guidance to perform an accurate delivery of the injected product. Viscosupplementation in hip OA seems to show similar results to those obtained by viscosupplementation in knee OA. However, an unmet need is the duration of symptomatic relief, therefore several new products are proposed to prolong and increase symptomatic effects. Among these, an innovative viscosupplement has been produced from high a concentration of HA combined with a high concentration of sorbitol as a free radical scavenger. The aim of this study is to evaluate the mid-term pain-relief effect of an ultrasound-guided injection of SynolisV-A (ANTI-OX-VS) in patients suffering from symptomatic hip osteoarthritis. Lequesne index, Health Assessment Questionnaire (HAQ), pain reduction, Global Patient Assessment (GPA), Global Medical Assessment (GMA) and reduction in monthly analgesic consumption were assessed during the 12-month follow-up after the injection. A total of 20 patients were enrolled in the study and received one IA US-guided injection of two syringes of ANTI-OX-VS into the target hip. Eleven drop-out patients were registered, of whom 2 were for loss of efficacy at 6 months, 1 for loss of efficacy at 9 months and 8 patients for severe comorbilities. Mean scores of all clinical parameters evaluated at each control visit were significantly different when compared with baseline mean value. No systemic adverse events were observed. Even though the sample size of this study is limited, the results suggest a durable good efficacy of a 4-ml single injection of ANTI-OX-VS in hip OA, at least for the patients who completed the study. A larger number of patients and an RCT are needed to confirm these data, investigating also the predictive factors of clinical response to ANTI-OX-VS.

  5. 玉树地震应急医学救援人员结构分析%Structural analysis of members in Yushu earthquake emergency medical relief team

    Institute of Scientific and Technical Information of China (English)

    沈燕; 张鹭鹭; 刘源; 刘旭; 林俊聪

    2012-01-01

    目的 分析玉树地震应急医学救援人员结构,为应急医学救援队伍优化配置提供依据.方法 对参与玉树地震救援的来自青海省44个卫生单位的911名医学救援队员进行全面问卷调查及部分访谈并进行描述性分析.结果 在总体卫生专业技术人员中,男女比例为1:0.4;外科专业卫生技术人员最多,其次为相关护理专业,内科专业位居第3位;本科及以上学历者占53.6%,以中级职称为主;临床专业技术人员年龄分布主要集中在36~45岁,护理人员年龄则集中在23~32岁.结论 玉树地震应急医学救援人员结构相对合理,但是也要深化医学救援队伍建设,在更大的范围实现专业优化配置.%Objective To analyze the structure of members in Yushu earthquake emergency medical relief team, in order to provide basis for optimal allocation of emergency medical relief team. Methods 911 members in Yushu earthquake emergency medical relief team from 44 medical units of Qinghai Province were investigated by comprehensive questionnaire survey and interviews, and the results were analyzed descriptively. Results Among all professional medical workers, male to female ratio was 1:0.4; most of them were surgical professional health workers, followed by the relevant care professionals. medical professional was ranked in the third place; works with bachelor degree or above were accounted for 53-6%, most of them had medium-grade professional title: the age distribution of clinical professional and technical personnel was mainly between 36 to 45 years old, the age of nurses was concentrated in 23 to 32 years old. Conclusion Structure of members in Yushu earthquake emergency medical medical relief team is relatively reasonable, but it also need to deepen medical rescue team building, to achieve professional optimization configuration in a larger range.

  6. Anxiety and depressive symptoms and medical illness among adults with anxiety disorders.

    Science.gov (United States)

    Niles, Andrea N; Dour, Halina J; Stanton, Annette L; Roy-Byrne, Peter P; Stein, Murray B; Sullivan, Greer; Sherbourne, Cathy D; Rose, Raphael D; Craske, Michelle G

    2015-02-01

    Anxiety is linked to a number of medical conditions, yet few studies have examined how symptom severity relates to medical comorbidity. The current study assessed associations between severity of anxiety and depression and the presence of medical conditions in adults diagnosed with anxiety disorders. Nine-hundred eighty-nine patients diagnosed with panic, generalized anxiety, social anxiety, and posttraumatic stress disorders reported on the severity of anxiety and depressive symptoms and on diagnoses of 11 medical conditions. Severity of anxiety and depressive symptoms was strongly associated with having more medical conditions over and above control variables, and the association was as strong as that between BMI and disease. Odds of having asthma, heart disease, back problems, ulcer, migraine headache and eyesight difficulties also increased as anxiety and depressive symptom severity increased. Anxiety symptoms were independently associated with ulcer, whereas depressive symptoms were independently associated with heart disease, migraine, and eyesight difficulties. These findings add to a growing body of research linking anxiety disorders with physical health problems and indicate that anxiety and depressive symptoms deserve greater attention in their association with disease. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. COMBINED MEDICATIONS OF LOCAL ACTION IN THE TREATMENT OF PAIN AND SORE THROAT SYMPTOMS

    Directory of Open Access Journals (Sweden)

    M. I. Petrovskaya

    2012-01-01

    Full Text Available For relief symptoms of pain and sore throat the prescription of combined topical preparations containing antiseptic and analgesic components is the most appropriate from the pathogenetic point of view. This article discusses the use of local therapy for the treatment of acute inflammatory diseases associated with pain, feeling a tickle in throat. The author introduces the local action drug, which has antiseptic and analgesic effects and is safe and effective in the symptomatic treatment of pharyngitis, tonsillitis and laryngitis in children older than 4 years.

  8. Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms

    Directory of Open Access Journals (Sweden)

    Lee D

    2013-09-01

    Full Text Available INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3 years and 59% were women. The median number of medications used was 6 (range 1-21 medications. The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49% of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale ≥5 and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54. DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed.

  9. The COMTval158met polymorphism is associated with symptom relief during exposure-based cognitive-behavioral treatment in panic disorder

    Directory of Open Access Journals (Sweden)

    Bergström Jan

    2010-11-01

    Full Text Available Abstract Background Cognitive behavioral therapy (CBT represents a learning process leading to symptom relief and resulting in long-term changes in behavior. CBT for panic disorder is based on exposure and exposure-based processes can be studied in the laboratory as extinction of experimentally acquired fear responses. We have recently demonstrated that the ability to extinguish learned fear responses is associated with a functional genetic polymorphism (COMTval158met in the COMT gene and this study was aimed at transferring the experimental results on the COMTval158met polymorphism on extinction into a clinical setting. Methods We tested a possible effect of the COMTval158met polymorphism on the efficacy of CBT, in particular exposure-based treatment modules, in a sample of 69 panic disorder patients. Results We present evidence that panic patients with the COMTval158met met/met genotype may profit less from (exposure-based CBT treatment methods as compared to patients carrying at least one val-allele. No association was found with the 5-HTTLPR/rs25531 genotypes which is presented as additional material. Conclusions We were thus able to transfer findings on the effect of the COMTval158met polymorphism from an experimental extinction study obtained using healthy subjects to a clinical setting. Furthermore patients carrying a COMT val-allele tend to report more anxiety and more depression symptoms as compared to those with the met/met genotype. Limitations of the study as well as possible clinical implications are discussed. Trial registration Clinical Trial Registry name: Internet-Versus Group-Administered Cognitive Behavior Therapy for Panic Disorder (IP2. Registration Identification number: NCT00845260, http://www.clinicaltrials.gov/ct2/show/NCT00845260

  10. Health care utilization of mexican patients with medically unexplained physical symptoms

    Science.gov (United States)

    Ramírez Aranda, José Manuel; de los Santos Reséndiz, Homero; Lara Duarte, María Yolanda; Pazaran Zanella, Santiago Oscar; Méndez López, Jafet Felipe; Gil Alfaro, Issa; Islas Ruz, Félix Gilberto; Navarrete Floriano, Gloria; Guillen Salomón, Edith; Texon Fernández, Obdulia; Cruz Duarte, Silvia; Romo Salazar, Juan Carlos; Pérez Ruiz, Claudia Elsa; López Salas, Sara de Jesús; Benítez Amaya, Lizbeth; Zapata Gallardo, Javier Nahum

    2016-01-01

    Objective: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. Methods: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al. Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. Results: Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). Conclusions: The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs. PMID:27821895

  11. EMDR and the Treatment of Medically Unexplained Symptoms

    OpenAIRE

    Simon Proudlock

    2015-01-01

    This current research used a single case study design to examine how Eye Movement Desensitization and Reprocessing (EMDR) was effective for one individual experiencing medically unexplained chronic pain in his abdomen. EMDR is briefly explained as is how it has been adapted to be used with pain. A brief literature review is also included.

  12. EMDR and the Treatment of Medically Unexplained Symptoms

    Directory of Open Access Journals (Sweden)

    Simon Proudlock

    2015-11-01

    Full Text Available This current research used a single case study design to examine how Eye Movement Desensitization and Reprocessing (EMDR was effective for one individual experiencing medically unexplained chronic pain in his abdomen. EMDR is briefly explained as is how it has been adapted to be used with pain. A brief literature review is also included.

  13. How do hospital doctors manage patients with medically unexplained symptoms: a qualitative study of physicians.

    Science.gov (United States)

    Warner, Alex; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

    2017-02-01

    Objective Medically unexplained symptoms are a common presentation in medical practice and are associated with significant morbidity and high levels of service use. Most research exploring the attitudes and training of doctors in treating patients with unexplained symptoms has been conducted in primary care. This study aims to explore the ways in which doctors working in secondary care approach and manage patients with medically unexplained symptoms. Design A qualitative study using in-depth interviews and thematic analysis. Setting Three hospitals in the North Thames area. Participants Twenty consultant and training-grade physicians working in cardiology, gastroenterology, rheumatology and neurology. Main outcome measure Physicians' approach to patients with medically unexplained symptoms and their views on managing these patients. Results There was considerable variation in how the physicians approached patients who presented with medically unexplained symptoms. Investigations were often ordered without a clear rationale and the explanations given to patients when results of investigations were normal were highly variable, both within and across specialties. The doctor's level of experience appeared to be a more important factor in their investigation and management strategies than their medical specialty. Physicians reported little or no formal training in how to manage such presentations, with no apparent consistency in how they had developed their approach. Doctors described learning from their own experience and from senior role models. Organisational barriers were identified to the effective management of these patients, particularly in terms of continuity of care. Conclusions Given the importance of this topic, there is a need for serious consideration as to how the management of patients with medically unexplained symptoms is included in medical training and in the planning and delivery of services.

  14. Introduction to the special issue on medically unexplained symptoms: background and future directions.

    Science.gov (United States)

    Brown, Richard J

    2007-10-01

    This special issue is devoted to the topic of medically unexplained symptoms (MUS), a heterogeneous group of conditions characterized by persistent physical symptoms that cannot be explained by medical illness or injury. Although psychological factors have long been regarded as central to these problems, patients with MUS have typically been managed within medical settings and referrals to mental health services have been relatively rare. In recent years, however, interest in the psychological nature and treatment of MUS has expanded, culminating in the development of tailored psychological interventions for these conditions. This, coupled with the increasing willingness of practitioners to diagnose conditions such as chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome, has led to an increase in the number of patients who are referred for psychological treatment. At present, however, many psychological therapists are unfamiliar with the literature on MUS. With this in mind, this special issue presents a series of papers that provide an overview of what is known about the nature, aetiology and treatment of medically unexplained illness. This introductory paper provides general information about the clinical presentation, diagnosis, classification, terminology and epidemiology of MUS in adults, and concludes with an examination of important areas for future development in the field. Subsequent papers address the psychological mechanisms [Deary, V., Chalder, T., & Sharpe, M. (2007-this issue). The cognitive behavioural model of medically unexplained symptoms: A theoretical and empirical review. Clinical Psychology Review; Iverson, A., Chalder, T., & Wessely, S. (2007-this issue). Gulf war illness: Lessons from medically unexplained illness. Clinical Psychology Review; Rief, W., & Broadbent, E. (2007-this issue). Explaining medically unexplained symptoms: Models and mechanisms. Clinical Psychology Review; Roelofs, K., & Spinhoven, P. (2007-this issue

  15. Making sense of medically unexplained symptoms in general practice: a grounded theory study.

    Science.gov (United States)

    Stone, Louise

    2013-06-01

    Background General practitioners often encounter patients with medically unexplained symptoms. These patients share many common features, but there is little agreement about the best diagnostic framework for describing them. Aims This study aimed to explore how GPs make sense of medically unexplained symptoms. Design Semi-structured interviews were conducted with 24 GPs. Each participant was asked to describe a patient with medically unexplained symptoms and discuss their assessment and management. Setting The study was conducted among GPs from teaching practices across Australia. Methods Participants were selected by purposive sampling and all interviews were transcribed. Iterative analysis was undertaken using constructivist grounded theory methodology. Results GPs used a variety of frameworks to understand and manage patients with medically unexplained symptoms. They used different frameworks to reason, to help patients make sense of their suffering, and to communicate with other health professionals. GPs tried to avoid using stigmatising labels such as 'borderline personality disorder', which were seen to apply a 'layer of dismissal' to patients. They worried about missing serious physical disease, but managed the risk by deliberately attending to physical cues during some consultations, and focusing on coping with medically unexplained symptoms in others. They also used referrals to exclude serious disease, but were wary of triggering a harmful cycle of uncoordinated care. Conclusion GPs were aware of the ethical relevance of psychiatric diagnoses, and attempted to protect their patients from stigma. They crafted helpful explanatory narratives for patients that shaped their experience of suffering. Disease surveillance remained an important role for GPs who were managing medically unexplained symptoms.

  16. Symptom clusters on primary care medical service trips in five regions in Latin America.

    Science.gov (United States)

    Dainton, Christopher; Chu, Charlene

    2015-09-01

    Short-term primary care medical service trips organized by the North American non-governmental organizations (NGOs) serve many communities in Latin America that are poorly served by the national health system. This descriptive study contributes to the understanding of the epidemiology of patients seen on such low-resource trips. An analysis was conducted on epidemiologic data collected from anonymized electronic medical records on patients seen during 34 short-term medical service trips in five regions in Ecuador, Guatemala, and the Dominican Republic between April 2013 and April 2014. A total of 22,977 patients were assessed by North American clinicians (physicians, nurse practitioners, physician assistants) on primary care, low-resource medical service trips. The majority of patients were female (67.1%), and their average age was 36. The most common presenting symptoms in all regions were general pain, upper respiratory tract symptoms, skin disorders, eye irritation, dyspepsia, and nonspecific abdominal complaints; 71-78% of primary care complaints were easily aggregated into well-defined symptom clusters. The results suggest that guideline development for clinicians involved in these types of medical service trips should focus on management of the high-yield symptom clusters described by these data.

  17. Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

    Science.gov (United States)

    Güleç, Mahir; Bakir, Bilal; Ozer, Mustafa; Uçar, Muharrem; Kiliç, Selim; Hasde, Metin

    2005-04-30

    An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

  18. Health outcome priorities among competing cardiovascular, fall injury, and medication-related symptom outcomes.

    Science.gov (United States)

    Tinetti, Mary E; McAvay, Gail J; Fried, Terri R; Allore, Heather G; Salmon, Joanna C; Foody, Joanne M; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana

    2008-08-01

    To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. Interview. Community. One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P=.02), unsteadiness (P=.02), functional dependency (P=.04), lower cognition (P=.02) and depressive symptoms (P=.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals.

  19. Health Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication-Related Symptom Outcomes

    Science.gov (United States)

    Tinetti, Mary E.; McAvay, Gail J.; Fried, Terri R.; Allore, Heather G.; Salmon, JoAnna C.; Foody, Joanne M.; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana

    2012-01-01

    OBJECTIVES To determine the priority that older adults with coexisting hypertension and fall risk give to optimizing cardiovascular outcomes versus fall- and medication symptom-related outcomes. DESIGN Interview. SETTING Community. PARTICIPANTS One hundred twenty-three cognitively intact persons aged 70 and older with hypertension and fall risk. MEASUREMENTS Discrete choice task was used to elicit the relative importance placed on reducing the risk of three outcomes: cardiovascular events, serious fall injuries, and medication symptoms. Risk estimates with and without antihypertensive medications were obtained from the literature. Participants chose between 11 pairs of options that displayed lower risks for one or two outcomes and a higher risk for the other outcome(s), versus the reverse. Results were used to calculate relative importance scores for the three outcomes. These scores, which sum to 100, reflect the relative priority participants placed on the difference between the risk estimates of each outcome. RESULTS Sixty-two participants (50.4%) placed greater importance on reducing risk of cardiovascular events than reducing risk of the combination of fall injuries and medication symptoms; 61 participants did the converse. A lower percentage of participants with chronic obstructive pulmonary disease (P =.02), unsteadiness (P =.02), functional dependency (P =.04), lower cognition (P =.02) and depressive symptoms (P =.03) prioritized cardiovascular outcomes over fall injuries and medication symptoms than did participants without these characteristics. CONCLUSION Interindividual variability in the face of competing outcomes supports individualizing decision-making to individual priorities. In the current example, this may mean forgoing antihypertensive medications or compromising on blood pressure reduction for some individuals. PMID:18662210

  20. Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme

    NARCIS (Netherlands)

    Weiland, A.; Blankenstein, A.H.; Willems, M.H.; Saase, J.L. Van; Molen, H.T. Van der; Dulmen, A.M. van; Arends, L.R.

    2013-01-01

    OBJECTIVE: Stepwise description of the development of a post-graduate communication skills training programme for medical specialists focused on patients with medically unexplained physical symptoms (MUPS) to improve specialist interaction with MUPS patients. METHODS: Using the 'intervention mapping

  1. Safety of anticholinergic medications in the elderly: Anticholinergic burden and lower urinary tract symptoms (LUTS)

    NARCIS (Netherlands)

    Pont, Lisa G.; Nielen, J.T.H.; McLachlan, Andrew; Gnjidic, Danijela; Chan, Lewis; Cumming, Robert; Taxis, Katja

    2014-01-01

    Background: Lower Urinary Tract Symptoms (LUTS) are a significant health issue for the elderly yet little is known about the clinical relevance of anticholinergic medication use on urinary function. Objectives: To explore the relationship between anticholinergic burden and urinary outcomes (LUTS) in

  2. Big Five personality traits and medically unexplained symptoms in later life

    NARCIS (Netherlands)

    Dijk, van S. D. M.; Hanssen, D. J. C.; Naarding, P.; Lucassen, P.; Comijs, H.; Voshaar, R. Oude

    2016-01-01

    Background: Personality dysfunction has been postulated as the most clinically salient problem of persons suffering from medically unexplained symptoms (MUS) but empirical studies are scarce. This study aims to compare the personality profile of older patients suffering from MUS with two comparison

  3. Characteristics of College Students with Attention-Deficit Hyperactivity Disorder Symptoms Who Misuse Their Medications

    Science.gov (United States)

    Jardin, Bianca; Looby, Alison; Earleywine, Mitch

    2011-01-01

    Objective: The purpose of the current investigation is to examine the characteristics of college students with attention-deficit hyperactivity disorder symptoms who misuse their prescribed psychostimulant medications. Methods and Participants: Forty-three undergraduate students with a prescription for Ritalin or Adderall completed structured…

  4. Asthma symptoms and medication in the PIAMA birth cohort : Evidence for under and overtreatment

    NARCIS (Netherlands)

    Caudri, Daan; Wijga, Alet H.; Smit, Henriette A.; Koppelman, Gerard H.; Kerkhof, Marjan; Hoekstra, Maarten O.; Brunekreef, Bert; de Jongste, Johan C.

    2011-01-01

    Objective: Under and overtreatment of asthma may be a serious problem especially in young children, but the evidence is scarce and no longitudinal data are available. Our aim was to investigate whether inhaled medication use in young children was in agreement with asthma symptoms at the age of 2-8 y

  5. Self-Help for Medically Unexplained Symptoms : A Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    van Gils, Anne; Schoevers, Robert A.; Bonvanie, Irma J.; Gelauff, Jeannette M.; Roest, Annelieke M.; Rosmalen, Judith G. M.

    2016-01-01

    Objective: Medically unexplained symptoms (MUS), which are highly prevalent in all fields of medicine, are considered difficult to treat. The primary objective of this systematic review and meta-analysis was to assess the efficacy of self-help for adults with MUS. Methods: Four electronic databases

  6. Characteristics of College Students with Attention-Deficit Hyperactivity Disorder Symptoms Who Misuse Their Medications

    Science.gov (United States)

    Jardin, Bianca; Looby, Alison; Earleywine, Mitch

    2011-01-01

    Objective: The purpose of the current investigation is to examine the characteristics of college students with attention-deficit hyperactivity disorder symptoms who misuse their prescribed psychostimulant medications. Methods and Participants: Forty-three undergraduate students with a prescription for Ritalin or Adderall completed structured…

  7. Mindfulness-based cognitive therapy (MBCT) for patients with medically unexplained symptoms: Process of change

    NARCIS (Netherlands)

    Ravesteijn, H.J. van; Suijkerbuijk, Y.B.; Langbroek, J.A.; Muskens, E.M.; Lucassen, P.L.B.J.; Weel, C. van; Wester, F.P.J.; Speckens, A.E.M.

    2014-01-01

    BACKGROUND: A recent randomized controlled trial provided preliminary evidence for the effectiveness of mindfulness based cognitive therapy (MBCT) for the top 10% frequent attenders in primary care with persistent medically unexplained symptoms (MUS). This qualitative study aims to explore working m

  8. Stress and symptoms of depression among medical students at the University of Copenhagen.

    Science.gov (United States)

    Haldorsen, Hilde; Bak, Nanna Hasle; Dissing, Agnete; Petersson, Birgit

    2014-02-01

    This article aims to assess the levels of stress and symptoms of depression among Danish medical students, as well as explore the effect of social support on psychological distress. The results are based on numbers from the follow-up study 'From Student to Graduate' (j.nr 2006-41-6876). Two dimensions of stress, frequency and perception, were measured on a scale from 0-6. Odds ratios and significance of associations between the various exposure variables and the outcome measure, symptoms of depression, were calculated using multiple logistic regression and Wald tests. 30.5% of the students reported depressive symptoms. Stress frequency measured a mean of 2.26 (SD = 1.35). The mean for stress perception was 2.85 (SD = 1.30). Women reported higher levels of stress and depression compared to male medical students, but the differences were not significant (p > 0.05). Only the dimensions of stress and coping alone were significantly associated with reporting symptoms of depression (p Stress levels were moderate, but significantly associated with symptoms of depression. The interaction between the stress dimensions and the outcome measure illustrates the importance of stress appraisal. Coping alone with psychological problems was significantly associated with symptoms of depression.

  9. Stress and symptoms of depression among medical students at the University of Copenhagen

    DEFF Research Database (Denmark)

    Haldorsen, Hilde; Hasle Bak, Nanna; Dissing, Agnete

    2014-01-01

    : 30.5% of the students reported depressive symptoms. Stress frequency measured a mean of 2.26 (SD = 1.35). The mean for stress perception was 2.85 (SD = 1.30). Women reported higher levels of stress and depression compared to male medical students, but the differences were not significant (p > 0......This article aims to assess the levels of stress and symptoms of depression among Danish medical students, as well as explore the effect of social support on psychological distress. The results are based on numbers from the follow-up study 'From Student to Graduate' (j.nr 2006-41-6876). Materials...... and methods: Two dimensions of stress, frequency and perception, were measured on a scale from 0-6. Odds ratios and significance of associations between the various exposure variables and the outcome measure, symptoms of depression, were calculated using multiple logistic regression and Wald tests. Results...

  10. The Effects of a Problem Solving-Based Intervention on Depressive Symptoms and HIV Medication Adherence Are Independent

    NARCIS (Netherlands)

    Gross, Robert; Bellamy, Scarlett L.; Chapman, Jennifer; Han, Xiaoyan; O'Duor, Jacqueline; Strom, Brian L.; Houts, Peter S.; Palmer, Steven C.; Coyne, James C.

    2014-01-01

    Depression and depressive symptoms predict poor adherence to medical therapy, but the association is complex, nonspecific, and difficult to interpret. Understanding this association may help to identify the mechanism explaining the results of interventions that improve both medical therapy adherence

  11. Depth relief

    NARCIS (Netherlands)

    Kappers, A.M.L.; Koenderink, J.J.; Doorn, A.J. van

    1995-01-01

    A study is reported of the depth relief in a simple three-dimensional scene consisting of a white, rough sphere on a planar support, illuminated in a natural manner. Viewing conditions included monocular and binocular as well as 'synoptical' viewing. In the synoptical condition the eyes are

  12. General practitioners' views on reattribution for patients with medically unexplained symptoms: a questionnaire and qualitative study

    Directory of Open Access Journals (Sweden)

    Salmon Peter

    2008-08-01

    Full Text Available Abstract Background The successful introduction of new methods for managing medically unexplained symptoms in primary care is dependent to a large degree on the attitudes, experiences and expectations of practitioners. As part of an exploratory randomised controlled trial of reattribution training, we sought the views of participating practitioners on patients with medically unexplained symptoms, and on the value of and barriers to the implementation of reattribution in practice. Methods A nested attitudinal survey and qualitative study in sixteen primary care teams in north-west England. All practitioners participating in the trial (n = 74 were invited to complete a structured survey. Semi-structured interviews were undertaken with a purposive sub-sample of survey respondents, using a structured topic guide. Interview transcripts were used to identify key issues, concepts and themes, which were grouped to construct a conceptual framework: this framework was applied systematically to the data. Results Seventy (95% of study participants responded to the survey. Survey respondents often found it stressful to work with patients with medically unexplained symptoms, though those who had received reattribution training were more optimistic about their ability to help them. Interview participants trained in reattribution (n = 12 reported that reattribution increased their confidence to practice in a difficult area, with heightened awareness, altered perceptions of these patients, improved opportunities for team-building and transferable skills. However general practitioners also reported potential barriers to the implementation of reattribution in routine clinical practice, at the level of the patient, the doctor, the consultation, diagnosis and the healthcare context. Conclusion Reattribution training increases practitioners' sense of competence in managing patients with medically unexplained symptoms. However, barriers to its implementation are

  13. 医疗救助立法的必要性和可行性研究%Study on the Necessity and Feasibility of Medical Relief Legislation

    Institute of Scientific and Technical Information of China (English)

    王海容; 程文玉

    2015-01-01

    Medical relief legislation is the need of medical treatment specification operation, the need of reg-ulating the social relations of medical treatment, the need of realizing the rule of law and building a harmonious society. Theoretically, medical treatment, as a social security system, is safeguarded and promoted by law, which is the international practice; practically, medical treatment has entered the stage of full implementation, which pro-vides the opportunity and condition for its legislation, which is feasible.%医疗救助立法是医疗救助规范运行的需要,是调节医疗救助各社会关系的需要,是实现依法治国、构建和谐社会的需要。从理论上看,医疗救助作为一项社会保障制度,靠立法强制予以保障和推行是国际惯例;从实践上看,医疗救助已进入全面实施阶段,为立法提供了时机和条件,其立法具有可行性。

  14. Health service and medication use among veterans with persistent postconcussive symptoms.

    Science.gov (United States)

    King, Paul R; Wade, Michael J; Beehler, Gregory P

    2014-03-01

    Persistent postconcussive symptoms (PPCS) are noted when a series of cognitive, emotional, and somatosensory complaints persist for months after a concussion. Clinical management of PPCS can be challenging in the veteran population because of the nonspecific nature of symptoms and co-occurrence with affective disturbances such as posttraumatic stress disorder (PTSD) and chronic pain. In this study, we compared health service and medication use patterns in a sample of 421 veterans with PPCS with an age-matched cohort of case controls. The results suggest that the veterans with PPCS showed high rates of medical and mental health service utilization during a mean treatment period of 2 years. Although chronic pain commonly co-occurs with PPCS in veterans, service use and medication prescribing trends seem to have been influenced more by the presence of PTSD than chronic pain. Our findings reinforce the overlap among PPCS, PTSD, and chronic pain and demonstrate the complexity inherent in treating these conditions in veterans.

  15. Depressive symptoms, HIV medication adherence, and HIV clinical outcomes in Tanzania: a prospective, observational study.

    Directory of Open Access Journals (Sweden)

    Nadya M Belenky

    Full Text Available Depressive symptoms have been shown to independently affect both antiretroviral therapy (ART adherence and HIV clinical outcomes in high-income countries. We examined the prospective relationship between depressive symptoms and adherence, virologic failure, and suppressed immune function in people living with HIV/AIDS in Tanzania. Data from 403 study participants who were on stable ART and engaged in HIV clinical care were analyzed. We assessed crude and adjusted associations of depressive symptoms and ART adherence, both at baseline and at 12 months, using logistic regression. We used logistic generalized estimating equations to assess the association and 95% confidence intervals (CI between depressive symptoms and both virologic failure and suppressed immune function. Ten percent of participants reported moderate or severe depressive symptoms at baseline and 31% of participants experienced virologic failure (>150 copies/ml over two years. Depressive symptoms were associated with greater odds of reported medication nonadherence at both baseline (Odds Ratio [OR] per 1-unit increase = 1.18, 95% CI [1.12, 1.24] and 12 months (OR = 1.08, 95% CI [1.03, 1.14]. By contrast, increases in depressive symptom score were inversely related to both virologic failure (OR = 0.93, 95% CI [0.87, 1.00] and immune system suppression (OR = 0.88, 95% CI [0.79, 0.99], though the association between depressive symptoms and clinical outcomes was less precise than for the association with nonadherence. Findings indicate a positive association between depressive symptoms and nonadherence, and also an inverse relationship between depressive symptoms and clinical outcomes, possibly due to informative loss to follow-up.

  16. A PROSPECTIVE STUDY OF MEDICALLY UNEXPLAINED PHYSICAL SYMPTOMS IN DEPRESSIVE DISORDERS

    Directory of Open Access Journals (Sweden)

    John Dinesh

    2014-09-01

    Full Text Available : Physical symptoms in depression are highly prevalent and associated with substantial functional impairment. The prevalence of physical illness in psychiatric patients is higher than that in the general population. Both in developed & developing countries, very little attention is paid to the physical illness of psychiatric patients, which leads to a poorer outcome. Hence we decided to conduct this study and find out the effect of antidepressant treatment on somatic symptoms in depressive disorders. The study was conducted at Sri Venkateshwaraa medical college hospital & research center, Puducherry. Our study sample consisted of 72 consecutive new patients who fulfilled inclusion criteria and had consented to participate in the study. All new patients in the age group 18 to 60 years, who fulfill ICD-10-DCR (Diagnostic criteria for Research criteria for the Depressive episode (F 32, recurrent depressive disorder (F33, Dysthymia (F 34.1, bipolar affective disorder, current episode depression (F 31.3 were included in our study. MATERIALS AND METHODS: A semi-structured proforma was used to collect socio demographic and clinical data from all the subjects included in the study. Enrolment of cases was done over a period of 6 months. All the subjects were rated on the Hamilton Depression Rating Scale (HDRS-17 to quantify the baseline severity of the depressive symptoms. Screenings for physical symptoms were done for all patients using the Patient Health Questionnaire (PHQ-15. The patients were classified into 4 groups based on physical complaints & co-morbid medical/ surgical diagnosis. HDRS-17 rating was recorded at baseline, 1 month & 6 months for the entire study sample. PHQ-15 scores were recorded at baseline, 1 month & 6 months after initiation of antidepressant treatment for all patients enrolled in the study. RESULTS: The study revealed the prevalence of medically unexplained physical symptoms in depressive disorders in patients attending our

  17. Depressive symptoms in Parkinson’s disease and in non-neurological medical illnesses

    Science.gov (United States)

    Assogna, Francesca; Fagioli, Sabrina; Cravello, Luca; Meco, Giuseppe; Pierantozzi, Mariangela; Stefani, Alessandro; Imperiale, Francesca; Caltagirone, Carlo; Pontieri, Francesco E; Spalletta, Gianfranco

    2013-01-01

    Background Patients with neurological and non-neurological medical illnesses very often complain of depressive symptoms that are associated with cognitive and functional impairments. We compared the profile of depressive symptoms in Parkinson’s disease (PD) patients with that of control subjects (CS) suffering from non-neurological medical illnesses. Methods One-hundred PD patients and 100 CS were submitted to a structured clinical interview for identification of major depressive disorder (MDD) and minor depressive disorder (MIND), according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR), criteria. The Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) were also administered to measure depression severity. Results When considering the whole groups, there were no differences in depressive symptom frequency between PD and CS apart from worthlessness/guilt, and changes in appetite reduced rates in PD. Further, total scores and psychic and somatic subscores of HDRS and BDI did not differ between PD and CS. After we separated PD and CS in those with MDD, MIND, and no depression (NODEP), comparing total scores and psychic/somatic subscores of HDRS and BDI, we found increased total depression severity in NODEP PD and reduced severity of the psychic symptoms of depression in MDD PD, with no differences in MIND. However, the severity of individual symptom frequency of depression was not different between PD and CS in MDD, MIND, and NODEP groups. Conclusion Although MDD and MIND phenomenology in PD may be very similar to that of CS with non-neurological medical illnesses, neurological symptoms of PD may worsen (or confound) depression severity in patients with no formal/structured DSM-IV-TR, diagnosis of depressive mood disorders. Thus, a thorough assessment of depression in PD should take into consideration the different impacts of neurological manifestations on MDD, MIND, and NODEP. PMID

  18. Balance deficits and ADHD symptoms in medication-naïve school-aged boys

    Directory of Open Access Journals (Sweden)

    Konicarova J

    2014-01-01

    Full Text Available Jana Konicarova,1 Petr Bob,1,2 Jiri Raboch11Center for Neuropsychiatric Research of Traumatic Stress, Department of Psychiatry and UHSL, 1st Faculty of Medicine, Charles University, Prague, Czech Republic; 2Central European Institute of Technology, Faculty of Medicine, Masaryk University, Brno, Czech RepublicBackground and objectives: Functional disturbances developed early in life include balance deficits which are linked to dysfunctions of higher levels of cognitive and motor integration. According to our knowledge, there are only a few studies suggesting that balance deficits are related to behavioral disturbances in attention-deficit/hyperactivity disorder (ADHD.Methods: We tested the extent to which balance deficits were related to ADHD symptoms in 35 medication-naïve boys of school age (8–11 years and compared the results with a control group of 30 boys of the same age.Results: ADHD symptoms in medication-naïve boys had specific relationships to disturbances of postural and gait balance.Conclusion: To our knowledge, this study provides the first evidence in the medical literature for a direct relationship between ADHD symptoms and balance deficits, that cannot be attributed to medication and the presence of any neurological disease.Keywords: ADHD, balance deficits, conduct problems, developmental disorders, inhibitory deficits, impulsivity

  19. Symptom experience associated with immunosuppressive drugs after liver transplantation in adults : possible relationship with medication non-compliance?

    NARCIS (Netherlands)

    Drent, Gerda; Moons, P.; De Geest, S.; Kleibeuker, J. H.; Haagsma, E. B.

    2008-01-01

    Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in clin

  20. Symptom experience associated with immunosuppressive drugs after liver transplantation in adults : possible relationship with medication non-compliance?

    NARCIS (Netherlands)

    Drent, Gerda; Moons, P.; De Geest, S.; Kleibeuker, J. H.; Haagsma, E. B.

    2008-01-01

    Symptom experience (occurrence and perceived distress) associated with side effects of immunosuppressive medications in organ transplant patients may well be associated with poorer quality of life and medication non-compliance. The aims of this study were: first, to assess symptom experience in

  1. Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS. A Randomized, Controlled Trial.

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    Anne Weiland

    Full Text Available Patients with medically unexplained physical symptoms (MUPS are prevalent 25-50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don't feel understood. We developed an evidence-based communication training, aimed to improve specialists' interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness.The intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment that reinforced a patient's symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors' MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study.123 doctors (40% specialists, 60% residents and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80% and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001, summarized information in a more patient-centered way (p = 0.001, and better explained MUPS and the role of perpetuating factors (p < 0.05. No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79.MUPS-focused communication training increases the interviewing and

  2. Assessment for self-blame and trauma symptoms during the medical evaluation of suspected sexual abuse.

    Science.gov (United States)

    Melville, John D; Kellogg, Nancy D; Perez, Nadia; Lukefahr, James L

    2014-05-01

    The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8-17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse.

  3. 参加救灾军人应急状态下用药分析%Soldiers participate in relief state of emergency under medication analysis

    Institute of Scientific and Technical Information of China (English)

    金伟华; 张勤; 谭永红; 陈华

    2014-01-01

    Objective Through the analysis of the 5.12 earthquake relief soldiers medication , to provide a reference for future e-mergency treatment relief workers .Methods May 18, 2008 to August 19, the officers and men of our hospital free treatment for earth-quake relief prescription 161 analysis.Results The skin diseases and accessories were the most reported situations and it′s up to a total of 47 prescriptions ( accounting for 29.19%) , diagnosis of insect bite dermatitis and acute bronchitis prescription , 11 and 9, respective-ly, constitute more than 6.83%and 5.59%.The first factor is the environment in emergency rescue personnel .Conclusion during the emergency relief process , rescue workers targeted prevention is very important .%目的:通过分析“5.12”抗震灾区官兵用药情况,为今后应急救治灾区人员提供用药参考。方法收集2008年5月18日至8月19日期间,成都军区总医院门诊救治抗震救灾官兵的161张处方进行分析。结果皮肤及附件疾病的处方最多,共47张处方(占29.19%),诊断为虫咬皮炎和急性支气管炎的处方最多,分别为11张(6.83%)和9张(5.59%)。应急救援人员患病的第一因素是环境影响。结论在进行应急救灾过程中,救援人员有针对性的防护是非常重要的。

  4. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students

    Science.gov (United States)

    Rotenstein, Lisa S.; Ramos, Marco A.; Torre, Matthew; Segal, J. Bradley; Peluso, Michael J.; Guille, Constance; Sen, Srijan; Mata, Douglas A.

    2017-01-01

    IMPORTANCE Medical students are at high risk for depression and suicidal ideation. However, the prevalence estimates of these disorders vary between studies. OBJECTIVE To estimate the prevalence of depression, depressive symptoms, and suicidal ideation in medical students. DATA SOURCES AND STUDY SELECTION Systematic search of EMBASE, ERIC, MEDLINE, psycARTICLES, and psycINFO without language restriction for studies on the prevalence of depression, depressive symptoms, or suicidal ideation in medical students published before September 17, 2016. Studies that were published in the peer-reviewed literature and used validated assessment methods were included. DATA EXTRACTION AND SYNTHESIS Information on study characteristics; prevalence of depression or depressive symptoms and suicidal ideation; and whether students who screened positive for depression sought treatment was extracted independently by 3 investigators. Estimates were pooled using random-effects meta-analysis. Differences by study-level characteristics were estimated using stratified meta-analysis and meta-regression. MAIN OUTCOMES AND MEASURES Point or period prevalence of depression, depressive symptoms, or suicidal ideation as assessed by validated questionnaire or structured interview. RESULTS Depression or depressive symptom prevalence data were extracted from 167 cross-sectional studies (n = 116 628) and 16 longitudinal studies (n = 5728) from 43 countries. All but 1 study used self-report instruments. The overall pooled crude prevalence of depression or depressive symptoms was 27.2% (37 933/122 356 individuals; 95% CI, 24.7% to 29.9%, I2 = 98.9%). Summary prevalence estimates ranged across assessment modalities from 9.3% to 55.9%. Depressive symptom prevalence remained relatively constant over the period studied (baseline survey year range of 1982–2015; slope, 0.2% increase per year [95% CI, −0.2% to 0.7%]). In the 9 longitudinal studies that assessed depressive symptoms before and during

  5. Experiences of sickness absence, marginality and Medically Unexplained Physical Symptoms - A focus group study

    DEFF Research Database (Denmark)

    E.L., Werner; A, Aamland; Malterud, Kirsti

    2013-01-01

    with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically......PURPOSE: Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence. METHODS: Two focus-group discussions were conducted...

  6. Experience of Field Shelter Hospital Medical Rounds Module in Earthquake Relief%野战方舱医院医疗巡诊模块在抗震救灾中的应用体会

    Institute of Scientific and Technical Information of China (English)

    任晓荣; 王军; 曹敏; 刘树新; 才蔚涛

    2012-01-01

    Objective To explore the using of field shelter hospital medical rounds module in the earthquake relief. Methods Based on the relief mission execution in Wenchuan and Yushu earthquake, medical rounds squad constituted of 4 to 6 persons was set up to do the medical rounds work regularly for the earthquake victims, the relief forces, the local relief workers and students and teachers of the temporary schools, and the use of medical equipment and personnel division were proposed. Results Medical rounds facilitated the early detection of the disease, and also the health education, health and epidemic prevention and the psychological counseling work. Conclusion The configuration of medical rounds module in the field shelter hospital meets the security needs of the hospital earthquake relief medical rare. [Chinese Medical Equipment Journal,2012,33(5) :80-81]%目的:探讨野战医院在抗震救灾中医疗巡诊模块的使用.方法:通过对在汶川、玉树2次执行抗震救灾任务中,医院组建了4~6人医疗巡诊小分队,定期对灾区灾民、救灾部队官兵、地方救变人员、临时学校师生等进行医疗巡诊工作,提出卫生装备的使用和人员的分工.结果:医疗巡诊便于及早发现疾病,开展健康宣教、卫生防疫、心理疏导等工作.结论:野战方舱医院配置巡诊模块,适合医院抗震救灾医疗救治的保障需要.

  7. Impacts of medical treatments for lower urinary tract symptoms suggestive to benign prostatic hyperplasia on male sexual functions

    Directory of Open Access Journals (Sweden)

    Shih-Tsung Huang

    2016-03-01

    Full Text Available Although alpha blockers with or without 5-alpha reductase inhibitors (5-ARIs have become the standard of treatment for men with moderate to severe lower urinary tract symptoms suggestive to benign prostatic hyperplasia (LUTS/BPH, their negative adverse effects on male sexual functions have become another major issue, which may have a direct impact on patients' quality of life and overall satisfaction. Erectile dysfunction, ejaculation disorders, reduced libido, or anorgasmia have been noted among patients receiving these standards of treatments and these adverse events may be irreversible even after discontinuation of medications. Physicians should inform and discuss with their patients about these potential side effects before prescribing these medications for their LUTS/BPH treatment. Tadalafil is the first phosphodiesterase type 5 inhibitor which has the indications for LUTS/BPH and erectile dysfunction and its efficacy is comparable to alpha-blockers with regards to the reduction of LUTS and improvement of quality of life. Moreover, early clinical studies have showed that the combination use tadalafil with alpha blockers or 5-ARIs may have an additional benefit on symptom relief and maximum urinary flow rate (Qmax improvement. As expected, the improvement on erectile function is significant, especially among patients taking 5-ARIs regularly. Although there are promising data from the combination use of tadalafil with 5-ARIs or tadalafil with alpha-blockers, more large-scale clinical studies are still needed to confirm their long term safety and efficacy profiles.

  8. Effectiveness of a cognitive behavioral intervention in patients with medically unexplained symptoms: cluster randomized trial

    Directory of Open Access Journals (Sweden)

    López-García-Franco Alberto

    2012-05-01

    Full Text Available Abstract Background Medically unexplained symptoms are an important mental health problem in primary care and generate a high cost in health services. Cognitive behavioral therapy and psychodynamic therapy have proven effective in these patients. However, there are few studies on the effectiveness of psychosocial interventions by primary health care. The project aims to determine whether a cognitive-behavioral group intervention in patients with medically unexplained symptoms, is more effective than routine clinical practice to improve the quality of life measured by the SF-12 questionary at 12 month. Methods/design This study involves a community based cluster randomized trial in primary healthcare centres in Madrid (Spain. The number of patients required is 242 (121 in each arm, all between 18 and 65 of age with medically unexplained symptoms that had seeked medical attention in primary care at least 10 times during the previous year. The main outcome variable is the quality of life measured by the SF-12 questionnaire on Mental Healthcare. Secondary outcome variables include number of consultations, number of drug (prescriptions and number of days of sick leave together with other prognosis and descriptive variables. Main effectiveness will be analyzed by comparing the percentage of patients that improve at least 4 points on the SF-12 questionnaire between intervention and control groups at 12 months. All statistical tests will be performed with intention to treat. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis. Discussion This study aims to provide more insight to address medically unexplained symptoms, highly prevalent in primary care, from a quantitative methodology. It involves intervention group conducted by previously trained nursing staff to diminish the progression to the chronicity

  9. Sleep quality moderates the relation between depression symptoms and problematic cannabis use among medical cannabis users.

    Science.gov (United States)

    Babson, Kimberly A; Boden, Matthew Tyler; Bonn-Miller, Marcel O

    2013-05-01

    This study sought to extend research on the relation between depression symptoms and problematic cannabis use by evaluating the potential moderating role of perceived sleep quality among medical cannabis users. This employed a cross-sectional design. The sample consisted of 162 adults (mean age = 42.05 years, SD = 14.8; 22% female), with current recommendations from a doctor for medical cannabis, recruited from a medical cannabis dispensary. Consistent with previous research, individuals with heightened depression symptoms had greater problematic cannabis use. In addition, perceived sleep quality moderated this relation, such that depression symptoms differentially related to problematic cannabis use as a function of perceived quality of sleep (ΔR(2) = .03, p = .02). Participants with higher levels of depression and good perceived sleep quality had the greatest rates of problematic cannabis use. These results suggest that individuals with heightened depression may have higher rates of problematic cannabis use, in part, because of the beneficial effects of cannabis in terms of perceived sleep quality.

  10. Depressive symptoms in Parkinson’s disease and in non-neurological medical illnesses

    Directory of Open Access Journals (Sweden)

    Assogna F

    2013-03-01

    Full Text Available Francesca Assogna,1 Sabrina Fagioli,1 Luca Cravello,1 Giuseppe Meco,2 Mariangela Pierantozzi,3 Alessandro Stefani,3 Francesca Imperiale,2 Carlo Caltagirone,1,3 Francesco E Pontieri,4 Gianfranco Spalletta11I.R.C.C.S. Santa Lucia Foundation, Rome, Italy; 2Department of Neurology and Psychiatry (Parkinson’s Centre and Research Centre of Social Diseases (CIMS, University “Sapienza”, Rome, Italy; 3Department of Neuroscience, University “Tor Vergata”, Rome, Italy; 4Department of Neuroscience, Mental Health and Sensory Systems, University “Sapienza”, Movement Disorder Unit, Sant’Andrea Hospital, Rome, ItalyBackground: Patients with neurological and non-neurological medical illnesses very often complain of depressive symptoms that are associated with cognitive and functional impairments. We compared the profile of depressive symptoms in Parkinson’s disease (PD patients with that of control subjects (CS suffering from non-neurological medical illnesses.Methods: One-hundred PD patients and 100 CS were submitted to a structured clinical interview for identification of major depressive disorder (MDD and minor depressive disorder (MIND, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR, criteria. The Hamilton Depression Rating Scale (HDRS and the Beck Depression Inventory (BDI were also administered to measure depression severity.Results: When considering the whole groups, there were no differences in depressive symptom frequency between PD and CS apart from worthlessness/guilt, and changes in appetite reduced rates in PD. Further, total scores and psychic and somatic subscores of HDRS and BDI did not differ between PD and CS. After we separated PD and CS in those with MDD, MIND, and no depression (NODEP, comparing total scores and psychic/somatic subscores of HDRS and BDI, we found increased total depression severity in NODEP PD and reduced severity of the psychic symptoms of

  11. Knowledge on Perimenopausal Symptoms among Women Attending Lumbini Medical College Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Parbati Nepal Paudyal

    2014-12-01

    Full Text Available Introduction: Perimenopause is an unavoidable stage of a woman's reproductive life that starts several years before menopause. Due to declining estrogen level, women experience physiological and psychological changes during perimenopausal period and sometimes symptoms are very distressing that affect the women’s quality of life negatively. This study was done to assess the knowledge of women about perimenopausal symptoms. Methods: A cross-sectional analytical study was done at Lumbini Medical college (LMC throughout the months of November and December, 2013. Women of age 40-60 years, attending various clinics in LMC and ready to take part in the study were included. A total of 142 women were selected purposefully. The data was collected using the semi structured interview schedule. Results: The study revealed that half of respondents were between age group 40-44 years, 141 (99.3% were married and 82 (57.7% were literate. Three quarter of respondents (74.6% were menstruating women. The main source of information on perimenopausal symptoms was friends and relatives (81.2%. Majority of respondents (n=90, 63.4% had poor, 52 (33.8% had fair and only 2.8% had good level of knowledge on perimenopausal symptoms. The respondents’ level of knowledge on perimenopausal symptoms was statistically significant with educational status (p<0.001, level of education (p=0.048 and economic status (p=0.02. Conclusion: Many women have poor knowledge on perimenopausal symptoms. The role of health care provider is that they should seriously discuss about mid-life women’s health problems including perimenopausal symptoms and treatment modality including hormonal replacement therapy so the quality of life of women can be improved.

  12. Medication Responsiveness of Motor Symptoms in a Population-Based Study of Parkinson Disease

    Directory of Open Access Journals (Sweden)

    Yvette M. Bordelon

    2011-01-01

    Full Text Available We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

  13. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

    Science.gov (United States)

    Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A.

    2016-01-01

    Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale. Results: Students acquired on average, 5.8 hours of sleep each night, with an average bedtime at 01:53. Approximately 8% reported acquiring sleep during the day, and not during nighttime. Poor sleep quality was present in 30%, excessive daytime sleepiness (EDS) in 40%, and insomnia symptoms in 33% of students. Multivariable regression models revealed significant associations between stress, poor sleep quality, and EDS. Poorer academic performance and stress were associated with symptoms of insomnia. Conclusion: Sleep deprivation, poor sleep quality, and EDS are common among clinical years medical students. High levels of stress and the pressure of maintaining grade point averages may be influencing their quality of sleep. PMID:26837401

  14. Restless legs syndrome: associated non-motor symptoms and medical comorbidities: a controlled study

    Directory of Open Access Journals (Sweden)

    Sanghera MK

    2015-10-01

    Full Text Available Manjit K Sanghera,1 Samantha G Sales,2 Jennifer L Robinson,1 Juhee Song,3 Elmyra V Encarnacion,4 R Malcolm Stewart5 1Department of Neurosurgery, Baylor-Scott and White Hospital, Temple, TX, 2Texas A & M College of Medicine, College Station, TX, 3Department of Biostatistics, Baylor-Scott and White Hospital, Temple, TX, 4Department of Neurology, Baylor-Scott and White Hospital, Temple, TX, 5Human Performance Laboratory, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA Introduction: Restless legs syndrome (RLS is a chronic sensorimotor disorder characterized by discomfort or pain, predominantly in the legs, resulting in an urge to move during times of rest. These disturbances are often accompanied by sleep fragmentation, which can significantly increase medical comorbidities over time and can have a detrimental effect on a patient's overall quality of life. In this retrospective study, we examined the temporal relationship between the time of RLS diagnosis and the onset of non-motor symptoms (NMS and medical comorbidities. Patients and methods: Thirty-six RLS patients were evaluated for age at: symptom onset, time of diagnosis, time of occurrence of NMS, and medical comorbidities. We used structured interviews, validated questionnaires, and past medical records to aggregate and verify patient data. There was no clinical evidence to suggest secondary RLS in any patient at time of diagnosis. Results: Twenty-five patients were diagnosed as having RLS alone and eleven were diagnosed with RLS and Parkinson's disease (RLS + PD. In the RLS + PD group, irrespective of which disorder presented first, we found that patients exhibited symptoms of RLS at a significantly later age than those patients with RLS alone (P<0.05. The incidence and severity of NMS were significantly higher in the RLS + PD group compared to RLS alone and controls (P<0.001. Increased risk of RLS was identified in patients exhibiting mood changes and sleep deficits, and these

  15. Medical signs and symptoms associated with disability, pain, and psychosocial adjustment in systemic sclerosis.

    Science.gov (United States)

    Malcarne, Vanessa L; Hansdottir, Ingunn; McKinney, Ann; Upchurch, Renn; Greenbergs, Helen L; Henstorf, Gretchen H; Furst, Daniel E; Clements, Philip J; Weisman, Michael H

    2007-02-01

    To examine physician-assessed medical signs and patient-reported medical symptoms as correlates of 3 quality of life (QOL) outcomes in patients with systemic sclerosis (SSc): disability, pain, and psychosocial adjustment. One hundred fourteen patients with SSc underwent a comprehensive clinical examination including determination of skin thickening [Modified Rodnan Skin Score (MRSS)]. Patients reported current symptoms and completed standardized questionnaires assessing disability and pain (Health Assessment Questionnaire) and psychosocial adjustment (Psychosocial Adjustment to Illness Scale). Regression analysis was used to examine physician-determined and patient-reported correlates of the 3 outcomes. MRSS was a significant correlate of all outcomes, although it explained only a small amount of the variance in psychosocial adjustment. Patient-reported postprandial bloating was the strongest correlate of psychosocial adjustment, explaining more than twice as much variance as MRSS. After accounting for MRSS, patient-reported dependent edema significantly correlated with all outcomes. For disability, significant correlates were physician-determined joint tenderness and number of tender points, and patient-reported joint pain on motion, joint contracture, extremity ulcers other than digital, and dyspnea. Patient-reported joint tenderness was significantly associated with pain. Regression analysis supported a model in which disability and pain mediated the relationship between MRSS and psychosocial adjustment. Skin score is strongly associated with disability and pain, but only weakly associated with psychosocial adjustment. Dependent edema has negative implications across quality-of-life outcomes. Disability and pain mediate the relationship between disease severity and psychosocial adjustment to disease. Assessment (including self-report of patient symptoms) of specific medical signs and symptoms may indicate SSc patients experiencing diminished QOL.

  16. Posttraumatic stress disorder in primary care: prevalence and relationships with physical symptoms and medical utilization.

    Science.gov (United States)

    Gillock, Karen L; Zayfert, Claudia; Hegel, Mark T; Ferguson, Robert J

    2005-01-01

    This study estimates the prevalence of posttraumatic stress disorder (PTSD) and describes the relationships among PTSD status and health indices in a civilian primary care patient sample. Participants (N = 232) completed a paper-and-pencil survey of life events, PTSD symptoms, physical symptoms and health functioning. Utilization was assessed from medical records. Nine percent of the participants met the criteria for full PTSD (based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) and another 25% were defined as partial PTSD. The full-PTSD group evidenced higher rates of medical utilization, more intense physical symptoms and poorer health functioning than the no-PTSD group. The partial-PTSD group more closely resembled the full-PTSD group. This study, although limited by sample size and diagnosis by questionnaire vs. diagnostic interview, suggests research directions for enhancing our understanding of PTSD among civilian primary care patients and for developing appropriate interventions that can be conducted in the primary care setting.

  17. 军队医院灾害医学救援能力建设的思考%Medical Support Capability Construction of Military Hospital in Disaster Relief

    Institute of Scientific and Technical Information of China (English)

    张军勇; 丁迎周; 张美进

    2012-01-01

    Objective Seeking for ways to coping with the emergency medical support of increasingly grow natural disasters, and enhancing the support capabilities of military hospitals. Methods The features of natural disasters in the spot were introduced mainly. The casualties caused by disasters and the difficulties of disaster relief were also analyzed. Results Four issues of enhancing the capacity of emergency medical rescue in disasters are discussed. Conclusion Through the capability construction, military hospital can achieve the objective of precise, rapid and efficient support.%目的 针对日益增多的自然灾害现状,寻求途径方法,为提升军队医院灾害应急医学救援能力提供支持.方法 重点介绍灾害现场的主要特点,并分析灾害所致伤情和灾害救援的难点.结果 对提升应急医学救援能力建设应重点关注的四方面问题进行了探讨.结论 军队医院通过能力建设,可以实现灾害中精确、快速、高效的救援能力.

  18. Mobile emergency (surgical) hospital: Development and application in medical relief of "4.20" Lushan earthquake in Sichuan Province, China

    Institute of Scientific and Technical Information of China (English)

    Bin Cheng; Ruofei Shi; Dingyuan Du; Ping Hu; Jun Feng; Guangbin Huang; Anning Cai

    2015-01-01

    In the 21st century,natural disasters and emergencies occur frequently worldwide,which leads to the loss of hundreds of thousands of lives as well as the direct and indirect economic losses.China has a vast territory frequently struck by natural disasters.However,the reality is not optimistic.Poor organization and management during the rescue actions,the lack of large-scale,systematic medical rescue equipment were all great barriers to the outcomes.Mobile hospitals are expected to provide better health care.We were inspired by the concept of mobile hospital.Chongqing Emergency Medical Center,has set up trauma care system since 1988,in which prehospital care,intensive care,and in-hospital treatment is fully integrated.As a major advantage,such a system provided assurance of"golden hour" rescue treatment.Providing mobile intensive care and prehospital surgical service for severe trauma patients could reduce mortality significantly.Based on the civilian experiences in Chongqing Emergency Medical Center,the mobile emergency (surgical) hospital was developed.

  19. Religion and beliefs about treating medically unexplained symptoms: a survey of primary care physicians and psychiatrists.

    Science.gov (United States)

    Lawrence, Ryan E; Rasinski, Kenneth A; Yoon, John D; Curlin, Farr A

    2013-01-01

    Historical evidence and prior research suggest that psychiatry is biased against religion, and religious physicians are biased against the mental health professions. Here we examine whether religious and non-religious physicians differ in their treatment recommendations for a patient with medically unexplained symptoms. We conducted a national survey of primary care physicians and psychiatrists. We presented a vignette of a patient with medically unexplained symptoms, and experimentally varied whether the patient was religiously observant. We asked whether physicians would recommend six interventions: antidepressant medication, in-office counseling, referral to a psychiatrist, referral to a psychologist or licensed counselor, participation in meaningful relationships and activities, and involvement in religious community. Predictors included the physician's specialty and the physician's attendance at religious services. The response rate was 63% (896 of 1427) primary care physicians and 64% (312 of 487) psychiatrists. We did not find evidence that religious physicians were less likely to recommend mental health resources, nor did we find evidence that psychiatrists were less likely to recommend religious involvement. Primary care physicians (but not psychiatrists) were more likely to recommend that the patient get more involved in their religious community when the patient was more religiously observant, and when the physician more frequently attended services. We did not find evidence that mental health professionals are biased against religion, nor that religious physicians are biased against mental health professionals. Historical tensions are potentially being replaced by collaboration.

  20. Prevalence of depressive and anxiety symptoms in medical students in the city of Santos

    Directory of Open Access Journals (Sweden)

    Rosana Denobile Serra

    2015-09-01

    Full Text Available ABSTRACT Objective Ascertain the prevalence of depressive and anxiety symptoms in medical students, considering data in the literature that indicate higher vulnerability to emotional disorders in this population. Methods A descriptive cross-sectional study with a sample of 657 (98% students. The instruments used were: questionnaire of socioeconomic-demographic characteristics, Beck Depression Inventory and Beck Anxiety Inventory. Results Predominance of the female gender (61%, aged between 17 and 30 years (98%, Catholic religion (64.2% from the city of São Paulo (40.7% and other cities in the state (35.7%; 30% presented depressive symptoms and 21% anxiety symptoms. Female students had higher scores both for depression (34.8% and for anxiety (26.8%. As regards the course year, the highest rates were found in the 5th year (40.7% for depression and in the 2nd year for anxiety (28.8%. Conclusion The data obtained in this study (30% agreed with the literature regarding the prevalence of depressive symptoms in medical students, but this index was higher compared to the population in general (15.1% to 16.8%, and related to people in São Paulo city (18.5%. Concerning anxiety the rates found were slightly lower than those in specific literature but higher than those in literature for the population in general (8% to 18% and in city São Paulo (16.8%. These indices indicate that the school of medicine may play a role as a predisposing and/or triggering factor in some students. The results suggest that more attention should be directed to 5th year students, who are beginning the internship period.

  1. Role of Mindfulness and Cognitive Emotion Regulation Strategies on Predicting the Psychological Symptoms of Medical Students

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    Sajjadi MS

    2015-12-01

    Full Text Available Aims: Besides many problems during education courses, an increase in the level of stress, depression, or anxiety leads to interferences with the students’ professional roles. Mindfulness and cognitive strategies to regulate emotions positively affect human health in different human classes and different psychological symptoms. The aim of this study was to investigate the differentiation roles of mindfulness and cognitive strategies to regulate emotions in prediction of the psychological symptoms in the medical students.  Instrument & Methods: As a descriptive-correlational study, 375 students of Kerman University of Medical Sciences were randomly studied in 2014-15. The study tools were 5-dimension Mindfulness Questionnaire, Cognitive Strategies to Regulate the Emotions Questionnaire, and Depression, Anxiety, and Stress Questionnaire. Data was analyzed in SPSS 20 software using Pearson Correlation Coefficient, and Stepwise Regression test. Findings: There was a significant correlation between the emotion regulation strategies and mindfulness and depression, anxiety, and stress (p<0.01. 25% of variance changes in depression were explained by the emotion regulation negative cognitive strategies (12%, the emotion regulation positive cognitive strategies (9%, and mindfulness (4%. 17% of the variance changes in anxiety were explained by the emotion regulation negative (12% and positive (5% cognitive strategies. 19.3% of the variance changes in stress were explained by the emotion regulation negative (17% and positive (2.3% cognitive strategies (p<0.05. Conclusion: The effectiveness of cognitive strategies to regulate the emotions and especially, negative cognitive strategies to regulate the emotions is more considerable in explaining the psychological symptoms in the medical students than mindfulness. 

  2. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    OpenAIRE

    Mehta Bharati

    2016-01-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a...

  3. The MMPI-2 Symptom Validity Scale (FBS) Not Influenced by Medical Impairment: A Large Sleep Center Investigation

    Science.gov (United States)

    Greiffenstein, Manfred F.

    2010-01-01

    The Symptom Validity Scale (Minnesota Multiphasic Personality Inventory-2-FBS [MMPI-2-FBS]) is a standard MMPI-2 validity scale measuring overstatement of somatic distress and subjective disability. Some critics assert the MMPI-2-FBS misclassifies too many medically impaired persons as malingering symptoms. This study tests the assertion of…

  4. Characteristics of Prison Hospice Patients: Medical History, Hospice Care, and End-of-Life Symptom Prevalence.

    Science.gov (United States)

    Cloyes, Kristin G; Berry, Patricia H; Martz, Kim; Supiano, Katherine

    2015-07-01

    Increasing numbers of prisoners in the United States are dying from age-related and chronic illnesses while incarcerated. This study is among the first to document characteristics of a population of prison hospice patients. Retrospective review of medical records for all patients admitted to the Louisiana State Penitentiary prison hospice program between January 1, 2004, and May 31, 2012 (N = 79) examined demographics, medical history, hospice diagnosis, length of stay, and end-of-life symptom prevalence on admission and during final 72 hours before death. Resulting data were contrasted with community-based end-of-life care study data, demonstrating a unique clinical profile of this group. As prisons consider adopting programs to meet the growing need for inmate end-of-life care, more research concerning the particular characteristics and unique needs of prison hospice patients will inform these efforts.

  5. Bringing Relief

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    China is mobilizing medical and epidemic prevention resources from around the country to ensure adequate levels of care for earthquake survivors"When the rescued people arrive, what we can do is to try our best to restore their health,"said Liu Xiaoguang,Deputy Principal of Peking University Third Hospital and head of Beijing’s medical rescue team for the Sichuan earthquake.As one of the first

  6. Prevalence of depressive symptoms among medical students taught using problem-based learning versus traditional methods.

    Science.gov (United States)

    Aragão, José Aderval; Freire, Marianna Ribeiro de Menezes; Nolasco Farias, Lucas Guimarães; Diniz, Sarah Santana; Sant'anna Aragão, Felipe Matheus; Sant'anna Aragão, Iapunira Catarina; Lima, Tarcisio Brandão; Reis, Francisco Prado

    2017-10-03

    To compare depressive symptoms among medical students taught using problem-based learning (PBL) and the traditional method. Beck's Depression Inventory was applied to 215 medical students. The prevalence of depression was calculated as the number of individuals with depression divided by the total number in the sample from each course, with 95% confidence intervals. The statistical significance level used was 5% (p ≤ .05). Among the 215 students, 52.1% were male and 47.9% were female; and 51.6% were being taught using PBL methodology and 48.4% using traditional methods. The prevalence of depression was 29.73% with PBL and 22.12% with traditional methods. There was higher prevalence among females: 32.8% with PBL and 23.1% with traditional methods. The prevalence of depression with PBL among students up to 21 years of age was 29.4% and among those over 21 years, 32.1%. With traditional methods among students up to 21 years of age, it was 16.7%%, and among those over 21 years, 30.1%. The prevalence of depression with PBL was highest among students in the second semester and with traditional methods, in the eighth. Depressive symptoms were highly prevalent among students taught both with PBL and with traditional methods.

  7. Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine

    Directory of Open Access Journals (Sweden)

    Karen S. Ferreira

    Full Text Available OBJECTIVE: The pathophysiology of migraine and restless legs syndrome (RLS seems to involve inherited mechanism and dysfunction of the dopaminergic system. Previous articles have shown that the frequency of RLS is higher in migraine patients than in controls. We conducted a study to evaluate comorbidities, medication used and depressive symptoms that can explain the relation between migraine and RLS. METHODS: A case-control study was performed in which patients with migraine (n=72 and a control group without migraine (n=72 were interviewed. Data including RLS diagnosis, depressive symptoms, comorbidities and drugs used were evaluated. RESULTS: There was a significant association between migraine and RLS (p=0.01, but comorbidities such as diabetes, hypertension, anemia and drugs used did not explain this association. Depression scores, as measured by the Beck Depression Inventory, were higher in migraine patients with RLS (p =0.04. CONCLUSION: No specific factors explaining the association between migraine and RLS were found. Symptoms of depression were more frequent in patients with migraine and RLS.

  8. Symptoms and signs of ocular surface disease related to topical medication in patients with glaucoma

    Directory of Open Access Journals (Sweden)

    Cvenkel B

    2015-04-01

    Full Text Available Barbara Cvenkel,1 Špela Štunf,1 Irena Srebotnik Kirbiš,2 Margareta Strojan Fležar2 1Department of Ophthalmology, University Medical Center Ljubljana, Ljubljana, Slovenia; 2Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia Purpose: The aim of this study was to assess signs and symptoms of ocular surface disease (OSD and the cytomorphological changes of ocular surface in glaucoma patients using preserved antiglaucoma drops.Methods: In this cross-sectional study, 109 participants (79 patients with topical medication and 30 untreated controls completed the Ocular Surface Diseases Index (OSDI questionnaire and underwent an ophthalmic examination, including Schirmer test, tear film breakup time (TBUT, and fluorescein staining. Conjunctival specimens were collected by impression cytology and analyzed by light microscopy using Nelson’s grading scheme (grades 0–3. This classification is based on the nucleus-to-cytoplasm ratios of epithelial cells and the numbers of goblet cells, with grade 2 considered abnormal.Results: The medication group had significantly shorter TBUT (median [interquartile range]: 6.0 seconds [5.0–8.0 seconds] vs 9.5 seconds [6.0–12.3 seconds]; P<0.03, greater fluorescein staining (1.0 [0.75–1.25] vs 0 [0–0.25]; P<0.001, and higher impression cytology grade than the control group (median [range]: 1.0 [1:2 to 1:6] vs 0.6 [1:2 to 1:4]; P<0.001. The increasing number of drops instilled per day was associated with an increase in fluorescein staining (Spearman’s rho r=0.475; P<0.001 and shorter TBUT (r=-0.278; P=0.014. The OSDI did not discriminate between the two groups.Conclusion: Clinical tests and impression cytology showed ocular surface damage in patients using preserved antiglaucoma medications. However, there was no statistically and clinically significant difference in symptoms measured by OSDI score between the medication and control groups. Keywords: ocular surface

  9. Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

    Science.gov (United States)

    Quinn, Kevin

    This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

  10. New medical treatments for lower urinary tract symptoms due to benign prostatic hyperplasia and future perspectives.

    Science.gov (United States)

    Albisinni, Simone; Biaou, Ibrahim; Marcelis, Quentin; Aoun, Fouad; De Nunzio, Cosimo; Roumeguère, Thierry

    2016-09-15

    Lower Urinary Tract Symptoms (LUTS) in men are a common clinical problem in urology and have been historically strictly linked to benign prostatic hyperplasia (BPH), which may lead to bladder outlet obstruction (BOO). New molecules have been approved and have entered the urologists' armamentarium, targeting new signaling pathways and tackling specific aspects of LUTS. Objective of this review is to summarize the evidence regarding the new medical therapies currently available for male non-neurogenic LUTS, including superselective α1-antagonists, PDE-5 inhibitors, anticholinergic drugs and intraprostatic onabotulinum toxin injections. The National Library of Medicine Database was searched for relevant articles published between January 2006 and December 2015, including the combination of "BPH", "LUTS", "medical" and "new". Each article's title, abstract and text were reviewed for their appropriateness and their relevance. One hundred forty eight articles were reviewed. Of the 148 articles reviewed, 92 were excluded. Silodosin may be considered a valid alternative to non-selective α1-antagonists, especially in the older patients where blood pressure alterations may determine major clinical problems and ejaculatory alterations may be not truly bothersome. Tadalafil 5 mg causes a significant decrease of IPSS score with an amelioration of patients' QoL, although with no significant increase in Qmax. Antimuscarinic drugs are effective on storage symptoms but should be used with caution in patients with elevated post-void residual. Intraprostatic injections of botulinum toxin are well-tolerated and effective, with a low rate of adverse events; however profound ameliorations were seen also in the sham arms of RCTs evaluating intraprostatic injections. New drugs have been approved in the last years in the medical treatment of BPH-related LUTS. Practicing urologists should be familair with their pharmacodynamics and pharmacokinetics.

  11. Development of a practice guideline for optimal symptom relief for patients with pneumonia and dementia in nursing homes using a Delphi study

    NARCIS (Netherlands)

    van der Maaden, Tessa; van der Steen, Jenny T.; de Vet, Henrica C. W.; Achterberg, Wilco P.; Boersma, Froukje; Schols, Jos M. G. A.; van Berkel, Jos F. J. M.; Mehr, David R.; Arcand, Marcel; Hoepelman, Andy I. M.; Koopmans, Raymond T. C. M.; Hertogh, Cees M. P. M.

    2015-01-01

    ObjectiveThis study aimed to develop a practice guideline for a structured and consensus-based approach to relieve symptoms of pneumonia in patients with dementia in nursing homes. MethodsA five-round Delphi study involving a panel consisting of 24 experts was conducted. An initial version of the pr

  12. Development of a practice guideline for optimal symptom relief for patients with pneumonia and dementia in nursing homes using a Delphi study

    NARCIS (Netherlands)

    Maaden, T. van der; Steen, J.T. van der; Vet, H.C. de; Achterberg, W.P.; Boersma, F.; Schols, J.M.; Berkel, J.F. van; Mehr, D.R.; Arcand, M.; Hoepelman, A.I.; Koopmans, R.T.C.M.; Hertogh, C.M.

    2015-01-01

    OBJECTIVE: This study aimed to develop a practice guideline for a structured and consensus-based approach to relieve symptoms of pneumonia in patients with dementia in nursing homes. METHODS: A five-round Delphi study involving a panel consisting of 24 experts was conducted. An initial version of th

  13. Relief of BPO or improvement in quality of life?

    Science.gov (United States)

    Teillac, P

    1998-01-01

    Benign prostatic hyperplasia (BPH) can cause benign prostatic enlargement with subsequent benign prostatic obstruction (BPO) and lower urinary tract symptoms (LUTS). A reduction in the size of the prostate has long been considered one of the most important treatment goals. However, there is a poor correlation between prostate size and both LUTS and BPO, and between BPO and symptoms. Today, the urologist's primary objectives are to minimize symptoms, relieve BPO and decrease the morbidity associated with BPO. From the patient's point of view, rapid relief of LUTS and immediate improvement in associated quality of life (QOL) are the most important factors. Although there is a good correlation between relief of symptoms (as measured by the International Prostate Symptom Score [I-PSS], for example) and associated improvement in bothersomeness and QOL, particularly that associated with filling ('irritative') symptoms, it is still important to quantify LUTS-related bothersomeness and QOL. Various questionnaires have been developed to measure bothersomeness (e.g. Symptom Problem Index [SPI], Danish PSS [DAN-PSS], International Continence Society BPH Study Group [ICSmale] questionnaire) and QOL (e.g. I-PSS-QOL, BPH Impact Index [BII] and QOL9 BPH-specific questionnaire). In addition, the impact of treatment on sexual function should also be taken into account when judging the overall well being or QOL of the patient. A grading system to evaluate the global improvement in patients following treatment has been established. Patients are either graded as showing 'slight', 'moderate' or 'marked' improvement, with the reduction in I-PSS or BII scores required for each classification dependent on baseline symptom severity. Medical treatment strategies designed to alleviate the symptoms of BPH and consequently improve the patient's QOL are now becoming increasingly important.

  14. Symptoms intensification of post-traumatic stress in individuals performing the job of a medical rescue worker

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    Ewa Ogłodek

    2011-09-01

    Full Text Available Background: The purpose of the task was the assessment of stress and the intensification of the symptoms of post-traumatic stress disorder (PTSD in the group of medical rescue workers. Material and methods: The research covered 36 individuals, working as medical rescue workers (18 males and 18 females; average age: 40.9. The medical rescue workers were employed in the Hospital Emergency Department. The control group composed of 34 patients (17 males and 17 females; average age: 39.6 the questionnaires were completed by individuals assessing the intensification of post-traumatic stress, namely Mississippi-C PTSD Scale, and assessed the ambience dominant in their workplace. Results: What was observed was significant interdependencies among the intensification of symptoms of post-traumatic stress in case of the interviewed groups of medical rescue workers. Conclusions: What becomes import, is to take preventive action in the field of mental health among medical rescue workers.

  15. A sigh of relief or a sigh of expected relief: Sigh rate in response to dyspnea relief.

    Science.gov (United States)

    Vlemincx, Elke; Meulders, Michel; Luminet, Olivier

    2017-08-09

    Research has suggested that sighs may serve a regulatory function during stress and emotions by facilitating relief. Evidence supports the hypotheses that sighs both express and induce relief from stress. To explore the potential role of sighs in the regulation of symptoms, the present study aimed to investigate the relationship between sighs and relief of symptoms, and relief of dyspnea, specifically. Healthy volunteers participated in two studies (N = 44, N = 47) in which dyspnea was induced by mild (10 cmH2 O/l/s) or high (20 cmH2 0/l/s) inspiratory resistances. Dyspnea relief was induced by the offset of the inspiratory resistances (transitions from high and mild inspiratory resistance to no resistance). Control comparisons included dyspnea increases (transitions from no or mild inspiratory resistance to high inspiratory resistance) and dyspnea continuations (continuations of either no resistance or a high resistance). In Experiment 1, dyspnea levels were cued. In Experiment 2, no cues were provided. Sigh rate during dyspnea relief was significantly higher compared to control conditions, and sigh rate increased as self-reported dyspnea decreased. Additionally, sigh rate was higher during cued dyspnea relief compared to noncued dyspnea relief. These results suggest that sighs are important markers of dyspnea relief. Moreover, sighs may importantly express dyspnea relief, as they are related to experiential dyspnea decreases and occur more frequently during expected dyspnea relief. These findings suggest that sighs may not only be important in the regulation of stress and emotions, but also may be functional in the regulation of dyspnea. © 2017 Society for Psychophysiological Research.

  16. 抗震救灾医学救援先遣分队建设探讨%Construction of Medical Rescue Advance Team in Earthquake Relief

    Institute of Scientific and Technical Information of China (English)

    闫广庆; 周峰; 黄国琼; 刘国祥

    2014-01-01

    For military hospitals,it is an important task to provide support in earthquake relief , which is one type of multiple military operations .In this article, the author put forward the suggestions to establish some mo-bile medical team based on the previous experiences , the aim of it is to organize the teams to arrive at earthquake disaster areas at the first time .The main work of these teams included that to investigate the disasters and casual-ties,to treat patients and to carry out the rescue work .These teams will play an important role in saving lives and stabilizing emotions .%军队医院参加抗震救灾任务是执行多样化军事行动的一项重要内容。本文在总结以往参加抗震救灾经验的基础上,提出构建抗震救灾医学救援先遣分队的设想,目的就是在地震发生后的第一时间里,抽组部分人员组成先遣队先期抵达灾区,主要承担灾区灾情伤情调查、重要伤员救治、搭建伤员后送通道以及协调后方支援力量开展救援等工作,对抢救灾区民众生命、稳定灾区民众情绪起到重要的作用。

  17. Nocturnal giddiness in relation to nocturia and other symptoms and to medication in the elderly.

    Science.gov (United States)

    Asplund, Ragnar

    2005-01-01

    The aim of this study was to evaluate the relation of nocturia, somatic diseases, symptoms, and medication to nocturnal giddiness in a group of elderly men and women. A questionnaire survey was undertaken among 10,216 elderly subjects. The mean (+/-S.D.) ages of the men and women were 73.0 +/- 6.0 and 72.6 +/- 6.7 years, respectively. Nocturnal giddiness was reported by 14.1% of the men and 9.1% of the women. Poor health was reported by 44.4% (P or=3 versus nocturia or=80 years versus eyesight, poor versus good (1.8; 1.4-2.4); hearing, poor versus good (1.4; 1.1-1.9); pain in the cervical spine (2.1; 1.5-2.8); spasmodic chest pain (1.5; 1.1-2.0); diabetes (1.6; 1.0-2.4); analgesics (1.8; 1.3-2.4); and diuretics (1.4; 1.1-21.8). Sex, irregular heartbeats, and sleep medication were deleted by the logistic model.

  18. Prevalence of Sleep Deprivation and Relation with Depressive Symptoms among Medical Residents in King Fahd University Hospital, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Esraa M. Al-Maddah

    2015-01-01

    Full Text Available Objectives: Sleep deprivation is common among medical residents of all specialties. This study aimed to determine the prevalence of sleep deprivation and depressive symptoms among medical residents in King Fahd University Hospital (KFUH in Al Khobar, Saudi Arabia. Furthermore, the association between sleep deprivation, sleepiness and depressive symptoms was examined. Methods: This cross-sectional study took place between February and April 2012 and involved 171 KFUH medical residents of different specialties. Data were collected using a specifically designed questionnaire eliciting demographic information, working hours and number of hours of sleep. In addition, validated Arabic versions of the Epworth Sleepiness Scale and the Beck Depression Inventory-2 (BDI-2 were used. Results: The prevalence of acute sleep deprivation and chronic sleep deprivation among residents in KFUH was 85.9% and 63.2%, respectively. The prevalence of overall sleepiness was 52%; 43.3% reported being excessively sleepy in certain situations while 8.8% reported being excessively sleepy regardless of the situation. Based on the BDI-2, the prevalence of mild, moderate and severe depressive symptoms was 43.3%, 15.2% and 4.7%, respectively. Significant associations were found between sleep deprivation and depressive symptoms; depressive symptoms and sleepiness, and depressive symptoms and being a female resident. Conclusion: The vast majority of medical residents had acute sleep deprivation, with more than half suffering from chronic sleep deprivation. The number of hours and quality of sleep among the residents were strongly associated with depressive symptoms. New regulations are recommended regarding the number of working hours and night duties for medical residents. Further studies should assess these new regulations on a regular basis.

  19. Significant intravesical prostatic protrusion and prostatic calcification predict unfavorable outcomes of medical treatment for male lower urinary tract symptoms

    OpenAIRE

    Chia-Hao Kuei; Chun-Hou Liao; Bing-Juin Chiang

    2016-01-01

    Objective: To evaluate the impact of intravesical prostatic protrusion (IPP) and prostatic calcification on medical treatment for male lower urinary tract symptoms (LUTS). Materials and methods: Men over the age of 40 years with total International Prostate Symptom Score (IPSS) ≥ 8 were recruited from January to August 2013. The maximal flow rate, postvoiding residual (PVR) urine volume, total prostate volume (TPV), transitional zone volume (TZV), transitional zone index (TZI), and grades ...

  20. Symptoms, Quality of Life, and Daily Activities in People With Newly Diagnosed Solid Tumors Presenting to a Medical Oncologist.

    Science.gov (United States)

    Thomas, Shirley; Walsh, Declan; Shrotriya, Shiva; Aktas, Aynur; Hullihen, Barbara; Estfan, Bassam; Budd, G Thomas; Hjermstad, Marianne Jensen; O'Connor, Brenda

    2017-08-01

    Symptom and Quality of Life (QOL) data are important patient reported outcomes. Early identification of these is critical for appropriate interventions. Data collection may be helped by modern information technology. This study examined symptoms and QOL in people with solid tumors at their first visit to a medical oncologist. We also evaluated the clinical utility of tablet computers (TC) to collect this data. This was a prospective study of 105 consecutive patients in the cancer outpatient clinic of a tertiary level academic medical center. Symptom and QOL data was collected by TC with wireless database upload. One-third participants had moderate to severe pain; almost half clinically significant pain that interfered with daily activities. Tiredness, anxiety, and drowsiness were common (prevalence - 79%, 63% and 50% respectively). One-third of those who had items identified from the Edmonton System Assessment System also volunteered other symptoms, mostly gastrointestinal problems. Many of those affected also reported impaired Global Wellbeing and low Overall QOL. There was a 98% completion rate, which took on average ten minutes. Direct observation and informal feedback from patients and physicians regarding the acceptability of TC in this setting was uniformly positive. Amongst people with newly diagnosed solid tumors clinically important psychological and physical symptoms, QOL problems and difficulties with daily activities were commonly present in the 24-hour period and in the week before a first Medical Oncology visit. Symptom and QOL data collection by TC in busy outpatient clinics showed good clinical utility.

  1. Which Depressive Symptoms and Medication Side Effects Are Perceived by Patients as Interfering Most with Occupational Functioning?

    Directory of Open Access Journals (Sweden)

    Raymond W. Lam

    2012-01-01

    Full Text Available Background. Major depressive disorder (MDD is associated with significant impairment in occupational functioning. This study sought to determine which depressive symptoms and medication side effects were perceived by patients with MDD to have the greatest interference on work functioning. Methods. 164 consecutive patients with MDD by DSM-IV criteria completed a standard assessment that included a self-rated questionnaire about the degree to which symptoms and side effects interfered with work functioning. Results. The symptoms perceived by patients as interfering most with work functioning were fatigue and low energy, insomnia, concentration and memory problems, anxiety, and irritability. The medication side effects rated as interfering most with work functioning were daytime sedation, insomnia, headache, and agitation/anxiety. There were no differences between men and women in symptoms or side effects that were perceived as interfering with work functioning. Limitations. This was a cross-sectional study; only subjective assessments of work functioning were obtained; the fact that patients were using varied medications acts as a potential confound. Conclusions. Specific depressive symptoms and medication side effects were perceived by patients as interfering more with occupational functioning than others. These factors should be considered in treatment selection (e.g., in the choice of antidepressant in working patients with MDD.

  2. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    OpenAIRE

    Monica Köhn; Ulla Persson Lundholm; Ing-Liss Bryngelsson; Agneta Anderzén-Carlsson; Elisabeth Westerdahl

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, ove...

  3. A randomized clinical evaluation of the safety of Systane® Lubricant Eye Drops for the relief of dry eye symptoms following LASIK refractive surgery

    Directory of Open Access Journals (Sweden)

    Daniel Durrie

    2008-12-01

    Full Text Available Daniel Durrie, Jason StahlDurrie Vision, Overland Park, Kansas, USAPurpose: To evaluate the safety of Systane® Lubricant Eye Drops in relieving the symptoms of dry eye following laser-assisted in situ keratomileusis (LASIK surgery.Methods: This was a randomized, double-masked, single-center, placebo-controlled, contralateral eye study of 30 patients undergoing LASIK surgery. The mean age of patients was 42.4 ± 10.7 years, and the mean spherical equivalent was −3.29 (range, +1.75 to −7.38. Patients’ right and left eyes were randomized to receive either Systane® or placebo – a preserved, thimerosal-free saline solution – beginning from the day of surgery and ending 30 days following surgery. Outcome measures included tear film break up time (TFBUT, visual acuity, degree of corneal and conjunctival staining, and treatment-related adverse events.Results: Preoperatively, placebo-treated eyes had statistically significantly higher sum corneal staining score than Systane®-treated eyes (p = 0.0464; however, the difference was clinically insignificant (p = 0.27. Two weeks post operatively, the average TFBUT in the Systane®-treated eyes was 1.23 seconds longer than that of the placebo-treated eyes (p = 0.028. All other evaluated variables were comparable between the two treatments. No adverse events were reported in the study.Conclusion: Systane® Lubricant Eye Drops are safe for use following LASIK surgery to relieve the discomfort symptoms of dry eye associated with the procedure.Keywords: Systane®, safety, dry eye, LASIK

  4. [Symptoms of social phobia and their relationship to interpersonal characteristics in a sample of German medical students].

    Science.gov (United States)

    Baldauf, Matthias; Thomas, Andrea; Strauß, Bernhard

    2014-02-01

    The study aimed to detect the frequency of social phobia symptoms in a sample of German medical students and to compare students with and without these symptoms related to interpersonal characteristics. 525 students filled out a battery of self-report questionnaires consisting of the LSAS (Liebowitz Social Anxiety Scale), the SPAI (Social Phobia Anxiety Inventory), the IIP-32 (Inventar of interpersonal problems) and the IIM (Inventar of interpersonal motives). Relevant social phobia symptoms were found in 12.2%. Students with symptoms of social phobia differed significantly in subscales of the IIP and the IIM. Students with symptoms of social phobia also had higher scores for interpersonal problems especially related to the main issue of being too "socially avoidant".

  5. Repurposing Medications for Hospice/Palliative Care Symptom Control Is No Longer Sufficient: A Manifesto for Change.

    Science.gov (United States)

    Currow, David C; Abernethy, Amy P; Fallon, Marie; Portenoy, Russell K

    2017-03-01

    The World Health Organization essential medications list for hospice/palliative care reflects that, with the judicious use of currently available medications, the majority of symptoms can be lessened, and some controlled completely. Even with optimal use of current medications, symptom control is still unacceptable for many people. Currently available medications offer great benefit to a minority of patients, some benefit to an additional group, and no benefit or harms to others. In symptom control, development of new drugs is advancing at a glacial pace, contrasting to the rapid advances seen in many other disciplines. Specialists in palliative care should agree on several principles consequently: 1) Access to symptom-control drugs codified in the World Health Organization Essential Medicines list deserves the strongest support from national policies and professional guidelines, especially in resource-challenged countries. 2) The optimal use of currently available symptom-control drugs cannot yield acceptably high rates of net benefits. 3) There is a compelling need to identify patient subgroups that are likely to benefit from available medications and provide rigorous empirical support for indications, dosing, and route of administration for clinical practice. 4) New therapies are needed requiring an accelerated effort to investigate further the pathophysiology, neurobiology, and pharmacogenetics of distressing symptoms, and factors contributing to variations in drug response. This development requires a lengthy lead time. 5) Smarter ways to promote new knowledge into practice are needed as no drug will be suitable for all patients. We need to improve clinical characterization and biomarker technology to bring the best drugs to the right patients every time. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  6. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    Directory of Open Access Journals (Sweden)

    Mehta Bharati

    2016-09-01

    Full Text Available Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months. Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  7. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates.

    Science.gov (United States)

    Bharati, Mehta

    2016-09-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months). Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months) and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome.

  8. 军队地震灾害应急医学救援组织指挥体制结构设想%Assumption on structure of military organization command system for emergency medical relief in earthquake disaster

    Institute of Scientific and Technical Information of China (English)

    公斌; 孔兵; 郭树森; 刘思含; 孙志宏; 罗耀钦; 韩冰

    2015-01-01

    According to the characteristics of earthquake disaster, the system structure of military organization command system for emergency medical relief in earthquake disaster, including command organization system, staff composition and the function, relationship between organizations, in order to provide the certain supporting theory for military organization command work of earthquake relief in the future.%根据地震灾害发生后的特点,阐述了我军地震灾害应急医学救援组织指挥的体制结构,包含组织指挥体系、人员组成及职能,以及组织之间的关系。以期为军队以后的抗震救灾组织指挥工作提供一定的理论支撑。

  9. The Process of Change in Cognitive Therapy for Depression when Combined with Antidepressant Medication: Predictors of Early Intersession Symptom Gains

    Science.gov (United States)

    Strunk, Daniel R.; Cooper, Andrew A.; Ryan, Elizabeth T.; DeRubeis, Robert J.; Hollon, Steven D.

    2012-01-01

    Objective: Previous studies of cognitive therapy (CT) for depression have examined therapist adherence and the therapeutic alliance as predictors of subsequent symptom change. However, little is known about these CT process variables when CT is delivered in combination with antidepressant medication. Method: In a sample of 176 depressed…

  10. Fewer symptoms vs. more side-effects in schizophrenia? Opposing pathways between antipsychotic medication compliance and quality of life

    NARCIS (Netherlands)

    Staring, A.B.P.; Mulder, C.L.; Duivenvoorden, H.J.; Haan, L.; Gaag, van der M.

    2009-01-01

    Background Non-compliance with medication often has long-term detrimental effects in patients with schizophrenia. However, when patients are compliant, it is not certain whether they experience short-term improved quality of life. By simultaneously reducing symptoms and increasing side-effects, comp

  11. Fibromyalgia syndrome pathology and environmental influences on afflictions with medically unexplained symptoms.

    Science.gov (United States)

    Albrecht, Phillip J; Rice, Frank L

    2016-06-01

    Fibromyalgia syndrome (FMS) is a clinical disorder predominant in females with unknown etiology and medically unexplained symptoms (MUS), similar to other afflictions, including irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), Gulf War illness (GFI), and others. External environmental stimuli drive behavior and impact physiologic homeostasis (internal environment) via autonomic functioning. These environments directly impact the individual affective state (mind), which feeds back to regulate physiology (body). FMS has emerged as a complex disorder with pathologies identified among neurotransmitter and enzyme levels, immune/cytokine functionality, cortical volumes, cutaneous innervation, as well as an increased frequency among people with a history of traumatic and/or emotionally negative events, and specific personality trait profiles. Yet, quantitative physical evidence of pathology or disease etiology among FMS has been limited (as with other afflictions with MUS). Previously, our group published findings of increased peptidergic sensory innervation associated with the arterio-venous shunts (AVS) in the glabrous hand skin of FMS patients, which provides a plausible mechanism for the wide-spread FMS symptomology. This review focuses on FMS as a model affliction with MUS to discuss the implications of the recently discovered peripheral innervation alterations, explore the role of peripheral innervation to central sensitization syndromes (CSS), and examine possible estrogen-related mechanisms through which external and internal environmental factors may contribute to FMS etiology and possibly other afflictions with MUS.

  12. Symptoms of Parkinson's

    Science.gov (United States)

    ... Primary Motor Symptoms Secondary Motor Symptoms Nonmotor Symptoms Causes Progression Medications & Treatments Clinical Trials Statistics on Parkinson's What's New In Parkinson's Research? What's in the ...

  13. The Relationship between Symptoms of Autism Spectrum Disorders and Psychotropic Medication Use in Infants and Toddlers

    Science.gov (United States)

    Horovitz, Max; Matson, Johnny L.; Barker, Alyse

    2012-01-01

    Little research has been conducted to date on the relationship between psychotropic medication use and autism spectrum disorders (ASDs). Participants in the current study were placed into one of four groups: ASD on psychotropic medications (N = 33), ASD off psychotropic medications (N = 45), atypically developing on psychotropic medications (N =…

  14. Suboptimal management of severe menopausal symptoms by Nigerian Gynaecologists: a call for mandatory continuing medical education for physicians

    Directory of Open Access Journals (Sweden)

    Nkwo Peter O

    2009-10-01

    Full Text Available Abstract Background Effective management of menopause is an important way to improve the quality of life of the increasing number of older women. The study sought to find out if Nigerian Gynaecologists offer effective treatment for severe menopausal symptoms. Methods 126 Nigerian Gynaecologists representing the six health zones of Nigeria were interviewed to determine the menopausal symptoms they had ever encountered in their practices, frequency of the symptoms, treatments ever offered for severe symptoms including their attitude to, and practice of hormone replacement therapy. Results A Nigerian Gynaecologist encountered an average of one patient with menopausal symptoms every three months (range: 0-3 patients per month. The commoner symptoms they encountered were hot flushes (88%, insomnia (75.4%, depression (58.0%, irritability (56.3%, night sweats (55.6% and muscle pains (54.8% while urinary symptoms (16.7% and fracture (1.6% were less common. Treatments ever offered for severe symptoms were reassurance (90.5%, anxiolytics (68.3%, analgesics (14.3, HRT (7.9%, Vitamins (4%, Beta-blockers (3.2% and Danazol (2.4%. These treatments were offered as a matter of institutional traditions rather than being based on any evidence of their efficacy. Conclusion The result revealed that most Nigerian Gynaecologists prefer reassurance and anxiolytics for managing severe menopausal symptoms instead of evidence-based effective therapies. A policy of mandatory continuing medical education for Nigerian physicians is recommended to ensure evidence-based management of gynaecological problems, including menopause.

  15. Extended-Release Guaifenesin/Pseudoephedrine Hydrochloride for Symptom Relief in Support of a Wait-and-See Approach for the Treatment of Acute Upper Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Septimus, Edward J; Albrecht, Helmut H; Solomon, Gail; Shea, Tim; Guenin, Eric P

    2017-01-01

    -to-treat population (n = 1179). At Day 8, significantly fewer patients receiving guaifenesin/pseudoephedrine versus placebo desired antibiotics (4.2% vs 8.0%). No adverse effects were reported due to patients not taking antibiotics. Significant reductions in URTI symptoms were observed for extended-release guaifenesin/pseudoephedrine versus placebo, from Day 1 throughout the study; however, the proportion of patients experiencing overall relief at the Day 4 evening assessment (primary end point) did not reach statistical significance. Treatment-related adverse events were reported in 9.8% and 4.7% of patients receiving guaifenesin/pseudoephedrine and placebo, respectively. The study found that a wait and see approach was associated with decreased antibiotic use. In addition, the use of a guaifenesin pseudoephedrine combination product provided an effective symptom control compared to a placebo and a well-tolerated first-line strategy for the management of URTIs. This study was not designed to assess the effects of guaifenesin or pseudoephedrine individually. Other limitations include the need for better clinical methods to assess the effectiveness of treatments for acute symptoms of patients with URTIs. ClinicalTrials.gov identifier: NCT01202279.

  16. Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Otivhia Elizabeth

    2010-10-01

    Full Text Available Abstract Background Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria. Methods A cross-sectional survey was administered to female undergraduate and graduate students (n = 706 at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression. Results The response rate was 95.4%. Eighty-six percent (95% CI: 83-88% of participants experienced menstrual symptoms, and 39% (95% CI: 36-43% reported using analgesics to treat them. Overall, 24% (95% CI: 21-27% of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR: 2.8, 95% CI: 1.1-7.1, p-value: 0.03; non-science major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04; usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: p-value: 0.05 and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06. Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%, friends (6%, 95% CI: 4-7% and family members (7%, 95% CI: 5-8% were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%. Conclusions This is

  17. Potentially harmful side-effects: medically unexplained symptoms, somatization, and the insufficient illness narrative for viewers of mystery diagnosis.

    Science.gov (United States)

    Farkas, Carol-Ann

    2013-09-01

    Illness narrative has often been found to play a positive role in both patients' and providers' efforts to find meaning in the illness experience. However, illness narrative can sometimes become counterproductive, even pathological, particularly in cases of medical mystery--cases wherein biopsychosocial factors blur the distinction between bodily dysfunction and somatizing behavior. In this article, the author draws attention to two examples of medical mystery, the clinical presentation of medically unexplained symptoms, and the popular reality television program Mystery Diagnosis, to demonstrate the potentially harmful effects of illness narrative. The medical mystery's complex narrative structure reflects and tends to reinforce providers' and patients' mistaken assumptions, anxieties, and conflicts in ways which obstruct, rather than facilitate, healing.

  18. The influence of sociodemografic and medical variables on severity of anxiety and depressive symptoms during particular trimesters of pregnancy

    Directory of Open Access Journals (Sweden)

    Morylowska-Topolska, Justyna

    2014-02-01

    Full Text Available Aim. The aim of the study was to research the effect of selected socio-demographic and medical variables on the severity of symptoms of anxiety and depression in different trimesters of pregnancy. Materials and methods. The study was prospective, longitudinal, the group consisted of 314 adult pregnant women. To assess the prevalence of depressive and anxiety symptoms the Hospital Anxiety and Depression Scale (HADS was used. The results were statistically analyzed. To assess the normal distribution the Shapiro-Wilk test was used. Non-parametric tests: Mann Whitney U test and Kruskal Wallis ANOVA were used due to the distribution of the variables tested against the intergroup comparisons that deviate from the normal distribution. Results. Only the assessment of the financial and housing situation given by the respondents was related to the severity of symptoms of anxiety and depression in the course of the entire pregnancy. The unmarried respondents had greater severity of depressive symptoms in the first and third trimesters. Other socio-demographic variables were not associated with the severity of symptoms of anxiety and depression in different trimesters of pregnancy. Medical variables (associated with an obstetric-gynecological history, such as a history of miscarriage, complications in a previous pregnancy, the mode of delivery in a previous pregnancy, generally did not affect the severity of symptoms of anxiety and depression during pregnancy. Only major symptoms of depression during the third trimester were associated with complications in a previous pregnancy. An unplanned pregnancy turned out to be one of the most crucial variables determining higher severity of anxiety and depression during pregnancy. Conclusions. The knowledge of socio-demographic and medical factors associated with the severity of symptoms of anxiety and depression during pregnancy may facilitate better monitoring the groups of women being particularly vulnerable to

  19. Medical management of frontotemporal dementias: the importance of the caregiver in symptom assessment and guidance of treatment strategies.

    Science.gov (United States)

    Jicha, Gregory A

    2011-11-01

    There are no currently Food and Drug Administration-approved or proven off-label treatments for the frontotemporal dementias (FTD). Clinicians, caregivers, and patients struggle regularly to find therapeutic regimens that can alleviate the problematic behavioral and cognitive symptoms associated with these devastating conditions. Success is "hit or miss" and the lessons learned are largely anecdotal to date. Drug discovery in this area has been largely hampered by the heterogeneous clinical presentations and pathological phenotypes of disease that represent significant obstacles to progress in this area. Biologically, plausible treatment strategies include the use of antidepressants (selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor and monoamine oxidase inhibitors), acetylcholinesterase inhibitors, N-methyl-D-aspartic acid antagonists, mood stabilizers, antipsychotics, stimulants, antihypertensives, and agents that may ameliorate the symptoms of parkinsonism, pseudobulbar affect, and motor neuron disease that can often coexist with FTD. These medications all carry potential risks as well as possible benefits for the person suffering from FTD, and a clear understanding of these factors is critical in selecting an appropriate therapeutic regimen to maximize cognition and daily functions, reduce behavioral symptoms, and alleviate caregiver burden in an individual patient. The role of the caregiver in tracking and reporting of symptoms and the effects of individual therapeutic interventions is pivotal in this process. This manuscript highlights the importance of establishing an effective therapeutic partnership between the physician and caregiver in the medical management of the person suffering from FTD.

  20. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Monica Köhn

    2013-01-01

    Full Text Available An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53±12 years were included. General stress level (measured using Perceived Stress Scale (PSS, burnout (Shirom-Melamed Burnout Questionnaire (SMBQ, anxiety and depression (Hospital Anxiety and Depression Scale (HADS, insomnia severity (Insomnia Severity Index (ISI, pain (visual analogue scale (VAS, and overall health status (Euro Quality of Life VAS (EQ-VAS were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P<0.000, anxiety (P<0.019, and overall health status (P<0.018 compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  1. Development of a tool for eliciting patient priority from among competing cardiovascular disease, medication-symptoms, and fall injury outcomes.

    Science.gov (United States)

    Tinetti, Mary E; McAvay, Gail J; Fried, Terri R; Foody, JoAnne M; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana

    2008-04-01

    To develop a choice task for eliciting priorities in the face of competing cardiovascular disease (CVD) outcomes, medication-related symptoms, and fall injuries. Conjoint analysis. Senior housing site. Convenience sample of 15 senior housing residents for the pretest, 13 residents for the pilot test. The final task included 11 sets of choices. In each, one option optimized the risk of one or two of the three outcomes at the expense of the other(s); the second option did the reverse. Relative importance scores for CVD, fall injury, and medication-symptom outcomes were calculated. Reliability was assessed for two administrations using intraclass correlations (ICCs). Wilcoxon rank sum tests were used to evaluate order effects. The ICCs between choice task administrations were 0.70 for fall injuries, 0.73 for medication symptoms, and 0.56 for CVD outcomes. The ICCs with removal of two outliers were 0.84, 0.72, and 0.84, respectively. Whether CVD or fall injuries appeared first had no effect on scores. Preliminary evidence of comprehensibility and reliability supports using the choice task to determine whether individuals' priorities differ in the face of competing outcomes.

  2. Development of a Tool for Eliciting Patient Priority from Among Competing Cardiovascular Disease, Medication-Symptoms, and Fall Injury Outcomes

    Science.gov (United States)

    Tinetti, Mary E.; McAvay, Gail J.; Fried, Terri R.; Foody, JoAnne M.; Bianco, Luann; Ginter, Sandra; Fraenkel, Liana

    2013-01-01

    OBJECTIVES To develop a choice task for eliciting priorities in the face of competing cardiovascular disease (CVD) outcomes, medication-related symptoms, and fall injuries. DESIGN Conjoint analysis. SETTING Senior housing site. PARTICIPANTS Convenience sample of 15 senior housing residents for the pretest, 13 residents for the pilot test. MEASUREMENTS The final task included 11 sets of choices. In each, one option optimized the risk of one or two of the three outcomes at the expense of the other(s); the second option did the reverse. Relative importance scores for CVD, fall injury, and medication-symptom outcomes were calculated. Reliability was assessed for two administrations using intraclass correlations (ICCs). Wilcoxon rank sum tests were used to evaluate order effects. RESULTS The ICCs between choice task administrations were 0.70 for fall injuries, 0.73 for medication symptoms, and 0.56 for CVD outcomes. The ICCs with removal of two outliers were 0.84, 0.72, and 0.84, respectively. Whether CVD or fall injuries appeared first had no effect on scores. CONCLUSION Preliminary evidence of comprehensibility and reliability supports using the choice task to determine whether individuals’ priorities differ in the face of competing outcomes. PMID:18266842

  3. [Medically unexplained symptoms' care in internal medicine: A paradigm of doctor-patient relationship in situation of uncertainty].

    Science.gov (United States)

    Ranque, B; Nardon, O

    2017-01-24

    Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered. Patients with MUS are regularly abused by the doctors, who unwittingly participate in the maintenance of their symptoms and even freeze them, leading to disastrous psychosocial and economic consequences. Yet the doctor-patient relationship is the key to their recovery or, at least, their improvement. The means of a successful patient-centered relationship are not always intuitive but can be learned. It is therefore essential to include SMI in medical school curricula and post-graduate medical education. Finally, if the management of early MUS mainly concerns the family medicine, that of severe MUS, including some fibromyalgia and chronic fatigue syndromes, falls within the scope of the internist doctor, who should be able to deliver a comprehensive care in partnership with the general practitioner and possibly a psychiatrist.

  4. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years

    OpenAIRE

    Alsaggaf, Mohammed A.; Wali, Siraj O.; Merdad, Roah A.; Merdad, Leena A

    2016-01-01

    Objectives: To determine sleep habits and sleep quality in medical students during their clinical years using validated measures; and to investigate associations with academic performance and psychological stress. Methods: In this cross-sectional study, medical students (n=320) were randomly selected from a list of all enrolled clinical-year students in a Saudi medical school from 2011-2012. Students filled a questionnaire including demographic and lifestyle factors, Pittsburgh Sleep Quality ...

  5. Relief for surviving relatives following a suicide.

    NARCIS (Netherlands)

    Oud, MJT; de Groot, MH

    2006-01-01

    Relief for surviving relatives following a suicide. - After the suicide of a 43-year-old woman with known depression, a 41-year-old paraplegic man who recently developed diarrhoea and a 41-year-old woman with probable depression with symptoms of psychosis, the general practitioners of the surviving

  6. Relief for surviving relatives following a suicide.

    NARCIS (Netherlands)

    Oud, MJT; de Groot, MH

    2006-01-01

    Relief for surviving relatives following a suicide. - After the suicide of a 43-year-old woman with known depression, a 41-year-old paraplegic man who recently developed diarrhoea and a 41-year-old woman with probable depression with symptoms of psychosis, the general practitioners of the surviving

  7. Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms.

    Science.gov (United States)

    Kosilov, Kirill Vladimirovich; Alexandrovich, Loparev Sergay; Gennadyevna, Kuzina Irina; Viktorovna, Shakirova Olga; Sergeevna, Zhuravskaya Natalia; Ivanovich, Ankudinov Ivan

    2016-09-01

    The prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population. Social, economic, and medical factors as well as the Overactive Bladder questionnaire - the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation. Among the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin. This study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients' satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were

  8. 武警部队执行地震救援中的药材保障%Medicinal materials guarantee of earthquake emergency medical relief team of the Chinese People’s Armed Police Forces

    Institute of Scientific and Technical Information of China (English)

    贺智; 安茜; 谢红; 郭海涛; 叶路

    2015-01-01

    Objective To develop a reasonable and scientific scheme for medicinal materials that disaster relief teams of the Chinese People’s Armed Police Forces (CPAPF) should carry in earthquake relief work. Methods The cases of disposition of medicinal materials of the disaster relief teams of the CPAPF in Wenchuan and Yushu Earthquake areas , 2008 and 2010 respectively, were investigated. The relevant disease spectra during the early periods of earthquake (within 3 days) were analyzed. In addition, literatrure review and expert counseling were used. According to the maximum outpatient quantity of 800 persons, the bases of medicinal materials needed for single appropriate medical skills were calculated based on the“Standard for the guarantee of military related medicines”and the“Standards of millitary matrerials of the Chinese Armed Police Forces”, and with the method of management of single disease cases. Thus the species of medicinal materials and quantities thererof necessary for the relief teams during the first 3 days after earthquake were determined . Results A detailed list of medicinal materials any relief team should carry during the first 3 days after earthquake, including 10 categories with 87 species, had been developed. Conclusion A reasonable and scientific scheme for medicinal materials carried by disaster relief teams of the CPAPF in earthquake relief work based on quantitative study has been made, thus providing a useful model for reference.%目的:为武警部队医学救援队携运药材制定合理、科学的药材保障配置方案。方法分析总结汶川和玉树地震救援中药材配置方面的现状,并根据地震早期伤病谱,采用文献调研法、以《军队相关药材保障标准》及《武警部队战材标准》为基本依据,借鉴单病种病例管理方法,同时结合救援专家建议,计算单项适宜医学治疗技术所需的药材保障基数,从而确定武警部队医学救援队

  9. Medical yoga for patients with stress-related symptoms and diagnoses in primary health care: a randomized controlled trial.

    Science.gov (United States)

    Köhn, Monica; Persson Lundholm, Ulla; Bryngelsson, Ing-Liss; Anderzén-Carlsson, Agneta; Westerdahl, Elisabeth

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53 ± 12 years were included. General stress level (measured using Perceived Stress Scale (PSS)), burnout (Shirom-Melamed Burnout Questionnaire (SMBQ)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), insomnia severity (Insomnia Severity Index (ISI)), pain (visual analogue scale (VAS)), and overall health status (Euro Quality of Life VAS (EQ-VAS)) were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  10. The PROSPECTS study: design of a prospective cohort study on prognosis and perpetuating factors of medically unexplained physical symptoms (MUPS).

    Science.gov (United States)

    van Dessel, Nikki; Leone, Stephanie S; van der Wouden, Johannes C; Dekker, Joost; van der Horst, Henriëtte E

    2014-03-01

    This paper describes the rationale and methodology of the PROSPECTS study, a study which aims to assess the course and prognosis of medically unexplained physical symptoms (MUPS), in terms of symptom severity and physical and social functioning. Additionally, it aims to identify different course types and to determine which factors are associated with these course types. Based on these factors, one or more prediction models will be developed. This study is a prospective, multicenter longitudinal cohort study with 1 baseline and 4 follow-up measurements during a 3 year period. 450 MUPS patients (age 18-70 years) will be included, divided over a primary care group, recruited in general practices, and a secondary/tertiary care group, recruited in specialized MUPS care programs. Primary outcome measures are severity of symptoms and degree of functional impairment. Secondary outcome measures are health care consumption and level of depressive symptoms and anxiety. Potential predictors are based on current theoretical models describing the perpetuation of MUPS and include somatic, psychological and social factors. Latent Class Growth Mixture Modeling will be used to identify distinct course types. Logistic regression analysis will be used to identify risk factors associated with these course types. Finally, one or more multivariate prediction models for the course of MUPS will be developed and tested. The PROSPECTS study aims to enhance our insight into the course of MUPS, thus contributing to better recognition of future patients at risk for persistent MUPS. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. The influence of obsessive-compulsive neurosis patients' premorbid personality on obsessive-compulsive symptoms and efficacy of medication.

    Science.gov (United States)

    Nishimura, R; Hosoba, T; Ide, M; Seiwa, H

    1998-06-01

    We conducted a survey with the Lynfield obsessive-compulsive symptom questionnaire (revised version) on 48 obsessive-compulsive neurotic patients as the survey subjects. In the factor analysis five factors of obsessions, were identified: (i) the desire for perfection; (ii) compulsive checking; (iii) washing; (iv) feelings of uncleanliness; and (v) anthropophobia. High correlations were noted between these factors. We also investigated the premorbid personalities of obsessive-compulsive neurotic patients with a multidimensional personality scale and obtained an extroversion dimension and neuroticism dimension. The influence of these premorbid personality dimensions on obsessive-compulsive symptoms became clear; (i) neuroticism is related to the levels of obsession after onset, but not related to compulsive behaviors; and (ii) No differences in premorbid personality dimensions were noted between compulsive checking and compulsive washing behaviors. We also studied whether it was possible to predict the efficacy of pharmacotherapy upon obsessive-compulsive symptoms. It was elucidated that the obsessions of those whose premorbid personalities are emotionally stable and extroversive are susceptible to antidepressants. Based on these results, we discussed the usefulness of premorbid personalities in predicting diversity of obsessive-compulsive symptoms, as well as in prediction the efficacy of medication.

  12. Medical relief activities, medical resourcing, and inpatient evacuation conducted by Nippon Medical School due to the Fukushima Daiichi Nuclear Power Plant accident following the Great East Japan Earthquake 2011.

    Science.gov (United States)

    Koyama, Atsushi; Fuse, Akira; Hagiwara, Jun; Matsumoto, Gaku; Shiraishi, Shinichiro; Masuno, Tomohiko; Miyauchi, Masato; Kawai, Makoto; Yokota, Hiroyuki

    2011-01-01

    On March 11, 2011, after the Great East Japan Earthquake and tsunami, the government declared a nuclear emergency following damage to the Fukushima Daiichi Nuclear Power Plant. A second hydrogen explosion occurred on March 14 at the plant's No. 3 reactor and injured 11 people. At that time the prime minister urged people living 20 to 30 km from the Daiichi plant to stay indoors. Under these circumstances, many residents of Iwaki City, which was largely outside the 30-km zone, left the city, making it difficult to get supplies to the remaining residents. The only transportation route open for supplies and medical resources was roads, and many drivers feared the rumor that the city was contaminated by radioactive materials and, so, refused to go there. Nippon Medical School (NMS) heard that medical resources were running short at Iwaki Kyoritsu Hospital, which requested water, medications, food, fuel (gasoline), medical support, and the evacuation of 300 inpatients. As a first step, NMS decided to evaluate the situation at the hospital and, on March 16, the director of the NMS Advanced Emergency Center visited the hospital and helped provide triage for about 200 patients. Critically ill patients receiving ventilatory support were given priority for evacuation because they would be most at risk of not being able to evacuate should the Japanese government order an immediate evacuation of the city. We tried to evacuate the inpatients via an official framework, such as the Disaster Medical Assistance Team (DMAT), but DMAT could not support this mission because this hospital was not within the 30-km evacuation zone. Moreover, the Iwaki City government could not support the evacuation efforts because they were fearful of the rumor that Iwaki was contaminated by radioactive material. Ultimately, we realized that we had to conduct the mission ourselves and, so, contacted our colleagues in the Tokyo metropolitan area to prepare enough hospital beds. We evacuated 15 patients

  13. The base rate of suboptimal effort in a pediatric mild TBI sample: performance on the Medical Symptom Validity Test.

    Science.gov (United States)

    Kirkwood, Michael W; Kirk, John W

    2010-01-01

    Performance on the Medical Symptom Validity Test (MSVT) was examined in 193 consecutively referred patients aged 8 through 17 years who had sustained a mild traumatic brain injury. A total of 33 participants failed to meet actuarial criteria for valid effort on the MSVT. After accounting for possible false positives and false negatives, the base rate of suboptimal effort in this clinical sample was 17%. Only one MSVT failure was thought to be influenced by litigation. The present results suggest that a sizable minority of children is capable of putting forth suboptimal effort during neuropsychological exam, even when external incentives are not readily apparent. The MSVT appears to have good potential value as an objective measure for detecting symptom invalidity in school-age youth.

  14. Levels of patient activation among adults with schizophrenia: associations with hope, symptoms, medication adherence, and recovery attitudes.

    Science.gov (United States)

    Kukla, Marina; Salyers, Michelle P; Lysaker, Paul H

    2013-04-01

    Patient activation, defined as one's attitudes and confidence toward managing illness, has been not been thoroughly studied in consumers with schizophrenia. The current study sought to understand the relationship between patient activation and symptoms, medication adherence, recovery attitudes, and hope in a sample of 119 adults with schizophrenia. The participants were enrolled in an 18-month randomized controlled study of the Illness Management and Recovery program. Data were collected at baseline; correlations and stepwise multiple regressions were used to examine the relationships and determine the unique contribution of variables. Higher patient activation was most strongly associated with positive recovery attitudes, higher levels of hope, and fewer emotional discomfort symptoms. Patient activation was significantly related to a broad measure of illness self-management, providing evidence for the construct validity of the patient activation measure. Our findings emphasize the importance of recovery-based mental health services that recognize level of patient activation as a potential factor in consumer outcomes.

  15. Relief-oriented use of marijuana by teens

    Directory of Open Access Journals (Sweden)

    Johnson Joy L

    2009-04-01

    Full Text Available Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were regular marijuana users, we analyzed interviews conducted with 20 youth who self-identified as using marijuana to relieve or manage health problems. Results Thematic analysis revealed that these teens differentiated themselves from recreational users and positioned their use of marijuana for relief by emphasizing their inability to find other ways to deal with their health problems, the sophisticated ways in which they titrated their intake, and the benefits that they experienced. These teens used marijuana to gain relief from difficult feelings (including depression, anxiety and stress, sleep difficulties, problems with concentration and physical pain. Most were not overly concerned about the risks associated with using marijuana, maintaining that their use of marijuana was not 'in excess' and that their use fit into the realm of 'normal.' Conclusion Marijuana is perceived by some teens to be the only available alternative for teens experiencing difficult health problems when medical treatments have failed or when they lack access to appropriate health care.

  16. Sustained medically unexplained physical symptoms in euthymic patients with recurrent depression : Predictive value for recurrence and associations with omega 3- and 6 fatty acids and 5-HTTLPR?

    NARCIS (Netherlands)

    Lok, Anja; Assies, Johanna; Koeter, Maarten W J; Bockting, Claudi L H; Wouters, Luuk F; Mocking, Roel J T; Schene, Aart H

    2012-01-01

    BACKGROUND: Identification of potentially modifiable risk factors for recurrence in recurrent depression could provide opportunities to improve preventive interventions. In this study we aimed to examine the predictive value of medically unexplained physical symptoms (MUPS) on time to recurrence in

  17. Adjustable safety relief valve

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, W.L.

    1990-06-12

    This patent describes a pressure relief valve having a relief set pressure. It comprises: a valve body having a fluid inlet and outlet, a spherical, metal valve seat associated with the inlet and a valve member comprising at least a portion of a spherical,metal ball attached to a ball holding element, the valve member being biased against the valve seat and thus providing a metal-to-metal seal preventing the passage of fluids past the valve seat when the fluid pressure in the inlet is below the relief pressure setting of the valve.

  18. A nationwide, retrospective analysis of symptoms, comorbidities, medical care and autopsy findings in cases of fatal pulmonary embolism in younger patients

    DEFF Research Database (Denmark)

    Haunsø, S; Theilade, J; Winkel, B G

    2010-01-01

    Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings.......Our objective was to provide a comprehensive description of fatal pulmonary embolism (PE) in younger persons. Specifically, we recorded information on symptoms, comorbidity, medical contact, if this had been required, and subsequent autopsy findings....

  19. Fermented milk containing Lactobacillus casei strain Shirota prevents the onset of physical symptoms in medical students under academic examination stress.

    Science.gov (United States)

    Kato-Kataoka, A; Nishida, K; Takada, M; Suda, K; Kawai, M; Shimizu, K; Kushiro, A; Hoshi, R; Watanabe, O; Igarashi, T; Miyazaki, K; Kuwano, Y; Rokutan, K

    2016-01-01

    This pilot study investigated the effects of the probiotic Lactobacillus casei strain Shirota (LcS) on psychological, physiological, and physical stress responses in medical students undertaking an authorised nationwide examination for promotion. In a double-blind, placebo-controlled trial, 24 and 23 healthy medical students consumed a fermented milk containing LcS and a placebo milk, respectively, once a day for 8 weeks until the day before the examination. Psychophysical state, salivary cortisol, faecal serotonin, and plasma L-tryptophan were analysed on 5 different sampling days (8 weeks before, 2 weeks before, 1 day before, immediately after, and 2 weeks after the examination). Physical symptoms were also recorded in a diary by subjects during the intervention period for 8 weeks. In association with a significant elevation of anxiety at 1 day before the examination, salivary cortisol and plasma L-tryptophan levels were significantly increased in only the placebo group (Pstressful situations.

  20. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

    Science.gov (United States)

    Ohn Mar, Saw; Malhi, Fatehpal; Syed Rahim, Syed Hamid; Chua, Chin Tong; Sidhu, Sarjeet Singh; Sandheep, Sugathan

    2015-11-01

    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654).

  1. Antipsychotic medication and remission of psychotic symptoms 10years after a first-episode psychosis

    DEFF Research Database (Denmark)

    Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten

    2017-01-01

    spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication. FINDINGS: 61% of the patients from the original cohort...

  2. Psychological treatment of depressive symptoms in patients with medical disorders: a meta-analysis

    NARCIS (Netherlands)

    Straten, van A.; Geraedts, A.S.; Leeuw, de I.M.; Andersson, G.; Cuijpers, P.

    2010-01-01

    Objective It is widely acknowledged that the prevalence of depression in the general population is high, but that it is even higher for patients with medical disorders. Yet, the effectiveness of psychological treatments in these patient populations has not been firmly established. Methods We conduct

  3. Finding Medical Care for Colorectal Cancer Symptoms: Experiences among Those Facing Financial Barriers

    Science.gov (United States)

    Thomson, Maria D.; Siminoff, Laura A.

    2015-01-01

    Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer…

  4. Increasing awareness of gynecological cancer symptoms and reducing barriers to medical help seeking: does health literacy play a role?

    Science.gov (United States)

    Boxell, Emily M; Smith, Samuel G; Morris, Melanie; Kummer, Sonja; Rowlands, Gill; Waller, Jo; Wardle, Jane; Simon, Alice E

    2012-01-01

    Health literacy may influence the efficacy of print-based public health interventions. A key part of the U.K. cancer control strategy is to provide information to the public on earlier diagnoses with a view to improving the United Kingdom's relatively poor 1-year cancer survival statistics. This study examined the effect of health literacy on the efficacy of a gynecological cancer information leaflet. Participants (n = 451) were recruited from 17 Cancer Research UK events. Health literacy was assessed with the Newest Vital Sign test. Gynecological cancer symptom awareness and barriers to medical help seeking were assessed before and after participants read the leaflet. Symptom awareness improved, and barriers to medical help seeking were reduced (ps .05). As predicted, individuals with lower health literacy benefited less after exposure to the leaflet (ps information design principles in the development of the leaflet, more intensive efforts may be required to ensure that inequalities are not exacerbated by reliance on print-based public health interventions.

  5. 基于汶川地震评估军队地震灾害应急医学救援组织体制%Evaluation of military organization system for emergency medical relief based on Wenchuan earthquake

    Institute of Scientific and Technical Information of China (English)

    公斌; 郭树森; 刘思含; 刘文清

    2016-01-01

    目的:评估我军参与汶川地震灾害应急医学救援中组织体制的得分及等级。方法利用已构建的军队地震灾害应急医学救援组织体制对汶川地震救援行动进行打分,以专家主观打分方式为主。结果本研究一级指标中平均得分最高分为防疫防护保障67.3分,乘权重后最高分为防疫防护保障20.2分;二级指标为组织协同71.0分,乘权重后最高分为分级救治39.2分;三级指标为内部协同74.0分,乘权重后最高分为部队卫勤机构、医院机动卫勤分队47.6分。24项三级指标中有6项等级为a(25.0%),10项等级为 b(41.7%),8项等级为 c(33.7%)。结论汶川地震中防疫防护保障和分级救治执行较为出色,未来改革重点是组织指挥手段、医学救治范围和自我医疗保障等方面。%Objective To evaluate score and grade of emergency medical relief organization system of the army participated in Wenchuan earthquake. Methods The established military organization system for emergency medical relief was used to grade Wenchuan earthquake relief operations, and subjective scoring from experts was the main way. Results In this study, the average score of epidemic prevention and protection was 67.3 points which was the highest in those of the first level index, and the highest was epidemic prevention and protection with 20.2 points after multiplied by weight; The average score of organization coordination was 71.0 points which was the highest in those of the second level index, and the highest was echelon treatment with 39.2 points after multiplied by weight; The average score of internal coordination was 74.0 points which was the highest in those of three-level index, and the highest was military medical institutions and hospital mobile medical teams with 47.6 points after multiplied by weight. 6 index(25.0%) was ranged as a in the total of 24 three-level index, 10 index(41.7%) was b and the other 8 index

  6. The General Practitioner’s Consultation Approaches to Medically Unexplained Symptoms: A Qualitative Study

    DEFF Research Database (Denmark)

    Hansen, Henriette Schou; Rosendal, Marianne; Fink, Per;

    2013-01-01

    Undersøgelsens formål var at få indblik i, hvordan praktiserende læger bruger begrebet medicinsk uforklarede symptomer (MUS), og hvordan de håndterer patienter med MUS i den kliniske hverdag. Resultaterne bygger på fokusgruppeinterviews af praktiserende læger. Vi fandt, at konsultationer vedr. MUS...... række faktorer som fx læge, patient og kontekst. Diagnosen MUS er således indlejret i en kontekst, og den diagnostiske proces er afhængig af konsultationstype....

  7. Effectiveness of a focused, brief psychoeducation program for parents of ADHD children: improvement of medication adherence and symptoms

    Directory of Open Access Journals (Sweden)

    Bai GN

    2015-10-01

    Full Text Available Guan-nan Bai,1 Yu-feng Wang,2,3 Li Yang,2,3 Wen-yi Niu1 1Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, People’s Republic of China; 2Peking University Sixth Hospital/Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, Beijing, People’s Republic of China; 3National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, People’s Republic of China Objective: To evaluate the efficacy of a psychoeducation program for parents of children with ADHD in enhancing adherence to pharmacological treatment and improving clinical symptoms. Methods: We developed a psychoeducation program based on the theory of planned behavior (TPB. Eighty-nine children with ADHD were cluster randomly assigned for their families to receive 3 months of well-structured psychoeducation (intervention group, n=44 or only general clinical counseling (control group, n=45. Parents in the intervention group were given an expert lecture (with slides and a parent manual, attended two expert-guided parent group sessions, and were invited to join a professional-guided online community. Measurement of parents’ knowledge about ADHD, components of the TPB model, and child ADHD symptoms were taken before and after intervention. Medication adherence was assessed thoroughly at the end of the first and third months. Satisfaction with the psychoeducation program was assessed only in the intervention group. Two-independent-samples t-test, ANOVA, and chi-square test were employed to compare differences between groups. Results: Compared to the control group, medication adherence in the intervention group was significantly higher after 1 and 3 months (97.7% intervention vs 75.6% control, P=0.002, and 86.4% intervention vs 53.3% control, P=0.001, respectively. Accordingly, the ADHD rating scale scores were lower in the intervention group than the control group after

  8. Explanation and relations. How do general practitioners deal with patients with persistent medically unexplained symptoms: a focus group study

    Directory of Open Access Journals (Sweden)

    van Spaendonck Karel P

    2009-09-01

    Full Text Available Abstract Background Persistent presentation of medically unexplained symptoms (MUS is troublesome for general practitioners (GPs and causes pressure on the doctor-patient relationship. As a consequence, GPs face the problem of establishing an ongoing, preferably effective relationship with these patients. This study aims at exploring GPs' perceptions about explaining MUS to patients and about how relationships with these patients evolve over time in daily practice. Methods A qualitative approach, interviewing a purposive sample of twenty-two Dutch GPs within five focus groups. Data were analyzed according to the principles of constant comparative analysis. Results GPs recognise the importance of an adequate explanation of the diagnosis of MUS but often feel incapable of being able to explain it clearly to their patients. GPs therefore indicate that they try to reassure patients in non-specific ways, for example by telling patients that there is no disease, by using metaphors and by normalizing the symptoms. When patients keep returning with MUS, GPs report the importance of maintaining the doctor-patient relationship. GPs describe three different models to do this; mutual alliance characterized by ritual care (e.g. regular physical examination, regular doctor visits with approval of the patient and the doctor, ambivalent alliance characterized by ritual care without approval of the doctor and non-alliance characterized by cutting off all reasons for encounter in which symptoms are not of somatic origin. Conclusion GPs feel difficulties in explaining the symptoms. GPs report that, when patients keep presenting with MUS, they focus on maintaining the doctor-patient relationship by using ritual care. In this care they meticulously balance between maintaining a good doctor-patient relationship and the prevention of unintended consequences of unnecessary interventions.

  9. Management of symptoms associated with advanced cancer: olanzapine and mirtazapine. A World Health Organization project.

    Science.gov (United States)

    Davis, Mellar P; Khawam, Elias; Pozuelo, Leo; Lagman, Ruth

    2002-08-01

    Advanced cancer patients are polysymptomatic and often receive multiple medications for symptom relief. Common symptoms include anorexia, weight loss, delirium and depression. Olanzapine and mirtazapine may have several advantages over older agents despite increased acquisition costs. Both medications can treat several symptoms with a low risk for drug-drug interactions and with only once- or twice-daily dosing. Drug side effects are low, compared with more conventionally used agents. The pharmacokinetics and pharmacodynamics of both agents are unique and explain many of the benefits. More research and clinical experience will be necessary to define their role in the palliation of advanced cancer.

  10. Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications.

    Science.gov (United States)

    Seftel, A; Rosen, R; Kuritzky, L

    2007-01-01

    In a large-scale epidemiology study, 50% of aging men reported erectile dysfunction (ED) or ejaculatory dysfunction (EjD), with lower urinary tract symptoms (LUTS) an independent risk factor for each of these conditions. In light of the shift from urologists (UROs) to primary care/internal medicine physicians (PCPs) for the initial management of men with LUTS associated with benign prostatic hyperplasia (BPH), a survey was conducted to assess the perceptions of UROs and PCPs regarding sexual dysfunction (SD) in men with LUTS/BPH and the effects of BPH treatments (alpha(1)-adrenergic receptor antagonists (alpha-blockers) and 5alpha-reductase inhibitors (5ARIs)) on sexual function. The survey was mailed to 7500 UROs and 2500 PCPs, with 1275 (13%) surveys returned (1087 by UROs, 177 by PCPs and 11 by other specialty). Alpha-blocker monotherapy was the most common medication prescribed by both UROs (56%) and PCPs (47%). UROs estimated that 19% of their patients with LUTS/BPH experienced SD owing to their symptoms compared with the estimate of 27% by PCPs. UROs estimated that 19% of their patients experienced SD owing to their BPH medication compared with the PCP estimate of 24%. The incidence of EjD owing to BPH medications estimated by UROs (32%) was higher than that estimated by PCPs (22%); the rate of ED estimated by PCPs (34%) was higher than that estimated by UROs (23%). UROs were more aware than PCPs of the specific sexual side effects caused by alpha-blockers versus 5ARIs. These results suggest that physicians are underestimating the prevalence of SD in men with LUTS/BPH. As men with LUTS/BPH are at increased risk for SD, physicians should be especially cognizant of BPH treatment-related sexual side effects.

  11. First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

    Directory of Open Access Journals (Sweden)

    Ana M. Bassols

    2014-09-01

    Full Text Available Objective: Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. Method: This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI, and the Beck Anxiety Inventory (BAI. Results: A total of 232 students (110 first-year, 122 sixth-year completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students. Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001. Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. Conclusion: A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

  12. First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

    Science.gov (United States)

    Bassols, Ana M; Okabayashi, Lucas S; Silva, Anais B da; Carneiro, Bruna B; Feijó, Fernando; Guimarães, Guilherme C; Cortes, Gabriela N; Rohde, Luis A; Eizirik, Claudio L

    2014-09-01

    Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

  13. The effects of concomitant GERD, dyspepsia, and rhinosinusitis on asthma symptoms and FeNO in asthmatic patients taking controller medications

    Directory of Open Access Journals (Sweden)

    Ishizuka T

    2014-09-01

    Full Text Available Tamotsu Ishizuka,1,2 Takeshi Hisada,2 Yosuke Kamide,2 Haruka Aoki,2 Kaori Seki,2 Chisato Honjo,1 Hiroyuki Sakai,1 Maiko Kadowaki,1 Yukihiro Umeda,1 Miwa Morikawa,1 Masaki Anzai,1 Shingo Ameshima,1 Takeshi Ishizaki,1 Kunio Dobashi,2 Masanobu Yamada,2 Motoyasu Kusano3 1Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, 2Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Maebashi, Japan Background: Losing the sense of smell, which suggests eosinophilic rhinosinusitis, is a subjective symptom, sometimes reported in asthmatic patients taking controller medication. Upper abdominal symptoms, suggesting gastroesophageal reflux disease (GERD or functional dyspepsia, occur also in these patients. However, the relationship between these symptoms, concomitant with asthma, and the intensity of eosinophilic airway inflammation remains obscure. Objective: To assess the symptoms of asthma and rhinosinusitis, and to examine the relationship between the symptoms and bronchial inflammation, a new questionnaire, the G scale, was developed. To investigate the effects of GERD, dyspepsia, and rhinosinusitis on asthma symptoms and bronchial inflammation, the symptoms of asthma and rhinosinusitis obtained by the G scale, upper abdominal symptoms obtained by the modified F scale, a questionnaire for GERD and dyspepsia, and fractional exhaled nitric oxide (FeNO were analyzed. Methods: A prospective, observational study was performed in four hospitals in Gunma prefecture, and a retrospective analysis was done using data obtained from five hospitals in Gunma prefecture and Fukui prefecture, Japan. A total of 252 patients diagnosed as having asthma participated in the prospective study. Results: The frequency of daytime phlegm or losing the sense of smell had a positive correlation with FeNO levels in asthmatic

  14. Applying Disaster Medicine Theory in Medical Rescue in Earthquake Relief%灾难医学理论在抗震救灾医疗救援中的应用

    Institute of Scientific and Technical Information of China (English)

    樊震林; 周伟平; 连斌

    2009-01-01

    In the situation of serious earthquake, numerous disadvantages may occur, such as the wide distribution of the in-juries, the vile condition of medical treatment as well as the heavy traffic jams etc and all these factors make it difficult for com-manders to direct the troops, so the earthquake relief seems troublesome. The article probed into the way to use the theories of dis-aster medicine to direct the relieving mission under the terrible condition, and try to achieve the goal of scientific organization, ra-tional rescue and to play the medical troops' role to the full.%在特大地震灾害条件下,由于人员伤亡分布广,医疗环境简陋,加上交通受阻等因素,造成组织指挥难度大,抗震救灾医疗救治任务艰巨.探讨了在这种条件下,运用灾难医学理论指导抗震救灾医疗救援工作,旨在做到科学组织,理性救治,最大程度发挥医疗队作用.

  15. Mobile emergency (surgical hospital: Development and application in medical relief of “4.20” Lushan earthquake in Sichuan Province, China

    Directory of Open Access Journals (Sweden)

    Cheng Bin

    2015-07-01

    Full Text Available In the 21st century, natural disasters and emergencies occur frequently worldwide, which leads to the loss of hundreds of thousands of lives as well as the direct and indirect economic losses. China has a vast territory frequently struck by natural disasters. However, the reality is not optimistic. Poor organization and management during the rescue actions, the lack of large-scale, systematic medical rescue equipment were all great barriers to the outcomes. Mobile hospitals are expected to provide better health care. We were inspired by the concept of mobile hospital. Chongqing Emergency Medical Center, has set up trauma care system since 1988, in which prehospital care, intensive care, and in-hospital treatment is fully integrated. As a major advantage, such a system provided assurance of “golden hour” rescue treatment. Providing mobile intensive care and prehospital surgical service for severe trauma patients could reduce mortality significantly. Based on the civilian experiences in Chongqing Emergency Medical Center, the mobile emergency (surgical hospital was developed.

  16. Incidence and risk factors of recurrence of overactive bladder symptoms after discontinuation of successful medical treatment

    Science.gov (United States)

    Kim, Aram; Lee, Kyu-Sung; Kim, Tae Beom; Kim, Hyung Joon; Yoo, Eun Sang; Yun, Jong-Hyun; Kim, Duk Yoon; Jung, Suk Gun; Lee, Jun Taik; Kim, Jung Man; Oh, Cheol Kyu; Shin, Ju Hyun; Jeon, Seung Hyun; Lee, Seong Ho; Han, Chang Hee; Lee, Dong Hwan; Cho, Hyuk Jin

    2017-01-01

    Purpose To identify incidence and risk factors of recurrence after discontinuation of successful antimuscarinic therapy in patients with overactive bladder (OAB). Materials and Methods This was a prospective, multicenter trial. Patients who had antimuscarinic agents for more than 12 weeks and showed successful response were enrolled. Successful response was defined as answering 'benefit' for patient perception of treatment benefit and answer lesser than 3 points in patient's perception of bladder condition (PPBC). The enrolled patients discontinued the antimuscarinics, and we evaluated their recurrence with PPBC and OAB symptom score (OABSS) at 1, 3, 6, and 12 months. Primary purpose was to identify the recurrence rate and secondary purpose was to reveal risk factors. Results Four hundred forty-one patients enrolled and 371 patients completed 6-month follow-up. The enrolled patients showed 1.6 points in PPBC, 2.9 points in OABSS and 1.4 points in IPSS (quality of life) which represented successful response after using antimuscarinics. The cumulative rates of recurrence were 25.6%, 42.3%, and 52.2% at 1, 3, 6 months, respectively. Among 177 patients who did not show recurrence at 6 months, 41 patients were followed up and 4 patients of the 41 patients (9.7%) showed recurrence at 12 months. On univariate and multivariate analyses of recurrence, OAB wet was the risk factor for recurrence after 6 months of discontinuation. Conclusions Discontinuation of antimuscarinic therapy after successful treatment resulted in high recurrence rate with time and OAB wet was the independent risk factor for recurrence. PMID:28097267

  17. 玉树地震伤病员空中急救转运初论%The role of air channel in disaster relief and medical rescue: experience from Yushu Earthquake

    Institute of Scientific and Technical Information of China (English)

    刘兆祺

    2011-01-01

    On 14 April 2010 a Richter magnitude 7 earthquake occurred in Yushu Pefecture, Qinghai Province, and caused heavy disruption in traffic and communications, health facilities, and electrical and water supply.In addition, there was a shortage of medical staff.Many seriously ill and injured persons needed to be transferred to proper hospitals.Three hours after the earthquake, the Yushu Batang Airport was open again, and 8 hours later the first professional rescue team and the first batch of disaster relief materials, including first aid equipments, stretchers, and drugs, and then daily necessities, arrived.During 72 hours 1100 severely injured patients were evacuated to Xining, the provincial capital, and then to the hospitals there, a small part was sent to Xi' an or Lanzhou via highway transportation.During 14 April to 7 May, altogether 14178 person-times of disaster relief staff members and 4458 injured persons were transported by airplanes.The practice showed that the air channel is very important in disaster relief and medical rescue.The Civil Aviation Administration of China has already developed a pre-plan for medical rescue in emergent public events.Disasters and accidents often occur in China.The civil aviation shoulders a heavy responsibility%目的 探讨"空中急救"的必要性和紧迫性.方法 对2010年青海玉树地震的空中急救进行回顾性分析,提出了空中救援体系建设的展望.结果 自2010年4月14日~5月7日,民航运送各类抗震救灾人员14 178人次,物资1 406吨,转运伤员4 459人次,无一例空中转运死亡病例,也未造成一例因转运不当所致的伤病员二次损伤.结果 表明,传统的、封闭的、单一的救护活动已无法满足当代社会生活工作的特点和日益增加的急救需求,政府统一指挥,各方救援力量团结协作,救援方案科学、有效落实,实现了民航应急救护参加社会救援的重大突破.结论 "空中急救"是一个系统的组织架构、

  18. Medical and Surgical Treatment Modalities for Lower Urinary Tract Symptoms in the Male Patient Secondary to Benign Prostatic Hyperplasia: A Review.

    Science.gov (United States)

    Macey, Matthew Ryan; Raynor, Mathew C

    2016-09-01

    Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) is one of the most common ailments affecting aging men. Symptoms typically associated with BPH include weak stream, hesitancy, urgency, frequency, and nocturia. More serious complications of BPH include urinary retention, gross hematuria, bladder calculi, recurrent urinary tract infection, obstructive uropathy, and renal failure. Evaluation of BPH includes a detailed history, objective assessment of urinary symptoms with validated questionnaires, and measurement of bladder function parameters, including uroflowmetry and postvoid residual. In general, treatment of LUTS associated with BPH is based on the effect of the symptoms on quality of life (QOL) and include medical therapy aimed at reducing outlet obstruction or decreasing the size of the prostate. If medical therapy fails or is contraindicated, various surgical options exist. As the elderly population continues to grow, the management of BPH will become more common and important in maintaining patient's QOL.

  19. Relief Aid Carefully Audited

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    In a recent interview with the national TV broadcaster CCTV,Wang Zhongxin,Director of the Social Security Audit Department at the National Audit Office,talks about the procedures that are in effect to ensure relief supplies for the Wenchuan earthquake victims reach the end users. Excerpts of

  20. Paper relief architecture

    NARCIS (Netherlands)

    Latka, J.F.

    2014-01-01

    The article presents two contemporary projects of paper structures relief architecture designed and built by Shigeru Ban Architects and Voluntary Architect Network. Author of the article took part in design and construction process of one of the projects. The project of Yaan Nursery School, which wa

  1. Vent Relief Valve Test

    Science.gov (United States)

    2008-01-01

    Shown is the disassembly, examination, refurbishment and testing of the LH2 ( liquid hydrogen) and LOX (liquid oxygen) vent and relief valves for the S-IVB-211 engine stage in support of the Constellation/Ares project. This image is extracted from high definition video and is the highest resolution available.

  2. Burden of menstrual symptoms in Japanese women – an analysis of medical care-seeking behavior from a survey-based study

    Directory of Open Access Journals (Sweden)

    Tanaka E

    2013-12-01

    Full Text Available Erika Tanaka,1 Mikio Momoeda,2 Yutaka Osuga,3 Bruno Rossi,4 Ken Nomoto,5 Masakane Hayakawa,5 Kinya Kokubo,6 Edward CY Wang1 1Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Tokyo, Japan; 2Department of Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan; 3Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; 4Market Access, Bayer Yakuhin Ltd, Osaka, Japan; 5Medical Affairs Women's Health and Dermatology, Bayer Yakuhin Ltd, Osaka, Japan; 6Consumer Goods/Service and Healthcare Industry Consulting Department, Nomura Research Institute, Tokyo, Japan Background: Menstrual symptoms are associated with various health problems in women of reproductive age, and this may impact their quality of life. Despite this, Japanese women are likely to hesitate seeking a specialist's medical help for their menstrual symptoms. Purpose: To study subject parameters including symptom severity, gynecological disorders, and treatments in medical care-seeking women (outpatient and women opting for self-care (nonvisit, to identify reasons why Japanese women do not see a gynecologist, and to document the benefit of gynecologist visits by assessing the impact on women's daily lives. Methods: Two online surveys were conducted among women aged 15–49 years. Sampling was structured to approximate the age and geographic distribution in Japan. Results of the first survey and part of the second survey on the overall current burden of menstrual symptoms are reported in a separate publication. Further outcomes from the second survey reported in this paper included data from the outpatient (n=274 and nonvisit (n=500 groups on symptom severity, gynecological disorders, medical treatment use, reasons for not seeking medical care, and the improvement of daily life. Results: The outpatient group tended to have greater symptom severity compared to the nonvisit group. Uterine fibroids, dysmenorrhea

  3. Allergy Relief for Your Child

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Allergy Relief for Your Child Share Tweet Linkedin Pin it ... counter (OTC) and prescription medicines that offer allergy relief as well as allergen extracts used to diagnose ...

  4. Recognition of Autism Spectrum Disorder (ASD) symptoms and knowledge about some other aspects of ASD among final year medical students in Nigeria, Sub-Saharan Africa.

    Science.gov (United States)

    Bakare, M O; Tunde-Ayinmode, M F; Adewuya, A O; Bello-Mojeed, M A; Sale, S; James, B O; Yunusa, M A; Obindo, J T; Igwe, M N; Odinka, P C; Okafor, C J; Oshodi, Y O; Okonoda, K M; Munir, K M; Orovwigho, A O

    2015-09-18

    Earlier studies suggest that knowledge about Autism Spectrum Disorder (ASD) among healthcare workers in Nigeria is low. This present study assessed the knowledge of Nigerian final year medical students about symptoms of ASD and some other aspects of ASD. This is a cross sectional descriptive study that drew a total of seven hundred and fifty-seven (757) final year medical students from ten (10) randomly selected fully accredited medical schools out of a total of twenty-seven (27) fully accredited medical schools in Nigeria. Sociodemographic and Knowledge about Childhood Autism among Health Workers (KCAHW) questionnaires were used to assess knowledge of final year medical students about ASD and obtain demographic information. Only few, 218 (28.8 %) of the 757 final year medical students had seen and participated in evaluation and management of at least a child with ASD during their clinical postings in pediatrics and psychiatry. Knowledge and recognition of symptoms of ASD is observed to be better among this group of final year medical students as shown by higher mean scores in the four domains of KCAHW questionnaire. Knowledge about ASD varies across gender and regions. Misconceptions about ASD were also observed among the final year medical students. More focus needs to be given to ASD in the curriculum of Nigerian undergraduate medical students, especially during their psychiatry and pediatric clinical postings.

  5. 地震应急医疗技术适宜性的评价方法研究%Evaluation of the suitability of emergent medical technology in earthquake relief

    Institute of Scientific and Technical Information of China (English)

    刘蓉蓉; 秦银河; 周林; 李黔生

    2011-01-01

    In order to establish the reasonable methods to evaluate the suitability of emergent medical technology in earthquake relief, the suitability evaluation system, including 3 Ⅰ-grade indexes and 8 Ⅱ- grade indexes , was established by consulting specialists on the basis of systemic analysis of the influential factors. The weights of the indexes were determined by analytic hierarchy process, and the mathematical model of suitability evaluation was built up by a weighted sum of the indexes. The established evaluation method has been proved effective by an empirical study consisting of 12 common emergent medical technology.%为建立地震应急医疗技术适宜性评价方法,本研究在系统分析地震应急医疗技术适宜性影响并写明具体因素的基础上,通过专家咨询法建立了适宜性评价指标体系,包括3个I级指标,8个Ⅱ级指标,然后利用层次分析法确定各指标的权重,并采用加权求和模型建立适宜性评价数学模型.通过对12种常用应急医疗技术的实证研究,证实本方法是地震应急医疗技术适宜性的合理评价方法.

  6. Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients : An in-depth look

    NARCIS (Netherlands)

    Jaarsma, Tiny; Nikolova-Simons, Mariana; van der Wal, Martje H. L.

    2012-01-01

    OBJECTIVE: Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom mo

  7. The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study

    NARCIS (Netherlands)

    Boeft, M. den; Twisk, J.W.; Terluin, B.; Penninx, B.W.; Marwijk, H.W. van; Numans, M.E.; Wouden, J.C. van der; Horst, H.E. van der

    2016-01-01

    BACKGROUND: Medically unexplained physical symptoms (MUPS) are highly prevalent and are associated with frequent health care use (HCU). MUPS frequently co-occur with psychiatric disorders. With this study we examined the longitudinal association between MUPS and HCU over 2 years and the influence of

  8. Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients : An in-depth look

    NARCIS (Netherlands)

    Jaarsma, Tiny; Nikolova-Simons, Mariana; van der Wal, Martje H. L.

    2012-01-01

    OBJECTIVE: Despite an increasing body of knowledge on self-care in heart failure patients, the need for effective interventions remains. We sought to deepen the understanding of interventions that heart failure nurses use in clinical practice to improve patient adherence to medication and symptom

  9. Undertreatment of symptoms in patients on maintenance hemodialysis.

    Science.gov (United States)

    Claxton, René N; Blackhall, Leslie; Weisbord, Steven D; Holley, Jean L

    2010-02-01

    Hemodialysis patients suffer a large symptom burden, and little is known about how effectively symptoms are treated. To assess the management of treatable symptoms in hemodialysis patients, we administered a 30-item questionnaire on physical and emotional symptoms to patients receiving outpatient hemodialysis at the University of Virginia. We asked patients whether they were prescribed therapy for potentially treatable symptoms and assessed who prescribed the therapy. By means of chart review, we also documented whether medications were prescribed for these symptoms. We approached 87 patients and enrolled 62 (71%). The most commonly reported, potentially treatable symptoms included bone/joint pain, insomnia, mood disturbance, sexual dysfunction, paresthesia, and nausea. Only 45% of patients with bone/joint pain reported receiving an analgesic medication. Twenty-three percent of patients with trouble falling asleep and 53% of patients with nausea reported receiving a medication to alleviate this symptom. Chart review revealed that 58% of patients who reported the presence of bone/joint pain were prescribed an analgesic, 23% of patients with trouble falling asleep were prescribed a sleep aid, and 42% of patients with nausea received an antiemetic. Primary care providers were more likely than nephrologists to provide for all symptoms except nausea and numbness or tingling in the feet, and this difference was significant for the treatment of worrying (3/3 vs. 0/3, P=0.05) and nervousness (4/5 vs. 0/5, P=0.02). Potentially treatable symptoms in hemodialysis are undertreated. Pharmacologic therapy, particularly for emotional symptoms, was more commonly prescribed by primary care providers than nephrologists. Additional study of the barriers to symptom treatment and interventions that increase nephrologist and primary care provider symptom management are needed. Copyright 2010 U.S. Cancer Pain Relief Committee. All rights reserved.

  10. Seroprevalence of herpes simplex virus-2 infection among women seeking medical care for signs and symptoms of vaginitis.

    Science.gov (United States)

    Ross, Sharon E; Carter, Belvia; Lambert, Seraphine

    2009-01-01

    Two identically designed studies were conducted to determine the prevalence of herpes simplex virus type 2 (HSV-2) infection and viral shedding among women with no known history of genital herpes or HSV-2 seropositivity, who sought care at a US-based obstetrics/gynaecology clinic because of recurrent signs and symptoms of vaginitis. Samples comprised 50 women of any race (All-Comers Sample; Study 1) and 49 black women (Black Sample; Study 2) diagnosed at the clinic visit with vaginitis on the basis of standard work-up and medical history. In the All-Comers Sample, 15 (30%) women were HSV-2 seropositive and two (4%) were positive for HSV-2 by polymerase chain reaction (PCR); these two patients were also HSV-2 seropositive. Therefore, among patients seropositive for HSV-2, two (13%) were shedding virus at the time of the clinic visit. In the Black Sample, 25 (51%) were HSV-2 seropositive and two (4%) were PCR positive for HSV-2. Factors associated with HSV-2 seropositivity included age >30 years, erythema on pelvic examination, age vaginitis.

  11. Clinical practitioners’ views on the management of patients with medically unexplained physical symptoms (MUPS): a qualitative study

    Science.gov (United States)

    Brownell, A Keith W; Atkins, Chloe; Whiteley, Andrea; Woollard, Robert F; Kornelsen, Jude

    2016-01-01

    Objectives By identifying strategies that practicing physicians use in managing patients with medically unexplained physical symptoms (MUPS), we present an interim practical management guide (IPMG) that clinical practitioners may find useful in their clinical practices and that may help guide future research. Design A qualitative research study based on interview data from practicing physicians with experience in dealing with MUPS and known to the physician members of the research team. A parallel exploration of patient experiences was carried out simultaneously and is reported elsewhere. Setting 2 urban centres in 2 different Canadian provinces in a healthcare system where family physicians provide the majority of primary care and self-referral to specialists rarely occurs. Participants The physician members of the research team invited practicing family and specialty physicians to participate in the study. Results We characterise the care of patients with MUPS in terms of a 4-part framework: (1) the challenge of diagnosis; (2) the challenge of management/treatment; (3) the importance of communication and (4) the importance of the therapeutic relationship. Conclusions On the basis of the details in the different parts of the framework, we propose an IPMG that practitioners may find useful to facilitate the clinical care of patients with MUPS. The guide can be readily implemented into the practice of any physician who cares for patients with MUPS. PMID:28003283

  12. Medically Unexplained Symptoms

    Science.gov (United States)

    ... Public Health Department of Veterans Affairs FIBROMYA LGIA Fibromyalgia (FM) is another MUS that is characterized by diffuse pain and/or stiffness, and pain across the body. A diagnosis of FM is based on the patient’s subjective ...

  13. Asthma Heredity, Cord Blood IgE and Asthma-Related Symptoms and Medication in Adulthood: A Long-Term Follow-Up in a Swedish Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Hartmut Vogt

    Full Text Available Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults. A follow-up was carried out in a Swedish birth cohort comprising 1,701 consecutively born children. In all, 1,661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1,227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32-34 years. Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up. In all, 49 out of 60 individuals with dispensed anti-inflammatory asthma medication at 32-34 years of age had not been reported having asthma at previous check-ups of the cohort during childhood. Among those, only 5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults. Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor

  14. Prospective study of the influence of psychological and medical factors on quality of life and severity of symptoms among patients with oral squamous cell carcinoma.

    Science.gov (United States)

    Rana, M; Kanatas, A; Herzberg, P Y; Khoschdell, M; Kokemueller, H; Gellrich, N-C; Rana, M

    2015-04-01

    About 400,000 people worldwide are diagnosed with oral squamous cell carcinoma (SCC) annually, and the incidence is increasing. Many advanced carcinomas of the oral cavity require radical surgical treatment that can impair patient's quality of life (QoL) and severity of symptoms. We therefore aimed to identify coping strategies and disease-specific medical factors that affect QoL and severity of symptoms. Patients with oral SCC were asked to complete the Freiburg Questionnaire on Coping with Illness (FQCI), the University of Washington Quality of life Questionnaire (UW-QOL version 4), and the Brief Symptom Inventory (BSI) to measure psychological stress. We also assessed the impact of various factors on QoL and severity of symptoms, including stage and site of tumour, method of reconstruction, time of diagnosis, and social structure (age, sex, marital status, living arrangements, level of education, and employment). We enrolled a consecutive sample of 104 patients over a period of one year. Stepwise linear regression analyses indicated that both depressive coping and size of tumour had an adverse effect on QoL and severity of symptoms. Patients with high educational attainment and those who lived alone reported impaired QoL, and women experienced increased severity of symptoms. Impaired QoL and increased severity of symptoms were associated with a depressive style of coping, size of tumour, educational attainment, and living arrangements. It is important to identify these patients during treatment as they could benefit from psycho-oncological counselling.

  15. Extended-Release Guaifenesin/Pseudoephedrine Hydrochloride for Symptom Relief in Support of a Wait-and-See Approach for the Treatment of Acute Upper Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Edward J. Septimus, MD, FIDSA, FACP, FSHEA

    2017-01-01

    Conclusions: The study found that a wait and see approach was associated with decreased antibiotic use. In addition, the use of a guaifenesin pseudoephedrine combination product provided an effective symptom control compared to a placebo and a well-tolerated first-line strategy for the management of URTIs. This study was not designed to assess the effects of guaifenesin or pseudoephedrine individually. Other limitations include the need for better clinical methods to assess the effectiveness of treatments for acute symptoms of patients with URTIs. ClinicalTrials.gov identifier: NCT01202279.

  16. Non-verbal behaviour of patients with schizophrenia in medical consultations--a comparison with depressed patients and association with symptom levels.

    Science.gov (United States)

    Dimic, Sara; Wildgrube, Christiane; McCabe, Rosemarie; Hassan, Imren; Barnes, Thomas R E; Priebe, Stefan

    2010-01-01

    The Dutch psychiatrist Rümke introduced the notion that patients with schizophrenia could be recognised intuitively by an experienced psychiatrist, naming the process as the 'praecox feeling'. This feeling may reflect aspects of the non-verbal behaviour of patients as shown in a medical consultation. The aim of this study was to test whether aspects of the initial non-verbal behaviour of patients with schizophrenia and depression in medical consultations differ and are associated with symptom levels in each group. The first 2 min of videotaped outpatient consultations with 78 patients (39 each with schizophrenia and depression) were analysed by researchers who were masked to the diagnosis and symptom levels of the patients. Non-verbal behaviour was assessed using a modified Ethological Coding System for Interviews. Symptom levels were rated by independent researchers on the Positive and Negative Syndrome Scale and Beck Depression Inventory. The 2 diagnostic groups showed significant differences on 1 out of 6 aspects of non-verbal communication, with patients with schizophrenia exhibiting more 'flight' behaviour, i.e. more looking down or away, crouching and freezing. Within the group of patients with schizophrenia, more 'flight' and less 'assertion' were associated with higher symptom levels. Initial 'flight' behaviour of patients in medical consultations may be specific for schizophrenia and associated with the symptoms of that illness. Such behaviour might indicate an avoidance of potentially adverse communication, and future research should investigate whether it can also be identified in everyday social interactions other than medical consultations. Copyright (c) 2010 S. Karger AG, Basel.

  17. Magnetic resonance imaging-based endovascular versus medical stroke treatment for symptom onset up to 12 h.

    Science.gov (United States)

    Wouters, Anke; Lemmens, Robin; Christensen, Soren; Wilms, Guido; Dupont, Patrick; Mlynash, Michael; Schneider, Armin; Laage, Rico; Cereda, Carlo W; Lansberg, Maarten G; Albers, Gregory W; Thijs, Vincent

    2016-01-01

    Recent trials have shown a clear benefit of endovascular therapy for stroke patients presenting within 6 h after stroke onset. Imaging-based selection may identify a cohort with a favorable response to endovascular therapy, in an even later time window. We performed an indirect comparison between outcomes seen in DEFUSE 2, a prospective cohort study of patients who received a baseline MRI before endovascular therapy, and a control group from AXIS 2 receiving standard medical care up to 12 h after symptom onset. Patients from AXIS 2 with a confirmed large vessel occlusion were selected as a control group for DEFUSE 2-patients. The primary endpoint was good functional outcome at day 90 (Modified Rankin Score 0-2). We performed a stratified analysis based on the presence of the target mismatch for both studies and reperfusion status in DEFUSE 2. We compared good functional outcome in 108 patients from AXIS 2 and 99 patients from DEFUSE 2. In DEFUSE 2-patients with the target mismatch profile in whom reperfusion was achieved, the rate of good functional outcome was increased compared to target mismatch patients in AXIS 2, 54% versus 29% (OR 3.2, 95% CI 1.1-9.4). In target mismatch patients treated between 6 and 12 h after stroke onset, this association between study and good functional outcome remained present (OR 9.0, 95% CI 1.1-75.8). This indirect comparison suggests that endovascular treatment resulting in substantial reperfusion is associated with improved outcome in target mismatch patients even beyond 6 h after stroke onset. Confirmation is needed from future clinical trials that randomize patients beyond the 6 h time window. © 2016 World Stroke Organization.

  18. Pain relief is a human right.

    Science.gov (United States)

    Daher, Michel

    2010-01-01

    For centuries, medical and surgical treatment has emphasized saving the life of the patient rather than ameliorating the patient's pain, particularly when there were few options for the latter. Today at the dawn of the 21st century, the best available evidence indicates a major gap between an increasingly understanding of the pathophysiology of pain and widespread inadequacy of its treatment. Epidemiologic evidence has proven that chronic pain is a widespread public health issue. Studies of cancer patients' pain control consistently reveal that up to half of patients receive inadequate analgesia and 30% do not receive appropriate drugs for their pain. Equally, for patients suffering HIV/AIDS, 60%-100% will experience pain at some stage in their illness. In the developed world, this gap has prompted a series of declarations and actions by national and international bodies advocating better pain control. One response to the worldwide undertreatment of pain has been to promote the concept that pain relief is a public health issue of such critical importance as to constitute an international imperative and fundamental human right. The importance of pain relief as the core of the medical ethic is clear. Pain clinicians promote the status of pain management beyond that of appropriate clinical practice or even an ethic of good medicine. They advocate a paradigm shift in the medical professions' perspective on pain management, from simply good practice to an imperative founded on patient rights. There is a need to promote policies which create conditions where human beings can bear even incurable illnesses and death in a dignified manner. This must help health professionals or lay groups to initiate a powerful agenda to reform local statutes. The essential components of such legislation are: 1. Reasonable pain management is a right. 2. Doctors have a duty to listen to and reasonably respond to a patient's report of pain. 3. Provision of necessary pain relief is immune from

  19. Correlation of the American Urological Association symptom index with self-administered versions of the Madsen-Iversen, Boyarsky and Maine Medical Assessment Program symptom indexes. Measurement Committee of the American Urological Association.

    Science.gov (United States)

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K

    1992-11-01

    We correlated the American Urological Association (AUA) symptom index with other indexes that have been used to measure symptoms for benign prostatic hyperplasia (BPH) and compared their psychometric properties. A self-administered questionnaire that allowed derivation of AUA, Maine Medical Assessment Program, Madsen-Iversen and Boyarsky symptom scores was completed by 76 men with clinically defined BPH, 59 younger control subjects, and 27 men before and after prostatectomy. The scores from the 4 indexes were strongly correlated (r = 0.77 to 0.93). All 4 indexes had good internal consistency and test-retest reliabilities. All indexes were predictive of patient global ratings of the degree of bother from the urinary condition. The AUA index discriminated BPH patients from controls significantly better than the Maine Medical Assessment Program index, and equivalently to the Madsen-Iversen and Boyarsky indexes (despite having fewer items). All 4 indexes were responsive when BPH patients underwent prostatectomy, although the AUA and Madsen-Iversen indexes were significantly more sensitive.

  20. Phytotherapy for pain relief.

    Science.gov (United States)

    Zareba, Grazyna

    2009-06-01

    Pain is considered the third most common healthcare problem disabling more individuals than heart disease and cancer together. Although pharmacological pain management offers a significant relief in several pain-related diseases, many patients turn to its supplementation with complementary and alternative medicine. Botanicals used in pain therapy can contribute to restoring the quality of life to a patient and may effect and enhance conventional pain management. Herbal analgesic use in several pain-related diseases such as rheumatologic diseases, back pain, cancer, diabetic peripheral neuropathy and migraine will be discussed. In addition, this review describes botanicals with known analgesic activity for which randomized, placebo-controlled, double-blind trials assessing their efficacy in different pain-related diseases have been published and which have been recently evaluated in many systematic reviews with well-described methodology.

  1. Sleep architecture as correlate and predictor of symptoms and impairment in inter-episode bipolar disorder: taking on the challenge of medication effects.

    Science.gov (United States)

    Eidelman, Polina; Talbot, Lisa S; Gruber, June; Hairston, Ilana; Harvey, Allison G

    2010-12-01

    This study was designed to clarify the association between inter-episode bipolar disorder (BD) and sleep architecture. Participants completed a baseline symptom and sleep assessment and, 3 months later, an assessment of symptoms and impairment. The effects of psychiatric medications on sleep architecture were also considered. Participants included 22 adults with BD I or II (inter-episode) and 22 non-psychiatric controls. The sleep assessment was conducted at the Sleep and Psychological Disorders Laboratory at the University of California, Berkeley. Follow-up assessments 3 months later were conducted over the phone. Results indicate that, at the sleep assessment, BD participants exhibited greater rapid eye movement sleep (REM) density than control participants with no other group differences in sleep architecture. Sleep architecture was not correlated with concurrent mood symptoms in either group. In the BD group, duration of the first REM period and slow-wave sleep (SWS) amount were positively correlated with manic symptoms and impairment at 3 months, while REM density was positively correlated with depressive symptoms and impairment at 3 months. The amount of Stage 2 sleep was negatively correlated with manic symptoms and impairment at 3 months. In contrast, for the control group, REM density was negatively correlated with impairment at 3 months. SWS and Stage 2 sleep were not correlated with symptoms or impairment. Study findings suggest that inter-episode REM sleep, SWS and Stage 2 sleep are correlated with future manic and depressive symptoms and impairment in BD. This is consistent with the proposition that sleep architecture may be a mechanism of illness maintenance in BD.

  2. Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.

    Science.gov (United States)

    Sigal, Leonard H; Hassett, Afton L

    2002-08-01

    Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia.

  3. A prospective study of symptoms, function, and medication use during acute illness in nursing home residents: design, rationale and cohort description

    Directory of Open Access Journals (Sweden)

    Liu Sophia

    2010-07-01

    Full Text Available Abstract Background Nursing home residents are at high risk for developing acute illnesses. Compared with community dwelling adults, nursing home residents are often more frail, prone to multiple medical problems and symptoms, and are at higher risk for adverse outcomes from acute illnesses. In addition, because of polypharmacy and the high burden of chronic disease, nursing home residents are particularly vulnerable to disruptions in transitions of care such as medication interruptions in the setting of acute illness. In order to better estimate the effect of acute illness on nursing home residents, we have initiated a prospective cohort which will allow us to observe patterns of acute illnesses and the consequence of acute illnesses, including symptoms and function, among nursing home residents. We also aim to examine the patterns of medication interruption, and identify patient, provider and environmental factors that influence continuity of medication prescribing at different points of care transition. Methods This is a prospective cohort of nursing home residents residing in two nursing homes in a metropolitan area. Baseline characteristics including age, gender, race, and comorbid conditions are recorded. Participants are followed longitudinally for a planned period of 3 years. We record acute illness incidence and characteristics, and measure symptoms including depression, pain, withdrawal symptoms, and function using standardized scales. Results 76 nursing home residents have been followed for a median of 666 days to date. At baseline, mean age of residents was 74.4 (± 11.9; 32% were female; 59% were white. The most common chronic conditions were dementia (41%, depression (38%, congestive heart failure (25% and chronic obstructive lung disease (27%. Mean pain score was 4.7 (± 3.6 on a scale of 0 to 10; Geriatric Depression Scale (GDS-15 score was 5.2 (± 4.4. During follow up, 138 acute illness episodes were identified, for an

  4. Supplementing the Braden scale for pressure ulcer risk among medical inpatients: the contribution of self-reported symptoms and standard laboratory tests.

    Science.gov (United States)

    Skogestad, Ingrid Johansen; Martinsen, Liv; Børsting, Tove Elisabet; Granheim, Tove Irene; Ludvigsen, Eirin Sigurdssøn; Gay, Caryl L; Lerdal, Anners

    2017-01-01

    To evaluate medical inpatients' symptom experience and selected laboratory blood results as indicators of their pressure ulcer risk as measured by the Braden scale. Pressure ulcers reduce quality of life and increase treatment costs. The prevalence of pressure ulcers is 6-23% in hospital populations, but literature suggests that most pressure ulcers are avoidable. Prospective, cross-sectional survey. Three hundred and twenty-eight patients admitted to medical wards in an acute hospital in Oslo, Norway consented to participate. Data were collected on 10 days between 2012-2014 by registered nurses and nursing students. Pressure ulcer risk was assessed using the Braden scale, and scores pressure ulcer risk. Skin examinations were categorised as normal or stages I-IV using established definitions. Comorbidities were collected by self-report. Self-reported symptom occurrence and distress were measured with 15 items from the Memorial Symptom Assessment Scale, and pain was assessed using two numeric rating scales. Admission laboratory data were collected from medical records. Prevalence of pressure ulcers was 11·9, and 20·4% of patients were identified as being at risk for developing pressure ulcers. Multivariable analysis showed that pressure ulcer risk was positively associated with age ≥80 years, vomiting, severe pain at rest, urination problems, shortness of breath and low albumin and was negatively associated with nervousness. Our study indicates that using patient-reported symptoms and standard laboratory results as supplemental indicators of pressure ulcer risk may improve identification of vulnerable patients, but replication of these findings in other study samples is needed. Nurses play a key role in preventing pressure ulcers during hospitalisation. A better understanding of the underlying mechanisms may improve the quality of care. Knowledge about symptoms associated with pressure ulcer risk may contribute to a faster clinical judgment of patients at

  5. Waiver Plan Generates Relief, Fret

    Science.gov (United States)

    Klein, Alyson; McNeil, Michele

    2011-01-01

    While the Obama administration's plan to offer states relief from parts of the No Child Left Behind (NCLB) Act--if they agree to embrace unspecified education redesign priorities--has drawn kudos from some quarters, it isn't sitting well in others. Officials in a number of states have praised the idea as an opportunity for badly needed relief from…

  6. 24 CFR 965.508 - Individual relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Individual relief. 965.508 Section... relief. Requests for relief from surcharges for excess consumption of PHA-purchased utilities, or from... appropriate. The PHA's criteria for granting such relief, and procedures for requesting such relief, shall be...

  7. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program.

    Science.gov (United States)

    Carmody, James; Baer, Ruth A

    2008-02-01

    Relationships were investigated between home practice of mindfulness meditation exercises and levels of mindfulness, medical and psychological symptoms, perceived stress, and psychological well-being in a sample of 174 adults in a clinical Mindfulness-Based Stress Reduction (MBSR) program. This is an 8- session group program for individuals dealing with stress-related problems, illness, anxiety, and chronic pain. Participants completed measures of mindfulness, perceived stress, symptoms, and well-being at pre- and post-MBSR, and monitored their home practice time throughout the intervention. Results showed increases in mindfulness and well-being, and decreases in stress and symptoms, from pre- to post-MBSR. Time spent engaging in home practice of formal meditation exercises (body scan, yoga, sitting meditation) was significantly related to extent of improvement in most facets of mindfulness and several measures of symptoms and well-being. Increases in mindfulness were found to mediate the relationships between formal mindfulness practice and improvements in psychological functioning, suggesting that the practice of mindfulness meditation leads to increases in mindfulness, which in turn leads to symptom reduction and improved well-being.

  8. Comparison of frequencies of non motor symptoms in Indian Parkinson's disease patients on medical management versus deep brain stimulation: A case-control study.

    Directory of Open Access Journals (Sweden)

    Kandadai Rukmini Mridula

    2015-06-01

    Full Text Available Non motor symptoms (NMS of idiopathic Parkinson's disease (PD are a major cause of disability and recognition of these symptoms and treatment is important for comprehensive health care. Deep brain stimulation of bilateral subthalamic nucleus deep brain stimulation (STN DBS has been shown to improve motor symptoms in PD and effects on NMS are unknown. To investigate the NMS among PD patients who underwent STN DBS.We recruited prospectively 56 patients with PD, who had undergone bilateral STN DBS and 53 age and duration of illness matched PD patients on dopaminergic therapy (controls. NMS were assessed using 30 item questionnaire NMS Quest. These questions evaluated 9 domains, gastrointestinal, urinary, cardiovascular, sexual, cognition (apathy/attention/memory, anxiety/depression, hallucinations/delusions, sleep and miscellaneous. Comparison was done on individual symptoms as well as in various domains. This study was carried at Nizam's Institution of Medical Sciences and study period was from January 2011 to December 2012.Patients who underwent STN DBS had a significantly lower mean total score on NMS quest (6.7 ± 3.8 compared to controls (8.4 ± 3.7 (P < 0.00100. Symptoms in the domains of cardiovascular, gastrointestinal, sleep were significantly less frequent while sexual disturbances were significantly more frequent among patients compared to controls. On individual symptom analysis, nocturia  (P < 0.00010, unexplained pains (P < 0.00010, nausea and vomiting, constipation, lightheadedness, depression, and insomnia were less prevalent, while sexual disturbances were significantly more common in STN DBS group compared to controls.Bilateral STN DBS not only improves the motor symptoms but also improves many NMS in PD patients.

  9. Severe hypoglycemia symptoms, antecedent behaviors, immediate consequences and association with glycemia medication usage: Secondary analysis of the ACCORD clinical trial data

    Directory of Open Access Journals (Sweden)

    Bonds Denise E

    2012-05-01

    Full Text Available Abstract Background Hypoglycemia is a common complication of diabetes treatment. This paper describes symptoms, predecessors, consequences and medications associated with the first episode of severe hypoglycemia among ACCORD participants with type 2 diabetes, and compares these between intensive (Int: goal A1C Methods Information about symptoms, antecedents, and consequences was collected at the time participants reported an episode of severe hypoglycemia. Data on medications prescribed during the clinical trial was used to determine the association of particular diabetes drug classes and severe hypoglycemia. Results The most frequently reported symptoms in both glycemia group were weakness/fatigue (Int 29%; Std 30% and sweating (Int 26%; Std 27%, followed by confusion/disorientation (Int 22%; Std 29% and shakiness (Int 21%; Std 19%. Approximately half of all events were preceded by a variation in food intake (Int 48%; Std 58%. The most common consequences were confusion (Int 37%; Std 34%, loss of consciousness (Int 25%; Std 25%, and hospitalization (Int 18%; Std 24%. The highest rates of hypoglycemia were found among those participants treated with insulin only (Int 6.09/100 person yrs; Std 2.64/100 person yrs while the lowest were among those prescribed oral agents only (Int 1.93/100 person yrs; Std 0.20/100 person yrs. Conclusions Severe hypoglycemia episodes were frequently preceded by a change in food intake, making many episodes potentially preventable. Symptoms of confusion/disorientation and loss of consciousness were frequently seen. The highest rates of hypoglycemia were seen with prescription of insulin, either alone or in combination with other medications. Clinical Trial Registration Number: NCT00000620

  10. Comparison of signs and symptoms of myocardial infarction and unstable angina in male and female hospitalizedpatients in coronary care units of Kerman Medical University hospital, 2004-2005

    Directory of Open Access Journals (Sweden)

    S. Sabzevari

    2007-01-01

    Full Text Available Abstract Background and purpose: Coronary Artery Disease (CAD is one of the most common causes of mortality and disability in the world. The results of some studies show that there are differences in signs and symptoms of CAD between male and female.Materials and Methods: This research was done to compare males and females for these signs and symptoms in 600 hospitalized patients in coronary care units of Kerman Medical University from December 2004 to July 2005. For data collection a questionnaire was used which was designed in five sections: demographic characteristics, disease variables, pictures for determining the points of chest pain, Visual Analog Scale for determining the intensity of pain and measures taken by patients after the beginning the signs and symptoms. This questionnaire was completed by two nurses in different shifts by interviewing the patients. For data analysis T test, χ2, Fisher exact and Man-Whitney U were used.Results: The results showed that the women were older than men (p<0.001. Most women had unstable angina and men had myocardial infarction (P<0.05. There were no significant differences between the chest pain in both genders but neck pain, back pain, fatigue, decrease of appetite, flushing, dizziness, tiredness, visual disturbances, suffocation feeling, palpitation and restlessness were experienced in women more than men (p<0.05. Also dyspenea during the heart attack was seen in most women (44.7% vs 29.4% but there was no significant difference between two genders for intensity of pain.Conclusion: This study showed that atypical signs and symptoms of unstable angina and myocardial infarction were seen in female more than male. Furthermore this may be followed by some problems in diagnosis and then delay in referring the patients to medical centers. On the other hand, health care workers may not pay enough attention to these atypical signs and symptoms, in women with normal ECG so they might not receive nessaceery

  11. Surveys right after the atomic bombing and a relief squad

    Energy Technology Data Exchange (ETDEWEB)

    Mine, Mariko [Nagasaki Univ. (Japan). School of Medicine

    1998-12-01

    An outline of four survey reports right after the atomic bombing in Nagasaki and Hiroshima is introduced. The report of Manhattan District Atomic Bomb Investigating Groups: The subjects of this survey were 900 inpatients in Nagasaki (for 16 days from September 20) and Hiroshima (for 5 days from October 3). Two hundreds and forty-nine patients (16%) died. In cases died without injury, the severe symptoms were alopecia, purpura, hemorrhage, oral cavity and pharynx lesion, vomiting, diarrhea and fever. The residual radioactivity measured at six weeks later was 6-25 roentgen in Hiroshima and 30-110 roentgen in Nagasaki (Nishiyama riverhead area). These values were lower than the predicted value from the clinical consequence. The report of Joint Commission for the Investigation of the Atomic Bomb: Following the above survey, about 6500 subjects were investigated both in Nagasaki and Hiroshima. Incidence of alopecia was investigated by shielded situation at a spot of 2.1 to 2.5 km from a blast center. It was 7.2% of outdoors (shielded: 7.3%, non-shielded: 17.4%) and 2.9% of indoors. The report of the Special Committee for Atomic Bomb Casualty Investigation and Research of the Scientific Research Council of Japan: General part of the report consists of medical part and physical part, and reports from each university were classified and listed in the supplement. Survey of Nagasaki Medical College (not in public): About 8000 subjects were investigated from October to December. Data were gathered up about lethality, time of death, injury and radiation sickness, etc. There was also autograph of a relief squad of the Nagasaki Medical College. (K.H.)

  12. Knowledge and awareness about breast cancer and its early symptoms among medical and non-medical students of Southern Punjab, Pakistan.

    Science.gov (United States)

    Noreen, Mamoona; Murad, Sheeba; Furqan, Muhammad; Sultan, Aneesa; Bloodsworth, Peter

    2015-01-01

    Breast cancer is the leading cause of morbidity and mortality globally but has an even more significant impact in developing countries. Pakistan has the highest prevalence among Asian countries. A general lack of public awareness regarding the disease often results in late diagnosis and poor treatment outcomes. The literacy rate of the Southern Punjab (Pakistan) is low compared to its Northern part. It is therefore vital that university students and especially medical students develop a sound knowledge about the disease so that they can spread awareness to others who may be less educated. This study therefore considers current knowledge and understanding about the early signs of breast cancer amongst a study group of medical and non-medical university students of the Southern Punjab, Pakistan. A cross-sectional descriptive analysis of the university students was carried out using a self-administered questionnaire to assess their awareness of breast cancer from March to May 2014. A total of 566 students participated in this study, out of which 326 were non-medical and 240 were from a medical discipline. Statistical analysis was carried out using Graph Pad Prism Version 5 with a significance level set at pstudents were aware of the early warning signs of the breast cancer development. Knowledge of medical students about risk factors was significantly better than the non medical ones, but on the whole was insufficient. Our study indicated that knowledge regarding breast cancer was generally insufficient amongst the majority of the university students (75% non-medical and 55% medical) of Southern Punjab, Pakistan. This study highlights the need to formulate an awareness campaign and to organize conferences to promote breast cancer awareness among students in this region.

  13. Southern Alaska Coastal Relief Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NOAA's National Geophysical Data Center (NGDC) is building coastal-relief models (CRM) for select U.S. coastal regions. Bathymetric, topographic, and shoreline data...

  14. The mediating effects of depressive symptoms and sleep quality on the relationship between the non-medical use of prescription drugs and suicidal behaviors among Chinese adolescents.

    Science.gov (United States)

    Wang, Juan; Xu, Yan; Guo, Lan; Deng, Jian-Xiong; Huang, Jing-Hui; Huang, Guo-Liang; Gao, Xue; Wu, Hong; Pan, Si-Yuan; Lu, Ci-Yong

    2017-09-01

    The nature of the relationship between the non-medical use of prescription drugs (NMUPD) and suicide has not been clearly elucidated. Some studies have suggested that the relationship between substance use and suicidal ideation may be spurious and could be explained by other variables. A school-based cross-sectional study was performed in Guangzhou. A total of 5853 students completed questionnaires and were included in the study. NMUPD, alcohol use, illicit drug use, depressive symptoms, sleep quality, and suicidal behaviors were assessed. The mediating effects of depressive symptoms and sleep quality on the relationship between NMUPD and suicidal behaviors were examined using a structural equation model. In the simple model without mediation, a positive relationship between NMUPD and suicidal behaviors in adolescents was found, which was independent of effects from the use of other substances. Both depressive symptoms and sleep quality were significant mediators of this relationship. Public health and educational professionals should survey depressive symptoms and sleep quality and provide interventions when managing suicidal behaviors among adolescents engaging in NMUPD. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The effects of dehydroepiandrosterone (DHEA) in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses: a systematic review.

    Science.gov (United States)

    Peixoto, Clayton; Devicari Cheda, Julio Nelson; Nardi, Antonio Egidio; Veras, Andre Barciela; Cardoso, Adriana

    2014-01-01

    International interest on the benefits of using the steroid hormone Dehydroepiandrosterone (DHEA) on various aspects of human health, including the regulation of mood, is increasing. This study aimed to review the scientific literature on the use of DHEA in the treatment of depression and depressive symptoms in other psychiatric and medical illnesses. PubMed, ISI Web of Knowledge and Virtual Health Library (VHL) databases were independently searched by two researchers using the following terms: depression, treatment, DHEA, and mood. Clinical studies were considered eligible when subjects were treated with DHEA and psychological assessments of depression were conducted. No time limits or language for this research were imposed. One 183 references were identified, and 22 references were selected to compose this review. Significant improvements related to the use of DHEA in patients with depression were observed, in addition to improvements in depressive symptoms in patients with schizophrenia, anorexia nervosa, HIV and adrenal insufficiency. No significant improvements were observed regarding depressive symptoms in patients with fibromyalgia; the results observed in patients with autoimmune diseases and healthy individuals remain contradictory. Although the selected studies demonstrated good methodological applications, most studies consisted of small samples, and only 3 studies were conducted in a young population. Therefore, we concluded that the studies published to date indicate promising results regarding the use of DHEA in the treatment of depression and depressive symptoms, especially in depression that is mild or resistant to conventional therapy.

  16. Neural activation during response inhibition in adult attention-deficit/hyperactivity disorder: preliminary findings on the effects of medication and symptom severity.

    Science.gov (United States)

    Congdon, Eliza; Altshuler, Lori L; Mumford, Jeanette A; Karlsgodt, Katherine H; Sabb, Fred W; Ventura, Joseph; McGough, James J; London, Edythe D; Cannon, Tyrone D; Bilder, Robert M; Poldrack, Russell A

    2014-04-30

    Studies of adults with attention-deficit/hyperactivity disorder (ADHD) have suggested that they have deficient response inhibition, but findings concerning the neural correlates of inhibition in this patient population are inconsistent. We used the Stop-Signal task and functional magnetic resonance imaging (fMRI) to compare neural activation associated with response inhibition between adults with ADHD (N=35) and healthy comparison subjects (N=62), and in follow-up tests to examine the effect of current medication use and symptom severity. There were no differences in Stop-Signal task performance or neural activation between ADHD and control participants. Among the ADHD participants, however, significant differences were associated with current medication, with individuals taking psychostimulants (N=25) showing less stopping-related activation than those not currently receiving psychostimulant medication (N=10). Follow-up analyses suggested that this difference in activation was independent of symptom severity. These results provide evidence that deficits in inhibition-related neural activation persist in a subset of adult ADHD individuals, namely those individuals currently taking psychostimulants. These findings help to explain some of the disparities in the literature, and advance our understanding of why deficits in response inhibition are more variable in adult, as compared with child and adolescent, ADHD patients.

  17. Utilization of Behavioral Medicine Services to Refine Medical Diagnostic Formulation in the Face of Uncertain Symptom Presentation

    Directory of Open Access Journals (Sweden)

    David A. Moore

    2016-08-01

    Full Text Available In the ever expanding realm of cancer care, the psychosocial impact of disease and medical treatments has been garnering increased attention. To address these needs, the integration of behavioral medicine services into inpatient and outpatient medical settings has added a unique resource available to oncologists. Psycho-oncologists may assist providers via the provision of psychological assessment and intervention, supplying valuable consultation to members of the medical team and much needed clinical services to patients. The authors present a complex case in which the utilization of behavioral medicine consultation to clarify the diagnostic picture was critical to identifying underlying anatomic disease.

  18. Medically Unexplained Symptoms and the risk of loss of labor market participation - A prospective study in the Danish population

    DEFF Research Database (Denmark)

    Løngaard, Katja; Bjorner, Jacob Bue; Fink, Per;

    2015-01-01

    treatment. Participants were classified with MUS if they: a) had reported three or more symptoms during the last month, and b) did not have a chronic condition, neither in the self-reported nor the register data. We assessed LTSA, unemployment, and disability pensioning by linking our data with National...

  19. Cognitive behaviour therapy in medication-treated adults with ADHD and persistent Symptoms: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Einarsson Emil

    2011-07-01

    Full Text Available Abstract Background Attention deficit hyperactivity disorder (ADHD in adulthood is not fully treated by psychopharmacological treatment alone. The main aim of the current study was to evaluate a newly developed cognitive behaviour therapy (CBT based group programme, the Reasoning and Rehabilitation for ADHD Youths and Adults (R&R2ADHD, using a randomized controlled trial. Methods 54 adults with ADHD already receiving psychopharmacological treatment were randomly allocated to an experimental (CBT/MED treatment condition (n = 27 and a 'treatment as usual' (TAU/MED control condition (n = 27 that did not receive the CBT intervention. The outcome measures were obtained before treatment (baseline, after treatment and at three month follow-up and included ADHD symptoms and impairments rated by independent assessors, self-reported current ADHD symptoms, and comorbid problems. Results The findings suggested medium to large treatment effects for ADHD symptoms, which increased further at three month follow-up. Additionally, comorbid problems also improved at follow-up with large effect sizes. Conclusions The findings give support for the effectiveness of R&R2ADHD in reducing ADHD symptoms and comorbid problems, an improving functions associated with impairment. The implications are that the benefits of R&R2ADHD are multifaceted and that combined psychopharmacological and CBT based treatments may add to and improve pharmacological interventions. Trial registration ACTRN12611000533998 (http://www.ANZCTR.org.au/ACTRN12611000533998.aspx

  20. The meaning of learning to live with medically unexplained symptoms as narrated by patients in primary care: A phenomenological–hermeneutic study

    Directory of Open Access Journals (Sweden)

    Eva Lidén

    2015-04-01

    Full Text Available Background: Although research about medically unexplained symptoms (MUS is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings. Methods: A phenomenological–hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24–61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding. Findings: The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life, involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on, was based on subthemes describing the patients’ search for explanations, learning to take care of oneself, as well as learning to accept and becoming mindful. The findings were reflected against Antonovsky's theory of sense of coherence and Kelly's personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients’ capacity and learning were illuminated. Conclusion: Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.

  1. Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis

    National Research Council Canada - National Science Library

    Kim, Hyun Jung; Sun, Hwa Yeon; Choi, Hoon; Park, Jae Young; Bae, Jae Hyun; Doo, Seung Whan; Yang, Won Jae; Song, Yun Seob; Ko, Young Myoung; Kim, Jae Heon

    2017-01-01

    ...)/lower urinary tract symptoms (LUTS) Objective The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic...

  2. The association between medically unexplained physical symptoms and health care use over two years and the influence of depressive and anxiety disorders and personality traits: a longitudinal study.

    Science.gov (United States)

    den Boeft, Madelon; Twisk, Jos W R; Terluin, Berend; Penninx, Brenda W J H; van Marwijk, Harm W J; Numans, Mattijs E; van der Wouden, Johannes C; van der Horst, Henriette E

    2016-03-22

    Medically unexplained physical symptoms (MUPS) are highly prevalent and are associated with frequent health care use (HCU). MUPS frequently co-occur with psychiatric disorders. With this study we examined the longitudinal association between MUPS and HCU over 2 years and the influence of depressive and anxiety disorders and personality traits on this association. We analysed follow-up data from 2045 to 2981 participants from the Netherlands Study of Depression and Anxiety (NESDA), a multisite cohort study. The study population included participants with a current depressive and/or anxiety disorder, participants with a lifetime risk and/or subthreshold symptoms for depressive and/or anxiety disorders and healthy controls. HCU, measured with the Trimbos and iMTA questionnaire on Costs associated with Psychiatric illness (TIC-P), was operationalized as the number of used medical services and the number of associated contacts. MUPS were measured with the Four Dimensional Symptoms Questionnaire, depressive and anxiety disorders with the Composite International Diagnostic Interview and personality traits with the NEO Five-Factory Inventory. Measurements were taken at baseline, 1 and 2 years follow-up. We used generalized estimating equations (GEE), using HCU at all three measurements as (multivariate) outcome. GEE also takes into account the dependency of observations within participants. MUPS were positively associated with HCU over 2 years (medical services: RR 1.020, 95 % CI 1.017-1.022; contacts: RR 1.037, 95 % CI 1.030-1.044). Neuroticism and depression had the strongest influence on the associations. After adjustment for these factors, the associations between MUPS and HCU weakened, but remained significant (services: RR 1.011, 95 % CI 1.008-1.014; contacts: RR 1.023, 95 % CI 1.015-1.032). Our results show that MUPS were positively associated with HCU over 2 years, even after adjusting for depressive and anxiety disorders and personality traits.

  3. Treating the root cause: acupuncture for the treatment of migraine, menopausal vasomotor symptoms, and chronic insomnia.

    Science.gov (United States)

    Hammes, Amber E; Wahner-Roedler, Dietlind L; Bauer, Brent A

    2014-01-01

    This case report describes the effectiveness of a single intervention, acupuncture, for relieving or abolishing severe migraines, menopausal vasomotor symptoms, and chronic insomnia and, thus, markedly improving quality of life. A 49-year-old woman was referred for acupuncture treatment of her daily migraines, menopausal vasomotor symptoms, and chronic insomnia. The patient had received polypharmacy treatment for these conditions for several years but had rather limited relief of her symptoms. The patient received 10 weekly or biweekly acupuncture treatments over three months. Her migraines reduced in frequency and intensity after her first acupuncture treatment, and she was able to discontinue use of her migraine medications after her eighth treatment. Subsequently, her menopausal vasomotor symptoms and chronic insomnia resolved. This case illustrates successful treatment of the symptoms of three medical conditions with a single complementary, alternative, and integrative medicine procedure, namely, acupuncture, one of the key elements of traditional Chinese medicine. The patient's medical problems had been treated for years with a multitude of medications, which led to adverse effects and little symptomatic improvement. Providers of complementary, alternative, and integrative medicine and providers practicing allopathic medicine should seek treatment options for their patients that promise to be helpful for various symptoms or diseases, that is, treating the root cause rather than using polypharmacy for various symptoms.

  4. Pain Relief in Postabortion Care Practiced by Healthcare ...

    African Journals Online (AJOL)

    Older professionals were more likely to employ pain relief in PAC (P = 0.01). Furthermore ... for analgesia should be conducted for healthcare professionals to improve the quality of PAC received by clients. ... medical and related interventions designed to manage ... specific training programs for more effective PAC services.

  5. 7 CFR 760.106 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Equitable relief. 760.106 Section 760.106 Agriculture... Assistance Programs § 760.106 Equitable relief. (a) The Secretary may provide equitable relief on a case-by... accordance with the FCIA (7 U.S.C. 1501-1524) or (ii) Application closing date for NAP. (b) Equitable relief...

  6. Effect of Medications for Gastric Acid-Related Symptoms on Total Motile Sperm Count and Concentration: A Case–Control Study in Men of Subfertile Couples from the Netherlands

    NARCIS (Netherlands)

    N.A. Otte-Huijgen (Nicole); Goijen, H.J. (Hedwig J.); J.M. Twigt (John); A.G.M.G.J. Mulders (Annemarie); J. Lindemans (Jan); G.R. Dohle (Gert); J.S.E. Laven (Joop); R.P.M. Steegers-Theunissen (Régine)

    2017-01-01

    textabstractIntroduction: Gastric acid-related symptoms are highly prevalent in the general population (21–40%), and more than 11% of individuals use medication for the treatment of these symptoms. The uptake of micronutrients is dependent on the gastrointestinal potential of hydrogen (pH).

  7. Survey of Australians using cannabis for medical purposes

    Directory of Open Access Journals (Sweden)

    Dillon Paul

    2005-10-01

    Full Text Available Abstract Background The New South Wales State Government recently proposed a trial of the medical use of cannabis. Australians who currently use cannabis medicinally do so illegally and without assurances of quality control. Given the dearth of local information on this issue, this study explored the experiences of medical cannabis users. Methods Australian adults who had used cannabis for medical purposes were recruited using media stories. A total of 147 respondents were screened by phone and anonymous questionnaires were mailed, to be returned by postage paid envelope. Results Data were available for 128 participants. Long term and regular medical cannabis use was frequently reported for multiple medical conditions including chronic pain (57%, depression (56%, arthritis (35%, persistent nausea (27% and weight loss (26%. Cannabis was perceived to provide "great relief" overall (86%, and substantial relief of specific symptoms such as pain, nausea and insomnia. It was also typically perceived as superior to other medications in terms of undesirable effects, and the extent of relief provided. However, nearly one half (41% experienced conditions or symptoms that were not helped by its use. The most prevalent concerns related to its illegality. Participants reported strong support for their use from clinicians and family. There was almost universal interest (89% in participating in a clinical trial of medical cannabis, and strong support (79% for investigating alternative delivery methods. Conclusion Australian medical cannabis users are risking legal ramifications, but consistent with users elsewhere, claim moderate to substantial benefits from its use in the management of their medical condition. In addition to strong public support, medical cannabis users show strong interest in clinical cannabis research, including the investigation of alternative delivery methods.

  8. Sleep paralysis and trauma, psychiatric symptoms and disorders in an adult African American population attending primary medical care.

    Science.gov (United States)

    Mellman, Thomas A; Aigbogun, Notalelomwan; Graves, Ruth Elaine; Lawson, William B; Alim, Tanya N

    2008-01-01

    The occurrence of sleep paralysis (SP) absent narcolepsy appears to not be uncommon in African Americans and probably other non-European groups. Prior research has linked SP to trauma and psychiatric disorders and suggested a specific relationship to panic disorder in African Americans. The objective of our study was to evaluate relationships of SP with trauma, concurrent psychiatric symptoms and lifetime psychiatric diagnoses in an adult African American population recruited from primary care. Cross sectional study with surveys and diagnostic interviews; Patients attending primary care clinics filled out a survey that determined the 6 month prevalence and associated features of SP, a panic disorder screen, the self-rated Hamilton Depression Scale, and an inventory of trauma exposure. A subset of trauma-exposed participants (N = 142) received comprehensive diagnostic interviews that incorporated the Structured Clinical Interview for DSM-IV and the Clinician Assessed PTSD Scale. Four hundred and forty-one adults participated (mean age-40.0 SD = 13.3, 68% female, 95% African American). Fourteen percent endorsed recent SP. In approximately 1/3 of those with SP, episodes also featured panic symptoms. SP was strongly associated with trauma history, and concurrent anxiety and mood symptoms. SP was not associated with specific psychiatric disorders other than lifetime (but not current) alcohol or substance use disorders. Our findings suggest that SP is not uncommon in adult African Americans and is associated with trauma and concurrent distress but not with a specific psychiatric diagnosis.

  9. Does Immediate Pain Relief After an Injection into the Sacroiliac Joint with Anesthetic and Corticosteroid Predict Subsequent Pain Relief?

    Science.gov (United States)

    Schneider, Byron J; Huynh, Lisa; Levin, Josh; Rinkaekan, Pranathip; Kordi, Ramin; Kennedy, David J

    2017-05-17

    To determine if immediate pain response following an injection with local anesthetic and corticosteroid predicts subsequent relief.  Prospective observational cohort.  An institutional review board-approved prospective study from a single academic medical center.  Patients with clinical diagnosis of sacroiliac (SIJ) pain and referred for SIJ injection were enrolled; 1 cc of 2% lidocaine and 1 cc of triamcinolone 40 mg/mL were injected into the SIJ. Pain score on 0-10 numeric rating scale (NRS) during provocation maneuvers was recorded immediately before injection, immediately after injection, and at two and four weeks of follow-up. Oswestry Disability Index (ODI) was also recorded.  Various cutoffs were identified to establish positive anesthetic response and successful outcomes at follow-up. These were used to calculated likelihood ratios. Of those with 100% anesthetic response, six of 11 (54.5%, 95% confidence interval [CI]+/-29.4%, +LR 2.6, 95% CI = 1.1-5.9) demonstrated 50% or greater pain relief at follow-up, and four of 11 (36.5%, 95% CI+/-28.4%, +LR 3.00, 95% CI = 1.4-5.1) had 100% relief at two to four weeks. Fourteen of 14 (100%, 95% CI+/-21.5%, -LR 0.0, 95% CI = 0.0-2.1) with an initial negative block failed to achieve 100% relief at follow-up.  Patients who fail to achieve initial relief after SIJ injection with anesthetic and steroid are very unlikely to achieve significant pain relief at follow-up; negative likelihood ratios (LR) in this study, based on how success is defined, range between 0 and 0.9. Clinically significant positive likelihood ratios of anesthetic response to SIJ injection are more limited and less robust, but are valuable in predicting 50% relief or 100% relief at two to four weeks.

  10. Increased population use of medications for male lower urinary tract symptoms/benign prostatic hyperplasia correlates with changes in indications for transurethral resection of the prostate.

    Science.gov (United States)

    Ingimarsson, Johann P; Isaksson, Helgi J; Sigbjarnarson, Hermann P; Gudmundsson, Jens; Geirsson, Gudmundur

    2014-02-01

    The aim of this study was to determine whether there are correlations between medication use for lower urinary tract symptoms/benign prostate hypertrophy (LUTS/BPH) and alteration in incidence and indications for transurethral resection of the prostate (TURP). The number of TURP patients between 1984 and 2008 in Iceland was obtained from hospital registries. The number of defined daily doses (DDDs) of 5-alpha-reductase inhibitors (5aRIs) and alpha-blockers (ABs) sold was obtained from the Icelandic Medicines Control Agency. Charts of all surgical BPH patients in Iceland from 1998 to 2008 were retrospectively reviewed. The main outcomes measures were: DDDs sold of 5aRIs and ABs, total numbers of TURP, indications for TURP and complications. After the introduction of ABs and 5aRIs, sales increased annually at a near linear rate. TURP rates peaked in 1992, then declined. In 2008, 81 and 3.4 of 1000 men over the age of 50 used LUTS/BPH medications or underwent TURP, respectively. There was an inverse correlation between LUTS/BPH medication use and (i) overall TURP (R(2) = 0.85), (ii) TURP done for absolute indications (R(2) = 0.91), and (iii) LUTS with (R(2) = 0.77) and (iv) without previous medical therapy (R(2) = 0.75). As medication use rose, fewer TURPs were performed for previous history of urinary retention, and more for recurrent urinary tract infections. Increased use of ABs and 5aRIs in the Icelandic population correlated with decreasing incidences of TURP procedures for both LUTS and absolute indications. The sequelae of BPH and indications for TURP are changing as medication use increases, although a clear causative link is hard to establish.

  11. Subjective memory complaints of Chinese HIV-infected patients in Hong Kong: relationships with social support, depressive mood and medical symptoms.

    Science.gov (United States)

    Chan, I; Chan, E; Au, A; Leung, P; Li, P; Lee, M P; Chung, R; Yu, P

    2007-10-01

    The present study aimed at investigating the contribution of social support, depressive mood, medical symptoms and objective memory performance to the subjective memory complaints of Chinese HIV-infected persons in Hong Kong. Ninety HIV-infected persons were administered the Hong Kong List Learning Test (HKLLT) as an objective measure of memory. They also reported their subjective memory complaints, HIV-related medical symptoms, depressive mood and perceived social support by self-administered questionnaires. Path analyses were conducted to evaluate models that depicted the relationships among the variables. The final model that showed the best fit to the data suggested that objective memory performance had no significant role to play in patients' subjective memory complaints. Depressive mood was found to be a significant factor that directly affected patient's subjective memory complaints and social support played an indirect role with depressive mood as a mediating variable. These findings suggest that memory complaints might be an indicator of mood disturbance and social support might be useful in ameliorating depressive mood and these complaints. The need of assessment of other cognitive functions in future research is also discussed.

  12. Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma

    Directory of Open Access Journals (Sweden)

    Paul Schutzmeier

    2016-12-01

    Full Text Available Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values. Eight hundred and sixty-five (865 urine samples were collected and analysed for their mercury content, using cold vapor atom absorption spectroscopy. The prevalence of high mercury values (>25 μg/L was estimated. Forty-four (44 miners with mercury levels >15 μg/L filled in a questionnaire for characteristics and possible confounders, and were examined for intoxication symptoms to establish the ten points medical score sum. The median urine value was 1.8 μg/L; 78.3% of miners were below 7 μg/L and were not at risk of an intoxication, whereas 5.9% of miners exceeded the limit of 25 μg/L and were probable to experience intoxication symptoms. The medical score sum had a range of 2 to 8 points with a median of 6. The low prevalence of high mercury concentrations shows that the politics and techniques to eliminate the use of mercury are being successfully implemented. Further studies are needed to identify factors enabling this process.

  13. Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma.

    Science.gov (United States)

    Schutzmeier, Paul; Berger, Ursula; Bose-O'Reilly, Stephan

    2016-12-30

    Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values. Eight hundred and sixty-five (865) urine samples were collected and analysed for their mercury content, using cold vapor atom absorption spectroscopy. The prevalence of high mercury values (>25 μg/L) was estimated. Forty-four (44) miners with mercury levels >15 μg/L filled in a questionnaire for characteristics and possible confounders, and were examined for intoxication symptoms to establish the ten points medical score sum. The median urine value was 1.8 μg/L; 78.3% of miners were below 7 μg/L and were not at risk of an intoxication, whereas 5.9% of miners exceeded the limit of 25 μg/L and were probable to experience intoxication symptoms. The medical score sum had a range of 2 to 8 points with a median of 6. The low prevalence of high mercury concentrations shows that the politics and techniques to eliminate the use of mercury are being successfully implemented. Further studies are needed to identify factors enabling this process.

  14. Retrospective comparison of cognitive behavioral therapy and symptom-specific medication to treat anxiety and depression in throat cancer patients after laryngectomy.

    Science.gov (United States)

    Chen, Jing; Chen, Chuancheng; Zhi, Shengli

    2014-04-01

    Laryngectomy, a common treatment for laryngeal cancer, is a disabling operation that can induce tremendous stress, but little is known about how to alleviate the psychological effects of the operation. Compare the effectiveness of cognitive behavioral therapy (CBT) and medication in treating anxiety and depression among throat cancer patients after laryngectomy. Review of medical records of the psychological outpatient clinic in the Third People's Hospital of Huzhou City between March 2009 and May 2013 identified 63 patients with post-laryngectomy depression or anxiety disorders who received 8 weeks of one-on-one treatment with CBT (in which patients responded in writing because they were unable to speak) and 56 patients who received 8 weeks of treatment with buspirone (n=11), sertraline (n=9) or both busipirone and sertraline (n=36). The treatment provided (CBT or medications) was based on the stated preference of the patient. The Zung Self-rating Anxiety Scale (SAS) and the Zung Self-rating Depression Scale (SDS) were administered before and after treatment. After 8 weeks of treatment the mean SAS and SDS scores had decreased significantly in both groups and the prevalence of clinically significant anxiety and depression (based on SAS and SDS cutoff scores) had dropped dramatically. There were, however, no significant differences between the two treatment methods. In the medication group 32% of participants experienced one or more adverse reactions during treatment, but none of these were severe enough to require withdrawal from treatment. CBT is an effective, short-term treatment for reducing the anxiety and depressive symptoms that often occur after an individual is diagnosed with cancer or treated for cancer. There is robust evidence that treatment of these psychological symptoms can improve both the quality of life and course of illness in cancer patients, so oncologists and other clinicians need to regularly screen patients with cancer and other chronic life

  15. The Relationship Between Symptoms of Eating Disorders and Worry About Body Image, Attachment Styles, and Cognitive Emotion Regulation Strategies Among Students of Ahvaz Jundishapur University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Davodi

    2016-02-01

    Full Text Available Background There are different assumptions about the factors responsible for the genesis and maintenance of eating disorders. Each of the two main types of eating disorders results from a complex interaction of emotional and psychological factors. Objectives The purpose of the current research was to study the relationship between symptoms of eating disorders and worry about body image, attachment styles, and cognitive emotion regulation strategies, among a sample of students at Ahvaz Jundishapur University. Materials and Methods The study sample consisted of students of Ahvaz Jundishapur University of Medical Sciences, 2011 - 2012. The research participants were selected with use of multistage random sample from various colleges. Our research tools were the eating attitudes questionnaire (EAT-26, the Worry about body image questionnaire, the attachment styles questionnaire, and a questionnaire on cognitive emotion regulation strategies. Pearson correlation and stepwise regression methods, with inter and stepwise methods, were used during data analysis. Results The results of this research indicated that worry about body image, an avoidant attachment style, negative cognitive emotion regulation strategies, and secure attachment style in regression equation remained significant (P < 0.0001. Results also showed that worry about body image, an anxious attachment style, an avoidant attachment style, and negative cognitive emotion regulation strategies were significant in the regression equation, predicting 19% of the variance in the eating disorder symptoms. Conclusions Concerns about body image, an avoidant attachment style, and cognitive strategies to regulate negative emotions were the strongest predictors for eating disorder symptoms. Based on current research findings, an avoidance attachment style, concerns about body image, and negative emotion regulation cognitive strategies increase eating disorder symptoms in students. Because attachment

  16. The Influence of Medical Evaluation Board Status on Symptom Reporting Among Service Members with Traumatic Brain Injury

    Science.gov (United States)

    2017-04-21

    the 59th Clinical Research Division may pay for your basic journal publishing charges (to include costs for tables and black and white photos). We...Graduate Health Sciences Education (GHSE) (SGS O&M); SGS R&D; Tri-Service Nursing Research Program (TSNRP); Defense Medical Research & Development...This should be accomplished no later than 30 days before fina l clearance Is required to publish/present your materials. If you have any questions or

  17. Roller-coaster Ride to, Relief From TMJ | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... is to treat. She went from taking the pain killer Motrin, at the beginning of her problems, through four years of mouth splints (day and night), heat therapy, and craniofacial massage, physical therapy, prescription medications, stress relief, and ...

  18. Pressure relief valve/safety relief valve testing

    Energy Technology Data Exchange (ETDEWEB)

    Murray, W.A.; Hamm, E.R.; Barber, J.R.

    1994-02-01

    Pressure vessels and piping systems are protected form overpressurization by pressure relief valves. These safety features are required to be tested-inspected on some periodic basis and, in most cases witnessed by a third party inspector. As a result nonconformances found by third parties Westinghouse Hanford Company initiated a task team to develop a pressure safety program. This paper reveals their findings.

  19. Medical yoga: Another way of being in the world—A phenomenological study from the perspective of persons suffering from stress-related symptoms

    Directory of Open Access Journals (Sweden)

    Agneta Anderzén-Carlsson

    2014-01-01

    Full Text Available The prevalence of stress-related illness has grown in recent years. Many of these patients seek help in primary health care. Yoga can reduce stress and thus complements pharmacological therapy in medical practice. To our knowledge, no studies have investigated patients’ experiences of yoga treatment in a primary health care setting or, specifically, the experiences of yoga when suffering from stress-related illness. Thus, the aim of the present study was to explore the meaning of participating in medical yoga as a complementary treatment for stress-related symptoms and diagnosis in a primary health care setting. This study has a descriptive phenomenological design and took place at a primary health care centre in Sweden during 2011. Five women and one man (43–51 years participated. They were recruited from the intervention group (n=18 in a randomized control trial, in which they had participated in a medical yoga group in addition to standard care for 12 weeks. Data were collected by means of qualitative interviews, and a phenomenological data analysis was conducted. The essential meaning of the medical yoga experience was that the medical yoga was not an endpoint of recovery but the start of a process towards an increased sense of wholeness. It was described as a way of alleviating suffering, and it provided the participants with a tool for dealing with their stress and current situation on a practical level. It led to greater self-awareness and self-esteem, which in turn had an implicit impact on their lifeworld. In phenomenological terms, this can be summarized as Another way of being in the world, encompassing a perception of deepened identity. From a philosophical perspective, due to using the body in a new way (yoga, the participants had learnt to see things differently, which enriched and recast their perception of themselves and their lives.

  20. Medical yoga: another way of being in the world-a phenomenological study from the perspective of persons suffering from stress-related symptoms.

    Science.gov (United States)

    Anderzén-Carlsson, Agneta; Persson Lundholm, Ulla; Köhn, Monica; Westerdahl, Elisabeth

    2014-01-01

    The prevalence of stress-related illness has grown in recent years. Many of these patients seek help in primary health care. Yoga can reduce stress and thus complements pharmacological therapy in medical practice. To our knowledge, no studies have investigated patients' experiences of yoga treatment in a primary health care setting or, specifically, the experiences of yoga when suffering from stress-related illness. Thus, the aim of the present study was to explore the meaning of participating in medical yoga as a complementary treatment for stress-related symptoms and diagnosis in a primary health care setting. This study has a descriptive phenomenological design and took place at a primary health care centre in Sweden during 2011. Five women and one man (43-51 years) participated. They were recruited from the intervention group (n=18) in a randomized control trial, in which they had participated in a medical yoga group in addition to standard care for 12 weeks. Data were collected by means of qualitative interviews, and a phenomenological data analysis was conducted. The essential meaning of the medical yoga experience was that the medical yoga was not an endpoint of recovery but the start of a process towards an increased sense of wholeness. It was described as a way of alleviating suffering, and it provided the participants with a tool for dealing with their stress and current situation on a practical level. It led to greater self-awareness and self-esteem, which in turn had an implicit impact on their lifeworld. In phenomenological terms, this can be summarized as Another way of being in the world, encompassing a perception of deepened identity. From a philosophical perspective, due to using the body in a new way (yoga), the participants had learnt to see things differently, which enriched and recast their perception of themselves and their lives.

  1. Sintomas depressivos entre internos de medicina em uma universidade pública brasileira Depressive symptoms among medical intern students in a Brazilian public university

    Directory of Open Access Journals (Sweden)

    Edméa Fontes de Oliva Costa

    2012-02-01

    Full Text Available OBJETIVO: Estimar entre internos de medicina a prevalência de sintomas depressivos e sua intensidade, além dos fatores associados. MÉTODOS: Estudo transversal, em maio de 2008, com amostra representativa dos internos de medicina (n = 84 da Universidade Federal de Sergipe (UFS. Foram utilizados o Inventário de Depressão de Beck (IDB e um questionário estruturado contendo informações sobre variáveis sociodemográficas, processo ensino-aprendizagem e aspectos pessoais. A análise exploratória dos dados foi realizada através de Estatística Descritiva e Inferencial. Finalmente foi realizada a análise de múltiplas variáveis através de regressão logística e cálculo das OR simples e ajustadas com seus respectivos intervalos de 95% de confiança. RESULTADOS: A prevalência geral foi de 40,5%, dos quais: 1,2% (IC 95% 0,0-6,5 foram de sintomas depressivos graves; 4,8% (IC 95% 1,3-11,7 de moderados; e 34,5% de leves (IC 95% 24,5-45,7. A regressão logística revelou as variáveis de maior impacto associadas ao aparecimento de sintomas depressivos: pensamento de abandonar o curso (OR 6,24; p = 0,002; tensão emocional (OR 7,43; p = 0,0004; e desempenho acadêmico regular (OR 4,74; p = 0,0001. CONCLUSÃO: A elevada prevalência de sintomas depressivos na população estudada esteve associada com variáveis relacionadas ao processo ensino-aprendizagem e aspectos pessoais, sugerindo a necessidade de medidas preventivas imediatas referentes à formação médica e à assistência ao estudante.OBJECTIVE: To estimate, among Medical School intern students, the prevalence of depressive symptoms and their severity, as well as associated factors. METHODS: Cross-sectional study in May 2008, with a representative sample of medical intern students (n = 84 from Universidade Federal de Sergipe (UFS. Beck Depression Inventory (BDI and a structured questionnaire containing informationon sociodemographic variables, teaching-learning process, and personal

  2. Attachment, symptom severity, and depression in medically unexplained musculoskeletal pain and osteoarthritis: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Corinna Schroeter

    Full Text Available Attachment insecurity relates to the onset and course of chronic pain via dysfunctional reactions to pain. However, few studies have investigated the proportion of insecure attachment styles in different pain conditions, and results regarding associations between attachment, pain severity, and disability in chronic pain are inconsistent. This study aims to clarify the relationships between insecure attachment and occurrence or severity of chronic pain with and without clearly defined organic cause. To detect potential differences in the importance of global and romantic attachment representations, we included both concepts in our study.85 patients with medically unexplained musculoskeletal pain (UMP and 89 patients with joint pain from osteoarthritis (OA completed self-report measures of global and romantic attachment, pain intensity, physical functioning, and depression.Patients reporting global insecure attachment representations were more likely to suffer from medically unexplained musculoskeletal pain (OR 3.4, compared to securely attached patients. Romantic attachment did not differ between pain conditions. Pain intensity was associated with romantic attachment anxiety, and this relationship was more pronounced in the OA group compared to the UMP group. Both global and romantic attachment anxiety predicted depression, accounting for 15% and 17% of the variance, respectively. Disability was independent from attachment patterns.Our results indicate that global insecure attachment is associated with the experience of medically unexplained musculoskeletal pain, but not with osteoarthritis. In contrast, insecure attachment patterns seem to be linked to pain intensity and pain-related depression in unexplained musculoskeletal pain and in osteoarthritis. These findings suggest that relationship-informed focused treatment strategies may alleviate pain severity and psychological distress in chronic pain independent of underlying pathology.

  3. Get Smart: Know When Antibiotics Work - Symptom Relief

    Science.gov (United States)

    ... Submit Search The CDC Get Smart: Know When Antibiotics Work Note: Javascript is disabled or is not ... What Everyone Should Know What You Can Do Antibiotic Resistance Q&As Fast Facts Antibiotics Quiz Glossary ...

  4. Fraktalnist deformational relief polycrystalline aluminum

    Directory of Open Access Journals (Sweden)

    М.В. Карускевич

    2006-02-01

    Full Text Available  The possibility of the fractal geometry method application for the analisys of surface deformation structures under cyclic loading is presented.It is shown, that deformation relief of the alclad aluminium alloyes meets the criteria of the fractality. For the fractal demention estimation the method of  “box-counting”can be applied.

  5. Stress relief of transition zones

    Energy Technology Data Exchange (ETDEWEB)

    Woodward, J.; van Rooyen, D.

    1984-01-01

    This paper considers the problem of intergranular stress corrosion cracking, initiated on the primary side, in the expansion transition region of roller expanded Alloy 600 tubing. In general it is believed that residual stresses, arising from the expansion process, are the cause of the problem. The work reported here concentrated on the identification of an optimal, in-situ stress relief treatment.

  6. Digital relief generation from 3D models

    Science.gov (United States)

    Wang, Meili; Sun, Yu; Zhang, Hongming; Qian, Kun; Chang, Jian; He, Dongjian

    2016-09-01

    It is difficult to extend image-based relief generation to high-relief generation, as the images contain insufficient height information. To generate reliefs from three-dimensional (3D) models, it is necessary to extract the height fields from the model, but this can only generate bas-reliefs. To overcome this problem, an efficient method is proposed to generate bas-reliefs and high-reliefs directly from 3D meshes. To produce relief features that are visually appropriate, the 3D meshes are first scaled. 3D unsharp masking is used to enhance the visual features in the 3D mesh, and average smoothing and Laplacian smoothing are implemented to achieve better smoothing results. A nonlinear variable scaling scheme is then employed to generate the final bas-reliefs and high-reliefs. Using the proposed method, relief models can be generated from arbitrary viewing positions with different gestures and combinations of multiple 3D models. The generated relief models can be printed by 3D printers. The proposed method provides a means of generating both high-reliefs and bas-reliefs in an efficient and effective way under the appropriate scaling factors.

  7. A disaster relief exercise

    Science.gov (United States)

    Quagliotti, Fulvia; Novaro Mascarello, Laura

    2016-04-01

    The Remotely Piloted Aircraft Systems (RPAS) is an effective tool for military applications, both for properly military operations, such as research missions and road surveillance, and for civilian support after natural disasters, like landslides, floods, and earthquakes, when reaching victims is often hard or it would take too much time for their survival. Information are needed without hazarding the life of the military troops. When roads, bridges and other communication ways are usually not available, the unmanned platform is the only easy and fast way to contact people. It can be launched directly from the operation site and it could take crucial information or carry medication, necessaries and everything that could help rescue teams. The unmanned platform can also be used for the first aid in an emergency situation when the use of a helicopter is too dangerous and other troops could be involved in heavy fighting. The RPAS has some advantages. First is the reduced cost, compared to traditional aircraft, that could enable the user to have several operating units. Secondly, pilots are not on board and therefore, if needed, the crew' rotation and rest do not imply the need to stop operations. The third fact is that, depending on the type of delivery that is used, the operations may take place on a twenty-four hours' base. The main benefit achieved with these three facts is that continuous operation may take place and eventually make up the capacity difference. To sum up, the main motivation behind this employment of UAS is to replace human lives on the cockpits and to assure the execution of Dangerous, Dull and Dirty missions. In May 2015, the ERIDANO Exercise was performed in Moncalieri city, near Turin (Italy) and it was a joint exercise between the Italian Army, National Emergency Service and Politecnico of Turin. The aim was the control and management of emergency situations due to natural disasters. In particular, a flood was simulated. A multicopter was used

  8. Young child with severe brain volume loss easily passes the word memory test and medical symptom validity test: implications for mild TBI.

    Science.gov (United States)

    Carone, Dominic A

    2014-01-01

    The Word Memory Test (WMT) and Medical Symptom Validity Test (MSVT) are two commonly used free-standing measures of test-taking effort. The use of any test as a measure of effort is enhanced when evidence shows that it can be easily passed by patients with severe neurological conditions. The opportunity arose to administer the WMT and MSVT to a 9-year-old girl (referred to as CJ) with severe congenital bilateral brain tissue loss (shown via a compelling brain MRI image), chronic epilepsy, an extremely low Full Scale IQ, extremely low adaptive functioning, developmental delays, numerous severe cognitive impairments, and treatment with multiple high-dose benzodiazepines. She received extensive early intervention services and numerous academic accommodations. Despite this set of problems, CJ passed the WMT and MSVT at perfect to near perfect levels. Implications for failure on these tests among patients with known or alleged mild traumatic brain injury are discussed.

  9. The Team Approach to Pain Relief

    Science.gov (United States)

    ... Issue Past Issues The Team Approach to Pain Relief Past Issues / Fall 2007 Table of Contents For ... with her quality of life, and acupuncture brought relief from severe shoulder pain. "I'm functional again. ...

  10. The impact of expired and empty quick-relief asthma inhalers: The Asthma and Allergy Foundation of America's Asthma Inhaler Design Survey.

    Science.gov (United States)

    Storms, William W; Tringale, Mike; Ferro, Thomas J

    2015-01-01

    Despite the available treatments, asthma remains a serious illness, with a considerable socioeconomic burden associated with a high number of unscheduled visits to the emergency department (ED). Poor adherence and inadequate inhaler technique are contributing factors to poor asthma management and control. The Asthma Inhaler Design Survey assessed the behaviors, attitudes, needs, and preferences of patients with asthma and their caregivers with regard to quick-relief inhaler usage and device design. The Asthma and Allergy Foundation of America invited 19,157 adult patients and parents of children with asthma to take part in an online survey that focused on previous asthma diagnosis, symptom severity, and quick-relief and controller medication use. Opinions were also collected. Data from 590 respondents (366 adults; 224 children) were included in the final analysis. Relief inhalers were needed and found to be past the expiration date by 284 of 561 (50.6%) and relief inhalers were found to be empty by 270 of 560 (48.2%). Of the empty inhaler group, 28 of 270 (10.4%) had to visit the ED for treatment, 18 of 270 (6.7%) missed work or school for an unscheduled physician office visit, and 54 of 270 (20%) went without treatment. Although 78.5% indicated that they had at least two quick-relief inhalers nearby, these were not always easily accessible. Few respondents (194/578 [33.6%]) indicated that they and/or their child were very confident that they were using their inhaler properly, even though the majority had received some instruction. When asked what they would do to improve satisfaction with their quick-relief inhalers, 173 of 558 (31%) responded that they would add a dose counter. Unnecessary health care utilization and avoidable loss of time at work or school were associated with the lack of full availability of properly functioning quick-relief inhalers when needed. Adding a dose counter was the most frequently cited response for improving satisfaction with quick-relief

  11. VA administrators breahe a sigh of relief

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-06-01

    Full Text Available No abstract available. Article truncated at 150 words. On May 30, Eric Shinseki, the Secretary for Veterans Affairs (VA, resigned under pressure amidst a growing scandal regarding falsification of patient wait times at nearly 40 VA medical centers. Before leaving office Shinseki fired Sharon Helman, the former hospital director at the Phoenix VA, where the story first broke, along with her deputy and another unnamed administrator. In addition, Susan Bowers, director of VA Veterans Integrated Service Network (VISN 18 and Helman’s boss, resigned. Robert Petzel, undersecretary for the Veterans Health Administration (VHA, head of the VA hospitals and clinics, had resigned earlier. You could hear the sigh of relief from the VA administrators. With their bosses resigning left and right, the VA leadership in shambles and the reputation of the VA soiled for many years to come, why are the VA administrators relieved? The simple answer is that nothing has really changed. There for a moment it looked ...

  12. Relief of diabetic neuropathy with fluoxetine.

    Science.gov (United States)

    Theesen, K A; Marsh, W R

    1989-01-01

    A 31-year-old woman with advanced diabetes mellitus with secondary autonomic and peripheral neuropathy was admitted for treatment of major depression. Previous therapy with desipramine resulted in exacerbation of the patient's orthostatic hypotension. After admission to the psychiatric facility she was initially stabilized medically and treated with psychotherapy. Subsequent treatment with low-dose fluoxetine 5 mg resulted in a decrease of the patient's diabetic neuropathy pain. Further increases in the fluoxetine dosage resulted in improvement of her depression and increased pain relief. Therapy with fluoxetine did not result in exacerbation of the orthostatic hypotension. This preliminary case report indicates that fluoxetine may be an alternative to the tricyclic antidepressants and trazodone in the treatment of diabetic peripheral neuropathy.

  13. What is the problem with medically unexplained symptoms for GPs? A meta-synthesis of qualitative studies.

    Science.gov (United States)

    Johansen, May-Lill; Risor, Mette Bech

    2017-04-01

    To gain a deeper understanding of challenges faced by GPs when managing patients with MUS. We used meta-ethnography to synthesize qualitative studies on GPs' perception and management of MUS. The problem with MUS for GPs is the epistemological incongruence between dominant disease models and the reality of meeting patients suffering from persistent illness. GPs have used flexible approaches to manage the situation, yet patients and doctors have had parallel negative experiences of being stuck, untrustworthy and helpless. In the face of cognitive incongruence, GPs have strived to achieve relational congruence with their patients. This has led to parallel positive experiences of mutual trust and validation. With more experience, some GPs seem to overcome the incongruences, and later studies point towards a reframing of the MUS problem. For GPs, the challenge with MUS is most importantly at an epistemological level. Hence, a full reframing of the problem of MUS for GPs (and for patients) implies broad changes in basic medical knowledge and education. Short-term: Improve management of patients with MUS by transferring experience-based, reality-adjusted knowledge from senior GPs to juniors. Long-term: Work towards new models of disease that integrate knowledge from all relevant disciplines. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. 47 CFR 69.727 - Regulatory relief.

    Science.gov (United States)

    2010-10-01

    ... similarly situated customers; and (ii) The price cap LEC excludes all contract tariff offerings from price... customer. (b) Phase II relief. Upon satisfaction of the Phase II triggers specified in §§ 69.709(c) or 69... Pricing Flexibility § 69.727 Regulatory relief. (a) Phase I relief. Upon satisfaction of the Phase I...

  15. 7 CFR 1465.33 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Equitable relief. 1465.33 Section 1465.33 Agriculture... § 1465.33 Equitable relief. (a) If a participant relied upon the advice or action of any authorized NRCS... participant may be eligible for equitable relief under 7 CFR part 635, section 635.3. The financial or...

  16. 28 CFR 36.504 - Relief.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Relief. 36.504 Section 36.504 Judicial... COMMERCIAL FACILITIES Enforcement § 36.504 Relief. (a) Authority of court. In a civil action under § 36.503, the court— (1) May grant any equitable relief that such court considers to be appropriate, including...

  17. 29 CFR 553.225 - Early relief.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Early relief. 553.225 Section 553.225 Labor Regulations... relief. It is a common practice among employees engaged in fire protection activities to relieve employees on the previous shift prior to the scheduled starting time. Such early relief time may occur...

  18. 29 CFR 4041.4 - Disaster relief.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Disaster relief. 4041.4 Section 4041.4 Labor Regulations...-EMPLOYER PLANS General Provisions § 4041.4 Disaster relief. When the President of the United States declares that, under the Disaster Relief Act (42 U.S.C. 5121, 5122(2), 5141(b)), a major disaster exists...

  19. 29 CFR 1614.505 - Interim relief.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Interim relief. 1614.505 Section 1614.505 Labor Regulations... OPPORTUNITY Remedies and Enforcement § 1614.505 Interim relief. (a)(1) When the agency appeals and the case... interim relief. (2) Service under the temporary or conditional restoration provisions of paragraph (a)(1...

  20. 7 CFR 276.5 - Injunctive relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Injunctive relief. 276.5 Section 276.5 Agriculture... Injunctive relief. (a) General. If FNS determines that a State agency has failed to comply with the Food... Secretary may seek injunctive relief against the State agency to require compliance. The Secretary may...

  1. 20 CFR 627.803 - Relief.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Relief. 627.803 Section 627.803 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR GENERAL PROVISIONS GOVERNING PROGRAMS... Relief. In ordering relief, the ALJ shall have the full authority of the Secretary under section 164 of...

  2. 24 CFR 7.44 - Interim relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Interim relief. 7.44 Section 7.44... § 7.44 Interim relief. (a) When the Department appeals and the case involves removal, separation, or... outcome of the Department appeal. The employee may decline the offer of interim relief. (b) Service under...

  3. 7 CFR 1466.33 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Equitable relief. 1466.33 Section 1466.33 Agriculture... Administration § 1466.33 Equitable relief. (a) If a participant relied upon the advice or action of any... relief, to the extent it is deemed desirable by NRCS, to provide a fair and equitable treatment because...

  4. 7 CFR 1470.34 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Equitable relief. 1470.34 Section 1470.34 Agriculture... § 1470.34 Equitable relief. (a) If a participant relied upon the advice or action of NRCS and did not... be eligible for equitable relief under 7 CFR part 635. The financial or technical liability for any...

  5. 12 CFR 268.505 - Interim relief.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Interim relief. 268.505 Section 268.505 Banks... REGARDING EQUAL OPPORTUNITY Remedies and Enforcement § 268.505 Interim relief. (a)(1) When the Board appeals... offer of interim relief. (2) Service under the temporary or conditional restoration provisions of...

  6. 7 CFR 636.20 - Equitable relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Equitable relief. 636.20 Section 636.20 Agriculture... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVES PROGRAM § 636.20 Equitable relief. (a) If a... as meeting program requirements and grant relief because of the good-faith reliance on the part of...

  7. 7 CFR 795.24 - Relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Relief. 795.24 Section 795.24 Agriculture Regulations... PROVISIONS COMMON TO MORE THAN ONE PROGRAM PAYMENT LIMITATION General § 795.24 Relief. If a producer relied... reviewing authority makes a more restrictive determination, the Deputy Administrator may grant relief only...

  8. 32 CFR 516.19 - Injunctive relief.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Injunctive relief. 516.19 Section 516.19 National... RELATIONS LITIGATION Reporting Legal Proceedings to HQDA § 516.19 Injunctive relief. (a) General. Plaintiffs... injunctive relief: (1) Plaintiff's likelihood of success on the merits. (2) Whether plaintiff will be...

  9. 18 CFR 281.215 - Additional relief.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Additional relief. 281... Additional relief. If an interstate pipeline rejects (under § 281.210 or otherwise) a request for... aggrieved by such action may file a request for relief from curtailment under § 385.206 of this chapter. The...

  10. 49 CFR 1108.4 - Relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Relief. 1108.4 Section 1108.4 Transportation Other... TRANSPORTATION BOARD § 1108.4 Relief. (a) Subject to specification in the complaint, as provided in § 1108.7 herein, an Arbitrator may grant the following types of relief: (1) Monetary damages, to the extent...

  11. [Food additives as a cause of medical symptoms: relationship shown between sulfites and asthma and anaphylaxis; results of a literature review].

    Science.gov (United States)

    Reus, K E; Houben, G F; Stam, M; Dubois, A E

    2000-09-16

    To determine if a causal connection exists between food additives and various medical complaints. Literature study. Medline over the period January 1966-January 1999 was searched for articles on the following substances not containing protein and lactose: monosodium glutamate (MSG), sulfites, azo-dyes (tartrazine, sunset yellow, azorubin, amarant, cochineal red), benzoates, sorbates, butylated hydroxyanisole/butylated hydroxytoluene (BHA/BHT), parabens, cinnamon and vanilla, in combination with key words regarding food and side effects. Of those studies purporting to demonstrate an effect, only double-blind randomized placebo-controlled studies with oral challenge were assessed further, unless the complaint was anaphylaxis. Of studies not demonstrating an effect the design was assessed. Only for sulfites as causative agents of asthma and anaphylaxis, methodologically adequate studies demonstrating a causal connection could be found. For azo-dyes, benzoates, MSG, sorbates and BHA/BHT, no link with medical symptoms was demonstrable. For parabens, cinnamon and vanilla there were insufficient or inadequate data to justify a conclusion.

  12. Service Learning Through Disaster Relief

    Directory of Open Access Journals (Sweden)

    Donna J. Duerst

    2010-06-01

    Full Text Available The Rock County 4-H Disaster Relief Committee raised $1,550 to aid tsunami victims in Sri Lanka and then turned its attention to Hurricane Katrina relief efforts. Thirty-one 4-H youth participated in a service learning trip to the South with the objectives of helping hurricane victims, learning about new cultures and achieving personal growth during three days of service projects in Louisiana and Mississippi. Their written reflections and other evaluative measures revealed they learned about southern culture, gained a greater appreciation for their lives, gained self confidence and developed a desire to help others more often. The trip was a valuable developmental experience for the youth, and information from the trip could be utilized to create similar experiences based on service learning. This article provides an overview of the trip and describes the evaluation methods used to measure learning and assess personal growth.

  13. Symptoms of Blood Disorders

    Science.gov (United States)

    ... leg (causing most often swelling, redness, and/or warmth of the leg or shortness of breath) Petechiae ( ... Disorders Symptoms of Blood Disorders Medical History and Physical Examination for Blood Disorders Laboratory Tests for Blood ...

  14. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

    Directory of Open Access Journals (Sweden)

    Fill Malfertheiner Sara

    2012-09-01

    Full Text Available Abstract Background Symptoms of gastro-esophageal reflux disease (GERD in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed. Methods We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3. Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ. Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7 was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy. Results The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%. Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI. Conclusion GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief.

  15. [Reminiscence of the "Relief Houses" that operated in rural Chile between 1931 and 1945].

    Science.gov (United States)

    Laval, Enrique

    2016-06-01

    In June 1929, the medical charity inspectors (Isauro Torres and Enrique Laval M.) submitted to the Direction of the Institution a plan for the normalization of all hospitals, which was approved by the Central Board at its meeting on 19 July of that year. The plan was to phase in the hospital action from the First-aid Posts or "Relief Houses" to the large referral hospitals. The "Relief House" would become the initial phase of hospital organization, located in rural areas. Finally, we emphasize that the Relief Houses were establishments for preventive and curative medicine in rural areas.

  16. [Textual research on Capital's Puji Tang (Relief Houses) in the Qing Dynasty].

    Science.gov (United States)

    Zhang, Lei; Liang, Jun

    2010-05-01

    Puji Tang (Relief Houses) was established in 1706 with the function of helping the poor, comforting and compensating people by medicine, therefore, which was supported by the Emperors of the Qing Dynasty. As a representation of medical relief organization of the Qing Dynasty, Puji Tang was developed from a folk relief organization to a government national organization. Because of the declination of the Qing Empire and the problems within its own organization, Puji Tang changed finally to an organization of reeducation through labor in 1907.

  17. Exercise, Behavioral Therapy Reduce Menopausal Symptoms Caused by Breast Cancer Treatment

    Science.gov (United States)

    Women with breast cancer who were suffering from treatment-related menopausal symptoms experienced symptom relief with cognitive behavioral therapy, physical exercise, or both, according to a Dutch study.

  18. Recognizing Symptoms

    Science.gov (United States)

    ... bowel habits. Learn More About Pain in IBS Symptoms Won’t Stop Everyone suffers from bowel changes ... They can be constant or keep coming back. Symptoms Change Some or all of IBS symptoms can ...

  19. Coordinating Robot Teams for Disaster Relief

    Science.gov (United States)

    2015-05-01

    Coordinating Robot Teams for Disaster Relief Mark Roberts1, Thomas Apker2, Benjamin Johnson1, Bryan Auslander3, Briana Wellman4 & David W...for Humanitarian Assistance / Disaster Relief operations. We demonstrate that the SDP responds to a dynamic, open world while ensuring that vehicles...facilitate such information gathering tasks, freeing humans to perform more critical tasks in Humanitarian Assistance / Disaster Relief (HA/DR

  20. TAILOR - tapered discontinuation versus maintenance therapy of antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder in remission of psychotic symptoms: study protocol for a randomized clinical trial.

    Science.gov (United States)

    Stürup, Anne Emilie; Jensen, Heidi Dorthe; Dolmer, Signe; Birk, Merete; Albert, Nikolai; Nielsen, Mai; Hjorthøj, Carsten; Eplov, Lene; Ebdrup, Bjørn H; Mors, Ole; Nordentoft, Merete

    2017-09-29

    The aim of the TAILOR trial is to investigate the effect of closely monitored tapering/discontinuation versus maintenance therapy with antipsychotic medication in patients with newly diagnosed schizophrenia or persistent delusional disorder and with minimum 3 months' remission of psychotic symptoms. Two hundred and fifty patients will be included from the psychiatric early intervention program, OPUS, in two regions in Denmark. Inclusion criteria are: ICD-10 diagnoses schizophrenia (F20, except F20.6) or persistent delusional disorder (F22), minimum 3 months' remission of psychotic symptoms and in treatment with antipsychotic medication (except clozapine). The patients will be randomized to maintenance therapy or tapering/discontinuation with antipsychotic medication in a 1-year intervention. The tapering/discontinuation group will be using a smartphone application to monitor early warning signs of psychotic relapse. Patients will be assessed at baseline, 1-, 2- and 5-year follow-up regarding psychotic and negative symptoms, side-effects of antipsychotic medication, social functioning, cognitive functioning, perceived health status, patient satisfaction, substance and alcohol use, sexual functioning and quality of life. The primary outcome will be remission of psychotic symptoms and no antipsychotic medication after 1 year. Secondary outcome measures will include: co-occurrence of remission of psychotic symptoms and 0-1-mg haloperidol equivalents of antipsychotic medication after 1-year intervention; antipsychotic dose; antipsychotic side effects; negative symptoms; social functioning; cognitive functioning; and patient satisfaction. Exploratory outcomes will include remission, clinical recovery, substance and alcohol use, sexual functioning, quality of life, self-beliefs of coping and user experience of support from health workers. Safety measures will include death, admissions to psychiatric hospital, severe self-harm and psychotic relapses. The TAILOR trial

  1. Oxycodone combinations for pain relief.

    Science.gov (United States)

    Raffa, R B; Pergolizzi, J V; Segarnick, D J; Tallarida, R J

    2010-06-01

    No single analgesic drug provides the perfect therapeutic/adverse effect profile for every pain condition. In addition to convenience and possibly improved compliance, a combination of analgesic drugs offers the potential, requiring verification, of providing greater pain relief and/or reduced adverse effects than the constituent drugs when used individually. We review here analgesic combinations containing oxycodone. We found surprisingly little preclinical information about the analgesic or adverse effect profiles of the combinations (with acetaminophen, paracetamol, nonsteroidal anti-inflammatory drugs, morphine, gabapentin or pregabalin). Clinical experience and studies suggest that the combinations are safe and effective and may offer certain advantages. As with all combinations, the profile of adverse effects must also be determined in order to provide the clinician with the overall benefit/risk assessment.

  2. Exercise Based- Pain Relief Program

    DEFF Research Database (Denmark)

    Zadeh, Mahdi Hossein

    in the current study was to use exercise induced- muscle damage followed by ECC as an acute pain model and observe its effects on the sensitivity of the nociceptive system and blood supply in healthy subjects. Then, the effect of a repeated bout of the same exercise as a healthy pain relief strategy......Exercise-based pain management programs are suggested for relieving from musculoskeletal pain; however the pain experienced after unaccustomed, especially eccentric exercise (ECC) alters people´s ability to participate in therapeutic exercises. Subsequent muscle pain after ECC has been shown...... to cause localized pressure pain and hyperalgesia. A prior bout of ECC has been repeatedly reported to produce a protective adaptation known as repeated bout effect (RBE). One of the main scopes of the current project was to investigate the adaptations by which the RBE can be resulted from. The approach...

  3. Pain relief can be painful

    Directory of Open Access Journals (Sweden)

    Ashish Bindra

    2015-01-01

    Full Text Available Mandibular nerve block is periodically used procedure used to treat neuralgic pain in the distribution of trigeminal nerve. It is a commonly performed block in outpatient settings at our institute. We present a case of an elderly edentulous patient with trigeminal neuralgia who suffered recurrent temporomandibular joint (TMJ dislocation following mandibular nerve block. The patient presented with complaints of severe pain, inability to close mouth, and eat food since 2 days. Anterior closed reduction of TMJ resulted in reduction of joint and immediate pain relief. However, the maneuver failed due to recurrent dislocation of the joint. A Barton dressing was applied to prevent another dislocation. This was followed by autologous blood injection into the joint. This case focuses on the preponderance of clinical evaluation and accentuates the need for additional forethought to be taken during pain procedures, particularly in the geriatric population.

  4. Symptomatic relief precedes improvement of myocardial blood flow in patients under spinal cord stimulation

    Directory of Open Access Journals (Sweden)

    Koulousakis Athanassios

    2005-05-01

    Full Text Available Abstract Background Spinal cord electrical stimulation (SCS has shown to be a treatment option for patients suffering from angina pectoris CCS III-IV although being on optimal medication and not suitable for conventional treatment strategies, e.g. CABG or PTCA. Although many studies demonstrated a clear symptomatic relief under SCS therapy, there are only a few short-term studies that investigated alterations in cardiac ischemia. Therefore doubts remain whether SCS has a direct effect on myocardial perfusion. Methods A prospective study to investigate the short- and long-term effect of spinal cord stimulation (SCS on myocardial ischemia in patients with refractory angina pectoris and coronary multivessel disease was designed. Myocardial ischemia was measured by MIBI-SPECT scintigraphy 3 months and 12 months after the beginning of neurostimulation. To further examine the relation between cardiac perfusion and functional status of the patients we measured exercise capacity (bicycle ergometry and 6-minute walk test, symptoms and quality of life (Seattle Angina Questionnaire [SAQ], as well. Results 31 patients (65 ± 11 SEM years; 25 male, 6 female were included into the study. The average consumption of short acting nitrates (SAN decreased rapidly from 12 ± 1.6 times to 3 ± 1 times per week. The walking distance and the maximum workload increased from 143 ± 22 to 225 ± 24 meters and 68 ± 7 to 96 ± 12 watt after 3 months. Quality of life increased (SAQ significantly after 3 month compared to baseline, as well. No further improvement was observed after one year of treament. Despite the symptomatic relief and the improvement in maximal workload computer based analysis (Emory Cardiac Toolbox of the MIBI-SPECT studies after 3 months of treatment did not show significant alterations of myocardial ischemia compared to baseline (16 patients idem, 7 with increase and 6 with decrease of ischemia, 2 patients dropped out during initial test phase

  5. The Relaxation Exercise and Social Support Trial (RESST: a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

    Directory of Open Access Journals (Sweden)

    Kobeissi Loulou

    2012-11-01

    Full Text Available Abstract Background Symptoms such as medically unexplained vaginal discharge (MUVD are common and bothersome, leading to potentially unnecessary use of resources. Methods A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs, through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25. Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used. Results Of 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI -31%, 0%, p=0.067. Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95% CI -4.9%, 0.0%, p=0.049. While there was also marginal evidence of a beneficial effect on anxiety, there was

  6. Inexpensive tamper proof safety relief valve

    Science.gov (United States)

    Frankewich, P. A.

    1970-01-01

    Basic relief valve has added safety relief valve capability that relieves overpressure before failure can occur. It may be installed in inaccesible areas with a high degree of reliability, constructed from a variety of materials, and adapted to the user's specific application.

  7. 44 CFR 68.12 - Relief.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Relief. 68.12 Section 68.12 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY... Relief. The final determination may be appealed by the appellant(s) to the United States district court...

  8. 24 CFR 220.753 - Forbearance relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Forbearance relief. 220.753 Section 220.753 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... and Obligations-Projects Project Mortgage Insurance § 220.753 Forbearance relief. (a) In a case where...

  9. 47 CFR 1.6009 - Relief.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Relief. 1.6009 Section 1.6009 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Implementation of Section 325(e) of the... Carriers for Retransmission Without Consent § 1.6009 Relief. If the Commission determines that a satellite...

  10. 24 CFR 236.255 - Forbearance relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Forbearance relief. 236.255 Section 236.255 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... Insurance § 236.255 Forbearance relief. (a) In a case where the mortgage is in default, the mortgagor and...

  11. 24 CFR 221.761 - Forbearance relief.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Forbearance relief. 221.761 Section 221.761 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... § 221.761 Forbearance relief. (a) In a case where the mortgage is in default, the mortgagor and the...

  12. Distraction methods for pain relief of cancer children submitted to painful procedures: systematic review

    OpenAIRE

    Ferreira, Elaine Barros; Cruz,Flávia Oliveira de Almeida Marques da; Silveira,Renata Cristina de Campos Pereira; Reis,Paula Elaine Diniz dos

    2015-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the most persistent cancer symptoms. Non-pharmacological therapies are potential sources for cancer children care and should be considered alternatives for handling cancer signs and symptoms. This study aimed at identifying effective distraction interventions for pain relief and control of cancer children submitted to invasive procedures. CONTENTS: This is a systematic review carried out in electronic databases LILACS, CINAHL, CENTRAL Cochran...

  13. Menopausal symptoms

    OpenAIRE

    Rymer, Janice; Morris, Edward P.

    2011-01-01

    In the UK, the median age for onset of menopausal symptoms is 45.5 to 47.5 years. Symptoms associated with the menopause include vasomotor symptoms, sleeplessness, mood changes, reduced energy levels, loss of libido, vaginal dryness, and urinary symptoms.Many symptoms, such as hot flushes, are temporary, but those resulting from reduced hormone levels, such as genital atrophy, may be permanent.

  14. Creating computable algorithms for symptom management in an outpatient thoracic oncology setting.

    Science.gov (United States)

    Cooley, Mary E; Lobach, David F; Johns, Ellis; Halpenny, Barbara; Saunders, Toni-Ann; Del Fiol, Guilherme; Rabin, Michael S; Calarese, Pamela; Berenbaum, Isidore L; Zaner, Ken; Finn, Kathleen; Berry, Donna L; Abrahm, Janet L

    2013-12-01

    Adequate symptom management is essential to ensure quality cancer care, but symptom management is not always evidence based. Adapting and automating national guidelines for use at the point of care may enhance use by clinicians. This article reports on a process of adapting research evidence for use in a clinical decision support system that provided individualized symptom management recommendations to clinicians at the point of care. Using a modified ADAPTE process, panels of local experts adapted national guidelines and integrated research evidence to create computable algorithms with explicit recommendations for management of the most common symptoms (pain, fatigue, dyspnea, depression, and anxiety) associated with lung cancer. Small multidisciplinary groups and a consensus panel, using a nominal group technique, modified and subsequently approved computable algorithms for fatigue, dyspnea, moderate pain, severe pain, depression, and anxiety. The approved algorithms represented the consensus of multidisciplinary clinicians on pharmacological and behavioral interventions tailored to the patient's age, comorbidities, laboratory values, current medications, and patient-reported symptom severity. Algorithms also were reconciled with one another to enable simultaneous management of several symptoms. A modified ADAPTE process and nominal group technique enabled the development and approval of locally adapted computable algorithms for individualized symptom management in patients with lung cancer. The process was more complex and required more time and resources than initially anticipated, but it resulted in computable algorithms that represented the consensus of many experts. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  15. Disaster relief in post-earthquake Haiti: unintended consequences of humanitarian volunteerism.

    Science.gov (United States)

    Jobe, Kathleen

    2011-01-01

    This article provides an overview of US humanitarian relief efforts in Haiti following the earthquake on January 12, 2010. Humanitarian aid arrived rapidly from many sources and was largely provided by organized and skilled humanitarian volunteers. There are however multiple impacts on the existing health care systems, as well as the pharmaceutical and medical supply chain created by massive relief efforts involving personnel, medicines, supplies and equipment that should be considered even in the immediate post-disaster period. Additionally the consequences of short-term medical missions by secular and non-secular NGOs should be considered carefully both in the post-disaster period and as ongoing support to underserved populations.

  16. 医护人员抑郁症状与职业紧张的关系研究%The Study of the Relationship between Depressive Symptoms and Occupational Stress of the Medical Staff

    Institute of Scientific and Technical Information of China (English)

    文凯; 洪文刚

    2015-01-01

    目的:研究医护人员抑郁症状与职业紧张的关系。方法:采用调查问卷分析758例医护人员在性别、年龄、婚姻状况、教育程度、职务、夜班情况、每周工作时间、福利待遇满意度及医患关系等方面的差异性,采用Logistic回归分析医护人员抑郁症状与职业紧张之间的关系。结果:758例医护人员中共有422例出现抑郁症状,抑郁症状检出率为55.67%,经单因素分析,医护人员在年龄、婚姻状况、职务、夜班情况、每周工作时间、福利待遇满意度及医患关系等方面比较差异有统计学意义(P<0.05);经Logistic回归分析,高付出-高回报、低付出-低回报、高付出-低回报均与抑郁症状均具有密切相关性,差异有统计学意义(P<0.05),且紧张程度越高,对抑郁症状的释放率越大。结论:医护人员抑郁症状与职业紧张之间存在着紧密联系,制订有效防治措施可明显降低医护人员精神抑郁症状的发生率,提高医疗工作效率和减少医疗纠纷事件的发生例数。%Objective: To study the relationship of between depressive symptoms and occupational stress of the medical staff.Method: The differences of the gender, age, marital status, education level, job, night shift situation, weekly working hours, welfare satisfaction and doctor-patient relationship of 758 cases of medical staff were compared by questionnaire analysis. The relationship of medical staff between depressive symptoms and occupational stress was analyzed by Logistic regression analysis.Result:422 cases among the 758 cases of medical staff showed depressive symptoms, and the detection rate of depressive symptoms was 55.67%. There were significant differences in medical staff among the age, marital status, position, the night shift, weekly working hours, welfare satisfaction and doctor-patient relationship by the single factor analysis, the differences were statistically

  17. Anthrax: Symptoms

    Science.gov (United States)

    ... EID Journal Articles Anthrax-Related MMWRs Medscape Commentaries Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet ... cause severe illness and even death. Cutaneous anthrax symptoms can include: A group of small blisters or ...

  18. Gynecological management of premenstrual symptoms.

    Science.gov (United States)

    Shulman, Lee P

    2010-10-01

    The vast majority of menstruating women experience uncomfortable symptoms during the premenstrual phase of their menstrual cycles. Although many women do not require specific treatment of their symptoms, approximately 20% to 50% report moderate to severe premenstrual symptoms and about 5% meet the diagnostic criteria for premenstrual dysphoric disorder, the most severe manifestation of premenstrual symptoms. While the etiology of premenstrual symptoms remains unclear, several theories have implicated sex steroids and neurotransmitters in the development and manifestation of symptoms. Further complicating the delineation of etiology is that premenstrual symptoms can be somatic, psychological, or behavioral, as well as a combination of all three. Developing successful interventions for premenstrual symptoms has thus been challenging, with interventions focused on a particular aspect of premenstrual symptomatology. Treatments for premenstrual symptoms include lifestyle changes, cognitive behavioral therapies, and pharmacologic agents including ovulation suppression regimens, antidepressant medications, and anxiolytics.

  19. Musculoskeletal symptoms among electricians.

    Science.gov (United States)

    Hunting, K L; Welch, L S; Cuccherini, B A; Seiger, L A

    1994-02-01

    This study ascertained the presence of musculoskeletal symptoms among electricians, in order to evaluate the prevalence of cumulative trauma disorders (CTD) in this population. We adapted the CTD surveillance questionnaire used by National Institute for Occupational Safety and Health (NIOSH) to assess the prevalence of neck, shoulder, elbow, hand/wrist, back, and knee symptoms in the year prior to the survey. Questionnaires were completed by 308 apprentices and journeymen enrolled in training classes at the local union hall. The participants were relatively young individuals, and 86% of the participants were currently working as electricians. Participants reported a high prevalence of symptoms which occurred more than three times during the past year or which lasted more than 1 week. Back symptoms and hand/wrist symptoms were experienced most frequently, by about half the population, while elbow symptoms were reported by only 15% of participants. Symptom prevalence was lower, but still notable, when defined as symptoms which had occurred at least once a month or lasted more than a week in the past year. Eighty-two percent of participants reported at least one musculoskeletal symptom using the most inclusive definition, while 57% reported two or more symptoms. This survey highlights that: 1) low back discomfort is common in young construction workers, and resulted in medical care, missed work, or light duty for almost 35% of the participants; 2) neck discomfort is also very common and required doctor visits or work modification for almost one quarter of the participants; 3) these construction workers continued to work with symptoms that are classifiable as a CTD; and 4) history of injury is correlated with the subsequent prevalence of musculoskeletal symptoms.

  20. Shaded Relief of Minnesota Elevation - Color

    Data.gov (United States)

    Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

  1. Lake Bathymetric DEM Shaded Relief Image

    Data.gov (United States)

    Minnesota Department of Natural Resources — Geo-referenced, shaded relief image of lake bathymetry classified at 5-foot depth intervals. This dataset has a cell resolution of 5 meters (occasionally 10m) as...

  2. Non-Drug Pain Relief: Imagery

    Science.gov (United States)

    PATIENT EDUCATION patienteducation.osumc.edu Non-Drug Pain Relief: Imagery Relaxation helps lessen tension. One way to help decrease pain is to use imagery. Imagery is using your imagination to create a ...

  3. U.S. Coastal Relief Model

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  4. Enveloping Relief Surfaces of Landslide Terrain

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Two relief surfaces that envelop the rock fall region in a part of Garhwal Himalayas around Chamoli have been identified. Relative relief and absolute relief have been analyzed and the enveloping surfaces recorded at two levels of relief in the landscape. All landslide activity lies within these surfaces. The lower enveloping surface (800 m) dips due south by 7-8 degrees, due to an elevation rise of 100 meters within 12 km from south to north, i.e., a gradient of 8 percent. The nature of the surface is smooth. The upper enveloping surface (> 2500 m) is almost parallel to the lower one but its surface is undulatory due to landslides and denudation. The area has been a seismically active region and has undergone seismic activity up until recently, as evidenced by the Chamoli earthquake of 29th March 1999. The effects of earthquakes are seen at higher levels in the form of landslide imprints on the terrain.

  5. U.S. Coastal Relief Model - Hawaii

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — NGDC's U.S. Coastal Relief Model (CRM) provides the first comprehensive view of the U.S. coastal zone integrating offshore bathymetry with land topography into a...

  6. Shaded Relief of Minnesota Elevation - Black & White

    Data.gov (United States)

    Minnesota Department of Natural Resources — This file is a product of a shaded relief process on the 30 meter resolution Digital Elevation Model data (dem30im3). This image was created using a custom AML...

  7. Brain Circuits Encoding Reward from Pain Relief

    Science.gov (United States)

    Navratilova, Edita; Atcherley, Christopher; Porreca, Frank

    2015-01-01

    Relief from pain in humans is rewarding and pleasurable. Primary rewards, or reward predictive cues, are encoded in brain reward/motivational circuits. While considerable advances have been made in our understanding of reward circuits underlying positive reinforcement, less is known about the circuits underlying the hedonic and reinforcing actions of pain relief. We review findings from electrophysiological, neuroimaging and behavioral studies supporting the concept that the rewarding effect of pain relief requires opioid signaling in the anterior cingulate cortex, activation of midbrain dopamine neurons and release of dopamine in the nucleus accumbens. Understanding of circuits that govern the reward of pain relief may allow the discovery of more effective and satisfying therapies for patients with acute and chronic pain. PMID:26603560

  8. Somatic Symptoms

    DEFF Research Database (Denmark)

    Eliasen, Marie; Kreiner, Svend; Ebstrup, Jeanette F

    2016-01-01

    ) the associations between the symptoms, and 3) the associations between the somatic symptoms, self-perceived health and limitations due to physical health accounting for the co-occurrence of symptoms. Information on 19 somatic symptoms, self-perceived health and limitations due to physical health was achieved from...... a population-based questionnaire survey of 36,163 randomly selected adults in the Capital Region of Denmark in 2006/07. Chain graph models were used to transparently identify and describe the associations between symptoms, self-perceived health and limitations due to physical health. In total, 94...... all strongly directly associated with both of the outcomes (γ>0.30). Chest pain was strongly associated with self-perceived health, and other musculoskeletal symptoms and urinary retention were strongly associated with limitations due to physical health. Other symptoms were either moderate...

  9. Is the surgical outcome for lumbar disc herniation related to the duration of symptoms?

    DEFF Research Database (Denmark)

    Støttrup, Christian; Ernst, Carsten; Clemmensen, Dorte;

    Background: Lumbar disc herniation (LDH) is associated with great morbidity and significant socio-economic impact in many parts of the world. Studies have shown that most LDH can be treated effectively with conservative management and the passage of time. However for the group of patients where...... pain and disability is unacceptable, surgical intervention provides effective clinical relief in many cases. Currently there is little consensus in the medical community on the timing of surgery for patients suffering from radicular pain due to LDH. Reports based on the SPORT database indicate...... that prolonged symptom-duration correlates with inferior outcome. Purpose / Aim of Study: The aim of this study is to evaluate if prolonged symptom-duration is correlated with less favorable outcome following surgery for LDH in a Single- Center Study. Materials and Methods: 832 patients with first-time LDH were...

  10. Safety/relief-valve test program

    Energy Technology Data Exchange (ETDEWEB)

    Hunter, J.A.

    1982-01-01

    In response to the NRC's Task 2.1.2 following the TMI-2 accident, government and industry programs were formulated to address the performance of safety and relief valve systems for pressurized and boiling water reactors. Objective is to demonstrate by testing and analysis that safety and relief valve systems in the reactor coolant system are qualified for the anticipated full range of reactor operating and accident conditions. The EPRI PWR program tested PWR safety valves and power operated relief valves (PORVs) under steam, liquid, and steam/liquid transition conditions. The program also tested PWR PORV block valves under steam conditions. The GE BWR program tested BWR relief and safety/relief valves under high pressure steam and low pressure liquid conditions. EG and G Idaho recent activities have focused on the evaluation of the industry test data, evaluation and modification of analytical codes for safety/relief valve system analysis, and initial evaluation of utility responses to US NRC program requirements.

  11. [Marijuana for medical purposes--public health perspective].

    Science.gov (United States)

    Gazdek, Davorka

    2014-01-01

    Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.

  12. Topical Drugs for Pain Relief

    Directory of Open Access Journals (Sweden)

    Anjali Srinivasan

    2015-03-01

    Full Text Available Topical therapy helps patients with oral and perioral pain problems such as ulcers, burning mouth syndrome, temporomandibular disorders, neuromas, neuropathies and neuralgias. Topical drugs used in the field of dentistry are topical anaesthetics, topical analgesics, topical antibiotics and topical corticosteroids. It provides symptomatic/curative effect. Topical drugs are easy to apply, avoids hepatic first pass metabolism and more sites specific. But it can only be used for medications that require low plasma concentrations to achieve a therapeutic effect.

  13. Topical Drugs for Pain Relief

    OpenAIRE

    Anjali Srinivasan; Prashanth Shenai; Laxmikanth Chatra; Veena KM; Prasanna Kumar Rao

    2015-01-01

    Topical therapy helps patients with oral and perioral pain problems such as ulcers, burning mouth syndrome, temporomandibular disorders, neuromas, neuropathies and neuralgias. Topical drugs used in the field of dentistry are topical anaesthetics, topical analgesics, topical antibiotics and topical corticosteroids. It provides symptomatic/curative effect. Topical drugs are easy to apply, avoids hepatic first pass metabolism and more sites specific. But it can only be used for medications that ...

  14. Current trends in management of men with lower urinary tract symptoms and benign prostatic hyperplasia.

    Science.gov (United States)

    Holtgrewe, H L

    1998-04-01

    Management of lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) has been central to urology for decades. The urologic community has increasingly come to realize that many men with LUTS do not have prostate enlargement and do not need their prostates debulked surgically. Of all the factors that have emerged to alter the trends associated with management of LUTS and BPH, none has had more impact than the advent of medical therapy. The selective, long-acting, alpha1-blocking agents terazosin, doxazosin, and tamsulosin have become most popular because of their specificity in the urinary tract, reduced side effects, and simplicity of dosage. In addition, finasteride, a 5-alpha-reductase inhibitor, was found to be effective in men with prostates of > or = 40 g. Furthermore, the larger the prostate at baseline, the greater the efficacy of finasteride on symptom relief and flow rate improvement. In addition to medical therapy, an array of device therapies has emerged in the management of LUTS and BPH. Laser prostatectomy is the oldest of the device therapies and includes transurethral vaporization of the prostate (VLAP), transurethral evaporation of the prostate (TUEP), and transurethral interstitial laser prostatectomy (TILP). Studies report beneficial outcomes approaching those achieved with transurethral resection of the prostate (TURP) with less morbidity and a shorter hospital stay. Common diseases contribute the most to national healthcare expenditures. The management of LUTS and BPH are such disorders and result in the expenditure of vast healthcare resources worldwide. The surgical strategies have an established record of outcomes documenting their potential for symptom relief and the avoidance of future complications. Medical and device therapies, although currently promising and attractive, therefore must prove comparable durability.

  15. 46 CFR 154.806 - Capacity of pressure relief valves.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Capacity of pressure relief valves. 154.806 Section 154... Equipment Cargo Vent Systems § 154.806 Capacity of pressure relief valves. Pressure relief valves for each... pressure above the set pressure of the relief valves: (a) The maximum capacity of an installed cargo...

  16. Laparoscopic Adhesiolysis and Relief of Chronic Pelvic Pain

    Science.gov (United States)

    Nezhat, Farr R.; Crystal, Ruth Ann; Nezhat, Ceana H.

    2000-01-01

    Objective: To evaluate the short- and long-term results of laparoscopic enterolysis in patients with chronic pelvic pain following hysterectomy. Methods: Forty-eight patients were evaluated at time intervals from 2 weeks to 5 years after laparoscopic enterolysis. Patients were asked to rate postoperative relief of their pelvic pain as complete/near complete relief (80-100% pain relief), significant relief (50-80% pain relief), or less than 50% or no pain relief. Results: We found that after 2 to 8 weeks, 39% of patients reported complete/near complete pain relief, 33% reported significant pain relief, and 28% reported less than 50% or no pain relief. Six months to one year postlaparoscopy, 49% of patients reported complete/near complete pain relief, 15% reported significant pain relief, and 36% reported less than 50% or no pain relief. Two to five years after laparoscopic enterolysis, 37% of patients reported complete/near complete pain relief, 30% reported significant pain relief, and 33% reported less than 50% or no pain relief. Some patients required between 1 and 3 subsequent laparoscopic adhesiolysis. A total of 3 enterotomies and 2 cystotomies occurred, all of which were repaired laparoscopically. Conclusion: We conclude that laparoscopic enterolysis may offer significant long-term relief of chronic pelvic pain in some patients. PMID:11051185

  17. 48 CFR 252.229-7001 - Tax relief.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Tax relief. 252.229-7001... Clauses 252.229-7001 Tax relief. As prescribed in 229.402-70(a), use the following clause: Tax Relief (JUN... or components intended to be imported in order to ensure that relief from import duties is obtained...

  18. 7 CFR 635.5 - Forms of relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Forms of relief. 635.5 Section 635.5 Agriculture... AGRICULTURE LONG TERM CONTRACTING EQUITABLE RELIEF FROM INELIGIBILITY § 635.5 Forms of relief. (a) The Chief... land covered by the program; and (5) Receive such other equitable relief as determined to be...

  19. 37 CFR 41.120 - Notice of basis for relief.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Notice of basis for relief... Notice of basis for relief. (a) The Board may require a party to provide a notice stating the relief it requests and the basis for its entitlement to relief. The Board may provide for the notice to be maintained...

  20. 19 CFR 210.52 - Motions for temporary relief.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Motions for temporary relief. 210.52 Section 210... IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.52 Motions for temporary relief. Requests for temporary relief under section 337 (e) or (f) of the Tariff Act of 1930 shall be made through...

  1. 43 CFR 4.1367 - Request for temporary relief.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Request for temporary relief. 4.1367... temporary relief. (a) Where review is requested pursuant to § 4.1362, any party may file a request for temporary relief at any time prior to a decision by an Administrative Law Judge, so long as the relief...

  2. 7 CFR 718.305 - Forms of relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Forms of relief. 718.305 Section 718.305 Agriculture... Equitable Relief From Ineligibility § 718.305 Forms of relief. (a) The Administrator of FSA, Executive Vice... all or part of the land covered by the program; and (5) Receive such other equitable relief as...

  3. Therapeutics for multiple sclerosis symptoms.

    Science.gov (United States)

    Ben-Zacharia, Aliza Bitton

    2011-01-01

    Symptoms management in multiple sclerosis is an integral part of its care. Accurate assessment and addressing the different symptoms provides increased quality of life among patients with multiple sclerosis. Multiple sclerosis symptoms may be identified as primary, secondary, or tertiary symptoms. Primary symptoms, such as weakness, sensory loss, and ataxia, are directly related to demyelination and axonal loss. Secondary symptoms, such as urinary tract infections as a result of urinary retention, are a result of the primary symptoms. Tertiary symptoms, such as reactive depression or social isolation, are a result of the social and psychological consequences of the disease. Common multiple sclerosis symptoms include fatigue and weakness; decreased balance, spasticity and gait problems; depression and cognitive issues; bladder, bowel, and sexual deficits; visual and sensory loss; and neuropathic pain. Less-common symptoms include dysarthria and dysphagia, vertigo, and tremors. Rare symptoms in multiple sclerosis include seizures, hearing loss, and paralysis. Symptom management includes nonpharmacological methods, such as rehabilitation and psychosocial support, and pharmacological methods, ie, medications and surgical procedures. The keys to symptom management are awareness, knowledge, and coordination of care. Symptoms have to be recognized and management needs to be individualized. Multiple sclerosis therapeutics include nonpharmacological strategies that consist of lifestyle modifications, rehabilitation, social support, counseling, and pharmacological agents or surgical procedures. The goal is vigilant management to improve quality of life and promote realistic expectations and hope.

  4. Bazedoxifene/conjugated estrogens for managing the burden of estrogen deficiency symptoms.

    Science.gov (United States)

    Mirkin, Sebastian; Ryan, Kelly A; Chandran, Arthi B; Komm, Barry S

    2014-01-01

    The bothersome vasomotor and vaginal symptoms and bone loss that accompany the menopausal transition are associated with significant direct costs due to physician visits and medication, as well as indirect costs from reduced health-related quality of life (HRQoL) and work productivity. With life expectancies increasing, the number of postmenopausal women is also increasing, and more women are remaining in the workforce. These factors have led to an increased burden of menopausal symptoms on healthcare systems. Hormone therapy (HT) has been shown to effectively reduce menopausal symptoms and significantly increase quality-adjusted life years in postmenopausal women, particularly in women experiencing severe symptoms. However, many women discontinue use of HT before their symptoms have dissipated due to safety and tolerability concerns. The tissue selective estrogen complex (TSEC) that pairs bazedoxifene (BZA) with conjugated estrogens (CE) has been developed to provide relief of menopausal symptoms and prevent bone loss without stimulating the breast or endometrium, and to have improved tolerability compared with HT. In this context, BZA 20mg/CE 0.45 and 0.625 mg were shown to prevent bone loss and effectively treat menopausal symptoms in postmenopausal women with an intact uterus, while also demonstrating a favorable safety/tolerability profile. BZA 20mg/CE 0.45 and 0.625 mg were further associated with clinically significant improvements in HRQoL, sleep, and treatment satisfaction. Taken together, the reduction in menopausal symptoms, improvement in HRQoL, and favorable safety/tolerability profile associated with BZA/CE suggest that it is a cost-effective alternative to HT for managing the burden of menopausal symptoms.

  5. Headache relief after anterior cervical discectomy: post hoc analysis of a randomized investigational device exemption trial: clinical article.

    Science.gov (United States)

    Schrot, Rudolph J; Mathew, Jesna S; Li, Yueju; Beckett, Laurel; Bae, Hyun W; Kim, Kee D

    2014-08-01

    The authors analyzed headache relief after anterior cervical discectomy. Headache may be relieved after anterior cervical discectomy, but the mechanism is unknown. If headaches were directly referred from upper cervical pathology, more headache relief would be expected from surgery performed at higher cervical levels. If spinal kinesthetics were the mechanism, then headache relief may differ between arthroplasty and fusion. Headache relief after anterior cervical discectomy was quantified by the operated disc level and by the method of operation (arthroplasty vs arthrodesis). The authors performed a post hoc analysis of an artificial disc trial. Data on headache pain were extracted from the Neck Disability Index (NDI) questionnaire. A total of 260 patients underwent single-level arthroplasty or arthodesis. Preoperatively, 52% reported NDI headache scores of 3 or greater, compared with only 13%-17% postoperatively. The model-based mean NDI headache score at baseline was 2.5 (95% CI 2.3-2.7) and was reduced by 1.3 points after surgery (95% CI 1.2-1.4, p relief. There was no significant difference in headache relief between arthroplasty and arthrodesis. Most patients with symptomatic cervical spondylosis have headache as a preoperative symptom (88%). Anterior cervical discectomy with both arthroplasty and arthrodesis is associated with a durable decrease in headache. Headache relief is not related to the level of operation. The mechanism for headache reduction remains unclear.

  6. Pain relief as an opponent process: a psychophysical investigation.

    Science.gov (United States)

    Leknes, Siri; Brooks, Jonathan C W; Wiech, Katja; Tracey, Irene

    2008-08-01

    Relief from pain in humans is frequently measured by computing the reduction on an 11-point pain intensity scale. However, this definition of relief may be insufficient to capture the utility of pain relief for the individual. Based on pain literature and evidence from studies examining relief and reward, it is clear that pain relief is a broad concept comprising several factors, only one of which is pain intensity reduction. According to opponent process theory, all sensations consist of a primary process and a slow 'opponent process' of opposite valence, the purpose of which is to reduce the deviation from homeostatic balance. Here, opponent process theory provided a framework to explore the interaction between pain, relief and reward. We devised three psychophysical studies examining the temporal (Experiment I) and magnitude (Experiments I and II) relationships between pain severity and its subsequent relief. In Experiment III, we further manipulated the magnitude and pleasantness of relief experienced by applying innocuous cooling following noxious heat stimulation of capsaicin-sensitized skin. Results confirmed predictions from opponent process theory and showed that pain intensity reduction was significantly stronger than relief intensity ratings. Furthermore, continuous relief ratings appeared to reflect the speed of pain intensity reduction. Varying pain intensity parametrically confirmed that relief increases with pain intensity. That innocuous cooling following primary hyperalgesia intervention significantly increased the intensity, pleasantness and duration of relief provides further evidence that pain relief encapsulates more than a reduction in pain intensity. Importantly, the high relief pleasantness ratings confirmed the hypothesized link between relief and reward.

  7. Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies.

    Science.gov (United States)

    Griffin, Sarah C; Curran, Sean; Chan, Annie W Y; Finn, Sacha B; Baker, Chris I; Pasquina, Paul F; Tsao, Jack W

    2017-04-01

    Research indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy. Data from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n=33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire. The severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (pMirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms. The degree of PLP at baseline predicts when mirror therapy relieves pain. This article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain. ClinicalTrials.gov numbers:NCT00623818 and NCT00662415. Copyright © 2017 Scandinavian Association for the Study of Pain. All rights reserved.

  8. Glovebox pressure relief and check valve

    Energy Technology Data Exchange (ETDEWEB)

    Blaedel, K.L.

    1986-03-17

    This device is a combined pressure relief valve and check valve providing overpressure protection and preventing back flow into an inert atmosphere enclosure. The pressure relief is embodied by a submerged vent line in a mercury reservior, the releif pressure being a function of the submerged depth. The pressure relief can be vented into an exhaust system and the relieving pressure is only slightly influenced by the varying pressure in the exhaust system. The check valve is embodied by a ball which floats on the mercury column and contacts a seat whenever vacuum exists within the glovebox enclosure. Alternatively, the check valve is embodied by a vertical column of mercury, the maximum back pressure being a function of the height of the column of mercury.

  9. Neuropathic Symptoms and Their Risk Factors in Medical Oncology Outpatients With Colorectal vs. Breast, Lung, or Prostate Cancer: Results From a Prospective Multicenter Study.

    Science.gov (United States)

    Lewis, Mark A; Zhao, Fengmin; Jones, Desiree; Loprinzi, Charles L; Brell, Joanna; Weiss, Matthias; Fisch, Michael J

    2015-06-01

    Few studies have examined the prevalence and severity of treatment-induced neuropathic symptoms in patients across different cancer types. This study aimed to report the prevalence of numbness/tingling (N/T) and neuropathic pain in patients with colorectal cancer (CRC) vs. other cancers, describe the prevalence of moderate-to-severe N/T by specific clinical variables, and examine factors associated with the presence of these symptoms. A total of 3106 outpatients with colorectal (n = 718), breast (n = 1544), lung (n = 524), or prostate (n = 320) cancer were enrolled at any point in their treatment. Assessments were conducted at the initial visit and 28-35 days later. Patients reported pain and N/T; clinicians reported mechanism of pain and ranked the top three symptoms causing difficulties. Moderate-to-severe N/T was higher in patients with CRC relative to other cancer types (25.8% vs. 17.1%, P cancers (P prevalence of neuropathic pain was comparable between patients with CRC and other cancers (P = 0.654). Patients with CRC, longer duration of cancer, prior therapy, on current therapy, older patients, and patients of black race experienced worse N/T. Patients with CRC experience significantly higher rates of N/T but comparable neuropathic pain, relative to patients with other cancers. Awareness of the prevalence and severity of neuropathic symptoms and their associated risk factors in this patient population is critical for both clinicians and patients. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Recent trends in the international relief system.

    Science.gov (United States)

    Borton, J

    1993-09-01

    Since 1991 the international relief system has been undergoing a process of rapid and fundamental change associated with the end of the Cold War period. The principal changes concern (i) the international community's approach to national sovereignty and the 'right' of armed intervention in support of humanitarian objectives, and (ii) organisatwnal changes aimed at improving the coordination and effectiveness of the response by donor organisations and the United Nations. This paper describes these changes and attempts to place them in the context of earlier trends within the international relief system, notably the enhanced role of non-governmental organisations, which occurred during the 1980s.

  11. Social Sensations of Symptoms:

    DEFF Research Database (Denmark)

    Meinert, Lotte; Whyte, Susan Reynolds

    2016-01-01

    The interpretation of sensations and the recognition of symptoms of a sickness, as well as the movement to seek treatment, have long been recognized in medical anthropology as inherently social processes. Based on cases of HIV and trauma (PTSD) in Uganda, we show that even the first signs...... and sensations of sickness can be radically social. The sensing body can be a ‘social body’ – a family, a couple, a network – a unit that transcends the individual body. In this article we focus on four aspects of the sociality of sensations and symptoms: mode of transmission; the shared experience of sensations...

  12. Chronic pain patients' perspectives of medical cannabis.

    Science.gov (United States)

    Piper, Brian J; Beals, Monica L; Abess, Alexander T; Nichols, Stephanie D; Martin, Maurice W; Cobb, Catherine M; DeKeuster, Rebecca M

    2017-07-01

    Medical cannabis (MC) is used for a variety of conditions including chronic pain. The goal of this report was to provide an in-depth qualitative exploration of patient perspectives on the strengths and limitations of MC. Members of MC dispensaries (N = 984) in New England including two-thirds with a history of chronic pain completed an online survey. In response to "How effective is medical cannabis in treating your symptoms or conditions?," with options of 0% "no relief" to 100% "complete relief," the average was 74.6% ± 0.6. The average amount spent on MC each year was $3064.47 ± 117.60, median = $2320.23, range = $52.14 to $52,140.00. Open-ended responses were coded into themes and subthemes. Analysis of answers to "What is it that you like most about MC?" (N = 2592 responses) identified 10 themes, including health benefits (36.0% of responses, eg, "Changes perception and experience of my chronic pain."), the product (14.2%, eg, "Knowing exactly what strain you are getting"), nonhealth benefits (14.1%), general considerations (10.3%), and medications (7.1%). Responses (N = 1678) to "What is it that you like least about MC?" identified 12 themes, including money (28.4%, eg, "The cost is expensive for someone on a fixed income"), effects (21.7%, eg, "The effects on my lungs"), the view of others (11.4%), access (8.2%), and method of administration (7.1%). These findings provide a patient-centered view on the advantages (eg, efficacy in pain treatment, reduced use of other medications) and disadvantages (eg, economic and stigma) of MC.

  13. Emergency relief system design: The DIERS users group safety relief valve example problem

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, H.G. [Union Carbide Corp., South Charleston, WV (United States)

    1995-12-31

    Emergency relief system design involving two-phase flow is an evolving and complex technology. Aspects of alternative design techniques have been published. Well-documented, comprehensive design methods for safety relief valves, rupture disks and breather vents, however, are not readily available and example problems supported by data do not exist. Design Institute for Emergency Relief Systems (DIERS) Users Group members recently completed an example rating problem consisting of a safety relief valve mounted in a typical industrial configuration. Participants were asked to compute the flow through the device and to calculate the inlet pipe irreversible pressure loss and discharge pipe back pressure. Case studies involving various flows and physical conditions were formulated. A {open_quotes}Modified Delphi{close_quotes} technique was used to encourage participants to work until the {open_quotes}consensus{close_quotes} result was achieved. The exercise served to educate participants in the complexities and subtleties of emergency relief system design involving safety relief installations as compared to ideal nozzle calculations. All learned from the various calculation techniques used by others to solve the problem. Participants corrected parts of their computer codes and/or added procedures to address aspects of the problem. The present example problem is not supported by data. Available safety relief valve two-phase flow data suggest complexity not presently included in problem solutions. Future modification of the results may be required as additional considerations are incorporated into existing analytical methods and computer codes. 20 refs., 21 tabs.

  14. The impact of medical technology on sense of security in the palliative home care setting.

    Science.gov (United States)

    Munck, Berit; Sandgren, Anna

    2017-03-02

    The increase in the use of medical devices in palliative home care requires that patients and next-of-kin feel secure. Therefore, the aim was to describe medical technology's impact on the sense of security for patients, next-of-kin and district nurses. Deductive content analysis was conducted on data from three previous studies, using the theoretical framework 'palliative home care as a secure base'. The use of medical technology was shown to have an impact on the sense of security for all involved. A sense of control was promoted by trust in staff and their competence in managing the technology, which was linked to continuity. Inner peace and being in comfort implied effective symptom relief facilitated by pain pumps and being relieved of responsibility. Health care professionals need to have practical knowledge about medical technology, but at the same time have an awareness of how to create and maintain a sense of security.

  15. Diphtheria Symptoms

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Diphtheria Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Diphtheria Home About Diphtheria Causes and Transmission Symptoms Complications ...

  16. Plague Symptoms

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search the CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  17. Symptoms Before Sudden Arrhythmic Death Syndrome

    DEFF Research Database (Denmark)

    Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke

    2015-01-01

    INTRODUCTION: No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation....... The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among...... these, 30 (22%) had contacted the healthcare system. Antecedent symptoms (symptoms >24 hours before death) were present in 34 (25%) patients. Prodromal symptoms (symptoms ≤24 hours before death) were present in 23 (17%) patients. Cardiac symptoms included chest pain (n = 16, 12%), dyspnea (n = 18, 13...

  18. A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication.

    Science.gov (United States)

    Tully, Phillip J; Selkow, Terina; Bengel, Jürgen; Rafanelli, Chiara

    2015-01-01

    No previous study has reported upon comorbid depression and anxiety disorders and their treatment in heart failure (HF), which the current study has sought to document. Total 29 HF patients under psychiatric management underwent primary depression cognitive behavioral therapy (CBT; n = 15) or primary generalized anxiety disorder (GAD) CBT (n = 14), and participated in a community exercise program and standard physician care. Repeated measures analysis of variance assessed Patient Health Questionnaire (PHQ-9) and GAD-7 symptom change pre- and post-CBT treatment, and assessed the interaction effects of treatment type, exercise, anti-depressant and anxiolytic. There was a significant time and treatment interaction effect that favored the primary GAD CBT group for reduction in PHQ symptoms (F(1, 24) = 4.52, p = 0.04). Analysis of PHQ-somatic symptoms also showed a significant main effect for participation in the exercise program (F(1, 24) = 4.21, p = 0.05) and a significant time and anxiolytic interaction (F(1, 24) = 3.98, p = 0.05). The average number of cardiac hospital readmissions favored the primary GAD CBT group (p = 0.05). The findings support the use of multifaceted interventions in the rehabilitation of HF patients with comorbid psychiatric needs. Implications for Rehabilitation Comorbid depression and anxiety disorders are a clinical and research focus that deserves more attention in the treatment of heart failure patients. Cognitive behavioral therapy, exercise, and anxiolytic use was associated with significant changes in depression and anxiety though discrete effects were evident. Multifaceted interventions are most likely to be successful in the rehabilitation of HF patients with psychiatric needs.

  19. What sets topographic relief in extensional footwalls?

    Science.gov (United States)

    Densmore, Alexander L.; Dawers, Nancye H.; Gupta, Sanjeev; Guidon, Roman

    2005-06-01

    We use three large normal fault arrays in the northeastern Basin and Range Province, western United States, to document catchment development and relief production during fault growth. Fault slip and slip rates increase systematically along strike from zero at the fault tips. Catchment relief and across-strike range width both increase as slip accumulates but reach maximum values at a distance of ˜15 km from the fault tips and remain uniform along strike over much of the footwalls. Catchment outlet spacing also increases away from the fault tips but does not reach a uniform value and may vary by a factor of 5 6 along strike. We infer that catchments first elongate in the across-strike direction as slip accumulates and the range half-width increases. Once the half-width reaches its maximum value, continued catchment growth is possible only by along-strike capture, which increases outlet spacing but not relief. The close correspondence between catchment relief and range half-width suggests that geomorphically limited hillslope and channel gradients are achieved within the 15 km tip zone. Thus, the limiting factor in footwall development is the width of the range, which is controlled by two external agents: the geometry and spacing of the major faults, and the elevations of base level on both flanks.

  20. 75 FR 75091 - Mortgage Assistance Relief Services

    Science.gov (United States)

    2010-12-01

    ... marketing of MARS, including misrepresentations regarding the services MARS providers will perform and... marketing to offer newly-minted forms of mortgage relief--for example, the possibility of entering a short...://ag.ca.gov/newsalerts/release.php?id=1821 . \\59\\ See State Bar of Cal., Ethics Alert: Legal...

  1. A node architecture for disaster relief networking

    NARCIS (Netherlands)

    Hoeksema, F.W.; Heskamp, M.; Schiphorst, R.; Slump, C.H.

    2005-01-01

    In this paper we present node architecture for a personal node in a cognitive ad-hoc disaster relief network. This architecture is motivated from the network system requirements, especially single-hop distance and jamming-resilience requirements. It is shown that the power consumption of current-day

  2. 'Birthgasm': A Literary Review of Orgasm as an Alternative Mode of Pain Relief in Childbirth.

    Science.gov (United States)

    Mayberry, Lorel; Daniel, Jacqueline

    2016-12-01

    Childbirth is a fundamental component of a woman's sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth. © The Author(s) 2015.

  3. 20 CFR 220.113 - Symptoms, signs, and laboratory findings.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Symptoms, signs, and laboratory findings. 220... RETIREMENT ACT DETERMINING DISABILITY Medical Considerations § 220.113 Symptoms, signs, and laboratory findings. Medical findings consist of symptoms, signs, and laboratory findings: (a) Symptoms are...

  4. Efficacy and Safety of Initial Combination Treatment of an Alpha Blocker with an Anticholinergic Medication in Benign Prostatic Hyperplasia Patients with Lower Urinary Tract Symptoms: Updated Meta-Analysis

    Science.gov (United States)

    Kim, Hyun Jung; Sun, Hwa Yeon; Choi, Hoon; Park, Jae Young; Bae, Jae Hyun; Doo, Seung Whan; Yang, Won Jae; Song, Yun Seob; Ko, Young Myoung

    2017-01-01

    Background There is still controversy as to whether initial combination treatment is superior to serial addition of anticholinergics after maintenance or induction of alpha blockers in benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) Objective The objective of this study was to determine the benefits and safety of initial combination treatment of an alpha blocker with anticholinergic medication in BPH/LUTS through a systematic review and meta-analysis. Methods We conducted a meta-analysis of improvement in LUTS using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Results In total, 16 studies were included in our analysis, with a total sample size of 3,548 subjects (2,195 experimental subjects and 1,353 controls). The mean change in total IPSS improvement from baseline in the combination group versus the alpha blocker monotherapy group was -0.03 (95% CI: -0.14–0.08). The pooled overall SMD change of storage IPSS improvement from baseline was -0.28 (95% CI: -0.40 - -0.17). The pooled overall SMD changes of QoL, Qmax, and PVR were -0.29 (95% CI: -0.50 - -0.07), 0.00 (95% CI: -0.08–0.08), and 0.56 (95% CI: 0.23–0.89), respectively. There was no significant difference in the number of acute urinary retention (AUR) events or PVR. Conclusions Initial combination treatment of an alpha blocker with anticholinergic medication is efficacious for in BPH/ LUTS with improved measures such as storage symptoms and QoL without causing significant deterioration of voiding function. PMID:28072862

  5. Refuge alternatives relief valve testing and design.

    Science.gov (United States)

    Lutz, T J; Bissert, P T; Homce, G T; Yonkey, J A

    2016-10-01

    The U.S. National Institute for Occupational Safety and Health (NIOSH) has been researching refuge alternatives (RAs) since 2007. RAs typically have built-in pressure relief valves (PRVs) to prevent the unit from reaching unsafe pressures. The U.S. Mine Safety and Health Administration requires that these valves vent the chamber at a maximum pressure of 1.25 kPa (0.18 psi, 5.0 in. H2O), or as specified by the manufacturer, above mine atmospheric pressure in the RA. To facilitate PRV testing, an instrumented benchtop test fixture was developed using an off-the-shelf centrifugal blower and ductwork. Relief pressures and flow characteristics were measured for three units: (1) a modified polyvinyl chloride check valve, (2) an off-the-shelf brass/cast-iron butterfly check valve and (3) a commercially available valve that was designed specifically for one manufacturer's steel prefabricated RAs and had been adapted for use in one mine operator's built-in-place RA. PRVs used in tent-style RAs were not investigated. The units were tested with different modifications and configurations in order to check compliance with Title 30 Code of Federal Regulations, or 30 CFR, regulations. The commercially available relief valve did not meet the 30 CFR relief pressure specification but may meet the manufacturer's specification. Alternative valve designs were modified to meet the 30 CFR relief pressure specification, but all valve designs will need further design research to examine survivability in the event of a 103 kPa (15.0 psi) impulse overpressure during a disaster.

  6. Medical Treatments for Fibroids

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Medical Treatments for Fibroids Skip sharing on social media ... Page Content Your health care provider may suggest medical treatments to reduce the symptoms of fibroids or ...

  7. Polymyositis: Medical Management

    Science.gov (United States)

    ... email share facebook twitter google plus linkedin Medical Management Polymyositis (PM) is a highly treatable disease. Some ... PM) Signs and Symptoms Diagnosis Causes/Inheritance Medical Management Research Find your MDA Care Center Current Clinical ...

  8. Perceptions of medical staff on uncomfortable symptoms of leukemia children during chemotherapy%医护人员对白血病患儿化疗期间不适症状感知的调查

    Institute of Scientific and Technical Information of China (English)

    卜秀青; 张婷婷; 杨瑞坤; 秦秀群; 梦玲

    2014-01-01

    目的:了解医护人员对白血病患儿化疗期间不适症状的感知状况,为制订干预措施提供依据。方法采用自行设计的白血病患儿化疗不适症状问卷,对61名医护人员进行调查。结果医护人员认为白血病患儿化疗期间的主要不适症状依次为脱发、食欲下降、恶心及呕吐、口腔炎、发热、疲乏等。结论白血病患儿化疗期间不适症状较为常见,需要综合考虑患儿的不适症状,制订和实施全方位的护理措施,提高患儿的生活质量。%Objective To investigate the perceptions of medical staff about chemotherapeutic symptoms in children with leukemia.Method Sixty-one doctors and nurses were involved in the investigation using a self-designed questionnaire on uncomfortable symptom scale.Result The main symptoms of chemotherapy included hair loss,poor appetite,nausea,vomiting, oral mucositis and fatigue.Conclusion Chemotherapeutic symptoms are common in children with leukemia and need appropriate nursing management.

  9. Do manualized treatments for depression reduce insomnia symptoms?

    Science.gov (United States)

    Yon, Adriana; Scogin, Forrest; DiNapoli, Elizabeth A; McPherron, Jesse; Arean, Patricia A; Bowman, Daniel; Jamison, Christine S; Karpe, Jennifer A; Latour, David; Reynolds, Charles F; Rohen, Noelle; Pardini, Jamie E L; Thompson, Larry W

    2014-07-01

    Researchers evaluated the effect of manualized treatments for depression on comorbid symptoms of insomnia. Hierarchical linear modeling was used to analyze archival data collected from 14 studies (N = 910) examining the efficacy of psychological treatments for depression in adults. Participants receiving a psychological treatment for depression experienced significantly more relief from symptoms of insomnia with overall, early-, middle-, and late-night sleep than those not receiving such treatment. Symptoms of insomnia in those with an average (or lower) level of depression can be reduced through psychological treatment for depression. However, more severe depressive symptoms do not receive great relief from sleep disturbance and may require an additional treatment component targeting symptoms of insomnia. © 2014 Wiley Periodicals, Inc.

  10. Topographic and Bathymetric Shaded Relief of North America - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Topographic and Bathymetric Shaded Relief of North America map layer shows depth and elevation ranges using colors, with relief enhanced by shading. The image...

  11. Bathymetric Shaded Relief of North America - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Bathymetric Shaded Relief of North America map layer shows depth ranges using colors, with relief enhanced by shading. The image was derived from the National...

  12. 100-Meter Resolution Color Shaded Relief of Hawaii - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of Hawaii map layer is a 100-meter resolution color-sliced elevation image of Hawaii, with relief shading added to accentuate terrain...

  13. 100-Meter Resolution Color Shaded Relief of Alaska - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Color Shaded Relief of Alaska map layer is a 100-meter resolution color-sliced elevation image of Alaska, with relief shading added to accentuate terrain...

  14. 100-Meter Resolution Grayscale Shaded Relief of Hawaii - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Hawaii map layer is a 100-meter resolution grayscale shaded relief image of Hawaii, in an Albers Equal-Area Conic projection. Shaded...

  15. 100-Meter Resolution Grayscale Shaded Relief of Alaska - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Grayscale Shaded Relief of Alaska map layer is a 100-meter resolution grayscale shaded relief image of Alaska, in an Albers Equal-Area Conic projection. Shaded...

  16. Mechanical Designs for Relief Valves for Cryogenic Apparatuses and Installations

    CERN Document Server

    CERN. Geneva

    2016-01-01

    There are also pressure relief valves with warm seat available on which the set pressure is based on an adjustment of forces by permanent magnets. Pressure vessel rules allows also the choice for an active triggered pressure relief valve (Cont...

  17. Ensuring Pain Relief for Children at the End of Life

    Directory of Open Access Journals (Sweden)

    Marie-Claude Grégoire

    2006-01-01

    Full Text Available Pain management in the context of pediatric palliative care can be challenging. The present article reviews, through a case-based presentation, the nonpharmacological and pharmacological methods used to ensure adequate pain control in children facing end of life. Details on the impressive range of opioid dosages required and routes of administration are highlighted from published literature and clinical experience. Where available, evidence-based recommendations are provided. Potential side effects of pain medication and barriers to good pain control are discussed. Novel analgesics and innovative delivery methods are presented as future tools enhancing pain relief at the end of life. Some challenges to ethically grounded research in this important context of care are reviewed.

  18. Does a view of nature promote relief from acute pain?

    Science.gov (United States)

    Kline, Grace A

    2009-09-01

    Inadequate control of acute pain is a well-recognized and serious problem. Distraction is one of the methods used in adjunct with medications to relieve pain. Nature-related sensory stimuli are frequently used for both distraction and relaxation. The human response model that focuses on individual adaptation to health conditions is used in this article to guide an analysis of relevant studies. Four studies in clinical settings evaluated the effect of nature (as a visual stimulus) to determine whether it promoted relief of acute pain. All these studies also used audio stimuli (nature sounds or music). Distracting visual and auditory stimuli used together provided stronger evidence of pain reduction than when either type of stimulus was used alone.

  19. Digital Shaded-Relief Image of Alaska

    Science.gov (United States)

    Riehle, J.R.; Fleming, Michael D.; Molnia, B.F.; Dover, J.H.; Kelley, J.S.; Miller, M.L.; Nokleberg, W.J.; Plafker, George; Till, A.B.

    1997-01-01

    Introduction One of the most spectacular physiographic images of the conterminous United States, and the first to have been produced digitally, is that by Thelin and Pike (USGS I-2206, 1991). The image is remarkable for its crispness of detail and for the natural appearance of the artificial land surface. Our goal has been to produce a shaded-relief image of Alaska that has the same look and feel as the Thelin and Pike image. The Alaskan image could have been produced at the same scale as its lower 48 counterpart (1:3,500,000). But by insetting the Aleutian Islands into the Gulf of Alaska, we were able to print the Alaska map at a larger scale (1:2,500,000) and about the same physical size as the Thelin and Pike image. Benefits of the 1:2,500,000 scale are (1) greater resolution of topographic features and (2) ease of reference to the U.S. Geological Survey (USGS) (1987) Alaska Map E and the statewide geologic map (Beikman, 1980), which are both 1:2,500,000 scale. Manually drawn, shaded-relief images of Alaska's land surface have long been available (for example, Department of the Interior, 1909; Raisz, 1948). The topography depicted on these early maps is mainly schematic. Maps showing topographic contours were first available for the entire State in 1953 (USGS, 1:250,000) (J.H. Wittmann, USGS, written commun., 1996). The Alaska Map E was initially released in 1954 in both planimetric (revised in 1973 and 1987) and shaded-relief versions (revised in 1973, 1987, and 1996); topography depicted on the shaded-relief version is based on the 1:250,000-scale USGS topographic maps. Alaska Map E was later modified to include hypsometric tinting by Raven Maps and Images (1989, revised 1993) as copyrighted versions. Other shaded-relief images were produced for The National Geographic Magazine (LaGorce, 1956; 1:3,000,000) or drawn by Harrison (1970; 1:7,500,000) for The National Atlas of the United States. Recently, the State of Alaska digitally produced a shaded-relief image

  20. Combined approaches for the relief of spinal cord injury-induced neuropathic pain.

    Science.gov (United States)

    Gwak, Young S; Kim, Hee Young; Lee, Bong Hyo; Yang, Chae Ha

    2016-04-01

    The adequate treatment of spinal cord injury (SCI)-induced neuropathic pain still remains an unresolved problem. The current medications predominantly used in the SCI-induced neuropathic pain therapy are morphine, anticonvulsants, antidepressants, and antiepileptics, which suggests that psychiatric aspects might be important factors in the treatment of neuropathic pain. It is well documented that the modulation of the sensory events is not a unique way for achieving pain relief. In addition, pain patients still express dissatisfaction and complain of unwanted effects of the medications, suggesting that alternative approaches for the treatment of neuropathic pain are essential. In psychiatry, pain relief represents relaxation and a feeling of comfort and satisfaction, which suggests that cognitive and emotional motivations are important factors in the treatment of neuropathic pain. The comorbidity of chronic pain and psychiatric disorders, which is well recognized, suggests that the effective therapeutic relief for neuropathic pain induced by SCI can be achieved in conjunction with the management of the sensory and psychiatric aspects of patient. In this review, we address the feasibility of a combined acupuncture and pharmacotherapy treatment for the relief of neuropathic pain behavior following SCI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Implementation of telemedicine services in the earthquake disaster relief: the best medical experts provide direct medical service to the affected people%地震救援中实施远程医疗服务:把最好的医学专家送到灾区人民身边

    Institute of Scientific and Technical Information of China (English)

    黎檀实; 柴家科

    2013-01-01

    Objective and Method To sum up the experience and significance of the remote medical consultation system used by the PLA General Hospital in 4 ·20 Sichuan Lushan earthquake medical rescue in 2013.Results and conclusions After the Lushan earthquake in April 20,2013,the expert medical rescue team of the PLA General Hospital immediately took the wireless portable telemedicine system to the converge hospital which had received many wounds in earthquake and had been connected with other hospitals,medical rescue teams and rescue ambulances to open the remote medical consultation system for disaster services including intensive care,emergency treatment,orthopedics,cerebral surgery,hepatobiliary surgery,obstetrics,gynecology and other related professional remote assistance services.The experts put forward the diagnosis and treatment for victims and had a benign interaction between the experts in disaster site and rear experts,as a result improved the ability of treatment of the disaster expert medical team.The PLA General Hospital treated more than 110 patients by remote medical consultation system in the Lushan earthquake and achieved real-time HD consultation and on-site operation guide.The using of remote medical consultation system achieved the connection between multimedia communication system and medical information system of the hospital and the interconnection of video,audio,data and medical services among each united hospitals,which can provide the significant experience of using remote medical consultation system in our disaster medical rescue activities.%目的和方法 总结解放军总医院远程医疗会诊系统在2013年“4·20”四川芦山地震救援中发挥其远程医疗服务的经验,探讨远程医疗会诊系统在灾难救援中的作用.结果和结论 在2013年4月20日四川芦山地震后,解放军总医院专家医疗队及时将无线便携式远程医疗会诊系统发送至地震灾区伤员集合点医院,第一时间组织开通

  2. Disability and health-related rehabilitation in international disaster relief

    Directory of Open Access Journals (Sweden)

    On behalf of the International Society of Physical and Rehabilitation Medicine's Sub-Committee on Rehabilitation Disaster Relief

    2011-08-01

    Full Text Available Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention.To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1 epidemiology of injury and disability, (2 impact on health and rehabilitation systems, and (3 the assessment and measurement of disability.Qualitative literature review and secondary data analysis.Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI, and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested.Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health-related rehabilitation following

  3. 46 CFR 154.519 - Piping relief valves.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Piping relief valves. 154.519 Section 154.519 Shipping... Process Piping Systems § 154.519 Piping relief valves. (a) The liquid relief valve that protects the cargo piping system from liquid pressure exceeding the design pressure must discharge into: (1) A cargo...

  4. 49 CFR 179.15 - Pressure relief devices.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief devices. 179.15 Section 179.15... Design Requirements § 179.15 Pressure relief devices. Except for DOT Class 106, 107, 110, and 113 tank cars, tanks must have a pressure relief device, made of material compatible with the lading,...

  5. 46 CFR 154.912 - Inerted spaces: Relief devices.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Inerted spaces: Relief devices. 154.912 Section 154.912... Atmospheric Control in Cargo Containment Systems § 154.912 Inerted spaces: Relief devices. Inerted spaces must be fitted with relief valves, rupture discs, or other devices specially approved by the...

  6. 49 CFR 179.500-12 - Pressure relief devices.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief devices. 179.500-12 Section 179... and 107A) § 179.500-12 Pressure relief devices. (a) Tank shall be equipped with one or more pressure relief devices of approved type and discharge area, mounted on the cover or threaded into the...

  7. 49 CFR 179.300-15 - Pressure relief devices.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief devices. 179.300-15 Section 179... Pressure relief devices. (a) Unless prohibited in part 173 of this subchapter, tanks shall be equipped with one or more relief devices of approved type, made of metal not subject to rapid deterioration by...

  8. 21 CFR 358.310 - Ingrown toenail relief active ingredient.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Ingrown toenail relief active ingredient. 358.310... (CONTINUED) DRUGS FOR HUMAN USE MISCELLANEOUS EXTERNAL DRUG PRODUCTS FOR OVER-THE-COUNTER HUMAN USE Ingrown Toenail Relief Drug Products § 358.310 Ingrown toenail relief active ingredient. The active ingredient...

  9. 46 CFR 98.25-60 - Safety relief valves.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Safety relief valves. 98.25-60 Section 98.25-60 Shipping... § 98.25-60 Safety relief valves. (a) Each tank shall be fitted with two or more approved safety relief valves, designed, constructed, and flow-tested for capacity in conformance with subpart 162.018...

  10. 46 CFR 154.1846 - Relief valves: Changing set pressure.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Relief valves: Changing set pressure. 154.1846 Section... Relief valves: Changing set pressure. The master shall: (a) Supervise the changing of the set pressure of relief valves under § 154.802(b); (b) Enter the change of set pressure in the vessel's log; and...

  11. 27 CFR 24.158 - Extent of relief.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Extent of relief. 24.158... Extent of relief. (a) General. The surety on any bond required by this part who has filed a notice for relief from liability as provided in § 24.157 will be relieved from liability under bond as set forth in...

  12. 30 CFR 847.16 - Civil actions for relief.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Civil actions for relief. 847.16 Section 847.16... relief. (a) Under section 521(c) of the Act, we, the regulatory authority, may request the Attorney General to institute a civil action for relief whenever you, the permittee, or your agent— (1) Violate or...

  13. 19 CFR 171.3 - Oral presentations seeking relief.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Oral presentations seeking relief. 171.3 Section... OF THE TREASURY (CONTINUED) FINES, PENALTIES, AND FORFEITURES Application for Relief § 171.3 Oral presentations seeking relief. (a) For violation of section 592 or section 593A. If the penalty incurred is for a...

  14. 7 CFR 900.70 - Applications for interim relief.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Applications for interim relief. 900.70 Section 900.70... Applications for interim relief. (a) Filing the application. A person who has filed a petition pursuant to... the relief is requested, including any facts showing irreparable injury. The application must be...

  15. 19 CFR 172.2 - Petition for relief.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Petition for relief. 172.2 Section 172.2 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... Relief § 172.2 Petition for relief. (a) To whom addressed. Petitions for the cancellation of any claim...

  16. 47 CFR 52.19 - Area code relief.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Area code relief. 52.19 Section 52.19... Administration § 52.19 Area code relief. (a) State commissions may resolve matters involving the introduction of... whether area code relief will take the form of a geographic split, an overlay area code, or a boundary...

  17. 29 CFR 1601.23 - Preliminary or temporary relief.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Preliminary or temporary relief. 1601.23 Section 1601.23... Employment Practices § 1601.23 Preliminary or temporary relief. (a) In the interest of the expeditious... subdivision, any recommendation for preliminary or temporary relief shall be transmitted directly to the...

  18. 18 CFR 1308.11 - Contractor's request for relief.

    Science.gov (United States)

    2010-04-01

    ... for relief. 1308.11 Section 1308.11 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY CONTRACT DISPUTES Contracting Officers § 1308.11 Contractor's request for relief. Any request for relief which a Contractor believes is due under a contract shall be submitted to the Contracting Officer...

  19. 50 CFR 11.12 - Petition for relief.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Petition for relief. 11.12 Section 11.12... PROCEDURES Assessment Procedure § 11.12 Petition for relief. If the respondent so chooses he may ask that no... the charge and the Director's allegations of facts, by filing a petition for relief (hereinafter...

  20. 49 CFR 178.345-10 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief. 178.345-10 Section 178.345-10... Specifications for Containers for Motor Vehicle Transportation § 178.345-10 Pressure relief. (a) Each cargo tank... applicable individual specification. The pressure and vacuum relief system must be designed to operate and...

  1. 12 CFR 268.501 - Remedies and relief.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Remedies and relief. 268.501 Section 268.501... RULES REGARDING EQUAL OPPORTUNITY Remedies and Enforcement § 268.501 Remedies and relief. (a) When the... employee has been discriminated against, the Board shall provide full relief which shall include the...

  2. 49 CFR 1115.5 - Petitions for other relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Petitions for other relief. 1115.5 Section 1115.5... OF TRANSPORTATION RULES OF PRACTICE APPELLATE PROCEDURES § 1115.5 Petitions for other relief. (a) A... desired relief must be stated in the petition, and the petition must be filed not less than 10 days prior...

  3. 31 CFR 306.111 - Procedure for applying for relief.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Procedure for applying for relief... GOVERNING U.S. SECURITIES Relief for Loss, Theft, Destruction, Mutilation, or Defacement of Securities § 306.111 Procedure for applying for relief. Prompt report of the loss, theft, destruction, mutilation or...

  4. 49 CFR 178.347-4 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief. 178.347-4 Section 178.347-4... Specifications for Containers for Motor Vehicle Transportation § 178.347-4 Pressure relief. (a) Each cargo tank must be equipped with a pressure and vacuum relief system in accordance with § 178.345-10 and this...

  5. 49 CFR 601.41 - Petitions for relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Petitions for relief. 601.41 Section 601.41... Transportation Systems § 601.41 Petitions for relief. In the case of a national or regional emergency or disaster... for temporary relief from the provisions of any policy statement, circular, guidance document or rule. ...

  6. 49 CFR 178.346-3 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Pressure relief. 178.346-3 Section 178.346-3... Specifications for Containers for Motor Vehicle Transportation § 178.346-3 Pressure relief. (a) Each cargo tank must be equipped with a pressure relief system in accordance with § 178.345-10 and this section. (b...

  7. 26 CFR 1.6015-4 - Equitable relief.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 13 2010-04-01 2010-04-01 false Equitable relief. 1.6015-4 Section 1.6015-4...) INCOME TAXES Tax Returns Or Statements § 1.6015-4 Equitable relief. (a) A requesting spouse who files a joint return for which a liability remains unpaid and who does not qualify for full relief under § 1...

  8. 29 CFR 1614.501 - Remedies and relief.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Remedies and relief. 1614.501 Section 1614.501 Labor... EMPLOYMENT OPPORTUNITY Remedies and Enforcement § 1614.501 Remedies and relief. (a) When an agency, or the... discriminated against, the agency shall provide full relief which shall include the following elements in...

  9. 37 CFR 41.204 - Notice of basis for relief.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Notice of basis for relief... § 41.204 Notice of basis for relief. (a) Priority statement. (1) A party may not submit evidence of its... the precise relief sought. (c) Filing and service. The Board will set the times for filing and serving...

  10. 46 CFR 560.3 - Petitions for relief.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 9 2010-10-01 2010-10-01 false Petitions for relief. 560.3 Section 560.3 Shipping... PORTS § 560.3 Petitions for relief. (a) Filing. (1) Any owner or operator of a liner, bulk, tramp or... between foreign ports has been, or will be, unduly impaired may file a written petition for relief under...

  11. 19 CFR 171.1 - Petition for relief.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Petition for relief. 171.1 Section 171.1 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) FINES, PENALTIES, AND FORFEITURES Application for Relief § 171.1 Petition for relief. (a) To whom...

  12. Multiple perspectives on symptom interpretation in primary care research

    DEFF Research Database (Denmark)

    Rosendal, Marianne; Jarbøl, Dorte Ejg; Pedersen, Anette Fischer;

    2013-01-01

    BACKGROUND: Assessment and management of symptoms is a main task in primary care. Symptoms may be defined as 'any subjective evidence of a health problem as perceived by the patient'. In other words, symptoms do not appear as such; symptoms are rather the result of an interpretation process. We a......, including medicalisation of normal phenomena and devaluation of medically unexplained symptoms. Future research in primary care could gain from exploring symptoms as a generic phenomenon and raised awareness of symptom complexity....

  13. Libraries and information provision for African relief

    Directory of Open Access Journals (Sweden)

    Elsemieke Wishart

    2012-08-01

    Full Text Available This research article explores the concept that libraries as communication centres in sub-Saharan Africa can play a vital role in bringing poverty relief by providing greater access to information through modern technology. It discusses the patrons who can benefit from community information centres and explores their particular needs. I have researched how modern tools like the Internet, computers, e-readers and cell phones can bring valuable information to impoverished citizens. My research was conducted through reading research papers using article databases, books and Internet websites. The future for libraries in sub-Saharan Africa is bright, as new technology opens up vast opportunities to share information in a way that is accessible, affordable and adaptable to the needs of the African people. I recommend that librarians and relief organisations in Southern Africa seriously consider using modern technology to provide information that will empower its citizens.

  14. 38 CFR 17.96 - Medication prescribed by non-VA physicians.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Medication prescribed by non-VA physicians. 17.96 Section 17.96 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any...

  15. A review of sleep-promoting medications used in pregnancy.

    Science.gov (United States)

    Okun, Michele L; Ebert, Rebecca; Saini, Bandana

    2015-04-01

    Approximately 4% of adults who have symptoms of insomnia resort to various hypnotic or sedating medications for acute symptom relief. Although typically a common practice for nonpregnant adults, this is not the case for the thousands of pregnant women who also report substantial sleep issues. Unfortunately, a paucity of randomized controlled trials in this population, scant empiric evidence regarding the appropriateness of prescribing options, and the concern of subsequent teratogenicity restricts the ability of clinicians to make informed decisions. We synthesized the current research regarding hypnotics and sedating medications used (both on- and off-label) during pregnancy and their association with adverse outcomes. Medications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations. However, benzodiazepines and hypnotic benzodiazepine receptor agonists may increase rates of preterm birth, low birthweight, and/or small-for-gestational-age infants. The small number of studies and the small number of subjects prohibit any definitive interpretation regarding the consequences of the use of hypnotic or sedating medications in pregnancy. Additional case reports, randomized clinical trials, and epidemiologic studies are needed urgently.

  16. Computational analysis of aircraft pressure relief doors

    Science.gov (United States)

    Schott, Tyler

    Modern trends in commercial aircraft design have sought to improve fuel efficiency while reducing emissions by operating at higher pressures and temperatures than ever before. Consequently, greater demands are placed on the auxiliary bleed air systems used for a multitude of aircraft operations. The increased role of bleed air systems poses significant challenges for the pressure relief system to ensure the safe and reliable operation of the aircraft. The core compartment pressure relief door (PRD) is an essential component of the pressure relief system which functions to relieve internal pressure in the core casing of a high-bypass turbofan engine during a burst duct over-pressurization event. The successful modeling and analysis of a burst duct event are imperative to the design and development of PRD's to ensure that they will meet the increased demands placed on the pressure relief system. Leveraging high-performance computing coupled with advances in computational analysis, this thesis focuses on a comprehensive computational fluid dynamics (CFD) study to characterize turbulent flow dynamics and quantify the performance of a core compartment PRD across a range of operating conditions and geometric configurations. The CFD analysis was based on a compressible, steady-state, three-dimensional, Reynolds-averaged Navier-Stokes approach. Simulations were analyzed, and results show that variations in freestream conditions, plenum environment, and geometric configurations have a non-linear impact on the discharge, moment, thrust, and surface temperature characteristics. The CFD study revealed that the underlying physics for this behavior is explained by the interaction of vortices, jets, and shockwaves. This thesis research is innovative and provides a comprehensive and detailed analysis of existing and novel PRD geometries over a range of realistic operating conditions representative of a burst duct over-pressurization event. Further, the study provides aircraft

  17. Relief Evolution in Tectonically Active Mountain Ranges

    Science.gov (United States)

    Whipple, Kelin X.

    2004-01-01

    The overall aims of this 3-yr project, as originally proposed were to: (1) investigate quantitatively the roles of fluvial and glacial erosion in the evolution of relief in mountainous regions, and (2) test rigorously the quality and accuracy of SRTM topographic data in areas of rugged relief - both the most challenging and of greatest interest to geomorphic, neotectonic, and hazards applications. Natural laboratories in both the western US and the Southern Alps of New Zealand were identified as most promising. The project has been both successful and productive, despite the fact that no SRTM data for our primary field sites in New Zealand were released on the time frame of the work effort. Given the delayed release of SRTM data, we pursued the scientific questions of the roles of fluvial and, especially, glacial erosion in the evolution of relief in mountainous regions using available digital elevation models (DEMs) for the Southern Alps of New Zealand (available at both 25m and 50m pixel sizes), and USGS 10m and 30m DEMs within the Western US. As emphasized in the original proposal, we chose the emphasis on the role of glacial modification of topographic relief because there has been little quantitative investigation of glacial erosion processes at landscape scale. This is particularly surprising considering the dramatic sculpting of most mid- and high-latitude mountain ranges, the prodigious quantities of glacially-derived sediment in terrestrial and marine basins, and the current cross-disciplinary interest in the role of denudational processes in orogenesis and the evolution of topography in general. Moreover, the evolution of glaciated landscapes is not only a fundamental problem in geomorphology in its own right, but also is at the heart of the debate over Late Cenozoic linkages between climate and tectonics.

  18. Decreasing Time to Pain Relief for Emergency Department Patients with Extremity Fractures

    Science.gov (United States)

    Heilman, James A.; Tanski, Mary; Burns, Beech; Lin, Amber; Ma, John

    2016-01-01

    Significant delays occur in providing adequate pain relief for patients who present to the emergency department (ED) with extremity fractures. The median time to pain medication administration for patients presenting to our ED with extremity fractures was 72.5 minutes. We used a multidisciplinary approach to implement three improvement cycles with the goal of reducing the median time to pain medication by 15% over an eight month time period. First, we redesigned nursing triage and treatment processes. Second, we improved nursing documentation standardization to ensure accurate tracking of patients who declined pain medication. Third, through consensus building within our physician group, we implemented a department-wide standard of care to provide early pain relief for extremity fractures. Median time to pain medication for patients with an extremity fracture reduced significantly between the pre-and post-intervention periods (p=0.009). The average monthly median time to medication was 72.5 minutes (95% CI: 57.1 to 88.0) before the intervention (Jan 2013-Oct 2014) and 49.8 minutes (95% CI: 42.7 to 56.9) after the intervention (November 2014 to June 2016). In other words, monthly median time was 31% faster (22.7 minute difference) in the post intervention period. Implementing three key interventions reduced the time to pain medication for patients with extremity injuries. Since June 2016 the reductions in median time to medication have continued to improve. PMID:28090328

  19. Massage therapy for fibromyalgia symptoms.

    Science.gov (United States)

    Kalichman, Leonid

    2010-07-01

    Massage therapy is widely used by patients with fibromyalgia seeking symptom relief. We performed a review of all available studies with an emphasis on randomized controlled trials to determine whether massage therapy can be a viable treatment of fibromyalgia symptoms. Extensive narrative review. PubMed, PsychInfo, CINAHL, PEDro, ISI Web of Science, and Google Scholar databases (inception-December 2009) were searched for the key words "massage", "massotherapy", "self-massage", "soft tissue manipulation", "soft tissue mobilization", "complementary medicine", "fibromyalgia" "fibrositis", and "myofascial pain". No language restrictions were imposed. The reference lists of all articles retrieved in full were also searched. The effects of massage on fibromyalgia symptoms have been examined in two single-arm studies and six randomized controlled trials. All reviewed studies showed short-term benefits of massage, and only one single-arm study demonstrated long-term benefits. All reviewed studies had methodological problems. The existing literature provides modest support for use of massage therapy in treating fibromyalgia. Additional rigorous research is needed in order to establish massage therapy as a safe and effective intervention for fibromyalgia. In massage therapy of fibromyalgia, we suggest that massage will be painless, its intensity should be increased gradually from session to session, in accordance with patient's symptoms; and the sessions should be performed at least 1-2 times a week.

  20. The Signaling Theory of Symptoms

    Directory of Open Access Journals (Sweden)

    Leander Steinkopf

    2015-08-01

    Full Text Available Placebo research shows that the subjective quality of care and social support, as well as the patients’ expectations of treatment, influence therapeutic outcomes. However, this phenomenon, known as the placebo effect, does not usually cure the disease, but rather can provide symptomatic relief: It may soothe symptoms such as pain, swelling, or nausea that constitute part of an immune response. The function of this mechanism remains unclear. This article puts forward the Signaling Theory of Symptoms (STS as a possible explanation. According to STS, discernible aspects of an immune response, such as pain, swelling, or nausea, not only serve a defensive and healing function but also a signaling function: symptoms signal the need for care and treatment to potential helpers. Once help and treatment are granted, the signaling function is fulfilled and the symptoms diminish. This mechanism may have been a significant advantage in preindustrial environments, when sufferers depended on extensive social support and personal treatment. Nowadays, from the point of view of modern materialist medicine, the mobilization of social support no longer seems so crucial, and thus the placebo effect has been assigned a somewhat mysterious quality.

  1. Late-Cenozoic relief evolution under evolving climate: a review

    Science.gov (United States)

    Champagnac, Jean-Daniel; Valla, Pierre; Herman, Fred

    2014-05-01

    The present review is an attempt to summarize quantitative evidence of Late Cenozoic changes in topographic relief on Earth. We first define different meanings of the word "relief", as it is commonly used, and detail the metrics used to quantify it. We then specify methodological tools used to quantify relief change (primarily lowtemperature thermochronometry and terrestrial cosmogenic nuclides), and analyze published evidence for different regions. Our review first show that relief changes and rates of changes are more important at mid-, than high- or low-latitudes, and appear to be insensitive to mean precipitation rates. We also show that relief change is positive (relief increases) in most of the reported cases (~80%). We subsequently define two functional relationships between relief and erosion, depending on the chosen definition of relief, and propose a conceptual model of landscape memory. We conclude, following others, that erosion rates depends non-linearly on relief evolution, itself being a function of the spatial distribution and rates of erosion. The relief increases documented in this review may be related led to erosion rate increases during the same timescales. Lastly, we discuss the importance of glacial and periglacial processes on Late Cenozoic relief and erosion rate changes, and stress the importance of frost shattering and glacial erosion at mid- and high-latitudes.

  2. The search for pain relief in people with chronic fatigue syndrome: a descriptive study.

    Science.gov (United States)

    Marshall, Rebecca; Paul, Lorna; Wood, Les

    2011-07-01

    The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms. This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study. Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain. Each interview was conducted in the home of the participant. Fifty participants were recruited, of which, 10 participants were severely disabled by CFS. Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment. Three participants were currently receiving physiotherapy. Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief. Acupuncture was reported to provide the most pain relief (n=16). Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist. The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms. Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

  3. Relief-oriented use of marijuana by teens

    OpenAIRE

    Johnson Joy L; Bottorff Joan L; Moffat Barbara M; Mulvogue Tamsin

    2009-01-01

    Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were reg...

  4. Relief-oriented use of marijuana by teens

    OpenAIRE

    Johnson Joy L; Bottorff Joan L; Moffat Barbara M; Mulvogue Tamsin

    2009-01-01

    Abstract Background There are indications that marijuana is increasingly used to alleviate symptoms and for the treatment of a variety of medical conditions both physical and psychological. The purpose of this study was to describe the health concerns and problems that prompt some adolescents to use marijuana for therapeutic reasons, and their beliefs about the risks and benefits of the therapeutic use of marijuana. Methods As part of a larger ethnographic study of 63 adolescents who were reg...

  5. Relief of primary cervical dystonia symptoms by low frequency transcranial magnetic stimulation of the premotor cortex: case report Alívio da distonia cervical primária com o uso da estimulação magnética transcraniana de baixa freqüência sobre o córtex pré-motor: relato de caso

    Directory of Open Access Journals (Sweden)

    Nasser Allam

    2007-09-01

    Full Text Available OBJECTIVE: To evaluate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS on the symptoms of a patient with primary segmental dystonia (PSD. METHOD: 1200 TMS pulses at a frequency of 1Hz, over the premotor cortex, with an intensity of 90% of the motor threshold (MT, using an eight-shaped coil; a total of 5 sessions were carried out. RESULTS: A reduction of 50 percent in the neck subset of the Burke, Fahn and Marsden torsion dystonia scale (BFM was observed in our patient. CONCLUSION: The reduction in the BFM scale supports the concept that rTMS of the premotor cortex may reduce specific motor symptoms in PSD.OBJETIVO: Investigar o efeito da estimulação magnética transcraniana repetitiva (EMTr de baixa freqüência nos sintomas de um paciente com distonia segmentar primária (DSP. MÉTODO: 1200 pulsos a uma freqüência de 1Hz, sobre o córtex pré-motor, a uma intensidade de 90% do limiar motor (LM, usando uma bobina em forma de 8. Foram realizadas 5 sessões. RESULTADOS: Uma redução de 50% no sub-item "pescoço" na escala de distonia de torção de Burke, Fahn e Marsden (BFM foi observada no paciente em questão. CONCLUSÃO: A redução na escala BFM corrobora a idéia de que a EMTr sobre o córtex pré-motor pode reduzir sintomas motores específicos na DSP.

  6. EPRI PWR Safety and Relief Value Test Program: safety and relief valve test report

    Energy Technology Data Exchange (ETDEWEB)

    1982-12-01

    A safety and relief valve test program was conducted by EPRI for a group of participating PWR utilities to respond to the USNRC recommendations documented in NUREG 0578 Section 2.1.2, and as clarified in NUREG 0737 Item II.D.1.A. Seventeen safety and relief valves representative of those utilized in or planned for use in participating domestic PWR's were tested under the full range of selected test conditions. This report contains a listing of the selected test valves and the corresponding as tested test matrices, valve performance data and principal observations for the tested safety and relief valves. The information contained in this report may be used by the participating utilities in developing their response to the above mentioned USNRC recommendations.

  7. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    Science.gov (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents.

  8. Attitudes toward euthanasia among Swedish medical students.

    Science.gov (United States)

    Karlsson, Marit; Strang, Peter; Milberg, Anna

    2007-10-01

    Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life.

  9. Principles and practice of disaster relief: lessons from Haiti.

    Science.gov (United States)

    Benjamin, Ernest; Bassily-Marcus, Adel M; Babu, Elizabeth; Silver, Lester; Martin, Michael L

    2011-01-01

    Disaster relief is an interdisciplinary field dealing with the organizational processes that help prepare for and carry out all emergency functions necessary to prevent, prepare for, respond to, and recover from emergencies and disasters caused by all hazards, whether natural, technological, or human-made. Although it is an important function of local and national governing in the developed countries, it is often wanting in resource-poor, developing countries where, increasingly, catastrophic disasters tend to occur and have the greatest adverse consequences. The devastating January 12, 2010, Haiti earthquake is a case study of the impact of an extreme cataclysm in one of the poorest and most unprepared settings imaginable. As such, it offers useful lessons that are applicable elsewhere in the developing world. Emergency preparedness includes 4 phases: mitigation or prevention, preparedness, response, and recovery. Periods of normalcy are the best times to develop disaster preparedness plans. In resource-poor countries, where dealing with the expenses of daily living is already a burden, such planning is often neglected; and, when disasters strike, it is often with great delay that the assistance from international community can be deployed. In this increasingly interconnected world, the Haiti earthquake and the important international response to it make a strong case for a more proactive intervention of the international community in all phases of emergency management in developing countries, including in mitigation and preparedness, and not just in response and recovery. Predisaster planning can maximize the results of the international assistance and decrease the human and material tolls of inevitable disasters. There should be a minimum standard of preparedness that every country has to maintain and the international assistance to achieve that. International academic medical centers interested in global health could strengthen their programs by prospectively

  10. Impact of cognitive emotion regulation on mental symptom level of medical students%医学生认知情绪调节对心理症状水平的影响

    Institute of Scientific and Technical Information of China (English)

    李晋文; 傅文青

    2014-01-01

    Objective To study the impact of cognitive emotion regulation on mental symptom level of medical students. Methods Medical students of Soochow university were asked to complete Symptom Checklist 90( SCL-90 )and Cognitive Emotion Regulation Questionaire- Chinese Version( CERQ-C). Results ①The medical students who scored greater than 160 on SCL-90 adopted more self-blame,rumination,and catastrophizing,while less putting-into-perspective.②Maladaptive strategy showed significant positive correlation with each factor marks and total mean marks of SCL-90(P﹤0. 01),meanwhile,rumination and catastrophizing positively re-lated to each factor marks and total mean marks remarkably,while the positive correlation of self-blame with obsessive-compulsive , interpersonal sensitivity,depression,anxiety,psychoticism and total mean marks was very significant,with somati-zation and hostility was significant(P﹤0. 05). ③The combination of Catastrophizing,self-blame and Rumination was able to predict 15. 9% of the variation of mental health. Conclusion When facing negative events,the more maladap-tive regulation strategies medical students adopt,the higher mental symptom level they have.%目的:研究医学生认知情绪调节策略对心理症状水平的影响。方法运用症状自评量表( SCL-90)与认知情绪调节问卷中文版( CERQ-C)对江苏某大学医学部586名本科生进行调查,按SCL-90界值分组后进行认知情绪调节策略比较,并对两个工具各因子间的相关性进行分析。结果医学生阳性组( SCL-90总评分﹥160分)较多运用责难自己、沉思、灾难化策略,而较少运用理性分析策略;②不适应性调节策略与SCL-90各因子分及总均分呈正相关(P﹤0.01),其中,沉思和灾难化与各因子分及总均分正相关;责难自己与强迫症状、人际关系敏感、抑郁、焦虑、精神病性及总均分正相关(P﹤0.01),与躯体

  11. [War Relief of Japanese Red Cross Nurses in the Lost Battle of Burma].

    Science.gov (United States)

    Kawahara, Yukari

    2015-12-01

    This paper aims to reveal changes in the relief support of the Japanese Red Cross relief units dispatched to Burma during the Second World War, from the beginning of fighting in Burma to the Japanese withdrawal. Japanese Red Cross relief units began their relief support when Japan invaded Burma in February of 1942. Counterattacks by the British, Indian and Chinese armies from December 1942 caused an increase in the number of patients. There were also many cases of malnutrition and malaria due to the extreme shortage of medical supplies as a result of the Battle of Imphal, which began in March of 1944. Bomb raids became even more intense after the battle ended in July 1944, and patients were carried into bomb shelters and caves on a daily basis. Just prior to invasion by enemy troops, they were ordered to evacuate to neighboring Thailand. Nurses from the Wakayama group hid their identity as members of the Red Cross and evacuated, with 15 out of 23 dying or being reported missing in action.

  12. Technology and information sharing in disaster relief

    DEFF Research Database (Denmark)

    Bjerge, Benedikte; Clark, Nathan; Fisker, Peter;

    2016-01-01

    This paper seeks to examine the extent to which technological advances can enhance inter-organizational information sharing in disaster relief. Our case is the Virtual OSOCC (On-Site Operations Coordination Centre) which is a part of the Global Disaster Alert and Coordination System (GDACS) under...... database of user interaction including more than 20,000 users and 11,000 comments spread across approximately 300 disaster events. Controlling for types and severities of the events, location-specific vulnerabilities, and the overall trends, we find that the introduction of new features have led...

  13. EC Hidraulic Drive Cylinder Relief Vlave Test

    Energy Technology Data Exchange (ETDEWEB)

    Wu, J.; /Fermilab

    1991-04-03

    This engineering note documents the testing of the set pressure of the EC hydraulic drive cylinder relief valve. The purpose of the relief valve is to provide a safety measure in the event that oil becomes trapped in the rod side of the cylinder and pressure is applied to the cap side. The note includes an explanation of the procedure used and a summary of the result of the testing done on February 14, 1991 by Gary Trotter. The result was that the cylinder relief valve relieved at the correct set pressure of 10,500 psig. The basic concern is for the protection of the cylinder. The pump is capable of providing up to 10,500 psi of pressure to either side of the cylinder. The cylinder is rated for 10,500 psi. Under normal operating conditions, the valves would be open, and the pumping pressure would automatically flow oil into one side, and remove oil from the other side. If, however, the valve for the other side was closed, so that oil could not be removed, then the pressure would build in that side. If the rod side is pressurized to the maximum pump pressure of 10,500 psi, the cross sectional area ratio of 2.29 results in a pressure of approximately 4600 psi in the cap side, which is well under the rated pressure. If, however, the cap side is pressurized to 10,500 psi, the cross sectional area would produce a pressure of approximately 24,000 psi in the rod side, which could damage the cylinder. Therefore, the pressure on the rod side must be limited to the rated pressure of 10,500 psi. In reality, the maximum operating force on the piston would be under 11,000 Ibs., which would result in the maximum cylinder pressure being under 8000 psi to the rod side, and under 3500 psi to the cap side. Therefore, the relief is only needed as a safety precaution in the case that oil becomes trapped.

  14. LOFT pressurizer safety: relief valve reliability

    Energy Technology Data Exchange (ETDEWEB)

    Brown, E.S.

    1978-01-18

    The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice.

  15. Holistic relief of pain - Nursing approach

    Directory of Open Access Journals (Sweden)

    Evaggelos Giavasopoulos

    2007-01-01

    Full Text Available It is well known that the patients who suffer from pain can develop a wide variety of behaviours. At the same time they experience a plethora of biological, psychological and social problems. Undeniably the nurses constitute an integral part of the multidisciplinary team of approach and relief of patient’s pain. The nurse’s role is developed and organized with independence in the health care team and expresses itself in a wide spectrum of activities. Aim in the present article is to highlight the force of nurse among the multidisciplinary team, analyzing the multiple roles undertaken by nurses, as well as the necessity for holistic approach of pain.

  16. CAS scientists active in earthquake relief operation

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Soon after the devastating earthquake taking place on last 12 May in Sichuan, the CAS leadership promptly mobilized its researchers to dedicate their expertise to the nationwide drive of the disaster's relief and reduction. A leading group was established to coordinate the Academy's efforts in this regard. All of the eight CAS institutions located in Sichuan were organized to do everything possible to reduce their losses to the minimum. At the same time, a trans-departmental and interdisciplinary taskforce was formed to provide a powerful S&T backing for the nationwide drive.

  17. Insights into Casual Relief Teaching: Casual Relief Teachers' Perceptions of Their Knowledge and Skills

    Science.gov (United States)

    Nicholas, Maria; Wells, Muriel

    2017-01-01

    Research into the experiences of casual relief teachers (CRTs) (substitute or supply teachers) across Australia and internationally has reported feelings of marginalisation among participants. These findings are concerning when one considers that students might be in the care of CRTs for an equivalent of 1 year or more throughout their schooling.…

  18. Symptoms and related functioning in a traumatized community.

    NARCIS (Netherlands)

    Berg, B. van den; Grievink, L.; Stellato, R.K.; Yzermans, C.J.; Lebret, E.

    2005-01-01

    BACKGROUND: Traumatic events are described as precipitating factors for medically unexplained symptoms. The aim of this study was to examine the prevalence and course of symptoms reported by disaster survivors and to assess whether the symptoms have features similar to those of medically unexplained

  19. The glacial relief in the Leaota Mountains

    Directory of Open Access Journals (Sweden)

    George MURĂTOREANU

    2008-05-01

    Full Text Available The presence of glacial relief in the Romanian medium height massifs is still controversial. The medium height mountains, such as theLeaota Mountains (in the Bucegi group, with maximum altitudes of almost 2000 m andmedium altitudes of approximately 1250 m, can display traces of glacial relief dating from theUpper Pleistocene. The aim of this article is to provide evidence about the presence of theglacial morphology in the northern part of the Leaota Peak, the main orographic node in themassif with the same name. Thus, on the basis of field observations, of topographical mapanalysis and by using the geographic information systems which made possible a detailedmorphometric analysis, I was able to gather evidence proving the existence of a glacial cirquein the Leaota Mountains. The arguments put forward in this article show that the glacial reliefis represented in the Leaota Mountains through a small-size suspended glacial cirque, whichdisplays all the morphologic elements proving the existence of glaciation in this massif.

  20. Increasing the Useful Life of Quench Reliefs with Inconel Bellows

    Energy Technology Data Exchange (ETDEWEB)

    Soyars, W. M. [Fermilab

    1999-01-01

    Reliable quench relief valves are an important part of superconducting magnet systems. Fermilab developed bellows-actuated cryogenic quench reliefs which have been in use since the early l 980's. The original design uses a stainless steel bellows. A high frequency, low amplitude vibration during relieving events has resulted in fatigue failures in the original design. To take advantage of the improved resistance to fatigue of Inconel, a nickel-chromium alloy, reliefs using Inconel 625 bellows were made. Design, development, and testing of the new version reliefs will be discussed. Tests show that relief valve lifetimes using Inconel bellows are more than five times greater than when using the original stainless steel bellows. Inconel bellows show great promise in increasing the lifetime of quench relief valves, and thus the reliability of accelerator cryogenic systems.

  1. A randomized controlled pilot study comparing aqueous cream with a beeswax and herbal oil cream in the provision of relief from postburn pruritus.

    Science.gov (United States)

    Lewis, Peter A; Wright, Kay; Webster, Anne; Steer, Matthew; Rudd, Michael; Doubrovsky, Anna; Gardner, Glenn

    2012-01-01

    Postburn itch is reported to affect up to 87% of the burn population. Although treatments for postburn itch are multimodal, they remain consistently ineffective. However, recent anecdotal evidence from several outpatients at a tertiary referral hospital suggests that a cream combining beeswax and several herbal oils may be effective in the minimization of postburn itch. The aim of this study was to test the efficacy of beeswax and herbal oil cream against the standard treatment of aqueous cream in the provision of relief from the symptoms of postburn itch. A randomized controlled trial compared two groups using a visual analog scale, frequency of cream application, itch recurrence after cream application, use of antipruritic medications, and sleep disturbance to determine the effect of itch severity and duration. Fifty-two participants were enrolled in the study (84% male) with a mean age of 35 years (SD = 16) and mean burn TBSA of 7.2% (SD = 7.7). Study results found that the beeswax and herbal oil cream reduce itch after application more frequently than aqueous cream (P = .001). In addition, when managed with beeswax and herbal oil cream, participants found that their itch recurred later (P ≤ .001) and their use of antipruritic medications was lower (P = .023). Findings of this study suggest beeswax and herbal oil cream to be more effective in the minimization of postburn itch than aqueous cream. Given this, a larger study examining the efficacy of beeswax and herbal oil cream appears warranted.

  2. 46 CFR 64.71 - Marking of pressure relief devices.

    Science.gov (United States)

    2010-10-01

    ... AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.71 Marking...— (a) Set pressure rating; (b) Rated flow capacity expressed as cubic feet of standard air (60 °F 14.7... 46 Shipping 2 2010-10-01 2010-10-01 false Marking of pressure relief devices. 64.71 Section 64.71...

  3. Sandy PMO Disaster Relief Appropriations Act of 2013 Financial Data

    Data.gov (United States)

    Department of Homeland Security — Sandy PMO: Disaster Relief Appropriations Act of 2013 (Sandy Supplemental Bill) Financial Data. This is the Sandy Supplemental Quarterly Financial Datasets that are...

  4. SIMULATION OF VIBRATION STRESS RELIEF AFTER WELDING BASED ON FEM

    Institute of Scientific and Technical Information of China (English)

    X.C.Zhao; Y.D.Zhang; H.W.Zhang; Q.Wu

    2008-01-01

    A finite element model is developed for the simulation of vibration stress relief (VSR) after welding.For the nonresonant vibration,the reduction in stress strongly depends on the amplitude of vibration.For the resonant vibration,the vibration frequency is the key for stress relief.The vibration frequency should be close to the structure natural frequency for the desired vibration mode.Only small vibration amplitude is required,which will be amplified during vibration.Vibration time does not have a major impact on vibration stress relief.When the amplitude of vibration stress relief is large,the treatment will be more effective.

  5. Study of safety relief valve operation under ATWS conditions. [PWR

    Energy Technology Data Exchange (ETDEWEB)

    Hutmacher, E.S.; Nesmith, B.J.; Brukiewa, J.B.

    1979-06-25

    A literature survey and analysis project has been performed to determine if recent (since mid-1975) data has been reported which could influence the current approach to predicting PWR relief valve capacity under ATWS conditions. This study was conducted by the Energy Technology Engineering Center for NRC. Results indicate that the current relief valve capacity model tends to predict less capacity than actually obtains; however, no experimental verification at PWR ATWS conditions was found. Other project objectives were to establish the availability of methods for evaluating reaction forces and back pressure effects on relief valve capacity, and to determine if facilities exist which are capable of testing PWR relief valves at ATWS conditions.

  6. Analysis on the depressive symptoms and its cognitive characteristic among college students in a medical university%某医学院校大学生抑郁症状及其认知特征分析

    Institute of Scientific and Technical Information of China (English)

    丁建飞; 张洪波; 王君; 佘敏; 段毓雯

    2012-01-01

    目的 了解大学生认知易感性和抑郁症状发生之间的关系.方法 以某医学院校1 498名临床专业大学生为研究对象,采用抑郁量表,归因方式、应对方式和功能失调性态度问卷对其进行问卷调查.结果 大学生抑郁症状检出率为12.5%,抑郁症状评分与功能失调性态度评分之间呈正相关(P<0.01);与应对方式中的解决问题和求助两个维度评分之问呈负相关(均有P<0.01),而与应对方式中的白责、幻想、退避和合理化四个维度评分之间呈正相关(均有P<0.01);抑郁症状评分与归因方式中的消极外归因评分之间呈现负相关(均有P<0.01).结论 大学生抑郁症状与应对方式、功能失调性态度和归因方式存在密切关联,改善学生的认知易感性有助于降低其抑郁症状的发生.%Objective To know the prevalence of cognitive vulnerability and depressive symptoms among the college students. Methods A total of 1 498 students who came from a program of clinical medicine in a medical university were selected in this survey. The students were asked to answer the center for epidemiological survey depression scale (CES-D) , attributional style questionnaire, coping style questionnaire, dysfunctional attitudes scales( DAS). Results The prevalence of depression was 12. 5% among the college students. The scores of depressive symptoms had a significant positive correlation with DAS, had a significant negative positive correlation with resolving question and recourse of coping style(both P<0. 01) , had a significant positive correlation with self-abuse, fantasy, wince and rationalization of coping style ( all P<0. 01). There was a significant negative correlation of scores between depressive symptoms and passive external attribution of attributional style (all P<0.01). Conclusions Depressive symptoms among the college students had a strong relationship with coping style, dysfunctional attitudes and attributional

  7. Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine Comorbidades, medicações e sintomas depressivos em pacientes com síndrome das pernas inquietas e enxaqueca

    Directory of Open Access Journals (Sweden)

    Karen S. Ferreira

    2013-02-01

    Full Text Available OBJECTIVE: The pathophysiology of migraine and restless legs syndrome (RLS seems to involve inherited mechanism and dysfunction of the dopaminergic system. Previous articles have shown that the frequency of RLS is higher in migraine patients than in controls. We conducted a study to evaluate comorbidities, medication used and depressive symptoms that can explain the relation between migraine and RLS. METHODS: A case-control study was performed in which patients with migraine (n=72 and a control group without migraine (n=72 were interviewed. Data including RLS diagnosis, depressive symptoms, comorbidities and drugs used were evaluated. RESULTS: There was a significant association between migraine and RLS (p=0.01, but comorbidities such as diabetes, hypertension, anemia and drugs used did not explain this association. Depression scores, as measured by the Beck Depression Inventory, were higher in migraine patients with RLS (p =0.04. CONCLUSION: No specific factors explaining the association between migraine and RLS were found. Symptoms of depression were more frequent in patients with migraine and RLS.OBJETIVO: A fisiopatologia da enxaqueca e da síndrome das pernas inquietas (SPI parece envolver mecanismos genéticos e disfunção do sistema dopaminérgico. Artigos anteriores mostraram que a frequência de SPI em pacientes com enxaqueca é maior do que nos controles. Desenvolvemos um estudo para avaliar comorbidades, medicamentos utilizados e sintomas depressivos em pacientes com migrânea e SPI. MÉTODOS: Foi desenvolvido um estudo de caso-controle. Foram entrevistados pacientes com enxaqueca (n=72 e sujeitos de um grupo controle (n=72. Foram avaliados dados incluindo diagnóstico de SPI, sintomas depressivos, comorbidades e medicamentos usados. RESULTADOS: Houve associação significativa entre enxaqueca e SPI (p=0,01. Comorbidades como diabetes, hipertensão, anemia ou drogas utilizadas não explicam esta associação. Escores de depress

  8. Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine Comorbidades, medicações e sintomas depressivos em pacientes com síndrome das pernas inquietas e enxaqueca

    Directory of Open Access Journals (Sweden)

    Karen S. Ferreira

    2013-01-01

    Full Text Available OBJECTIVE: The pathophysiology of migraine and restless legs syndrome (RLS seems to involve inherited mechanism and dysfunction of the dopaminergic system. Previous articles have shown that the frequency of RLS is higher in migraine patients than in controls. We conducted a study to evaluate comorbidities, medication used and depressive symptoms that can explain the relation between migraine and RLS. METHODS: A case-control study was performed in which patients with migraine (n=72 and a control group without migraine (n=72 were interviewed. Data including RLS diagnosis, depressive symptoms, comorbidities and drugs used were evaluated. RESULTS: There was a significant association between migraine and RLS (p=0.01, but comorbidities such as diabetes, hypertension, anemia and drugs used did not explain this association. Depression scores, as measured by the Beck Depression Inventory, were higher in migraine patients with RLS (p =0.04. CONCLUSION: No specific factors explaining the association between migraine and RLS were found. Symptoms of depression were more frequent in patients with migraine and RLS.OBJETIVO: A fisiopatologia da enxaqueca e da síndrome das pernas inquietas (SPI parece envolver mecanismos genéticos e disfunção do sistema dopaminérgico. Artigos anteriores mostraram que a frequência de SPI em pacientes com enxaqueca é maior do que nos controles. Desenvolvemos um estudo para avaliar comorbidades, medicamentos utilizados e sintomas depressivos em pacientes com migrânea e SPI. MÉTODOS: Foi desenvolvido um estudo de caso-controle. Foram entrevistados pacientes com enxaqueca (n=72 e sujeitos de um grupo controle (n=72. Foram avaliados dados incluindo diagnóstico de SPI, sintomas depressivos, comorbidades e medicamentos usados. RESULTADOS: Houve associação significativa entre enxaqueca e SPI (p=0,01. Comorbidades como diabetes, hipertensão, anemia ou drogas utilizadas não explicam esta associação. Escores de depress

  9. 38 CFR 14.602 - Requests for medical information.

    Science.gov (United States)

    2010-07-01

    ... other information shall not be released without approval of the Regional Counsel. (b) Request for... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Requests for medical information. 14.602 Section 14.602 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS...

  10. The Intersection of Medical Child Abuse and Medical Complexity.

    Science.gov (United States)

    Petska, Hillary W; Gordon, John B; Jablonski, Debra; Sheets, Lynn K

    2017-02-01

    Children with medical complexity and victims of medical child abuse may have similar clinical presentations. Atypical or unexplained signs and symptoms due to rare diseases may lead providers to suspect medical child abuse when not present. Conversely, medical child abuse may be the cause of or coexist with medical complexity. Careful consideration of whether or not medical child abuse is present is essential when assessing a child with medical complexity since either diagnosis has significant consequences for children and families.

  11. A Review of Long-Term Pain Relief after Genicular Nerve Radiofrequency Ablation in Chronic Knee Osteoarthritis.

    Science.gov (United States)

    Iannaccone, Ferdinand; Dixon, Samuel; Kaufman, Andrew

    2017-03-01

    Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB). Chart review and follow-up was performed on all patients who underwent genicular nerve RFA during the period of February 2014 through August of 2015. During this inclusion period 41 genicular nerve RFAs were performed on 31 patients, 5 patients received RFA procedure in both knees. Patient follow-up was performed via telephone interview or in-office visit at least 3 months and 6 months post RFA. Procedures were performed in Medical Special Procedures at University Hospital in Newark, NJ, and the Pain Management Center at Overlook Medical Arts Center in Summit, NJ. Chart review and study design was approved by Newark Health Sciences IRB. Chart review was performed from February 2014 and continued through August 2015. Patient follow-up was conducted at 3 and at least 6 months post treatment to gauge degree of pain relief (0 - none, 100% - complete), their current day's pain score, other treatment modalities tried before RFA, and the medications used. Patients were asked to quantify their satisfaction with procedure length, pre-procedure anxiety, complications, and if they would recommend this procedure to others. Primary and secondary goals were the duration of pain relief after RFA, the quality of pain relief, and the efficacy of our approach for RFA of genicular nerves versus prior published techniques. At 3 month follow-up, the average pain relief was 67% improvement from baseline knee pain, 0% being no relief and 100% being complete relief, and average 0 - 10 pain score was 2.9. At 6 month follow-up, of those who

  12. Multiple Myeloma Symptoms

    Science.gov (United States)

    ... Treatment Center Finder Home » About Multiple Myeloma » Symptoms Multiple Myeloma Symptoms Multiple myeloma symptoms may vary by patient, ... to be managed or prevented. The most common multiple myeloma symptoms may include: Bone pain or bone fractures ...

  13. General IC Symptoms

    Science.gov (United States)

    ... IC Symptoms of IC General IC Symptoms General IC Symptoms Symptoms of interstitial cystitis (IC) differ from ... news and events. Please leave this field empty Interstitial Cystitis Association 7918 Jones Branch Drive, Suite 300 McLean, ...

  14. Symptoms of Acoustic Neuroma

    Science.gov (United States)

    ... Programs & Services Search ANAUSA.org Connect with us! Symptoms of Acoustic Neuroma Each heading slides to reveal more information. Early Symptoms Early Symptoms Early symptoms are easily overlooked, thus making diagnosis ...

  15. Symptoms and syndromes of bodily distress

    DEFF Research Database (Denmark)

    Fink, Per; Toft, Tomas; Hansen, Morten Steen

    2007-01-01

    OBJECTIVE: Physical complaints not attributable to verifiable, conventionally defined diseases, i.e., medically unexplained or functional somatic symptoms, are prevalent in all medical settings, but their classification is contested as numerous overlapping diagnoses and syndrome labels have been...... introduced. This study aims to determine whether functional somatic symptoms cluster into distinct syndromes and diagnostic entities. METHODS: The 978 consecutively admitted patients from a neurological department (n = 120), a medical department (n = 157), and from primary care (n = 701) were interviewed...... using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) diagnostic instrument. RESULTS: Patients complained of a median of five functional somatic symptoms; women of six, men of four (p symptoms stood out as distinctive for patients with multiple symptoms. Principal...

  16. Efficacy of stellate ganglion block in the treatment of anxiety symptoms from combat-related post-traumatic stress disorder: a case series.

    Science.gov (United States)

    Alino, Justin; Kosatka, Donald; McLean, Brian; Hirsch, Kenneth

    2013-04-01

    Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings. Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD. All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit. SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up. Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  17. Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

    DEFF Research Database (Denmark)

    Noiesen, Eline; Trosborg, Ingelise; Bager, Louise;

    2014-01-01

    To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

  18. Hurricane Relief Operations in the Caribbean: Is the Use of the Military in Hurricane Relief Operations

    Science.gov (United States)

    2007-11-02

    Caribbean hurricanes are a type of tropical cyclone . They originate in the Atlantic Ocean off the coast of Africa and affect the Caribbean and 2 the...that will prove to be more suitable in disaster relief situations. Matthew Yarrow also shares Dynes’ view. He believes that soldiers are ill-suited... Haiti operations, in part due to the battalion commander’s lack of authority over troops from different countries. However, the performance of the

  19. 46 CFR 56.50-20 - Pressure relief piping.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Pressure relief piping. 56.50-20 Section 56.50-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING PIPING SYSTEMS AND APPURTENANCES Design Requirements Pertaining to Specific Systems § 56.50-20 Pressure relief piping. (a)...

  20. Donation to disaster relief campaigns: underlying social cognitive factors exposed

    NARCIS (Netherlands)

    Oosterhof, Liesbeth; Heuvelman, Ard; Peters, Oscar

    2009-01-01

    number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on attitude

  1. Ethiopian Relief: A Case Study in Failed Public Relations.

    Science.gov (United States)

    Chapel, Gage W.

    1988-01-01

    Examines how InterAid, a private-sector relief agency, responded to the false charge that it had misappropriated $20 million purportedly raised for Ethiopian famine relief. Suggests that it was not primarily negative reporting that retarded the strength of InterAid, but InterAid's inability to demonstrate shared common interests with its primary…

  2. Donation to disaster relief campaigns: underlying social cognitive factors exposed

    NARCIS (Netherlands)

    Oosterhof, Liesbeth; Heuvelman, A.; Peters, O.

    2009-01-01

    number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on attitude

  3. 46 CFR 193.15-40 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Pressure relief. 193.15-40 Section 193.15-40 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) OCEANOGRAPHIC RESEARCH VESSELS FIRE PROTECTION EQUIPMENT Carbon Dioxide Extinguishing Systems, Details § 193.15-40 Pressure relief. (a) Where necessary...

  4. Emergency Relief for Teachers of Children Who Challenge

    Science.gov (United States)

    Crow, René; Cooper, Mark; Dallas, Jamie

    2015-01-01

    Teachers of students with chronic challenging behaviors need relief, and they need it quickly. While they may appreciate the sympathy of others, what they really need is some genuine help. Challenging children can make a teacher's day difficult. In this article, the authors share some strategies that can provide "emergency relief" to…

  5. 46 CFR 154.517 - Piping: Liquid pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Piping: Liquid pressure relief. 154.517 Section 154.517 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY... and Process Piping Systems § 154.517 Piping: Liquid pressure relief. The cargo loading and discharge...

  6. 46 CFR 76.15-40 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Pressure relief. 76.15-40 Section 76.15-40 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PASSENGER VESSELS FIRE PROTECTION EQUIPMENT Carbon Dioxide Extinguishing Systems, Details § 76.15-40 Pressure relief. (a) Where necessary, relatively...

  7. 46 CFR 95.15-40 - Pressure relief.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Pressure relief. 95.15-40 Section 95.15-40 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS FIRE PROTECTION EQUIPMENT Carbon Dioxide Extinguishing Systems, Details § 95.15-40 Pressure relief. (a) Where necessary...

  8. 40 CFR 1042.850 - Exemptions and hardship relief.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Exemptions and hardship relief. 1042.850 Section 1042.850 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... Special Provisions for Remanufactured Marine Engines § 1042.850 Exemptions and hardship relief. This...

  9. 12 CFR 742.4 - RegFlex Relief.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false RegFlex Relief. 742.4 Section 742.4 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS REGULATORY FLEXIBILITY PROGRAM § 742.4 RegFlex Relief. (a) Exemptions. RegFlex credit unions are exempt from the following...

  10. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth, a Cochrane systematic review.

    Science.gov (United States)

    Bailey, E; Worthington, H; Coulthard, P

    2014-04-01

    This paper compares the beneficial and harmful effects of paracetamol, ibuprofen and the novel combination of both in a single tablet for pain relief following the surgical removal of lower wisdom teeth. In this systematic review only randomised controlled double-blinded clinical trials were included. We calculated the proportion of patients with at least 50% pain relief at 2 and 6 hours post dosing, along with the proportion of participants using rescue medication at 6 and 8 hours. Adverse events were also analysed. Data was meta-analysed where possible. Seven studies were included with a total of 2,241 participants enrolled. Ibuprofen 400 mg is superior to 1,000 mg paracetamol with a risk ratio for at least 50% pain relief at 6 hours of 1.47 (95% confidence interval [CI] 1.28 to 1.69). For the combined drug, the risk ratio for at least 50% maximum pain relief over 6 hours is 1.77 (95% CI 1.32 to 2.39) based on total pain relief (TOTPAR) data. There is high quality evidence that ibuprofen is superior to paracetamol. The novel combination drug shows encouraging results when compared to the single drugs (based on two trials).

  11. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review.

    Science.gov (United States)

    Suter, Valerie G A; Sjölund, Sophia; Bornstein, Michael M

    2017-03-27

    The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7-90 for the laser and 5-90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO2 laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO2 laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).

  12. Medications (for IBS)

    Medline Plus

    Full Text Available ... Gynecological Aspects of Irritable Bowel Syndrome Symptom Diary Testing in IBS Changes You Should Not Ignore if ... IBS Medications Probiotics and Antibiotics Pharmacologic, or drug, therapy is best used in irritable bowel syndrome ( ...

  13. Medications (for IBS)

    Medline Plus

    Full Text Available ... discomfort, usually if the symptoms occur soon after eating. Examples include dicyclomine (Bentyl), and hyoscyamine (Levsin). Read ... who specializes in motility or stress-related gastrointestinal disorders. More complex medication regimens, and specialized motility and/ ...

  14. Medical Mysteries: "We Feel Deep Compassion for Patients..."

    Science.gov (United States)

    ... Javascript on. Feature: Medical Mysteries “We feel deep compassion for patients...” Past Issues / Spring 2011 Table of ... maybe even relief. As doctors, we feel deep compassion for patients who have been without hope because ...

  15. United Airlines Assists Tsunami Relief Effort United donates cargo space for relief supplies going to southern Asia

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ United Airlines today announced several initiatives to assist with the tsunami relief effort in Asia, including the donation of available cargo space to ship relief supplies to southern Thailand,Indonesia, Sri Lanka and other coastal areas on the Indian Ocean.

  16. United Airlines Assists Tsunami Relief Effort United donates cargo space for relief supplies going to southern Asia

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

      United Airlines today announced several initiatives to assist with the tsunami relief effort in Asia, including the donation of available cargo space to ship relief supplies to southern Thailand,Indonesia, Sri Lanka and other coastal areas on the Indian Ocean.……

  17. Contemporary management of uterine fibroids: focus on emerging medical treatments.

    Science.gov (United States)

    Singh, Sukhbir Sony; Belland, Liane

    2015-01-01

    This review provides an overview of therapeutic options, with a specific focus on the emerging role of medical options for UF management. PubMed, Google Scholar, and Cochrane Systematic Reviews were searched for articles published between 1980 and 2013. Relevant articles were identified using the following terms: 'uterine fibroids', 'leiomyoma', 'heavy menstrual bleeding', and 'menorrhagia'. The reference lists of articles identified were also searched for other relevant publications. Because of the largely benign nature of UFs, the most conservative options that minimize morbidity/risk and optimize outcomes should be considered. Watchful waiting, or no immediate intervention combined with regular follow-up, is an appropriate option for the majority of UF patients who experience no symptoms. For women with symptomatic UFs, the optimal treatment should restore quality of life through rapid relief of UF signs and symptoms, reduce tumor size for a sustained period, and maintain or improve fertility. Invasive surgical treatments, such as hysterectomy, have historically been the mainstay of UF treatment. Less invasive surgical and interventional techniques, such as myomectomy, uterine artery embolization, endometrial ablation, and myolysis provide alternatives to hysterectomy. Until recently, medical management of UFs was characterized by short-term treatments and therapies that provided symptomatic control. In addition to controlling abnormal uterine bleeding, newer medical therapies, including the recently Health-Canada-approved ulipristal acetate, act directly to shrink the tumor. Although no agent is currently approved for such use, emerging evidence suggests the potential for long-term medical management of UFs. The advent of novel medical therapies may diminish the long-held reliance on more invasive surgical UF treatment options.

  18. Donation to disaster relief campaigns: underlying social cognitive factors exposed.

    Science.gov (United States)

    Oosterhof, Liesbeth; Heuvelman, Ard; Peters, Oscar

    2009-05-01

    A number of very serious natural disasters have put an enormous pressure on relief organizations in the last few years. The present study exposes underlying social cognitive factors for donation to relief campaigns. A causal model was constructed, based on social cognitive theory, research on attitudes, and the impact of media exposure. The aim was to expand and improve an already existing model by Cheung and Chan [Cheung, C. K., & Chan, C. M. (2000). Social-cognitive factors of donating money to charity, with special attention to an international relief organisation. Evaluation and Program Planning, 23, 241-253]. The expanded model showed a better fit. Furthermore, the expanded model explained two-thirds of the variance of the intention to donate to a disaster relief campaign. The greatest predictor of the intention to donate proved to be "Past donation to disaster relief campaigns." The factor "News exposure" was indicated to be a valuable additional factor, as it had a significant direct effect on "Awareness of a disaster relief campaign" and was the only factor that had a total effect on all other factors, including "Intention to donate to a disaster relief campaign."

  19. Effects of drug relief hospital-based AIDS educational methods on drug users

    Institute of Scientific and Technical Information of China (English)

    Xiang Ping LI; Shun Zhen XIAO; Qiao Qin WAN; Sen Lin SONG; Yan Xia TENG

    2005-01-01

    The objective of this study is to explore a potentially effective training method for the hospital professionals to educate drug users and to enhance their knowledge of HIV infection. One hundred and sixty one subjects, who came from 13 different provinces and were admitted in a drug relief hospital in Beijing, were recruited for this study. The average age of these subjects was 35.21±6.24 year old. The average numbers of years for drug addiction were 7 years,and the average numbers of drug relief treatment received in the past was 5.5 times. The level of AIDS knowledge of these subjects, including pathogenic factors, source of infection, route of transmission and preventive measures, were evaluated before and after receiving the AIDS educational training to these drug users. Our results showed that there was a statistically significant increase (P<0.01) in the knowledge of HIV infection and prevention among these subjects.Positive attitude and behavioral tendencies toward HIV prevention were also improved. Therefore, it is imperative for the medical professionals to incorporate AIDS education into drug relief treatment to achieve the maximum effect on the knowledge of AIDS and improvement of positive attitudes and behaviors toward HIV prevention among drug users.

  20. A Real-Time Decision Support System for Anesthesiologist End-of-Shift Relief.

    Science.gov (United States)

    Wax, David B; McCormick, Patrick J

    2017-02-01

    A decision support system using recent data about work hours and real-time data about relief events was developed to guide anesthesiologist end-of-shift relief decisions in an effort to promote a relief order that prioritized relief for those who had recently worked later than others. After system implementation, there were fewer deviations from this idealized order of relief, and early relief was more evenly distributed.