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Sample records for patients suffering chronic

  1. Anxiety and depression in patients suffering from chronic low backache

    International Nuclear Information System (INIS)

    Bhatti, A.R.; Saleem, B.; Ahsin, S.; Farooqi, A.Z.; Farooqi, A.Z.

    2014-01-01

    To determine the frequency of anxiety and depression in patients with chronic low backache and to document other co-morbidities among these patients presenting at rheumatology clinic of a tertiary care hospital in Islamabad. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at Pakistan Institute of Medical Sciences from July 2012 to April 2013. Methodology: A total of 170 chronic low backache patients were administered urdu translated Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scales. Scoring was done on Likert-type scale of 1-4 (based on these replies: a little of the time, some of the time, good part of the time, most of the time) with overall assessment by cumulative score ranging from 20 to 80, where 20-44 was normal range, 45-59 mildly depressed/anxious, 60-69 moderately depressed / anxious and 70 and above severely depressed / anxious. Results: Out of 170 patients, 157 patients above 18 years of age with male to female ratio 2:3 completed the study. Among study sample 72.2% had mild depression, 21.6% had mild anxiety, 32% had mixed mild anxiety and depression, 0.8% had severe depression, 1.6% had severe anxiety while 2.4% suffered from severe mixed symptoms. Overall, 125 (79.6%) patients were suffering from mild to severe form of depression and anxiety both alone or mixed. Obesity was present in 34 (21.66%) of patients with chronic backache and out of these 29 (85.3%) had psychological co-morbidity. Conclusion: Two thirds of the chronic backache patients reporting at rheumatology clinic of a tertiary care hospital were suffering from mild to severe degree of depression and anxiety. This worrying situation calls for thorough systematic evaluation of all chronic backache patient arriving at rheumatology clinic for mood disorders and psychological ailment. (author)

  2. Acupuncture in the treatment of a female patient suffering from chronic schizophrenia and sleep disorders

    NARCIS (Netherlands)

    Bosch, M.P.C.; Lim, S.; Yeo, S.; Lee, S.H.; Staudte, H.; Noort, M.W.M.L. van den

    2016-01-01

    Background. The use of acupuncture in the treatment of sleep disorders in patients with chronic schizophrenia is investigated. Case Presentation. We report the case of a 44-year-old female outpatient of German origin who had been suffering from long-term schizophrenia and sleep disorders. The

  3. Microbiological profile from middle ear and nasopharynx in patients suffering from chronic active mucosal otitis media

    International Nuclear Information System (INIS)

    Khattak, S.F.; Sheikh, N.A.; Aleem, A.; Farooq, M.; Nadeem, K.

    2017-01-01

    Chronic otitis media is described as a tympanic membrane perforation and ear discharge for more than six weeks duration. Ascending infection from the nasopharynx into the middle ear cleft has been attributed to prevent resolution of chronic otitis media. This research aims to determine the association between the microbiological flora of the nasopharynx with that of the middle ear in patients suffering from chronic (active) mucosal otitis media. Methods: Our study is a hospital-based cross-sectional survey. It was conducted from December 2015 to February 2017 at the Department of ENT, Combined Military Hospital, Abbottabad. Ear and nasopharyngeal swabs were obtained from 65 patients of chronic active mucosal otitis media and sent for microbiological analysis. Microbiological culture and sensitivity test was performed to identify the microbial spectrum of each specimen. Performa bearing the result of otoscopy, aspirate and swabs were completed for middle ear and the nasopharyngeal culture with reference to each patient. Descriptive statistics and Pearson's chi square analysis were performed using SPSS-22. Results: Staphylococcus aureus and Pseudomonas aeruginosa are foremost micro-organisms found in otorrhea culture isolated from patients of chronic active mucosal otitis media. Majority of the cultures from nasopharynx of these patients did not reveal any growth after incubation for 48 hours. Conclusion: A statistically insignificant association exists between the microbiological spectrum of the middle ear and the nasopharynx of patients suffering from chronic active mucosal otitis media. Micro organisms' exposure from a perforated tympanic membrane remains leading cause of persistent otorrhea, rather than ascending infection through the Eustachian tube. (author)

  4. [Late results of surgical treatment in patients, suffering complicated forms of chronic pancreatitis].

    Science.gov (United States)

    Ratchyk, V M; Orlovs'kyĭ, D V; Makarchuk, V A; Zemlians'kyĭ, D É; Orlovs'kyĭ, V V

    2014-12-01

    Late results of treatment were analyzed in 58 patients, suffering complicated forms of chronic pancreatitis, to whom draining and resectional-draining surgical interventions were performed. On average the patients age was (49.90 ± 8.59) yrs, there were 42 (72.4%) men and 16 (27.6%) women. During period of the 3 yrs postoperative follow- up in the patients the pain syndrome severity have reduced essentially and quality of life improved, comparing with those indices after resectional-draining interventions.

  5. Economic Evaluation of Community-Based Case Management of Patients Suffering From Chronic Obstructive Pulmonary Disease

    DEFF Research Database (Denmark)

    Sørensen, Sabrina Storgaard; Pedersen, Kjeld Møller; Weinreich, Ulla Møller

    2017-01-01

    Objectives: To analyse the cost effectiveness of community-based case management for patients suffering from chronic obstructive pulmonary disease (COPD). Methods: The study took place in the third largest municipality in Denmark and was conducted as a randomised controlled trial with 12 months...... was the incremental cost-effectiveness ratio (ICER) as cost per quality-adjusted life year (QALY) from the perspective of the healthcare sector. Costs were valued in British Pounds (£) at price level 2016. Scenario analyses and probabilistic sensitivity analyses were conducted in order to assess uncertainty...... of the ICER estimate. Results: The intervention resulted in a QALY improvement of 0.0146 (95% CI −0.0216; 0.0585), and a cost increase of £494 (95% CI −1778; 2766) per patient. No statistically significant difference was observed either in costs or effects. The ICER was £33,865 per QALY gained. Scenario...

  6. In Vitro Antifungal Susceptibility of Oral Candida Isolates from Patients Suffering from Caries and Chronic Periodontitis.

    Science.gov (United States)

    De-la-Torre, Janire; Ortiz-Samperio, María Esther; Marcos-Arias, Cristina; Marichalar-Mendia, Xabier; Eraso, Elena; Echebarria-Goicouria, María Ángeles; Aguirre-Urizar, José Manuel; Quindós, Guillermo

    2017-06-01

    Caries and chronic periodontitis are common oral diseases where a higher Candida colonization is reported. Antifungal agents could be adjuvant drugs for the therapy of both clinical conditions. The aim of the current study has been to evaluate the in vitro activities of conventional and new antifungal drugs against oral Candida isolates from patients suffering from caries and/or chronic periodontitis. In vitro activities of amphotericin B, fluconazole, itraconazole, miconazole, nystatin, posaconazole and voriconazole against 126 oral Candida isolates (75 Candida albicans, 18 Candida parapsilosis, 11 Candida dubliniensis, six Candida guilliermondii, five Candida lipolytica, five Candida glabrata, four Candida tropicalis and two Candida krusei) from 61 patients were tested by the CLSI M27-A3 method. Most antifungal drugs were highly active, and resistance was observed in less than 5% of tested isolates. Miconazole was the most active antifungal drug, being more than 98% of isolates susceptible. Fluconazole, itraconazole, and the new triazoles, posaconazole and voriconazole, were also very active. Miconazole, fluconazole and voriconazole have excellent in vitro activities against all Candida isolates and could represent suitable treatment for a hypothetically adjunctive therapy of caries and chronic periodontitis.

  7. Determination of risk factors for hepatitis B and C in male patients suffering from chronic hepatitis

    Directory of Open Access Journals (Sweden)

    Ahmed Waquaruddin

    2009-10-01

    Full Text Available Abstract Background Hepatitis B and C is common in Pakistan and various risk factors are attributable to its spread. One thousand and fifty consecutive male cases suffering from chronic liver disease (327 HBV and 723 HCV were selected from the OPD of public sector hospital and a private clinic dealing exclusively with the liver patients. To compare the results 723 age and gender matched controls were selected from the blood transfusion services of the public sector hospital. A standard questionnaire was filled for all patients and controls which included the information on possible risk factors. Findings Family history of liver disease was significantly higher (43% and 34% in HBV and HCV positive cases as compared to 5% in controls [odds ratio 15.6; 95% Confidence Interval CI: 10.1 -- 24.1, 10.9; 95% Confidence Interval CI: 7.3 -- 16.4] and same trend was seen for death due to liver disease in the family. Majority 74% hepatitis B positive cases had their shaves done at communal barbers but this practice was equally prevalent amongst controls (68%, thus negating it as a possible risk factor, but there is a significant risk with p Conclusion Injections, surgery and dental treatment appear as major risk factors for the transmission of hepatitis B and C in the community. Massive health care awareness drives need to be done for both health care providers and the public to reduce this menace.

  8. A Serious Exergame for Patients Suffering from Chronic Musculoskeletal Back and Neck Pain: A Pilot Study.

    Science.gov (United States)

    Jansen-Kosterink, Stephanie M; Huis In 't Veld, Rianne M H A; Schönauer, Christian; Kaufmann, Hannes; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R

    2013-10-01

    Over recent years, the popularity of videogames has gone beyond youth and gamers and is slowly entering the field of professional healthcare. Exergames are an attractive alternative to physical therapy. The primary aim of this pilot study was to explore the user experience (usability, satisfaction, level of motivation, and game experience) of the patient with the "PlayMancer" exergame. The secondary aim was to explore the progression of the performed motor skills (walking velocity, overhead reach ability, and cervical range of motion) and the clinical changes (to physical condition, disability, and pain intensity) in a group of patients with chronic musculoskeletal pain using an exergame for 4 weeks. In the European PlayMancer project, an exergame for physical rehabilitation of chronic pain patients was developed. This exergame is controlled by relevant motions of the patient's body captured by a motion suit and several infrared cameras. In three different integrated minigames, the patient can train the following motor skills: Walking velocity, overhead reaching, and neck mobility. Ten patients participated in this study and completed the 4 weeks of gaming. Patients rated the usability of the exergames as good (score of 78.5 [standard deviation 9.7; range, 60.0-97.5]) on the System Usability Scale, and the game motivated all patients to perform their exercises. Patients enjoyed playing and were pleased with both the game environment and the game play. Overall, the patients made a progression in the examined motor skills during the minigames over the 4 weeks of gaming. The "PlayMancer" exergame is a potential tool for achieving physical rehabilitation because it motivates patients to perform their exercises and as a result increases their motor skills and physical condition.

  9. Problematic Use of Prescription Opioids and Medicinal Cannabis Among Patients Suffering from Chronic Pain.

    Science.gov (United States)

    Feingold, Daniel; Goor-Aryeh, Itay; Bril, Silviu; Delayahu, Yael; Lev-Ran, Shaul

    2017-02-01

    To assess prevalence rates and correlates of problematic use of prescription opioids and medicinal cannabis (MC) among patients receiving treatment for chronic pain. Cross-sectional study. Two leading pain clinics in Israel. Our sample included 888 individuals receiving treatment for chronic pain, of whom 99.4% received treatment with prescription opioids or MC. Problematic use of prescription opioids and MC was assessed using DSM-IV criteria, Portenoy’s Criteria (PC), and the Current Opioid Misuse Measure (COMM) questionnaire. Additional sociodemographic and clinical correlates of problematic use were also assessed. Among individuals treated with prescription opioids, prevalence of problematic use of opioids according to DSM-IV, PC, and COMM was 52.6%, 17.1%, and 28.7%, respectively. Among those treated with MC, prevalence of problematic use of cannabis according to DSM-IV and PC was 21.2% and 10.6%, respectively. Problematic use of opioids and cannabis was more common in individuals using medications for longer periods of time, reporting higher levels of depression and anxiety, and using alcohol or drugs. Problematic use of opioids was associated with higher self-reported levels of pain, and problematic use of cannabis was more common among individuals using larger amounts of MC. Problematic use of opioids is common among chronic pain patients treated with prescription opioids and is more prevalent than problematic use of cannabis among those receiving MC. Pain patients should be screened for risk factors for problematic use before initiating long-term treatment for pain-control.

  10. Differences in maladaptive schemas between patients suffering from chronic and acute posttraumatic stress disorder and healthy controls

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    Ahmadian A

    2015-07-01

    Full Text Available Alireza Ahmadian,1,2 Jafar Mirzaee,1 Maryam Omidbeygi,1 Edith Holsboer-Trachsler,3 Serge Brand3,41Department of Psychology, Kharazmi University, 2Sadr Psychiatric Hospital, Janbazan Medical and Engineering Research Center (JMERC, Tehran, Iran; 3Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 4Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: War, as a stressor event, has a variety of acute and chronic negative consequences, such as posttraumatic stress disorder (PTSD. In this context, early maladaptive schema-based problems in PTSD have recently become an important research area. The aim of this study was to assess early maladaptive schemas in patients with acute and chronic PTSD.Method: Using available sampling methods and diagnostic criteria, 30 patients with chronic PTSD, 30 patients with acute PTSD, and 30 normal military personnel who were matched in terms of age and wartime experience were selected and assessed with the Young Schema Questionnaire-Long Form, Beck Depression Inventory second version (BDI-II, the Beck Anxiety Inventory (BAI, and the Impact of Events Scale (IES.Results: Both acute and chronic PTSD patients, when compared with normal military personnel, had higher scores for all early maladaptive schemas. Additionally, veterans suffering from chronic PTSD, as compared with veterans suffering from acute PTSD and veterans without PTSD, reported more impaired schemas related, for instance, to Self-Control, Social Isolation, and Vulnerability to Harm and Illness.Discussion: The results of the present study have significant preventative, diagnostic, clinical, research, and educational implications with respect to PTSD. Keywords: veterans, PTSD, depression, anxiety 

  11. [Initial contact in clinical interview with patients suffering from chronic insomnia].

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    Gaillard, J M

    1994-01-01

    One of the most controversial issue concerning chronic insomnia is its association with psychopathology. Many patients tend to present their sleep disturbances as isolated, whereas others admit that they have difficulties in other sectors of their life too. If psychopathology exists in chronic insomnia, it should manifest itself in the form of defensive mechanisms which can be clinically observed. In order to have information concerning this problem, the initial interview of patients with chronic insomnia has been analysed in every details, in order to detect behavioural features and characteristics of verbal expression, indicating that defense mechanisms are working. A group of 100 patients from the specialized consultation for sleep disorders has been studied They were referred by their physicians. The patients with a somatic disease or a psychiatric condition corresponding to a diagnostic on axis I of DSM III-R were not included. The patients with a form of insomnia corresponding to psychophysiological insomnia, idiopathic insomnia or sleep state misperception of the international classification were included in this sample. For all patients except 2 of them, the initial interview was audiovisually recorded. This interview aimed at establishing the clinical features of the disturbance, the psychiatric and somatic condition as well as the history of the trouble and the treatment taken at the time or attempted in the past. After an initial open query: "what seems to be the problem?", a semi-structured interview was conducted to obtain information about nocturnal sleep, daytime condition, dream and parasomnia, the history of the disturbance and the treatment. Anxiety and depression, as well as other psychiatric conditions were systematically investigated. Under these conditions, the patients showed from the very beginning of the interview, noticeable characteristics in their behaviour and verbal expression. Therefore, it is essentially the first 10 minutes of the

  12. Neuropsychological dysfunction in patients suffering from end-stage chronic obstructive pulmonary disease

    Science.gov (United States)

    Crews, W. David; Jefferson, Angela L.; Bolduc, Tara; Elliott, Jennifer B.; Ferro, Nikola M.; Broshek, Donna K.; Barth, Jeffrey T.; Robbins, Mark K.

    2009-01-01

    Few studies have examined the neuropsychological sequelae associated with end-stage pulmonary disease. Neuropsychological data are presented for 47 patients with end-stage chronic obstructive pulmonary disease (COPD) who were being evaluated as potential candidates for lung transplantation. Although patients exhibited a diversity of neurocognitive deficits, their highest frequencies of impairment were found on the Selective Reminding Test (SRT). Specifically, over 50% of the patients completing the SRT exhibited impaired immediate free recall and consistent long-term retrieval deficits, while more than 44% of these individuals displayed deficient long-term retrieval. Deficient SRT long-term storage strategies, cued recall, and delayed recall were exhibited by between 26% and 35% of these patients, while more than 32% of this sample displayed elevated numbers of intrusion errors. Over 31% of the patients completing the Wisconsin Card Sorting Test (WCST) failed to achieve the expected number of categories on this measure, while more than 23% of these individuals demonstrated elevated numbers of perseverative errors and total errors. Clinically notable frequencies of impairment (greater than 20% of the sample) were also found on the Trail Making Test (TMT): Part B and the Wechsler Memory Scale-R (WMS-R) Visual Reproduction II subtest. Minnesota Multiphasic Personality Inventory-2 (MMPI-2) personality assessments indicated that patients were experiencing a diversity of somatic complaints and that they may have been functioning at a reduced level of efficiency. These findings are discussed in light of patients’ end-stage COPD and factors possibly contributing to their neuropsychological test performances. Implications for clinical practice and future research are also included. PMID:14589783

  13. ROLE OF PSYCHOLOGICAL PROBLEMS IN EFFICACY OF TRANSCUTANEOUS ELECTRICAL NERVE STIMU-LATION IN PATIENTS SUFFERING FROM CHRONIC PAIN

    Directory of Open Access Journals (Sweden)

    S. M. Mirzamani

    2006-07-01

    Full Text Available Patients afflicted with chronic pain have both physical and psychological problems. This research investigated the impact of the psychological factors in the treatment results of transcutaneous electrical nerve stimulation (TENS in the patients afflicted with chronic diseases. The subjects were 37 individuals (20 males and 17 females with the mean age of 46 who had referred to two centers of physiotherapy treatment to receive TENS treatment process. Subjects were suffering from chronic pain in upper part of their body, hands and legs. The subjects were tested and screened psychologically by PDQ4+, MPQ, MPI, and BDI questionnaires. On the basis of the personality disorder and the intensity of the depression, they were divided into two groups: 1 patients with psychological symptoms (n = 14; and 2 patients without psychological symptoms (n = 23. In order to study the rate of the pain intensity reduction in both groups, the MPQ questionnaire was used in three stages (before beginning, in the middle and at the end of the treatment. Also, the MPI questionnaire was used in order to review the inter-personal problems, the interference of the pain in life, daily performance and the rate of social support. Results showed that in each group, the pain intensity had significantly reduced as a result of the impact of TENS treatment and the psychological factors did not have meaningful impacts. Also there was statistically significant correlation between the rate of social support of the family members and the reduction of pain intensity.

  14. Modulation of Interleukin-8 and staphylococcal flora by Avène hydrotherapy in patients suffering from chronic inflammatory dermatoses.

    Science.gov (United States)

    Casas, C; Ribet, V; Alvarez-Georges, S; Sibaud, V; Guerrero, D; Schmitt, A-M; Redoulès, D

    2011-02-01

    A number of studies argue in favour of an important role of microbial colonization, in particular of Staphylococcus aureus, in triggering atopic dermatitis (AD) flare-up and psoriasis, in particular through the superantigenic properties of toxins generated by S. aureus. The aim of this study was to assess the efficacy of a 3-week Avène hydrotherapy on the skin surface of patients suffering from psoriasis or atopic dermatitis. Skin samples were taken from healthy subjects or atopic (n = 18) or psoriatic patients (n = 39) undergoing hydrotherapy at Avène at the beginning (D0) and the end of treatment (D18). The severity of the dermatosis was evaluated according to SCORing Atopic Dermatitis (SCORAD) or Psoriasis Area Severity Index (PASI) scores at D0 and D18. Marker of inflammation interleukin 8 (IL-8), S. aureus colonization (protein A) and enterotoxins were assessed in skin samples using RT-PCR. At D0, significant differences were observed between healthy subjects and atopic or psoriatic patients in all the parameters evaluated (IL-8, protein A). At the end of the hydrotherapy, a significant decrease in SCORAD was associated with a significant reduction of IL-8, S. aureus colonization and enterotoxin D in patients with atopic dermatitis. Similarly, a significant decrease in PASI was associated with a significant reduction of IL-8, S. aureus colonization and enterotoxin N in patients with psoriasis. This study demonstrates the positive effects of Avène hydrotherapy on the skin of patients suffering from chronic dermatosis, with decreased inflammation and reduced colonization by S. aureus. © 2010 The Authors. JEADV © 2010 European Academy of Dermatology and Venereology.

  15. Impact of one-dose package dispensing with patient counseling on medication adherence in geriatrics suffering from chronic disorders

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    Narayana Goruntla

    2018-01-01

    Full Text Available Introduction: Medication nonadherence in elderly patients could result in a waste of medical expenses in a long-time span as well as deterioration of the patient's medical condition. Aim: The aim of this study is to evaluate the impact of one-dose package dispensing with patient counseling on medication adherence among elderly patients suffering from chronic disorders. Settings and Design: This is prospective, open-labeled, randomized trial carried out at dispensing pharmacy of the secondary care referral hospital, located in resource-limited settings of Anantapur District, Andhra Pradesh, India. Subjects and Methods: A total of 330 (aged ≥60 years patients were randomly assigned to one of three study groups: Group A (n = 110, no change in dosing and packing; Group B (n = 110, one-dose package dispensing; Group C (n = 110, One-dose package dispensing with patient counseling. Medication adherence levels were measured using a pill count and visual analog scale (VAS method at baseline and follow-up (after 1 month. Statistical Analysis: Descriptive statistics were used to represent the sociodemographic, clinical, and medication adherence profile of study participants. One-way ANOVA test is used to assess significant differences between three groups with a P 60 years who are on multiple medications can benefit from one-dose package dispensing and appropriate counseling. This will improve medication adherence hence better outcomes.

  16. Patients with Chronic Obstructive Pulmonary Disease Suffer from Worse Periodontal Health-Evidence from a Meta-Analysis.

    Science.gov (United States)

    Shi, Quan; Zhang, Bin; Xing, Helin; Yang, Shuo; Xu, Juan; Liu, Hongchen

    2018-01-01

    Background and Objective: It is widely accepted that there is an association between chronic obstructive pulmonary disease (COPD) and periodontitis. However, whether the periodontal status of the COPD patients is worse than that of the non-COPD subjects is seldom assessed. The findings currently available are inconsistent, some even contradictory. Therefore, we performed this meta-analysis to compare the periodontal health status of COPD patients and non-COPD subjects. Methods: PubMed and Embase were searched for all of the eligible studies which comparing the periodontal status between COPD patients and non-COPD subjects. The results of periodontal parameters in each study were extracted and the mean differences and 95% confidence intervals (CIs) for each parameter were calculated to determine their overall effects. Results: In total, 14 studies involving 3348 COPD patients and 20612 non-COPD controls were included and 9 periodontal indexes were analyzed. The mean differences (95% CIs) between COPD and non-COPD subjects for probing depth, clinical attachment loss, level of alveolar bone loss, plaque index, oral hygiene index, bleeding index, bleeding on probing, gingival index, and remaining teeth were 0.261 (0.020-0.501), 0.480 (0.280-0.681), 0.127 (0.000-0.254), 0.226 (0.043-0.408), 0.802 (0.326-1.279), 0.241 (-0.106 to 0.588), 6.878 (5.489-8.266), 0.364 (0.036-0.692), and -3.726 (-5.120 to -2.331), respectively. Conclusion: In summary, this meta-analysis demonstrates that the COPD patients suffer from worse periodontal health status, indicated by deeper periodontal pockets, high level of clinical attachment loss, worse oral hygiene, more inflammation and bleeding in the gingival tissue, and lower number of remaining teeth. Nevertheless, considering the limitations in our meta-analysis, more high-quality, and well-designed studies focusing on the periodontal health of the COPD patients are required to validate our conclusion.

  17. Educating patients suffering from re-acutisation of chronic bronchitis. A pilot support project within Intermediate Care

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    Giulio Cocco

    2006-06-01

    Full Text Available

    Background: Chronic Obstructive Pulmonary Disease (COPD represents one of the main causes of hospitalization, disability and mortality worldwide; it is predicted that by the year 2020 it will become the third leading cause of death and the fifth leading cause of disability in industrialized countries. An educational programme has been proposed to allow the COPD patient to prevent or to deal with a reacutisation.

    Methods: The project involved 50 patients with a diagnosis of moderate or severe COPD. The education program included information relating to disease process, proper use of medication, energy conservation methods, and the filling in of the Saint George’s Respiratory Questionnaire (SGRQ, the Zung Self-Rating Depression Scale (ZSDS and the State Trait Anxiety Inventory (STAI. Sociodemographic factors, assessment of living arrangements, social and family conditions were also collected. One year later the same questionnaires and learning assessment tests were re-administered.

    Results: The mean age of the participants was 69.7±10.4 years with a mean low income and a limited degree of education. Following the educational program, an improvement of quality of life emerged consequent to the awareness of all of the forms of support provided for the pathology and socio-economic conditions. The ability to manage their therapy and their activities of daily living have improved. The mean total score on SGRQ was 78.07±7.2 pre-program and 73.12±7.2 post-program; 52% of the patients are now within normal parameters compared to the initial 30% suffering from depression syndrome, furthermore the mean anxiety value decreased from 59.54 ± 8.6 to 54.54±7.8. The number of hospital admissions and the number of smokers were also halved.

    Conclusion: The improvements obtained after conducting all of the educational sessions are significant. The high value of the mean

  18. The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease.

    Science.gov (United States)

    Karabuva, Svjetlana; Carević, Vedran; Radić, Mislav; Fabijanić, Damir

    2013-01-01

    The aim of study was to: 1) examine the relationship between ABO blood groups and extent of coronary atherosclerosis in patients with chronic coronary artery disease (CAD), 2) compare ABO blood groups distribution in CAD patients and general population, 3) examine possible differences in traditional risk factors frequency in CAD patients with different ABO blood groups. In the 646 chronic CAD patients (72.4% males) coronary angiograms were scored by quantitative assessment using multiple angiographic scoring system, Traditional risk factors were self reported or measured by standard methods. ABO blood distribution of patients was compared with group of 651 healthy blood donors (74.6% males). Among all ABO blood group patients there was no significant difference between the extent of coronary atherosclerosis with regard to all the three scoring systems: number of affected coronary arteries (P = 0.857), Gensini score (P = 0.818), and number of segments narrowed > 50% (P = 0.781). There was no significant difference in ABO blood group distribution between CAD patients and healthy blood donors. Among CAD patients, men with blood group AB were significantly younger than their pairs with non-AB blood groups (P = 0.008). Among CAD patients with AB blood group, males groups (P = 0.003). No association between ABO blood groups and the extent of coronary atherosclerosis in Croatian CAD patients is observed. Observation that AB blood group might possibly identify Croatian males at risk to develop the premature CAD has to be tested in larger cohort of patients.

  19. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

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    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  20. Emotional control, styles of coping with stress and acceptance of illness among patients suffering from chronic somatic diseases.

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    Janowski, Konrad; Kurpas, Donata; Kusz, Joanna; Mroczek, Bożena; Jedynak, Tomasz

    2014-02-01

    The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task-oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness. Copyright © 2013 John Wiley & Sons, Ltd.

  1. To the nucleolar bodies (nucleoli) in cells of the lymphocytic lineage in patients suffering from B - chronic lymphocytic leukemia.

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    Smetana, K; Karban, J; Trneny, M

    2010-01-01

    The present study was undertaken to provide more information on nucleoli in lymphocytes of B - chronic lymphocytic leukemia. The computer assisted nucleolar and cytoplasmic RNA image densitometry, reflecting the nucleolar and cytoplasmic RNA concentration at the single cell level, demonstrated a remarkable stability during the differentiation and maturation of B- lymphocytes. In contrast, as it was expected, the nucleolar diameter during the lymphocytic development markedly decreased. Thus the nucleolar RNA content of leukemic B-lymphocytes was apparently related to the nucleolar size. In both immature and mature lymphocytes, the cytostatic treatment increased the incidence of micronucleoli, which represent the "inactive" type of nucleoli. However, the decreased values of the nucleolar diameter were statistically significant only in mature lymphocytes of treated patients. On the other hand, despite such observation, it must be mentioned that "large active" and "ring shaped resting" nucleoli were still present in immature and mature lymphocytes after the cytostatic therapy and such cells might represent a potential pool of proliferating cells. As it is generally accepted "large active nucleoli" with multiple fibrillar centers are known to be characteristic for proliferating cells. "Ring shaped resting nucleoli" are present in sleeping cells, which may be stimulated to return to the cell cycle and to proliferate again. In addition, the nucleolar RNA distribution also indicated that Gumprecht ghosts mostly originated from mature lymphocytes. Increased ratio of the nucleolar to cytoplasmic RNA density in Gumprecht ghosts or apoptotic cells and apoptotic bodies of the lymphocytic origin was related to the decreased cytoplasmic RNA concentration. The increased nucleolar size together with the markedly decreased cytoplasmic RNA concentration characteristic for Gumprecht ghosts just reflected the spreading of lymphocytes during smear preparations. In apoptotic cells or

  2. [Helping reintegration of patients suffering from chronic musculoskeletal diseases with decreased working ability in the National Institute of Rheumatology and Physiotherapy, Budapest, Hungary].

    Science.gov (United States)

    Sallai, Julianna Rozália; Hunka, Aniella; Héjj, Gábor; Bálint, Géza; Poór, Gyula

    2017-04-01

    An important task of our institute is to support social reintegration: including occupational rehabilitation of patients suffering from chronic musculoskeletal diseases with decreased working ability. The aim of the authors was to provide informations of their daily practice, how they perform patient education, giving information for their patients about their disease, the rehabilitation possibilities, how they support the patients with decreased working ability to take part in their own rehabilitation. Patients taking part in in-patient rehabilitation received teaching and education about their disease and rehabilitation options in groups. Patients interested in part-time jobs were individually interviewed by a 30-120 minutes talk about their educational level and training, social conditions and about the available part time jobs. The part time jobs were available with the help of the Motivation Foundation of the National Association of the Societies of Motion Disabled, and the Alfa Rehabilitation Nonprofit Rt. The data of patients receiving in-patient rehabilitation betwen the 1st of January 2009 and 31st of December 2014 were analyzed. Out of the 230 patients seeking our help for part time job, our social service could organise jobs for 180 disabled persons, all town-inhabitants, but was unsuccesful in getting jobs for patients living in villages and separated farms. Part time jobs can be organized for musculoskeletal disabled living in cities and towns. For village-dwellers there are no suitable jobs and working places. It is necessary to organize rehabilitation working possibitities for musculoskeletal disabled patients living in villages. Orv Hetil. 2017; 158(17): 662-667.

  3. Chronic intermittent hypoxia is independently associated with reduced postoperative opioid consumption in bariatric patients suffering from sleep-disordered breathing.

    Directory of Open Access Journals (Sweden)

    Alparslan Turan

    Full Text Available Evidence suggests that recurrent nocturnal hypoxemia may affect pain response and/or the sensitivity to opioid analgesia. We tested the hypothesis that nocturnal hypoxemia, quantified by sleep time spent at an arterial saturation (SaO2 < 90% and minimum nocturnal SaO2 on polysomnography, are associated with decreased pain and reduced opioid consumption during the initial 72 postoperative hours in patients having laparoscopic bariatric surgery.With Institutional Review Board approval, we examined the records of all patients who underwent laparoscopic bariatric surgery between 2004 and 2010 and had an available nocturnal polysomnography study. We assessed the relationships between the time-weighted average of pain score and total opioid consumption during the initial 72 postoperative hours, and: (a the percentage of total sleep time spent at SaO2 < 90%, (b the minimum nocturnal SaO2, and (c the number of apnea/hypopnea episodes per hour of sleep. We used multivariable regression models to adjust for both clinical and sleep-related confounders.Two hundred eighteen patients were included in the analysis. Percentage of total sleep time spent at SaO2 < 90% was inversely associated with total postoperative opioid consumption; a 5-%- absolute increase in the former would relatively decrease median opioid consumption by 16% (98.75% CI: 2% to 28%, P = 0.006. However, the percentage of total sleep time spent at SaO2 < 90% was not associated with pain. The minimum nocturnal SaO2 was associated neither with total postoperative opioid consumption nor with pain. In addition, neither pain nor total opioid consumption was significantly associated with the number of apnea/hypopnea episodes per hour of sleep.Preoperative nocturnal intermittent hypoxia may enhance sensitivity to opioids.

  4. Role of heteroplasmic mutations in the mitochondrial genome and the ID4 gene promoter methylation region in the pathogenesis of chronic aplastic anemia in patients suffering from Kidney yin deficiency.

    Science.gov (United States)

    Cui, Xing; Wang, Jing-Yi; Liu, Kui; Cui, Si-Yuan; Zhang, Jie; Luo, Ya-Qin; Wang, Xin

    2016-06-01

    To analyze changes in gene amplification in the mitochondrial genome and in the ID4 gene promoter methylation region in patients with chronic aplastic anemia (CAA) suffering from Kidney (Shen) yin deficiency or Kidney yang deficiency. Bone marrow and oral epithelium samples were collected from CAA patients with Kidney yin deficiency or Kidney yang deficiency (20 cases). Bone marrow samples were collected from 20 healthy volunteers. The mitochondrial genome was amplified by polymerase chain reaction (PCR), and PCR products were used for sequencing and analysis. Higher mutational rates were observed in the ND1-2, ND4-6, and CYTB genes in CAA patients suffering from Kidney yin deficiency. Moreover, the ID4 gene was unmethylated in bone marrow samples from healthy individuals, but was methylated in some CAA patients suffering from Kidney yin deficiency (positive rate, 60%) and Kidney yang deficiency (positive rate, 55%). These data supported that gene mutations can alter the expression of respiratory chain enzyme complexes in CAA patients, resulting in energy metabolism impairment and promoting the physiological and pathological processes of hematopoietic failure. Functional impairment of the mitochondrial respiration chain induced by gene mutation may be an important reason for hematopoietic failure in patients with CAA. This change is closely related to maternal inheritance and Kidney yin deficiency. Finally, these data supported the assertion that it is easy to treat disease in patients suffering from yang deficiency and difficult to treat disease in patients suffering from yin deficiency.

  5. [A plan for the improvement in the quality of life of people suffering from chronic diseases].

    Science.gov (United States)

    Portal, Stéphanie

    2011-10-01

    In 2007, the French Ministry of Health launched a plan devoted to the improvement of the quality of life of patients suffering from chronic diseases. Over the last four years this plan has resulted in a number of concrete actions: events and seminars have been organised, patients' education has obtained legislative recognition and several partnerships have been created. Time for a progress report.

  6. Sleep quality in subjects suffering from chronic pain

    OpenAIRE

    Keilani, Mohammad; Crevenna, Richard; Dorner, Thomas Ernst

    2017-01-01

    Summary Background Sleeping problems are very common in patients with chronic pain. The aim of the study was to investigate the association between different dimensions of chronic pain and sleep quality in chronic pain patients. Methods In this cross-sectional interview-based questionnaire study, patients from 3 different pain treatment centers in Vienna aged 18–65 years, with pain lasting 3 months or longer were asked to participate. The association between the short-form McGill pain questio...

  7. Spiritual Needs in Patients Suffering from Fibromyalgia

    Directory of Open Access Journals (Sweden)

    M. Offenbaecher

    2013-01-01

    Full Text Available The objective of this study was to assess spiritual needs of patients with fibromyalgia syndrome (FMS and to evaluate correlations with disease and health associated variables. Using a set of standardized questionnaires (i.e., Spiritual Needs Questionnaire, Fibromyalgia Impact Questionnaire, SF-36's Quality of Life, Brief Multidimensional Life Satisfaction Scale, etc., we enrolled 141 patients (95% women, mean age 58 ± 10 years. Here, needs for inner peace and giving/generativity scored the highest, while existential needs and religious needs scored lowest. Particularly inner peace needs and existential needs correlated with different domains of reduced mental health, particularly with anxiety, the intention to escape from illness, and psychosocial restrictions. Thirty-eight percent of the patients stated needs to be forgiven and nearly half to forgive someone from their past life. Therefore, the specific spiritual needs of patients with chronic diseases should be addressed in clinical care in order to identify potential therapeutic avenues to support and stabilize their psychoemotional situation.

  8. Sleep quality in subjects suffering from chronic pain.

    Science.gov (United States)

    Keilani, Mohammad; Crevenna, Richard; Dorner, Thomas Ernst

    2018-01-01

    Sleeping problems are very common in patients with chronic pain. The aim of the study was to investigate the association between different dimensions of chronic pain and sleep quality in chronic pain patients. In this cross-sectional interview-based questionnaire study, patients from 3 different pain treatment centers in Vienna aged 18-65 years, with pain lasting 3 months or longer were asked to participate. The association between the short-form McGill pain questionnaire (SF-MPQ) and sleep quality (sleep onset latency, interrupted sleep due to pain, sleep duration and recovering effect of sleep) was assessed. In this study 121 patients (male 32, female 89, mean age 49 ± 9 years) could be analyzed. Of the patients 38.8% needed more than 30 min for falling asleep, 63.6% reported sleep fragmentation, 30.6% slept less than 5 h and 60.3% reported no recovering effect of sleep. The strongest associations between pain characteristics and sleep quality were found for pain intensity and affective pain aspects. Logistic regression analyses revealed that one point more in the total score of SF-MPQ increased the odds of needing more than 30 min for falling asleep, waking up more than 3 times due to pain, sleeping less than 5 h, and perceiving the sleep as non-recovering, by 6%. Adjusting for physical and psychological quality of life lowered the odds ratios and the association was no longer significant. The results underline the importance of paying attention to sleep quality in patients with chronic pain. The results also indicate that psychological factors might mediate the association between pain and sleep quality.

  9. Motor Cortex Stimulation in Patients Suffering from Chronic Neuropathic Pain : Summary of Expert Meeting and Premeeting Questionnaire, Combined with Literature Review

    NARCIS (Netherlands)

    Kurt, Erkan; Henssen, Dylan J. H. A.; Steegers, Monique; Staal, Michiel; Beese, Ulrich; Maarrawi, Joseph; Pirotte, Benoit; Garcia-Larrea, Luis; Rasche, Dirk; Vesper, Jan; Holsheimer, Jan; Duyvendak, Wim; Herregodts, Patrick; van Dongen, Robert; Moens, Maarten

    2017-01-01

    BACKGROUND: Motor cortex stimulation (MCS) was introduced in the early 1990s by Tsubokawa and his group for patients diagnosed with drug-resistant, central neuropathic pain. Inconsistencies concerning the details of this therapy and its outcomes and poor methodology of most clinical essays divide

  10. Ventilation therapy for patients suffering from obstructive lung diseases.

    Science.gov (United States)

    Jungblut, Sven A; Heidelmann, Lena M; Westerfeld, Andreas; Frickmann, Hagen; Körber, Mareike K; Zautner, Andreas E

    2014-01-01

    Severe bronchial obstruction due to one of the major pulmonary diseases: asthma, COPD, or emphysema often requires mechanical ventilation support. Otherwise, patients are at risk of severe hypooxygenation with consecutive overloading and dilatation of the right cardiac ventricle with subsequent failure. This review focuses on how to manage a calculated ventilation therapy of patients suffering from bronchial obstruction and relevant patents. Options and pitfalls of invasive and non-invasive ventilation in the intensive care setting regarding clinical improvement and final outcome are discussed. The non-invasive ventilation is very efficient in treating acute or chronic respiratory failure in COPD patients and is capable of shortening the duration of hospitalization. Further non-invasive ventilation can successfully support the weaning after a long-lasting ventilation therapy and improve the prognosis of COPD patients. "Permissive hypercapnia" is unequivocally established in invasive ventilation therapy of severe bronchial obstruction in situations of limited ventilation. When intrinsic positive end-expiratory pressure (PEEP) and elevated airways resistance are present PEEP may be useful although external-PEEP application relieves over-inflation only in selected patients with airway obstruction during controlled mechanical ventilation. Upper limit of airways peak pressure used in "protective ventilation" of adult respiratory distress syndrome (ARDS) patients can be exceeded under certain circumstances.

  11. Hearing Recovey in Patients Suffering Sudden Deafness

    Directory of Open Access Journals (Sweden)

    Parviz Eslami

    1992-04-01

    Full Text Available The study included 80 patients treated for sudden deafness over the last 5-7 years. Case history, laboratory findings, pure-tone audiogram and electronystagmography (ENG findings were noted. If any abnormalities had been recorded in ENG studies, the studies were redone. ORL status was redefined and audiograms were obtained in all patients. When becoming ill, the 80 patients had not differed from the normal population in common cardiovascular risk factors. None of them had had signs of viral infection (paired serum samples had been taken at 2-week intervals; routine examinations had been done for common viral antigens. As many as 31 of the 80 patients with acute hearing loss had had abnormalities such as spontaneous nystagmus (PN, hypoexcitability (HE and directional preponderance (DP in the bithermal caloric tests (+44 degrees C, + 30 degrees C of their ENG studies. Twenty of the 31 patients still had abnormal ENG studies after 5-7 years. Only 1 subject had positional nystagmus, and none had subjective vertigo. Patients with an abnormal ENG study showed a poor recovery of the speech reception threshold, whereas those with a normal ENG study showed slightly significant (p less than 0.05 recovery.

  12. Estado redox en pacientes infectados por VIH/sida con insuficiencia renal crónica sometidos a hemodiálisis The redox state of VIH/AIDS patients suffering chronic renal failure and undergoing hemodyalisis

    Directory of Open Access Journals (Sweden)

    Olga Castaño Araujo

    2012-12-01

    Full Text Available Introducción: el balance redox alterado en el curso de la insuficiencia renal crónica ha sido considerado un factor contribuyente a la morbilidad y mortalidad de la enfermedad y un factor asociado a la progresión de la infección por sida. Objetivo: valorar el estado redox en pacientes infectados por VIH con insuficiencia renal crónica que requirieron hemodiálisis. Métodos: se realizó un estudio de casos y controles en 20 pacientes VIH/sida con insuficiencia renal crónica y 40 individuos aparentemente sanos. Se realizaron determinaciones de malonildialdehído, glutatión, superóxido dismutasa, catalasa, productos avanzados de la oxidación de proteínas, hidroperóxidos y potencial de peroxidación, conjuntamente con los marcadores de progresión: conteo de linfocitos T CD4+ y carga viral y una serie de determinaciones hemoquímicas y hematológicas. El análisis se realizó antes, a los 30 min y a los 240 min del tratamiento dialítico. Estadísticamente se verificaron los supuestos de igualdad de varianza y normalidad de las variables, y en dependencia se aplicó una prueba paramétrica o no paramétrica. El resultado fue significativo para pIntroduction: the altered redox balance in chronic renal failure has been considered a contributing factor to morbidity and mortality from this disease and as an AIDS progression-associated factor. Objective: to assess the redox state in HIV patients suffering chronic renal failure that requires haemodialysis. Methods: a case-control study was conducted in 20 HIV/AIDS patients with chronic renal failure and in 40 apparently healthy individuals. Estimations of malonildialdehyde, gluthatione, superoxide dismutase, catalase, advanced products from protein oxidation, hydroperoxides and peroxidation potentials, as well as progression markers such as T CD4+ lymphocyte count, viral load and a series of hemochemical and hematological determinations were all made. The analysis was made before, 30 minutes

  13. THE SUFFERING OF PATIENTS WITH RESPIRATORY DISORDERS DURING SLEEP

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    Jacek Lech

    2013-11-01

    Full Text Available Assumption : Respiratory disorders during sleep involving the occurrence of sleep apnoea leading to a reduction in arterial oxygen saturation are classified as: obstructive sleep apnoea, central sleep apnoea and sleep-related hypoventilation with hypoxaemia. A close correlation has been proved between the occurrence of apnoea and obesity. This problem concerns 2–4% of the population, and is more likely to affect men. Aim : Presentation of the problem of respiratory disorders during sleep as a chronic disease causing much suffering. Its symptoms may lead to sleep fragmentation and somatic consequences (such as dysfunction of the cardiovascular system as well as mental consequences (personality changes. Method : An analysis of literature concerning the subject-matter from the perspective of a doctor conducting ventilation therapy of patients with respiratory sleep disorders. Summary : The problem of sleep apnoea is most often diagnosed and treated too late due to the number of symptoms with a simultaneous absence of pathognomonic symptoms. Despite its commonness, recognition of this disease is still insufficient.

  14. Stress and sleep duration predict headache severity in chronic headache sufferers.

    Science.gov (United States)

    Houle, Timothy T; Butschek, Ross A; Turner, Dana P; Smitherman, Todd A; Rains, Jeanetta C; Penzien, Donald B

    2012-12-01

    The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n=33) and chronic tension-type headache (n=22) sufferers. Patients completed the Daily Stress Inventory and recorded headache and sleep variables using a daily sleep/headache diary. Stress ratings, duration of previous nights' sleep, and headache severity were modeled using a series of linear mixed models with random effects to account for individual differences in observed associations. Models were displayed using contour plots. Two consecutive days of either high stress or low sleep were strongly predictive of headache, whereas 2 days of low stress or adequate sleep were protective. When patterns of stress or sleep were divergent across days, headache risk was increased only when the earlier day was characterized by high stress or poor sleep. As predicted, headache activity in the combined model was highest when high stress and low sleep occurred concurrently during the prior 2 days, denoting an additive effect. Future research is needed to expand on current findings among chronic headache patients and to develop individualized models that account for multiple simultaneous influences of headache trigger factors. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  15. Alleviating cancer patients' suffering: whose responsibility is it?

    Science.gov (United States)

    Grau, Jorge

    2009-07-01

    In medicine, we have historically been better at learning about the body and disease than we have at understanding the human beings who come to us with the ailments. We have acted to relieve pain, consoling patients and families as a complement, but done little to understand and alleviate suffering as a fundamental part of our practice. In fact, only in more recent decades has "suffering" been conceptualized as something apart from pain, associated with distress and its causes. It was Eric T. Cassell, in his ground-breaking work in the 1980s, who posed the need to consider alleviation of suffering and treatment of illness as twin-and equally important-obligations of the medical profession. Suffering is defined as a negative, complex emotional and cognitive state, characterized by feeling under constant threat and powerless to confront it, having drained the physical and psycho-social resources that might have made resistance possible. This unique depletion of personal resources is key to understanding suffering.

  16. Not all suffering is pain: sources of patients' suffering in the emergency department call for improvements in communication from practitioners.

    Science.gov (United States)

    Body, Richard; Kaide, Ergul; Kendal, Sarah; Foex, Bernard

    2015-01-01

    Provision of prompt, effective analgesia is rightly considered as a standard of care in the emergency department (ED). However, much suffering is not 'painful' and may be under-recognised. We sought to describe the burden of suffering in the ED and explore how this may be best addressed from a patient centred perspective. In a prospective cohort study, we included undifferentiated patients presenting to the ED. We undertook two face to face questionnaires with the first immediately following triage. We asked patients: (a) if they were 'suffering'; (b) how they were suffering; and (c) what they hoped would be done to ease this. Prior to leaving the ED, we asked patients what had been done to ease their suffering. Data were analysed thematically. Of 125 patients included, 77 (61.6%) reported suffering on direct questioning and 92 (73.6%) listed at least one way in which they were suffering. 90 (72.0%) patients had a pain score >0/10 but only 37 (29.6%) reported that pain was causing suffering. Patients reported suffering from both physical symptoms (especially pain, nausea, vomiting and dizziness) and emotional distress (notably anxiety). Treatment (to ease physical and emotional symptoms), information (particularly diagnosis, reassurance and explanation), care (notably friendly staff) and closure (being seen, resolving the problem and going home) were the key themes identified as important for relief of suffering. In seeking to ease suffering in the ED, clinicians must focus not only on providing analgesia but on treating Emotional distress, Physical symptoms, providing Information, Care and Closure (EPICC). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia (experimental research

    Directory of Open Access Journals (Sweden)

    O. V. Kaluzhina

    2015-04-01

    Full Text Available The cardiovascular system in newborns with chronic hypoxia is affected in 40–70%. Aim. To investigate morphological state of aorta in the fetuses and newborns suffered from chronic intrauterine hypoxia. Methods and results. Aortic wall was investigated with modern morphological methods in 34 laboratory animals in order to identify the morphological features of the fetuses and newborns’ vessel affected by this pathogenic factor. It was established that chronic hypoxia leads to endothelial trophics deterioration, its flattening, dystrophic processes with following cells desquamation, density reduction of smooth muscle cells, thickening of the intima-media. Conclusion. It shows alterative-sclerotic changes in aorta in cases with chronic hypoxia influence.

  18. Multiple fractures of infant suffering from chronic subdural hematoma as a consequence of physical abuse?

    International Nuclear Information System (INIS)

    Mihal, V.; Petrova, Z.; Michalkova, K.

    2015-01-01

    Infants with multiple unexplained fractures are often victims of inflicted injury. Fractures from child abuse are significantly more common in children under 18 months of age than in older children, which should inform the differential diagnostic approach in this age group. The authors describe multiple unrecognized fractures of infant suffering from chronic subdural hematoma. (author)

  19. Stress and Sleep Duration Predict Headache Severity in Chronic Headache Sufferers

    OpenAIRE

    Houle, Timothy T.; Butschek, Ross A.; Turner, Dana P.; Smitherman, Todd A.; Rains, Jeanetta C.; Penzien, Donald B.

    2012-01-01

    The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (< 15 headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥ 15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n = 33) and chronic tension...

  20. [COMMUNICATION AND HEALTH OUTCOMES IN PATIENTS SUFFERING FROM GASTROINTESTINAL DISEASES].

    Science.gov (United States)

    Petriček, G; Cerovečki, V; Adžić, Z Ožvačić

    2015-11-01

    Although survey results indicate clear connection between the physician-patient communication and health outcomes, mechanisms of their action are still insufficiently clear. The aim was to investigate the specificity of communication with patients suffering from gastrointestinal diseases and the impact of good communication on measurable outcomes. We performed PubMed (Medline) search using the following key words: communication, health outcomes, and gastrointestinal diseases. Seven pathways through which communication can lead to better health include increased access to care, greater patient knowledge and shared understanding, higher quality medical decisions, enhanced therapeutic alliances, increased social support, patient agency and empowerment, and better management of emotions. Although these pathways were explored with respect to cancer care, they are certainly applicable to other health conditions as well, including the care of patients suffering from gastrointestinal diseases. Although proposing a number of pathways through which communication can lead to improved health, it should be emphasized that the relative importance of a particular pathway will depend on the outcome of interest, the health condition, where the patient is in the illness trajectory, and the patient’s life circumstances. Besides, research increasingly points to the importance of placebo effect, and it is recommended that health professionals encourage placebo effect by applying precisely targeted communication skills, as the unquestionable and successful part of many treatments. It is important that the clinician knows the possible positive and negative effects of communication on health outcomes, and in daily work consciously maximizes therapeutic effects of communication, reaching its proximal (understanding, satisfaction, clinician-patient agreement, trust, feeling known, rapport, motivation) and intermediate outcomes (access to care, quality medical decision, commitment to

  1. Outcome among patients suffering from in-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Trpković Sladjana

    2014-01-01

    Full Text Available Introduction. In relation to pre-hospital treatment of patients with cardiac arrest (CA in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective. The aim was to define the factors associated with an improved outcome among patients suffering from the inhospital CA (IHCA. Methods. The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC. Results. Most patients (61% had cardiac etiology. Return of spontaneous circulation (ROSC was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69±11.37, (p<0.05, non-surgical patients (76.1%, (p<0.01 and in patients who were in continuous monitoring (66.7% (p<0.05. The outcome of CPR was significantly better in patients who received advanced life support (ALS (76.6% (p<0.01. Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67±1.13 min, (p<0.01. A total of 5% of IHCA patients survived to hospital discharge. Conclusion. In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.

  2. [The transition process from paediatric to adult services: A perspective from hospitalised adolescent sufferers of chronic diseases].

    Science.gov (United States)

    Inostroza Quezada, Carolina; Correa Venegas, María Loreto; Besoain Arrau, Carolina; Reinoso Medinelli, Alejandro; Velarde Lizama, Macarena; Valenzuela Mujica, María Teresa; Bedregal García, Paula; Zubarew Gurtchin, Tamara

    2016-01-01

    Chronic illnesses during adolescence are a big challenge for the patient, his or her family, and health care providers. The transition from paediatric health services to adult health services involves a programmed and planned transfer process of adolescent sufferers of chronic illnesses, in order to maintain a high quality of life and bio-psycho-social development. There is currently no transition model. The objective of the study is to understand the transition process from the perspective of hospitalised adolescents to collaborate towards the design of a model that meets the needs studied. Semi-structured interviews with 13 adolescent sufferers of chronic illnesses, hospitalised in two healthcare centres in Santiago, Chile, in one analytical-relational study, supported by qualitative methodology. In the analysis, 5 major themes stand out: experience of living with the illness, the importance of the doctor-patient relationship, the concept of limited autonomy to the pharmacology, the absence of the transition process as such, and the identification of barriers and needs for an adequate transition. This study is new in Chile in that it explores the phenomenom of the transition of adolescents with chronic illnesses. It emphasises the need to reinforce the concept of self-care and autonomy from early stages of care, and the importance of early planning of a healthy transition process, in accordance to the detected needs of the adolescents themselves. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  3. Cognition and Comorbidity Behavior in Hospitalized Patients Suffering from Stroke. Seychelles 2010-2011

    Directory of Open Access Journals (Sweden)

    Armando Carlos Roca Socarras

    2012-10-01

    Full Text Available Background: cognitive impairment and high comorbidity are common health problems in patients with cerebrovascular disease. Objective: to describe the behavior of cognitive impairment and comorbidity in hospitalized patients suffering from stroke. Method: descriptive study of 77 patients with ischemic stroke admitted from April 2010 to December 2011, in Seychelles General Hospital. The behavior of this disease in relation to variables such as age, presence of chronic noncommunicable diseases, cognitive impairment, educational level, affected cerebral hemisphere and time of evolution was analyzed. Results: 68,9 % of patients presented cognitive impairment, their average age was 74,2 (± 9,19 years old compared to 62,4 (± 14,2 years old for those with no cognitive impairment. We found a higher frequency of chronic noncommunicable diseases in cognitively impaired patients with a Charlson comorbidity index of 2,11 (± 0,97. 18 patients with cognitive impairment and 23 patients with no cognitive impairment were diagnosed with depression. Conclusions: more than half of hospitalized patients experienced cognitive impairment and in most cases previous to cerebrovascular disease. Male patients predominated. There was an increase in age, severity of depression, as well as in the frequency of chronic noncommunicable diseases, and myocardial infarction of considerable size, in respect to patients with no cognitive impairment.

  4. Resources for hyperhidrosis sufferers, patients, and health care providers.

    Science.gov (United States)

    Pieretti, Lisa J

    2014-10-01

    The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Cornual pregnancy in a patient suffering from sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Onilda Labrada Silva

    2015-10-01

    Full Text Available Nowadays, ectopic pregnancy is a pathological entity of great incidence, which is increased, among other things, by each time earlier sexual relations. Cornual pregnancy is as a result of the implantation of the blastocyte within the segment of the fallopian tube that goes into the uterus wall or between the tubal ostium and the proximal portion of the isthmus. This is a case of a cornual pregnancy in which the use of ultrasonography played an essential role for its diagnosis, since it is about a patient suffering from sickle cell anemia, where it was not possible to clinically eliminate the possibility of an occlusive vessel crisis as the cause of abdominal pain. Subtotal hysterectomy of the right tube was performed. The patient’s evolution is satisfactory.

  6. Nonmotor symptoms in patients suffering from motor neuron diseases

    Directory of Open Access Journals (Sweden)

    Rene Günther

    2016-07-01

    Full Text Available Background: The recently postulated disease spreading hypothesis has gained much attention, especially for Parkinson’s disease (PD. The various nonmotor symptoms (NMS in neurodegenerative diseases would be much better explained by this hypothesis than by the degeneration of disease-specific cell populations. Motor neuron disease (MND is primarily known as a group of diseases with a selective loss of motor function. Recent evidence, however, suggests disease spreading into nonmotor brain regions also in MND. The aim of this study was to comprehensively detect NMS in patients suffering from MND.Methods: We used a self-rating questionnaire including 30 different items of gastrointestinal, autonomic, neuropsychiatric and sleep complaints (NMSQuest which is an established tool in PD patients. 90 MND patients were included and compared to 96 controls.Results: In total, MND patients reported significantly higher NMS scores (median: 7 points in comparison to controls (median: 4 points. Dribbling, impaired taste/smelling, impaired swallowing, weight loss, loss of interest, sad/blues, falling and insomnia were significantly more prevalent in MND patients compared to controls. Interestingly excessive sweating was more reported in the MND group. Correlation analysis revealed an increase of total NMS score with disease progression.Conclusions: NMS in MND patients seemed to increase with disease progression which would fit with the recently postulated disease spreading hypothesis. The total NMS score in the MND group significantly exceeded the score for the control group, but only 8 of the 30 single complaints of the NMSQuest were significantly more often reported by MND patients. Dribbling, impaired swallowing, weight loss and falling could primarily be connected to motor neuron degeneration and declared as motor symptoms in MND.

  7. Roflumilast: clinical benefit in patients suffering from COPD

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Calverley, Peter Michael Anthony

    2010-01-01

    BACKGROUND AND AIMS: Chronic obstructive pulmonary disease (COPD) is associated with substantial morbidity and mortality and is characterised by persistent airway inflammation, which leads to impaired airway function, quality of life and intermittent exacerbations. In spite of recent advances...... in the treatment of COPD, new treatment options for COPD are clearly necessary. The oral phosphodiesterase-4 (PDE4) inhibitor roflumilast represents a new class of drugs that has shown efficacy and acceptable tolerability in preclinical and short-term clinical studies in patients with COPD. METHODS AND RESULTS......) , and a reduction in frequency and severity of COPD exacerbations, as well as a positive effect on several patient-reported outcomes. The clinical benefit of roflumilast appears to be greatest in patients with more symptomatic and severe disease who experience exacerbations. The most common adverse effects...

  8. Roflumilast: clinical benefit in patients suffering from COPD

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Calverley, Peter Michael Anthony

    2010-01-01

    BACKGROUND AND AIMS:  Chronic obstructive pulmonary disease (COPD) is associated with substantial morbidity and mortality and is characterised by persistent airway inflammation, which leads to impaired airway function, quality of life and intermittent exacerbations. In spite of recent advances...... in the treatment of COPD, new treatment options for COPD are clearly necessary. The oral phosphodiesterase-4 (PDE4) inhibitor roflumilast represents a new class of drugs that has shown efficacy and acceptable tolerability in preclinical and short-term clinical studies in patients with COPD. METHODS AND RESULTS......) , and a reduction in frequency and severity of COPD exacerbations, as well as a positive effect on several patient-reported outcomes. The clinical benefit of roflumilast appears to be greatest in patients with more symptomatic and severe disease who experience exacerbations. The most common adverse effects...

  9. Positron emission tomography in patients suffering from HIV-1 infection

    Energy Technology Data Exchange (ETDEWEB)

    Sathekge, Mike [University Hospital of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Goethals, Ingeborg; Wiele, Christophe van de [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Maes, Alex [AZ Groening, Department of Nuclear Medicine, Kortrijk (Belgium)

    2009-07-15

    This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)

  10. Positron emission tomography in patients suffering from HIV-1 infection

    International Nuclear Information System (INIS)

    Sathekge, Mike; Goethals, Ingeborg; Wiele, Christophe van de; Maes, Alex

    2009-01-01

    This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. (orig.)

  11. Effect of calcium channels blockers and inhibitors of the renin-angiotensin system on renal outcomes and mortality in patients suffering from chronic kidney disease: systematic review and meta-analysis.

    Science.gov (United States)

    Zhao, Hong-Jin; Li, Yan; Liu, Shan-Mei; Sun, Xiang-Guo; Li, Min; Hao, Yan; Cui, Lian-Qun; Wang, Ai-Hong

    2016-07-01

    The renoprotective effect of inhibitors of renin-angiotensin system (RAS) has been identified through placebo-controlled trials. However, the effect of calcium-channel blockers (CCBs) on renal system is still controversial. Our current meta-analysis includes available evidences to compare the effect of dihydropyridine CCBs and ACEIs or ARBs on renal outcomes and mortality. We also further investigate whether CCBs can be used in combination with inhibitors of RAS to improve the prognosis of patients with chronic kidney disease (CKD). Electronic databases were searched up to July 2012, for clinical randomized controlled trials, assessing the effect of dihydropyridine CCBs on the incidence of end-stage renal disease (ESRD) and all-cause mortality in contrast to ACEIs or ARBs. Eight clinical trials were included containing 25,647 participants. ESRD showed significantly higher frequency with CCBs therapy compared with ACEIs or ARBs therapy, though blood pressure was decreased similarly in both groups in every trial (OR, 1.25; 95% CI, 1.05-1.48; p = 0.01). In contrast, there was no significant difference in the incidence of all-cause mortality between these two groups, though ACEIs or ARBs exhibited better renoprotective effect compared to CCBs (OR, 0.96; 95% CI, 0.89-1.03; p = 0.24). CCBs did not increase all-cause mortality incidence in patients with CKD though they displayed weaker renoprotective, compared to ACEIs or ARBs therapy. Our results suggest the combination of a CCB and an ACEI or ARB should be a preferable antihypertensive therapy in patients with CKD, considering their higher effect in decreasing blood pressure and fewer adverse metabolic problems caused.

  12. [Problems of military medical examination of military servicemen suffering from chronic obstructive pulmonary disease].

    Science.gov (United States)

    Chapliuk, A L; Brovkin, S G; Kal'manov, A S; Bulavin, V V

    2015-02-01

    The authors showed that at the present time military much more servicemen, suffering from obstructive pulmonary disease, may receive medical examination in outpatient conditions. Series of researches allow us to perform a medical examination on an outpatient basis. The calculation of the cost-effectiveness of health services to such patients during a military medical examination in the hospital and clinics was made. Savings during the examination in the clinic for 1 patient was 2829 rubbles.

  13. Suffering and euthanasia: a qualitative study of dying cancer patients' perspectives.

    Science.gov (United States)

    Karlsson, Marit; Milberg, Anna; Strang, Peter

    2012-05-01

    Although intolerable suffering is a core concept used to justify euthanasia, little is known about dying cancer patients' own interpretations and conclusions of suffering in relation to euthanasia. Sixty-six patients with cancer in a palliative phase were selected through maximum-variation sampling, and in-depth interviews were conducted on suffering and euthanasia. The interviews were analyzed using qualitative content analysis with no predetermined categories. The analysis demonstrated patients' different perspectives on suffering in connection to their attitude to euthanasia. Those advocating euthanasia, though not for themselves at the time of the study, did so due to (1) perceptions of suffering as meaningless, (2) anticipatory fears of losses and multi-dimensional suffering, or (3) doubts over the possibility of receiving help to alleviate suffering. Those opposing euthanasia did so due to (1) perceptions of life, despite suffering, as being meaningful, (2) trust in bodily or psychological adaptation to reduce suffering, a phenomenon personally experienced by informants, and (3) by placing trust in the provision of help and support by healthcare services to reduce future suffering. Dying cancer patients draw varying conclusions from suffering: suffering can, but does not necessarily, lead to advocations of euthanasia. Patients experiencing meaning and trust, and who find strategies to handle suffering, oppose euthanasia. In contrast, patients with anticipatory fears of multi-dimensional meaningless suffering and with lack of belief in the continuing availability of help, advocate euthanasia. This indicates a need for healthcare staff to address issues of trust, meaning, and anticipatory fears.

  14. Surgical-orthodontic treatment of patients suffering from severe periodontal disorders - a clinical case study.

    Science.gov (United States)

    Halimi, Abdelali; Zaoui, Fatima

    2013-09-01

    Orthodontic or, more precisely, surgico-orthodontic treatment of patients suffering from periodontal disorders generally requires a multidisciplinary approach by a qualified dental team. Periodontal bone healing is an essential factor for successful orthodontic treatment in a compromised periodontal situation. We report on the case of an adult patient suffering from severe chronic periodontitis; he was a hyperdivergent skeletal Class III with dento-alveolar compensation, esthetic problems and a significant lack of dental material. A multidisciplinary approach was adopted. First of all, periodontal treatment was undertaken (root scaling and planing) accompanied by appropriate medical treatment and a bone graft to strengthen the area of the lower incisors. After that, surgical and orthodontic treatment to correct the malocclusion was begun. The difficulty lay in the significant absence of dental material to ensure proper intercuspation. A surgical repositioning splint was constructed on an articulator to ensure adequate mandibular retraction after maxillary advancement surgery. After treatment, the missing teeth were replaced by a prosthesis. Following treatment, the periodontal bone resorption was stabilized; the bone deficit was improved and the malocclusion had been corrected; the missing teeth were replaced by appropriate dentures. Short- and medium-term follow-up confirmed the stability of the results obtained, which will be discussed. The right combination of properly managed orthodontic, periodontal and prosthetic treatment can contribute to effective elimination of chronic periodontitis, even at an advanced stage in an adult patient, while at the same time improving esthetic and functional parameters. Copyright © 2013. Published by Elsevier Masson SAS.

  15. Clinical Characteristics of Cerebrovascular Pathology with Patients Suffering from Ph-Negative Myeloproliferative Disease

    Directory of Open Access Journals (Sweden)

    Marine M. Tanashyan

    2016-09-01

    Full Text Available Background: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph myeloproliferative disorders (MPD including essential thrombocythemia (ET, polycythemia vera (PV, and primary myelofibrosis (PM. Materials and Methods: The study included 167 patients: 102 patients with Ph-MPD and the control group comprising 65 patients with CVD. According to MPD subtype, the patients were divided into three groups: patients with ET (37%, n = 38, male/female 7/31, age 52 ± 7 years, those with PV (40%, n = 41, male/female 20/21, age 50 ± 6 years and those with PM (23%, n = 23, male/female 5/18, age 54 ± 4 years. Results: In 79% (n = 81 of cases in the study group (with Ph-MPD, patients had chronic CVD, with the most frequently identified symptoms being asthenia (92% and headache (72%. Headache in Ph-MPD patients was more frequently (86% associated with PM, while in patients with PV and ET it was equally distributed (70%. Neurological symptoms in 53% of cases were associated with focal changes of the brain on MRI localized in the subcortical area of the frontal and parietal lobes. Twenty-one (21% patients suffered an acute cerebrovascular accident, 8 of them had thrombotic occlusion of one of the internal carotid arteries leading to hemispheric infarcts. Endothelial function (as measured by flow-dependent dilation of the brachial artery was severely impaired in all study groups (median 5% with normal cut-off at 10%, the lowest degree of vasodilator activity being specific for patients with a history of stroke (p = 0.011. Conclusion: Patients suffering from MPD had asymptomatic focal changes in the brain in the absence of concomitant vascular disease (hypertension

  16. Causes of death in patients with Itai-itai disease suffering from severe chronic cadmium poisoning: a nested case-control analysis of a follow-up study in Japan.

    Science.gov (United States)

    Nishijo, Muneko; Nakagawa, Hideaki; Suwazono, Yasushi; Nogawa, Kazuhiro; Kido, Teruhiko

    2017-07-13

    To clarify the causes of deaths among patients with Itai-itai disease and severe cadmium (Cd) poisoning. Nested case-control analysis of a population-based cohort study. Database of patients with Itai-itai disease and residents of Cd-polluted areas, maintained by the Ministry of Environment, Japan. Subjects included 142 women with Itai-itai disease, 111 women with Cd-induced renal tubular dysfunction and 253 controls matched for sex, age and occupation. All subjects participated in a health impact survey between 1979 and 1984 and were followed until 30 November 2005. Adjusted HRs with 95% CIs for cause of death in women with Itai-itai disease and screened female cases with tubular dysfunction were compared with matched pair controls, using Cox's proportional hazard model. Vital statistics data were used to determine cause of death. Direct causes of death from autopsy records were used in 29 patients who died from Cd poisoning. The most common cause of death among patients with Itai-itai disease was pneumonia, with a significantly increased adjusted HR of 4.54 (95% CI 2.65 to 7.76). Renal diseases were the most common cause of death in renal tubular dysfunction cases, with an increased HR of 12.0 (95% CI 3.92 to 36.8). The adjusted HR for renal diseases was also significantly increased in patients with Itai-itai disease (19.49 (95% CI 6.43 to 59.09)), with a greater impact on mortality of patients with Itai-itai disease than screened cases. The HR for gastrointestinal (GI) diseases was significantly increased (13.79 (95% CI 3.87 to 49.10)) in patients, especially in the first 10 years (37.1 (4.81 to 286.0)). Among patients with Itai-itai disease, pneumonia and GI diseases contributed to increased mortality risk. Renal disease is also a significant mortality risk in patients with Itai-itai disease and women with renal tubular dysfunction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No

  17. Design of a Randomized Controlled Trial (RCT) Evaluating Outcome and Cost-effectiveness of a Local Case-Management Intervention of Patients Suffering from Chronic Obstructive Pulmonary Disease (COPD)

    DEFF Research Database (Denmark)

    Sørensen, Sabrina Storgaard; Pedersen, Kjeld Møller; Ehlers, Lars Holger

    2013-01-01

    Introduktion: I december 2001 igangsatte den Danske Regering en ny national strategi for håndteringen af kronisk sygdom, hvor der bl.a. blev afsat knap 100 millioner kr. til oprettelsen af nye stillinger som forløbskoordinatorer, hvis formål er at understøtte særligt sårbare patienter. Der eksist...

  18. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis.

    Science.gov (United States)

    Tripoli, Tatiana M; Sato, Hélio; Sartori, Marair G; de Araujo, Fábio Fernando; Girão, Manoel J B C; Schor, Eduardo

    2011-02-01

    Chronic pelvic pain (CPP) is one of the most frequent symptoms in women of reproductive age. This is an enigmatic clinical condition that results from the complex interactions of physiological and psychological factors with direct impact on the social, marital, and professional lives of women. To evaluate the quality of life and sexual satisfaction of women who suffer from CPP with or without endometriosis. Forty-nine patients who had been diagnosed with endometriosis and 35 patients with CPP diagnosed with another gynecological condition, all 84 of whom were treated at the Chronic Pelvic Pain and Endometriosis Clinic at Universidade Federal de São Paulo (UNIFESP) from January to July of 2008. The controls were 50 healthy women from the Family Planning Clinic at UNIFESP. World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) quality of life questionnaire and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). No statistically significant differences were observed between the groups with CPP symptoms, in either the results from the WHOQOL-BREF or in the GRISS questionnaire. In both questionnaires, differences were observed when the two groups of symptomatic women were compared with the group of healthy women. CPP caused by endometriosis or other gynecological conditions leads to a significant reduction of quality of life and sexual satisfaction. © 2010 International Society for Sexual Medicine.

  19. Invited commentary on … When unbearable suffering incites psychiatric patients to request euthanasia.

    Science.gov (United States)

    Kelly, Brendan D

    2017-10-01

    Euthanasia is available in Belgium and Luxembourg for untreatable and unbearable suffering resulting from 'physical and/or psychological suffering that cannot be alleviated and results from a serious and incurable disease, caused by accident or illness'. Verhofstadt et al 's valuable analysis of testimonials from psychiatric patients requesting euthanasia demonstrates that elements of this suffering might well be alleviated. We should not kill our patients. © The Royal College of Psychiatrists 2017.

  20. Extracranial cerebral arterial atherosclerosis in Iranian patients suffering ischemic strokes

    Directory of Open Access Journals (Sweden)

    Sayed Ali Mousavi

    2006-12-01

    Full Text Available BACKGROUND: To determine the distribution and severity of extracranial carotid arterial atherosclerosis in Iranian patients with ischemic stroke. METHODS: 328 patients with ischemic stroke were included in this study. Doppler ultrasound was used for evaluation of atherosclerosis in extracranial carotid arteries. The NASCET criteria were used to measure carotid stenosis. RESULTS: Ninety of 328 patients (27.4% were found to have atherosclerotic plaques; 40 of these patients were women and 50 were men. Sixty-eight patients (20.7% had artery stenosis <50%, 13 patients (3.95% had 50-70 % artery stenosis and 6 (1.8% had >70% artery stenosis. CONCLUSIONS: Extracranial atherosclerosis is not rare in Iranian patients with ischemic stroke, but most carotid artery lesions were plaques with <50% stenosis. KEY WORDS: Atherosclerosis, ischemic stroke, carotid stenosis.

  1. CELLULAR IMMUNITY OF THE PATIENTS SUFFERING FROM RECURRENT GENITAL CANDIDOSE

    Directory of Open Access Journals (Sweden)

    Nataša Miladinovic

    2000-03-01

    Full Text Available The examination of the cellular immunity parameters comprised 20 women suffering from the recurrent genital candidose (RGK in the remission phase as well as 20 women of the control grooup that never had any verified genital mucous infection. The aim of the research was to determine the interferon-gamma (INF gamma production in the culture of specifically (by the Candida albicans - HKB-antigens and non-specifically (Concavalin-A-ConA stimulated mononuclear cells of the peripheral blood of the women with the RKG as well as of the healthy women for the sake of determining a possible presence of the system cellular immunity hypo-activity. The IFN gamma was determined by the quantitative immuno-enzymic Quantikine method (R/D system, Minneapolis, USA.The IFN gamma was confirmed in minimal quantities in the cultures of the lymphocytes stimulated by the specific antigen (average value - 15 pg/ml. A considerably higher value of the produced IFN gamma was confirmed in the cultures of the stimulated lymphocytes (average value - 954 pg/ml as well as at the ConA and the HKB lymphocyte stimulus (average value - 1247 pg/ml.

  2. Investigating hyperventilation syndrome in patients suffering from empty nose syndrome.

    Science.gov (United States)

    Mangin, David; Bequignon, Emilie; Zerah-Lancner, Francoise; Isabey, Daniel; Louis, Bruno; Adnot, Serge; Papon, Jean-François; Coste, André; Boyer, Laurent; Devars du Mayne, Marie

    2017-09-01

    Patients with empty nose syndrome (ENS) following turbinate surgery often complain about breathing difficulties. We set out to determine if dyspnea in patients with ENS was associated with hyperventilation syndrome (HVS). We hypothesized that lower airway symptoms in ENS could be explained by HVS. Observational prospective study. All consecutive patients referred to our center for ENS over 1 year were invited to participate. Patients completed the Nijmegen score and underwent a hyperventilation provocation test (HVPT) and arterial blood gas and cardiopulmonary tests. HVS was defined by a delayed return of the end-tidal partial pressure of carbon dioxide in the expired gas to baseline during HVPT. Patients with HVS were asked to complete the Sinonasal Outcome Test (SNOT)-16 questionnaire before and after a specific eight-session respiratory rehabilitation program. Twenty-two of the 29 patients referred for ENS during the study period were eligible for inclusion and underwent a complete workup. HVS was diagnosed in 17 of these patients (77.3%). In the five patients who completed the SNOT-16, the score was significantly lower after rehabilitation. This study suggests that HVS is frequent in patients with ENS, and that symptoms can be improved by respiratory rehabilitation. Pathophysiological links between ENS and HVS deserve to be further explored. 2b Laryngoscope, 127:1983-1988, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Radioimmunological vasopressin determination in the urine of patients suffering from hypertension and lung carcinomas

    International Nuclear Information System (INIS)

    Freisenhausen, H.D.; Frahm, H.; Wiethold, G.; Desaga, U.; Ebeling, J.; Schrader, D.

    1976-01-01

    The AVP content of the 24 h urine was investigated in 43 patients suffering from hypertension and 80 patients suffering from bronchial carcinoma. With 103.2 +- 52.4 ng, the AVD content of the 24 h urine of 21 untreated hypertensives was highly significantly (p [de

  4. Joint medico-psychological consultation for patients suffering from tinnitus.

    Science.gov (United States)

    Degive, Colette; Kos, Maria-Izabel

    2006-01-01

    Because no effective treatment against tinnitus is available, all sorts of approaches have been developed. We believe the care of tinnitus patients concerns mainly ENT medical doctors. In order to take care of such patients, we started in 1993 a joint medico-psychological consultation (JMPC) to dispense adequate care for patients and training to the ENT residents. Every patient visiting our clinic for a tinnitus consultation benefits first from a comprehensive audiological examination. Once all objective causes of tinnitus are excluded, those patients who were not able to accept their auditory disorder or who insist on focusing on the annoyance caused by the perception of their tinnitus are invited by the doctor to the JMPC. The intolerance caused by tinnitus is enhanced by psychological and social aspects. These aspects are considered and discussed during the JMPC. The patients talk about their tinnitus bringing additional information on professional, familial and relational issues. In the JMPC, the therapists try to help the patients to void the affective irritation and the internal tension they clearly demonstrate. When the patients notice that the therapists accept their distress, they usually talk more calmly about their hearing irritation and even consider it tolerable. The medical and psychological information given during the JMPC helps the patients to understand the links between tinnitus and the disturbing elements of their current life. During the JMPC, the medical residents have been able to observe how somatic complaints can lead to complaints of another nature, to distress, to aggressive or angered behaviors. They have acknowledged the way the psychologist deals with the attitudes of these patients. This learning process became mandatory to all our residents specializing in ENT. At the end of their training they should have learned how to help the patient accept the tinnitus and the irritation it causes. They should be able to help tinnitus patients

  5. Dynamic scintigraphy of salivary glands in patients suffering from Sycca Syndrome

    International Nuclear Information System (INIS)

    Mijatovic, J.M.; Rajkovaca Zvezdana, Z.R.

    2002-01-01

    Aim: The objective of the study was to analyse the obtained results and evaluate the dynamic scintigraphy value in appraising the functional condition of salivary glands in patient suffering from Sycca Syndrome. Materials: Fifty-three patients (5 men and 48 women), aged l8-80, were referred to specialist for rheumatic diseases in the period March 2000 - March 2002. The patients had some of the following symptoms: dryness of oral cavity, dryness of conjunctivas with or without a chronic polyarthritis symptom. Methodology: Upon intravenous injection of 142-222MBq 99mTc pertechnetate, acquisition (matrix 64x64, 25 frems of 60 seconds, l5 minutes, vitamin C tablet under tongue). Generating of dynamic curves above both parotid and both submandibular salivary glands and semi-quantitative analysis of curves. Results: Four (4) out fifty-three (53) patients had a normal (regular) finding. Forty-nine (49) out of 53 patients had deviating dynamic curvec generated above the mentioned glands. Nineteen (19) out of those 49 patients had deviated all 4 dynamic curves, 22 out of 49 patients had deviated curves only above submandibular salivary glands, 1 patient had deviated curves only above parotid glands, 1 patient had deviated curves above both parotid and one submandibular salivary glands and the other 6 out of 49 patients had deviated curve only above one of the mentioned glands. Conclusion: In the diagnosis of Sycca syndrome, simple and non-invasive method for observing functional condition of parotid and submandibular salivary glands may help in clinical management of patients for diagnosing of heterogenic group of immunosialoadenitis

  6. The problem of fatigue in patients suffering from neoplastic disease

    Directory of Open Access Journals (Sweden)

    Agnieszka Kolak

    2017-06-01

    Full Text Available Modern therapeutic management of patients with cancer is associated with many adverse side effects, including fatigue defined as weariness, burnout, lassitude, malaise, apathy, impatience, and/or inability to perform daily activities. It occurs frequently before the diagnosis of cancer and may persist for a long time after the end of cancer therapy. It is a common problem that occurs regardless of the type of cancer and applied therapeutic procedure. The appearance of this symptom significantly affects the quality of life of patients and often reduces the effectiveness of implemented treatment. The symptom of fatigue occurs among approximately 80% of patients treated with chemotherapy and/or radiotherapy, as well as among more than 75% of patients with metastatic disease. Causes of fatigue include metabolic and immune system disorders as well as increased level of tumour necrosis factor  (TNF-. Recent studies also indicate a significant contribution of other cytokines, especially pro-inflammatory ones, i.e. interleukin-1 (IL-1, interleukin-6 (IL-6, soluble tumour necrosis factor receptor type II (sTNF type II and C-reactive protein (CRP. A patient reporting fatigue should be properly diagnosed and thoroughly interviewed by doctors. Patients are mostly treated non-pharmacologically (by means of physical exercise and psychotherapy and pharmacologically (by applying methylphenidate and methylprednisolone. What is also extremely important is proper education of the patient and their closest family/friends on the symptoms, which significantly reduces anxiety and stress. On the other hand therapeutic management hinders the subjectivity of feeling and lack of standardised scales to rate symptoms.

  7. Olfactory dysfunction in persian patients suffering from parkinson's disease.

    Science.gov (United States)

    Soltanzadeh, Akbar; Shams, Mehdi; Noorolahi, Hamid; Ghorbani, Askar; Fatehi, Farzad

    2011-01-01

    Looking in literature reveals that aging is accompanied by olfactory dysfunction and hyposmia/anosmia is a common manifestation in some neurodegenerative disorders. Olfactory dysfunction is regarded as non-motor manifestations of Parkinson disease (PD). The main goal of this study was to examine the extent of olfactory dysfunction in Persian PD patients. We used seven types of odors including rosewater, mint, lemon, garlic which were produced by Barij Essence Company in Iran. Additionally, coffee and vinegar were used. Subjects had to distinguish and name between seven previously named odors, stimuli were administered to each nostril separately. Totally, 92 patients and 40 controls were recruited. The mean (standard deviation) (SD) age patients was 64.88 (11.30) versus 61.05 (7.93) in controls. The male: female ratio in patients was 50:42 versus 22:18 in control group. Also, mean UPDRS score (SD) in patients was 24.42 (5.08) and the disease duration (SD) was 3.72 (3.53). Regarding the number of truly detected odors, there were a significant higher number of correct identified odors in control group in comparison with the PD patients. Furthermore, there was a significant negative correlation between number of correct diagnosed smells and UPDRS (Pearson Correlation= -0.27, P = 0.009); conversely, no significant correlation between the duration of Parkinson disease and number of correct diagnosed smells (P > 0.05). Smelling dysfunction is a major problem in Persian PD patients and it requires vigilant investigation for the cause of olfactory dysfunction exclusively in elder group and looking for possible PD disease.

  8. Investigating the Mental Experience of Patients Suffering From Cancer

    Directory of Open Access Journals (Sweden)

    Reza Abdollahzadeh

    2017-07-01

    Full Text Available Background Despite the remarkable development of medical sciences, cancer has yet remained one of the most important diseases of the current century and the second cause of death following cardiovascular diseases. Although we witnessed considerable development in treating cancer and increased number of survivors, cancer is a unique disease that makes the patients deeply feel helplessness and fear. Methods A qualitative content analysis research was done. The present study investigated patients’ experience and behaviors after hearing about their cancer. Purposeful sampling was carried out and continued until data saturation. We used qualitative validation methods to verify the results. Results Study participants consisted of 14 patients. 10 main components emerged from the data including: 1 getting shocked, 2 fear, 3 anxiety and stress, 4 guilt, 5 hopelessness, 6 depression, 7 isolation, 8 lack of affection and dependency on family members, 9 getting prepared to die and, 10 reviving spiritual relationship with God. Conclusions There is a necessity to understand the mental feelings of cancer patients, and program suitable clinical interventions based on patients’ mental needs. As the number of cancer patients is increasing, the results of the present study can be useful for patients’ families and clinical personnel especially physicians and nurses in dealing with cancer patients.

  9. The Mozart effect in patients suffering from tinnitus.

    Science.gov (United States)

    Attanasio, Giuseppe; Cartocci, Giulia; Covelli, Edoardo; Ambrosetti, Elena; Martinelli, Valentina; Zaccone, Mariagrazia; Ponzanetti, Alessandra; Gueli, Nicolò; Filipo, Roberto; Cacciafesta, Mauro

    2012-11-01

    The study suggests that Mozart therapy could be a valid alternative to the common sound therapy methods in tinnitus patients. The aim of the study was to evaluate the presence of the Mozart effect as indexed by a variation in tinnitus intensity and tolerability. Sixty-two individuals aged between 22 and 78 years, reporting tinnitus for at least 1 year, were enrolled for the study. All patients attended a 1 h cognitive behavioral counseling session and listened to Mozart's sonata k448 for 1 h per day for a month. Afterwards patients listened to Beethoven's Für Elise sonata for 1 h per day for a month. To evaluate the general stress level, the impact of tinnitus on patients' quality of life, and the intensity of tinnitus, patients were invited to participate in three tests: the Measure du Stress Psychologique (MSP) questionnaire, the Tinnitus Handicap Inventory (THI), and a 0 to 10 visual analog scale (VAS). For all the parameters investigated, MSP, THI, and intensity, there was a general significant improvement between the pre- and post-listening evaluation. A significant improvement, as regards THI and intensity, could already be appreciated after a single exposure to Mozart's sonata.

  10. Alterations in the antioxidant status of patients suffering from ...

    African Journals Online (AJOL)

    In view of the high prevalence of type 2 diabetes mellitus, this study aimed at determining the total plasma antioxidant capacity of type 2 diabetic patients with and without macrovascular complications. The erythrocyte catalase level was also evaluated because of the implication of catalase as a risk factor in diabetes.

  11. Do over 200 million healthy altitude residents really suffer from chronic Acid-base disorders?

    Science.gov (United States)

    Zubieta-Calleja, Gustavo; Zubieta-Castillo, Gustavo; Zubieta-Calleja, Luis; Ardaya-Zubieta, Gustavo; Paulev, Poul-Erik

    2011-01-01

    As the oxygen tension of inspired air falls with increasing altitude in normal subjects, hyperventilation ensues. This acute respiratory alkalosis, induces increased renal excretion of bicarbonate, returning the pH back to normal, giving rise to compensated respiratory alkalosis or chronic hypocapnia. It seems a contradiction that so many normal people at high altitude should permanently live as chronic acid-base patients. Blood gas analyses of 1,865 subjects at 3,510 m, reported a P(a)CO(2) (arterial carbon dioxide tension ± SEM) = 29.4 ± 0.16 mmHg and pH = 7.40 ± 0.005. Base excess, calculated with the Van Slyke sea level equation, is -5 mM (milliMolar or mmol/l) as an average, suggesting chronic hypocapnia. THID, a new term replacing "Base Excess" is determined by titration to a pH of 7.40 at a P(a)CO(2) of 5.33 kPa (40 mmHg) at sea level, oxygen saturated and at 37°C blood temperature. Since our new modified Van Slyke equations operate with normal values for P(a)CO(2) at the actual altitude, a calculation of THID will always result in normal values-that is, zero.

  12. A phenomenological study on resilience of the elderly suffering from chronic disease: a qualitative study

    Directory of Open Access Journals (Sweden)

    Hassani P

    2017-02-01

    personal factors to overcome illness” with subthemes of “enthusiasm for following up the treatment program”, “aversion to physical dependence”, “hope for improvement”, “motivation and purpose”, and “being content with one’s belongings and blessings”.Conclusion: Improvement in resilience is associated with a patient-oriented approach. Providers of health services might make proper interventions based on unique needs of patients to improve their resilience and ability to overcome health problems. This can be performed by family members, health team, and related organizations and bodies. Keywords: chronic disease, resilience, aged, qualitative studies

  13. Heavy metal exposure in patients suffering from electromagnetic hypersensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Ghezel-Ahmadi, David, E-mail: david.ahmadi@web.de [Department of Psychiatry, University of Mainz (Germany); Engel, Alice; Weidemann, Joerg [Department of Psychiatry, University of Mainz (Germany); Budnik, Lygia Therese; Baur, Xaver [Institute for Occupational Medicine and Maritime Medicine (ZfAM), University of Hamburg (Germany); Frick, Ulrich [Department of Psychiatry, University of Regensburg (Germany); Department of Healthcare Management, Carinthia University of Applied Sciences (Austria); Hauser, Simone [Department of Psychiatry, University of Regensburg (Germany); Dahmen, Norbert [Department of Psychiatry, University of Mainz (Germany)

    2010-01-15

    Background: Risks from electromagnetic devices are of considerable concern. Electrohypersensitive (EHS) persons attribute a variety of rather unspecific symptoms to the exposure to electromagnetic fields. The pathophysiology of EHS is unknown and therapy remains a challenge. Objectives: Heavy metal load has been discussed as a potential factor in the symptomatology of EHS patients. The main objective of the study was to test the hypothesis of a link between EHS and heavy metal exposure. Methods: We measured lead, mercury and cadmium concentrations in the blood of 132 patients (n = 42 males and n = 90 females) and 101 controls (n = 34 males and n = 67 females). Results: Our results show that heavy metal load is of no concern in most cases of EHS but might play a role in exceptional cases. Conclusions: The data do not support the general advice to heavy metal detoxification in EHS.

  14. Heavy metal exposure in patients suffering from electromagnetic hypersensitivity

    International Nuclear Information System (INIS)

    Ghezel-Ahmadi, David; Engel, Alice; Weidemann, Joerg; Budnik, Lygia Therese; Baur, Xaver; Frick, Ulrich; Hauser, Simone; Dahmen, Norbert

    2010-01-01

    Background: Risks from electromagnetic devices are of considerable concern. Electrohypersensitive (EHS) persons attribute a variety of rather unspecific symptoms to the exposure to electromagnetic fields. The pathophysiology of EHS is unknown and therapy remains a challenge. Objectives: Heavy metal load has been discussed as a potential factor in the symptomatology of EHS patients. The main objective of the study was to test the hypothesis of a link between EHS and heavy metal exposure. Methods: We measured lead, mercury and cadmium concentrations in the blood of 132 patients (n = 42 males and n = 90 females) and 101 controls (n = 34 males and n = 67 females). Results: Our results show that heavy metal load is of no concern in most cases of EHS but might play a role in exceptional cases. Conclusions: The data do not support the general advice to heavy metal detoxification in EHS.

  15. Acupuncture treatment of a male patient suffering from long-term schizophrenia and sleep disorders

    NARCIS (Netherlands)

    Bosch, M.P.C.; Staudte, H.; Yeo, S.; Lee, S.H.; Lim, S.; Noort, M.W.M.L. van den

    2017-01-01

    Objective: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders. Methods: A 42-year-old German male outpatient, suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a

  16. Candida nivariensis isolated from an Indonesian human immunodeficiency virus-infected patient suffering from oropharyngeal candidiasis

    NARCIS (Netherlands)

    Wahyuningsih, Retno; SahBandar, Ivo N.; Theelen, Bart; Hagen, Ferry; Poot, Ge; Meis, Jacques F.; Rozalyani, Anna; Sjam, Ridhawati; Widodo, Djoko; Djauzi, Samsuridjal; Boekhout, Teun

    Candida nivariensis was isolated from an Indonesian human immunodeficiency virus-infected patient who suffered from oropharyngeal candidiasis and was identified with molecular tools. Our isolate demonstrated low MICs to amphotericin B, flucytosine, posaconazole, caspofungin, and isavueonazole and

  17. Candida nivariensis isolated from an Indonesian human immunodeficiency virus-infected patient suffering from oropharyngeal candidiasis.

    NARCIS (Netherlands)

    Wahyuningsih, R.; SahBandar, IN; Theelen, B.; Hagen, F.; Poot, G.; Meis, J.F.; Rozalyani, A.; Sjam, R.; Widodo, D.; Djauzi, S.; Boekhout, T.

    2008-01-01

    Candida nivariensis was isolated from an Indonesian human immunodeficiency virus-infected patient who suffered from oropharyngeal candidiasis and was identified with molecular tools. Our isolate demonstrated low MICs to amphotericin B, flucytosine, posaconazole, caspofungin, and isavuconazole and

  18. Symptom severity, quality of sleep, and treatment adherence among patients suffering from schizophrenia and depression

    NARCIS (Netherlands)

    Bosch, M.P.C.; Waberg, J.; Noort, M.W.M.L. van den; Staudte, H.; Lim, S.; Egger, J.I.M.

    2016-01-01

    Aim: Treatment non-adherence is a common problem in patients suffering from schizophrenia and depression. This study investigated the possible relationships between symptom severity, quality of sleep, and treatment adherence. Methods: Thirty outpatients with schizophrenia and 58 outpatients with

  19. When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study.

    Science.gov (United States)

    Verhofstadt, Monica; Thienpont, Lieve; Peters, Gjalt-Jorn Ygram

    2017-10-01

    Background The concept of 'unbearable suffering' is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. Aims To provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia. Method Testimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software. Results Five domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment. Conclusions The development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures. © The Royal College of Psychiatrists 2017.

  20. Concentrations of serum soluble transferring receptors in anemic children suffering from chronic renal failure

    International Nuclear Information System (INIS)

    Nassar, E.M.; Mostafa, A. M E.; Abdel-Latif, A. E.; El-Nashar, N.A.

    2004-01-01

    Inappropriate erythropoietin production is the main reason responsiblefor anemia in chronic renal failure children. Iron deficiency is the commonest cause of erythropoietin resistance in dialyzed children treated w ith recombinant human erythropoietin (r-HuEPO). Early detection of iron deficiency is vital to optimize management of chronic anemia associated with renal failure that is being treated with r-HuEPO but bclinical or functional iron deficiency is difficult to be diagnosed in these patients by the commonly used tests. This study was conducted in order to evaluate the role of serum soluble transferrin receptor (sTfR) in identifying iron deficiency among uremic children. Twenty-five patients with end stage renal failure were studied. They were classified into two groups; group I included 15 patients under conservative treatment and their ages ranged between 2-1] years with a mean value of 9.3 ± 3.79. Group II included 10 patients under regular hemodialysis treatment. This group was evaluated before receiving treatment (group IIa) and after treatment of anemia by r-HuEPO and intravenous iron for 8 weeks (group IIb). Their ages ranged between 4-10 years with a mean value of 8.1 ± 1.79 years. Ten healthy subjects, matched in age and sex, were served as controls (group III). All subjects were evaluated regarding renal function test, hematopoietic indices am ferrokinetic parameters including hypochromic cell percentage, serum iron, serum ferritin, total iron binding capacity (TIBC), sTfR and sTfR/log ferritu index. The study showed that the hypochromic cell percentage was significantly increased in both groups I and Ila when compared to controls (P < 0.0001). Also, a highly significant increase was detected in group Ila when compared with group I (P < 0.0001). Serum iron values showed reduction in both studied groups, which were not statistically significant. Serum ferritin showed high significant elevation in all the studied groups as compared to controls

  1. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    OpenAIRE

    Bablis, Peter; Pollard, Henry; Bonello, Rod

    2008-01-01

    Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiro...

  2. Psychological well-being in older adults suffering from chronic headache

    NARCIS (Netherlands)

    Jelicic, M.; Kempen, G.I.J.M.; Passchier, J.

    Objective. - The aim of this study was to examine two components of psychological well-being - life satisfaction and affective well-being - in community-dwelling elderly with (n = 321) and without chronic headache (n = 4955). Methods. - A checklist of chronic; medical conditions was used to

  3. When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study†

    Science.gov (United States)

    Verhofstadt, Monica; Thienpont, Lieve; Peters, Gjalt-Jorn Ygram

    2017-01-01

    Background The concept of ‘unbearable suffering’ is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients. Aims To provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia. Method Testimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software. Results Five domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment. Conclusions The development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures. PMID:28970302

  4. Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis

    Directory of Open Access Journals (Sweden)

    Jarmila Čelakovská

    2014-01-01

    Full Text Available Background: Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Aims and Objectives: Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. Materials and Methods: The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. Results: A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5 years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%, no reactions were recorded in 32 patients (24%. Foods with the most often recorded reactions are: Nuts (in 35% of patients, tomatoes (in 20%, and kiwi (in 17, 5%, apples and spices (in 16%, tangerines and oranges (in 15%, capsicum (in 13%, fishes (in 12%, celery (in 9%, and chocolate (in 7%. Conclusion: Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

  5. Food hypersensitivity in patients over 14 years of age suffering from atopic dermatitis.

    Science.gov (United States)

    Celakovská, Jarmila; Ettler, K; Ettlerová, K; Vaněčková, J

    2014-05-01

    Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%). Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen-associated foods play a role in the majority of patients suffering from atopic dermatitis.

  6. Beyond Pain: Nurses' Assessment of Patient Suffering, Dignity, and Dying in the Intensive Care Unit.

    Science.gov (United States)

    Su, Amanda; Lief, Lindsay; Berlin, David; Cooper, Zara; Ouyang, Daniel; Holmes, John; Maciejewski, Renee; Maciejewski, Paul K; Prigerson, Holly G

    2018-06-01

    Deaths in the intensive care unit (ICU) are increasingly common in the U.S., yet little is known about patients' experiences at the end of life in the ICU. The objective of this study was to determine nurse assessment of symptoms experienced, and care received by ICU patients in their final week, and their associations with nurse-perceived suffering and dignity. From September 2015 to March 2017, nurses who cared for 200 ICU patients who died were interviewed about physical and psychosocial dimensions of patients' experiences. Medical chart abstraction was used to document baseline patient characteristics and care. The patient sample was 61% males, 70.2% whites, and on average 66.9 (SD 15.1) years old. Nurses reported that 40.9% of patients suffered severely and 33.1% experienced severe loss of dignity. The most common symptoms perceived to contribute to suffering and loss of dignity included trouble breathing (44.0%), edema (41.9%), and loss of control of limbs (36.1%). Most (n = 9) remained significantly (P dignity (AOR 3.15). Use of feeding tube was associated with severe loss of dignity (AOR 3.12). Dying ICU patients are perceived by nurses to experience extreme indignities and suffer beyond physical pain. Attention to symptoms such as dyspnea and edema may improve the quality of death in the ICU. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Understanding the suffering of a patient with an illness: signs, context and strategies.

    Science.gov (United States)

    Hueso Montoro, César; Siles González, José; Amezcua, Manuel; Bonill de Las Nieves, Candela; Pastor Montero, Sonia; Celdrán Mañas, Miriam

    2012-01-01

    The aim of this study is to understand the suffering of a patient with an illness, by using a secondary research method, that is, a qualitative meta-study. The primary data source of the meta-study includes "biographical reports". This project is based on a case study, in which the first-hand experiences of a patient with an illness were collected. The findings of the reports were compiled using the Archivos de la Memoria collection of the Index Foundation (Granada, Spain) and journals specialized in editing these materials. A selection of 20 biographical reports was targeted. The results of the meta-study show that suffering is a multidimensional process within a framework of ambiguous feelings. The suffering involves family and social network participation. Patients develop a range of strategies to overcome the illness. One of the effects is the fear of illness relapse or worsening.

  8. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2008-05-01

    Full Text Available Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S; levator scapulae region (LS; sternocleidomastoid region (SCM and temporomandibular region (TMJ. For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables using forward stepwise General Linear Model. Results The visual analog scale (0 to 10 had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P Conclusion After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly

  9. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: a controlled clinical trial.

    Science.gov (United States)

    Bablis, Peter; Pollard, Henry; Bonello, Rod

    2008-05-21

    Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S); levator scapulae region (LS); sternocleidomastoid region (SCM) and temporomandibular region (TMJ). For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables) using forward stepwise General Linear Model. The visual analog scale (0 to 10) had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly improved when compared to a control group which received a sham protocol of NET. Chronic neck pain sufferers may benefit from NET treatment in the relief

  10. Functional disability in patients with low back pain: the mediator role of suffering and beliefs about pain control in patients receiving physical and chiropractic treatment.

    Science.gov (United States)

    Pereira, M Graça; Roios, Edite; Pereira, Marta

    Low back pain is the leading cause of disability worldwide. There is evidence that depression, anxiety, and external locus of control are negative predictors of functional disability in low back patients. This study focused on the mediator role of suffering and beliefs about pain control in the relationship between psychological morbidity and functional disability in patients receiving physical therapy and chiropractic treatment for chronic low back pain. The sample included 213 patients receiving chiropractic treatment and 125 receiving physical therapy, who answered the following instruments: Beliefs about Pain Control Questionnaire; Inventory of Subjective Experiences of Suffering in Illness; Oswestry Low Back Pain Disability Questionnaire; and the Hospital Anxiety and Depression Scales. Suffering was a mediator in the relationship between depression and functional disability in both treatment groups. Only beliefs related to external chance events mediated the relationship between depression and functional disability in the physical therapy group, but not in the chiropratic teratment group. Intervention should focus on suffering regardless of the type of treatment and target beliefs about pain control, in patients receiving physical therapy treatment since they seem to play a key role in functional disability in patients with low back pain. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Special features of old patients suffering from hyperthyroidism and clinical application of 131I therapy

    International Nuclear Information System (INIS)

    Deng Jinglan; Cheng Shiwu; Hou Yingping; Lin Guocheng; Wang Jing

    2005-01-01

    The special features of old patients suffering from hyperthyroidism are atypical. With light symptoms and light signs, it's called apathetic hyperthyroidism. Usually cardiovascular abnormality and concomitant atrial fibrillation are initial symptoms. Therefore, both early diagnosis and therapy in time are important. This paper reports the clinical data and the 131 I therapeutic results for 30 hyperthyroidism patients aged over 60 years and 30 patients aged 20-53 as control group, who were followed-up for 2-25 years. (authors)

  12. Influence of personality traits on sexual functioning of patients suffering from schizophrenia or depression.

    Science.gov (United States)

    Peitl, Marija Vucić; Peitl, Vjekoslav; Pavlović, Eduard; Blazević-Zelić, Sandra; Petrić, Daniela

    2011-09-01

    Aim of this research was to establish effects and influence of personality traits on sexual functioning of schizophrenic and depressive patients, compared to healthy individuals. 300 participants were included in this research. For patients suffering from schizophrenia it was established that the more they are open to experience and the less they are neurotic their sexual drive is stronger. For patients suffering from depression it was established that the more they are open to experience and conscientious and the less they are agreeable their sexual drive is stronger. Furthermore, higher openness is a significant predictor for easier sexual arousal and the more those patients are conscientious and the less they are agreeable easier is for them to achieve orgasms. Personality traits proved to be significant predictors of sexual functioning in schizophrenic and depressive patients, but not in healthy individuals.

  13. Radiation therapy for the old aged patient suffered from carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Arai, Tatsuo; Morita, Shinroku; Fukuhisa, Kenjiro; Wada, Susumu.

    1984-01-01

    Since a majority of old aged patients have the troublesome complications and their physical or mental emaciation is clearly appeared, it is necessary for them to adopt a new treatment method which was considered about thier such conditions. The crude survival rate of old aged, over 71, patients suffered from carcinoma of the uterine cervix were 63.6% (7/11) for stage 1, 60% (36/60) for stage 2, 50% (53/106) for stage 3 and 28.6% (8/28) for stage 4. About 20% of patients in each stages were suffered from the complications. We considered the treatment method for the old aged patients such as follows: the radiation dose must be reduced 10% for 71 to 75 year old and 20% for 76 to 80 year old. In the case of over 81 year old, an intracavitary irradiation is only applied for the palliative aim at the out patient clinic. (author)

  14. Evaluation of Narrative Abilities in Patients Suffering from Duchenne Muscular Dystrophy

    Science.gov (United States)

    Marini, A.; Lorusso, M. L.; D'Angelo, M. G.; Civati, F.; Turconi, A. C.; Fabbro, F.; Bresolin, N.

    2007-01-01

    The present work investigated cognitive, linguistic and narrative abilities in a group of children suffering from Duchenne Muscular Dystrophy, an allelic X-linked recessive disorder caused by mutations in the gene encoding dystrophin. The patients showed mildly reduced IQ with lower Verbal than Performance Intelligence Quotient and were mildly…

  15. Patient Suffering and Caregiver Compassion: New Opportunities for Research, Practice, and Policy

    Science.gov (United States)

    Schulz, Richard; Hebert, Randy S.; Dew, Mary Amanda; Brown, Stephanie L.; Scheier, Michael F.; Beach, Scott R.; Czaja, Sara J.; Martire, Lynn M.; Coon, David; Langa, Kenneth M.; Gitlin, Laura N.; Stevens, Alan B.; Nichols, Linda

    2007-01-01

    The purpose of this article is to stimulate discussion and research about patient suffering and caregiver compassion. It is our view that these constructs are central to understanding phenomena such as family caregiving, and that recognizing their unique role in the caregiving experience provides new directions for intervention research, clinical…

  16. Steps Toward Creating A Therapeutic Community for Inpatients Suffering from Chronic Ulcers: Lessons from Allada Buruli Ulcer Treatment Hospital in Benin.

    Directory of Open Access Journals (Sweden)

    Arnaud Setondji Amoussouhoui

    2016-07-01

    Full Text Available Reducing social distance between hospital staff and patients and establishing clear lines of communication is a major challenge when providing in-patient care for people afflicted by Buruli ulcer (BU and chronic ulcers. Research on hospitals as therapeutic communities is virtually non-existent in Africa and is currently being called for by medical anthropologists working in the field of health service and policy planning. This paper describes a pioneering attempt to establish a therapeutic community for patients suffering from BU and other chronic ulcers requiring long term hospital care in Benin.A six-month pilot project was undertaken with the objectives of establishing a therapeutic community and evaluating its impact on practitioner and patient relations. The project was designed and implemented by a team of social scientists working in concert with the current and previous director of a hospital serving patients suffering from advanced stage BU and other chronic ulcers. Qualitative research initially investigated patients' understanding of their illness and its treatment, identified questions patients had about their hospitalization, and ascertained their level of social support. Newly designed question-answer health education sessions were developed. Following these hospital wide education sessions, open forums were held each week to provide an opportunity for patients and hospital staff to express concerns and render sources of discontent transparent. Patient group representatives then met with hospital staff to problem solve issues in a non-confrontational manner. Psychosocial support for individual patients was provided in a second intervention which took the form of drop-in counseling sessions with social scientists trained to serve as therapy facilitators and culture brokers.Interviews with patients revealed that most patients had very little information about the identity of their illness and the duration of their treatment. This

  17. Attitudes towards treatment among patients suffering from sleep disorders. A Latin American survey

    Directory of Open Access Journals (Sweden)

    Lloret Santiago

    2003-11-01

    Full Text Available Abstract Background Although sleep disorders are common, they frequently remain unnoticed by the general practitioner. Few data are available about the willingness and reasons of patients with sleep disturbances to seek for medical assistance. Methods The results of a cross-sectional community-based multinational survey in three major Latin American urban areas, i.e. Buenos Aires, Mexico City and Sao Paulo, are reported. Two-hundred subjects suffering sleep disturbances and 100 non-sufferers were selected from the general population in each city (total number: 600 sufferers vs. 300 non-sufferers. A structured interview was conducted, sleep characteristics, feelings about sleep disturbances and strategies to cope with those problems being recorded. Data were analyzed by employing either t-test or analysis of variance (ANOVA to the Z-transformed proportions. Results 22.7 ± 3.5 % (mean ± SEM of subjects reported to suffer from sleep disturbances every night. About 3 out of 4 (74.2 ± 2.0 % considered their disorder as mild and were not very concerned about it. Only 31 ± 2 % of sufferers reported to have sought for medical help. Although 45 ± 2 % of sufferers reported frequent daily sleepiness, trouble to remember things, irritability and headaches, they did not seek for medical assistance. Among those patients who saw a physician with complaints different from sleep difficulties only 1 out of 3 (33 ± 2 % of patients were asked about quality of their sleep by the incumbent practitioner. Strategies of patients to cope with sleep problems included specific behaviors (taking a warm bath, reading or watching TV (44 ± 1.6 %, taking herbal beverages (17 ± 1.2 % or taking sleeping pills (10 ± 1.1 %. Benzodiazepines were consumed by 3 ± 0.6 % of sufferers. Conclusion Public educational campaigns on the consequences of sleep disorders and an adequate training of physicians in sleep medicine are needed to educate both the public and the general

  18. Clinical analysis of post-irradiation sensorineural hearing loss in patients suffering from nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Lu Xueguan; Liu Zhiyong; Zhang Liyuan; Tian Ye

    2005-01-01

    Objective: To investigate the incidence of post-irradiation sensorineural hearing loss (SNHL) in patients suffering from nasopharyngeal carcinoma and to evaluate its potentially contributing factors. Methods: Pure tonetest and impedance audiography were carried out in patients suffering from nasopharyngeal carcinoma with a post-irradiation follow-up time over 1 year. Additionally, the test results were combined with clinical data and analyzed retrospectively. Results: The follow-up time of all patients ranged from 12 to 94 months (median 53 months). The incidences of SNHL at low and high frequencies were 8% and 42% respectively. Univariate analysis showed that patient's age and follow-up time affected the incidence of SNHL at high frequencies (t=2.051, P=0.0269; t=2.978, P=0.0011), but sex, preirradiation subjective hearing loss, irradiation dose and chemotherapy including cisplatin had no significance. Multivariate analysis by Binary Logistic Regression revealed that the risk of SNHL was correlated with patient's age and follow-up time (P=0.02; P=0.009). Conclusion: Post-irradiation SNHL at high frequencies in patients suffering from nasopharyngeal carcinoma is more common than that at low frequencies. The independent prognostic factors for development of SNHL at high frequencies are patient's age and follow-up time. But the role of preirradiation hearing level ,irradiation dose and chemotherapy including cisplatin are not conclusive and further research is needed. (authors)

  19. Spiritual Needs of Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Harold G. Koenig

    2010-11-01

    Full Text Available For many patients confronted with chronic diseases, spirituality/religiosity is an important resource for coping. Patients often report unmet spiritual and existential needs, and spiritual support is also associated with better quality of life. Caring for spiritual, existential and psychosocial needs is not only relevant to patients at the end of their life but also to those suffering from long-term chronic illnesses. Spiritual needs may not always be associated with life satisfaction, but sometimes with anxiety, and can be interpreted as the patients’ longing for spiritual well-being. The needs for peace, health and social support are universal human needs and are of special importance to patients with long lasting courses of disease. The factor, Actively Giving, may be of particular importance because it can be interpreted as patients’ intention to leave the role of a `passive sufferer´ to become an active, self-actualizing, giving individual. One can identify four core dimensions of spiritual needs, i.e., Connection, Peace, Meaning/Purpose, and Transcendence, which can be attributed to underlying psychosocial, emotional, existential, and religious needs. The proposed model can provide a conceptual framework for further research and clinical practice. In fact, health care that addresses patients’ physical, emotional, social, existential and spiritual needs (referring to a bio-psychosocial-spiritual model of health care will contribute to patients’ improvement and recovery. Nevertheless, there are several barriers in the health care system that makes it difficult to adequately address these needs.

  20. [Application of antihelicobacter therapy in patients, suffering pyloroduodenal zone ulcers, complicated by hemorrhage].

    Science.gov (United States)

    Iaroshenko, K O

    2012-02-01

    There were examined 113 patients, suffering pyloroduodenal zone ulcers, complicated by an acute hemorrhage. H. pylori was revealed in 108 (96%) patients. To escape a false-negative results a serological method was applied, which was used to determine a content of IgG antibodies to H. pylori with the help of diagnostic panel GastroPanel (Biohit PLc firm, Finland). The H. pylori presence in patients must be considered as a risk factor for the early recurrent hemorrhage occurrence. A timely conducted examination, determination of H. pylori and timely prescription of antihelicobacter therapy promote the improvement of the treatment results in patients, suffering gastroduodenal ulcers, complicated by an acute hemorrhage due to reduction of the occurrence rate of early recurrence of hemorrhage.

  1. A brief analysis of patients suffering from stomach or duodenal ulcers in Almaty hospital №1

    Directory of Open Access Journals (Sweden)

    Aryzbekova Aliya

    2015-12-01

    Full Text Available Peptic ulcers are a serious problem worldwide, and affect about 4 million people each year. Their etiology is connected with the presence of Helicobacter pylori, the act of smoking, drinking alcohol, being stress, and taking excessively nonsteroidal anti-inflammatory drugs, as well as steroids. The most common symptoms are abdominal pain, nausea, chest pain and fatigue, while less frequent symptoms include vomiting and weight loss. Helicobacter pylori is responsible for about 80% of gastric and 90% of duodenal ulcer cases. In this work, an analysis is made of a correlation between stomach or duodenal ulcer and gender, residence and number of patients hospitalized in the Almaty hospital №1, from 2009-2012, in order to learn about trends in the incidence of these diseases in Kazakhstan. A total number of 950 patients with stomach and duodenal ulcers, in 2009-2012, were questioned. The patient’s residence, gender and stomach or duodenal ulcer problem were taken into account in the study. The result of this work reveals that the largest amount of hospitalized patients suffering from stomach or duodenal ulcers came from urban areas. Moreover, more women than men suffered from peptic ulcers. Furthermore, the number of patients admitted to the hospital due to duodenal ulcers did not show any variation throughout the study. However, the least number of patients suffering from gastric ulcers was noticed in December 2009, and the greatest was in October and November 2011. The obtained data show that ulcers are a serious problem in Kazakhstan.

  2. Aortic {sup 18}F-FDG uptake in patients suffering from granulomatosis with polyangiitis

    Energy Technology Data Exchange (ETDEWEB)

    Kemna, Michael J. [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Bucerius, Jan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); University Hospital RWTH Aachen, Department of Nuclear Medicine, Aachen (Germany); Drent, Marjolein [Maastricht University, Department of Pharmacology and Toxicology, Maastricht (Netherlands); Voeoe, Stefan [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Veenman, Martine [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Paassen, Pieter van [Maastricht University Medical Center, Department of Nephrology and Clinical Immunology, Maastricht (Netherlands); Tervaert, Jan Willem Cohen [Maastricht University, Cardiovascular Research Institute Maastricht (CARIM), Maastricht (Netherlands); Sint Franciscus Gasthuis, Noordoever Academy, Rotterdam (Netherlands); Kroonenburgh, Marinus J.P.G. van [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

    2015-08-15

    The objective of the study was to systematically assess aortic inflammation in patients with granulomatosis with polyangiitis (GPA) using {sup 18}F-2-deoxy-2-[{sup 18}F]fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. Aortic inflammation was studied in PET/CT scans obtained from 21 patients with GPA; 14 patients with sarcoidosis were included as disease controls, 7 patients with stage I or II head and neck carcinoma ascertained during routine clinical practice were used as healthy controls (HC) and 5 patients with large vessel vasculitis (LVV) were used as positive controls. Aortic {sup 18}F-FDG uptake was expressed as the blood-normalized maximum standardized uptake value (SUV{sub max}), known as the target to background ratio (mean TBR{sub max}). The mean TBR{sub max} (interquartile range) of the aorta in patients with GPA, sarcoidosis, HC and LVV were 1.75 (1.32-2.05), 1.62 (1.54-1.74), 1.29 (1.22-1.52) and 2.03 (1.67-2.45), respectively. The mean TBR{sub max} was significantly higher in patients suffering from GPA or LVV compared to HC (p < 0.05 and p < 0.005, respectively) and tended to be higher in patients suffering from sarcoidosis, but this did not reach statistical significance (p = 0.098). The mean TBR{sub max} of the most diseased segment was significantly higher compared to HC [1.57 (1.39-1.81)] in LVV patients [2.55 (2.22-2.82), p < 0.005], GPA patients [2.17 (1.89-2.83), p < 0.005] and patients suffering from sarcoidosis [2.04 (1.88-2.20), p < 0.05]. In GPA patients, the mean TBR{sub max} of the aorta was significantly higher in patients with previous renal involvement [2.01 (1.69-2.53)] compared to patients without renal involvement in the past [1.60 (1.51-1.80), p < 0.05]. Interrater reproducibility with a second reader was high (all intraclass correlation coefficients >0.9). Patients suffering from GPA show marked aortic FDG uptake. (orig.)

  3. Self-Reported Childhood Maltreatment and Traumatic Events among Israeli Patients Suffering from Fibromyalgia and Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Raneen Hellou

    2017-01-01

    Full Text Available Objective. The association between Fibromyalgia Syndrome (FMS and childhood maltreatment and adversity has frequently been proposed but limited data exists regarding the transcultural nature of this association. Methods. 75 Israeli FMS patients and 23 Rheumatoid Arthritis (RA patients were compared. Childhood maltreatment was assessed by the Childhood Trauma Questionnaire (CTQ and potential depressive and anxiety disorders were assessed by the Patient Health Questionnaire-4. FMS severity was assessed by the Widespread Pain Index (WPI, the Symptom Severity Score (SSS, and the FIQ. PTSD was diagnosed according to the DSM IV. RA severity was assessed by the RA Disease Activity Index. Health status was assessed by the SF-36. Results. Similar to reports in other countries, high levels of self-reported childhood adversity were reported by Israeli FMS patients. PTSD was significantly more common among FMS patients compared with RA patients, as well as childhood emotional abuse and physical and emotional neglect. Levels of depression and anxiety were significantly higher among FMS patients. Conclusion. The study demonstrated the cross cultural association between FMS and childhood maltreatment, including neglect, emotional abuse, and PTSD. Significant differences were demonstrated between FMS patients and patients suffering from RA, a model of an inflammatory chronic rheumatic disease.

  4. The effects of a medical hypnotherapy on clothing industry employees suffering from chronic pain.

    Science.gov (United States)

    Roja, Zenija; Kalkis, Valdis; Roja, Inara; Kalkis, Henrijs

    2013-09-25

    Problems associated with pain in several body regions due to work-related musculoskeletal disorders (WRMDs), repetitive movement and negative stress at work are quite common in many manufacturing industries of Latvia, int.al. clothing industry. The aim of this study was to evaluate efficiency of the psychotherapeutic intervention using medical hypnotherapy (MH) program for mind-body relaxation with pain-blocking imagery, cognitive restructuring of unpleasant physical and emotional experience. 300 sewers and 50 cutters with chronic pain were involved in the study. Self-rated WRMDs symptoms, pain intensity and interference were assessed using the extended version of Nordic Musculoskeletal Questionnaire and Brief Pain Inventory Scale. Assessment of the functional state of muscles was carried out using myotonometric (MYO) measurements. Work heaviness degree was estimated via heart rate monitoring (HRM). The MH program was composed of cognitive hypnotherapy and self-hypnosis training. Sunnen Trance Scale was used to determine person's hypnotic susceptibility. Life quality assessment before and after MH program was carried out using Quality of Life Scale. At the beginning of MH program sessions both sewers and cutters reported on pain interference with general activities, mood, sleep, normal work, etc., but after MH the interference of pain significantly decreased. HRM data confirmed that work heaviness degree of sewers and cutters can be referred to as light and moderate work (energy expenditure for their tasks varies from 3.4 till 4.7 kcal/min). Using MYO measurements it was stated that before MH 22% of workers involved in the study fell under III MYO category indices, consequently, their muscle tone was increased, which is associated with muscular fatigue. After MH muscle tone remained within the normal range meaning that they were able to adapt to the existing workload (II MYO category) or fully relax (I MYO category). MH program including exercises

  5. The Effect of Hypoallergenic Diagnostic Diet in Adolescents and Adult Patients Suffering from Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Jarmila Celakovská

    2012-01-01

    Full Text Available Aim: To evaluate the effect of a diagnostic hypoallergenic diet on the severity of atopic dermatitis in patients over 14 years of age. Materials and Methods: The diagnostic hypoallergenic diet was recommended to patients suffering from atopic dermatitis for a period of 3 weeks. The severity of atopic dermatitis was evaluated at the beginning and at the end of this diet (SCORAD I, SCORAD II and the difference in the SCORAD over this period was statistically evaluated. Results: One hundred and forty-nine patients suffering from atopic dermatitis were included in the study: 108 women and 41 men. The average age of the subjects was 26.03 (SD: 9.6 years, with the ages ranging from a minimum of 14 years to a maximum of 63 years. The mean SCORAD at the beginning of the study (SCORAD I was 32.9 points (SD: 14.1 and the mean SCORAD at the end of the diet (SCORAD II was 25.2 points (SD: 9.99. The difference between SCORAD I and SCORAD II was evaluated with the Wilcoxon signed-rank test. The average decrease of SCORAD was 7.7 points, which was statistically significant (P=.00000. Conclusion: Introduction of the diagnostic hypoallergenic diet may serve as a temporary medical solution" in patients suffering from moderate or severe forms of atopic dermatitis. It is recommended that this diet be used in the diagnostic workup of food allergy.

  6. [Actual vitamin and main foodstuffs consumption by recovered patients suffered from hemorrhagic fever with renal syndrome].

    Science.gov (United States)

    Kasanova, G M; Tutel'ian, A V

    2011-01-01

    Actual consumption of vitamins A, E, beta-carotene, ascorbic acid, thiamin, pyridoxine and main foodstuffs by recovered patients suffered from hemorrhagic fever with renal syndrome has been given. Frequency analysis of foodstuffs consumption was used to study actual nourishment of recovered patients. Surplus consumption of fat mainly due to the use of saturated fatty acids, deficiency of poly unsaturated fatty acids, surplus sugar consumption and predominance of proteins of animal origin over proteins of vegetable origin in ration has been revealed. Deficiency of water soluble vitamins equals to 41,6-78,7% of all examined patients, deficiency of fat water soluble vitamins is lower (21,4-38,3%).

  7. Longing for homeliness: exploring mealtime experiences of patients suffering from a neurological disease.

    Science.gov (United States)

    Beck, Malene; Poulsen, Ingrid; Martinsen, Bente; Birkelund, Regner

    2018-03-01

    Many patients suffering from a neurological disease experience eating difficulties during mealtimes in the hospital. Consequently, they often refrain from eating in public places to avoid potentially awkward situations. Eating is an essential part of life, providing patients with comfort during their hospitalisation. Therefore, attention should be paid to these patients, who encounter eating difficulties to foster a positive mealtime experience. To study what patients afflicted with a neurological disease experience and assign meaning when participating in mealtimes during hospitalisation. Ten semi-structured interviews with patients were conducted and recorded. After transcription the text was analysed, and interpreted compromising three methodological steps inspired by the French philosopher, Paul Ricouer. Three themes were identified through data analysis and interpretation: i) The missing feeling of homeliness, ii) The battle between socialisation vs. isolation, and iii) The sense of time, rhythm, and presence. To patients suffering from a neurological disease, mealtimes are not only a manageable task, but also a part of existential care that leads to positive experience. Aesthetic elements were shown to have the potential of making the patients feel comfortable and homely when hospitalised. This was important, as our study also identified that patients were longing for homeliness when participating in mealtimes during hospitalisation. Our findings emphasised the need of proceeding to interventions that includes mealtime assistance and protects the mealtime activity. Hence, it informs hospital organisations of the importance of restructuring mealtime environment, so that existential care can take place. © 2017 Nordic College of Caring Science.

  8. Can S100B predict cerebral vasospasms in patients suffering from subarachnoid hemorrhage?

    Directory of Open Access Journals (Sweden)

    Moshgan eAmiri

    2013-06-01

    Full Text Available Background: Protein S100B has proven to be a useful biomarker for cerebral damages. Increased levels of serum and CSF S100B have been shown in patients suffering subarachnoid hemorrhage, severe head injury and stroke. In patients with subarachnoid hemorrhage, the course of S100B levels has been correlated with neurological deficits and outcome. Cerebral vasospasm is a major contributor to morbidity and mortality. The primary aim of this study was to investigate the potential of S100B protein as a predictor of cerebral vasospasm in patients with severe subarachnoid hemorrhage.Methods: Patients with SAH, Fisher grade 3 and 4, were included in the study. Five samples of CSF and serum S100B were collected from each patient. The first sample (baseline sample was drawn within the first three days following ictus and the following four samples, once a day on days 5 to 8, with day of ictus defined as day 1. Clinical suspicion of cerebral vasospasm confirmed by computed tomography angiography was used to diagnose cerebral vasospasm.Results: A total of 18 patients were included. Five patients (28 % developed cerebral vasospasm, two (11 % developed ventriculitis. There were no significant differences between S100B for those with and without vasospasm. Serum S100B levels in patients with vasospasm were slightly lower within the first 5 days following ictus, compared to patients without vasospasm. Two out of 5 patients had elevated and increasing serum S100B prior to vasospasm. Only one showed a peak level of S100B one day before vasospasm could be diagnosed. Due to the low number of patients in the study, statistical significance could not be reached. Conclusion: Neither serum nor CSF S100B can be used as predictor of cerebral vasospasm in patients suffering from subarachnoid hemorrhage.

  9. Sleep quality in patients with chronic illness.

    Science.gov (United States)

    Kemple, Mary; O'Toole, Sinead; O'Toole, Conor

    2016-11-01

    To explore sleep quality in patients with chronic illness in primary care. Many people suffer from chronic illness with the numbers increasing. One common issue arises from problems that people have with their quality of sleep: a largely under-researched topic. This study exploring poor quality sleep allowed patients to describe their daily struggles with poor sleep in their own lives. This allowed the development of a deeper understanding of what it means to sleep poorly and find out how participants cope with not sleeping well. A qualitative approach enabling a deep exploration of patient's experiences of sleep quality was used. Interviews were conducted with a purposive sample of nine participants from a primary care clinic. Analysis utilised an interpretative approach. Data analysed produced four recurrent themes that were grouped into two categories. First, themes that identified the recognition by participants that 'something was wrong' were abrupt beginning and impact on their life. Second, themes that identified that the participants considered there was 'nothing wrong' were I am fine and I just carry on. Data revealed that poor quality sleep can have a profound effect on quality of life. Participants lived without good quality sleep for years. They had come to accept two seemingly irreconcilable ideas that not being able to sleep is an enduring problem with a distinct starting point, and paradoxically, this is not a problem that deserves much professional attention. Important original data were generated on the impact of poor quality sleep indicating that chronically disturbed sleep can increase the disease burden on patients with chronic illness. The results of this study suggest healthcare professionals need to understand how sleep quality issues impact on patient's experience of chronic illness. Data from this study will help nurses and other health professionals to deepen their understanding of the profound impact of poor quality sleep on patients with

  10. Empowering Patients with Chronic Diseases

    DEFF Research Database (Denmark)

    Bestek, Mate; Meglič, Matic; Kurent, Blaž

    2012-01-01

    Background: Chronic diseases require most of the resources in todays healthcare systems. Healthcare systems, as such, are thus not sustainable in the long term. Solutions to this problem are needed and a lot of research is focused on finding new approaches to more sustainable healthcare systems...... himself to become empowered. The patient needs to see data about his health in order to start thinking about new decisions in life that can lead to change in his behaviour. Objective: We have approached the problem of empowering patients with chronic diseases from a biological, psychological, sociological....... We want to develop extensible technology to support even more new interventions for different chronic diseases. We want the technology to enable semantic interoperability with other systems. Methods: We have collaborated with doctors in order to model the care plans for different chronic diseases...

  11. 1H MR chemical shift imaging detection of phenylalanine in patients suffering from phenylketonuria (PKU)

    International Nuclear Information System (INIS)

    Sijens, Paul E.; Oudkerk, Matthijs; Reijngoud, Dirk-Jan; Spronsen, Francjan J. van; Leenders, Klaas L.; Valk, Harold W. de

    2004-01-01

    Short echo time single voxel methods were used in previous MR spectroscopy studies of phenylalanine (Phe) levels in phenylketonuria (PKU) patients. In this study, apparent T 2 relaxation time of the 7.3-ppm Phe multiplet signal in the brain of PKU patients was assessed in order to establish which echo time would be optimal. 1 H chemical shift imaging (CSI) examinations of a transverse plain above the ventricles of the brain were performed in 10 PKU patients and 11 persons not suffering from PKU at 1.5 T, using four echo times (TE 20, 40, 135 and 270 ms). Phe was detectable only when the signals from all CSI voxels were summarized. In patients suffering from PKU the T 2 relaxation times of choline, creatine and N-acetyl aspartate (NAA) were similar to those previously reported for healthy volunteers (between 200 and 325 ms). The T 2 of Phe in brain tissue was 215±120 ms (standard deviation). In the PKU patients the brain tissue Phe concentrations were 141±69 μM as opposed to 58±23 μM in the persons not suffering from PKU. In the detection of Phe, MR spectroscopy performed at TE 135 or 270 ms is not inferior to that performed at TE 20 or 40 ms (all previous studies). Best results were obtained at TE=135 ms, relating to the fact that at that particular TE, the visibility of a compound with a T 2 of 215 ms still is good, while interfering signals from short-TE compounds are negligible. (orig.)

  12. {sup 1}H MR chemical shift imaging detection of phenylalanine in patients suffering from phenylketonuria (PKU)

    Energy Technology Data Exchange (ETDEWEB)

    Sijens, Paul E.; Oudkerk, Matthijs [University Hospital Groningen, Department of Radiology, Hanzeplein 1, P.O. Box 30001, Groningen (Netherlands); Reijngoud, Dirk-Jan; Spronsen, Francjan J. van [University Hospital Groningen, Department of Pediatrics, Groningen (Netherlands); Leenders, Klaas L. [University Hospital Groningen, Department of Neurology, Groningen (Netherlands); Valk, Harold W. de [University Medical Centre of Utrecht, Department of Internal Medicine, Utrecht (Netherlands)

    2004-10-01

    Short echo time single voxel methods were used in previous MR spectroscopy studies of phenylalanine (Phe) levels in phenylketonuria (PKU) patients. In this study, apparent T{sub 2} relaxation time of the 7.3-ppm Phe multiplet signal in the brain of PKU patients was assessed in order to establish which echo time would be optimal. {sup 1}H chemical shift imaging (CSI) examinations of a transverse plain above the ventricles of the brain were performed in 10 PKU patients and 11 persons not suffering from PKU at 1.5 T, using four echo times (TE 20, 40, 135 and 270 ms). Phe was detectable only when the signals from all CSI voxels were summarized. In patients suffering from PKU the T{sub 2} relaxation times of choline, creatine and N-acetyl aspartate (NAA) were similar to those previously reported for healthy volunteers (between 200 and 325 ms). The T{sub 2} of Phe in brain tissue was 215{+-}120 ms (standard deviation). In the PKU patients the brain tissue Phe concentrations were 141{+-}69 {mu}M as opposed to 58{+-}23 {mu}M in the persons not suffering from PKU. In the detection of Phe, MR spectroscopy performed at TE 135 or 270 ms is not inferior to that performed at TE 20 or 40 ms (all previous studies). Best results were obtained at TE=135 ms, relating to the fact that at that particular TE, the visibility of a compound with a T{sub 2} of 215 ms still is good, while interfering signals from short-TE compounds are negligible. (orig.)

  13. Clinical effects of diet supplementation with DHA in pediatric patients suffering from cystic fibrosis.

    Science.gov (United States)

    Leggieri, E; De Biase, R V; Savi, D; Zullo, S; Halili, I; Quattrucci, S

    2013-08-01

    Cystic fibrosis (CF) patients present an altered fatty acid (FA) metabolism characterized by imbalance in the arachidonic/docosohexasenoic acid (AA/DHA) ratio in favour of the former which can contribute to the increase in pulmonary inflammation. The present study aims to assess respiratory, nutritional, clinical and laboratory parameters, and inflammatory markers after six months of DHA supplementation in paediatric patients suffering from CF. A dose of 1 g/10 kg/die was administered to ten CF patients of paediatric age for the first month and 250 mg/10 kg/die for the remaining 5 months. We carried out follow-ups at T0 (baseline), T6 (after six months of the diet) and T12 (six months after supplementation was interrupted) during which respiratory, nutritional, clinical and laboratory parameters were assessed. After six months of DHA supplementation inflammatory marker levels had diminished: interleukin 8 (IL-8) and Tumour Necrosis Factor Alfa (TNF-α) in serum, and calprotectin in stools. In addition, auxometric parameters were improved as was the clinical condition of patients, who tolerated DHA well. Dietetic integration with DHA seems to improve clinical condition and the inflammatory pulmonary and intestinal state of pediatric patients suffering from CF.

  14. A regressional analysis of maladaptive rumination, illness perception and negative emotional outcomes in Asian patients suffering from depressive disorder.

    Science.gov (United States)

    Lu, Yanxia; Tang, Catherine; Liow, Chiew Shan; Ng, Winnie Wei Ni; Ho, Cyrus Su Hui; Ho, Roger Chun Mun

    2014-12-01

    Although illness perception has been shown to be associated with illness outcomes in various chronic physical diseases, the association of illness perception and rumination are not well elucidated in mental disorders. This study aims to investigate the mediational effects of adaptive and maladaptive rumination in the relationship between illness perception and negative emotions (depression, anxiety and stress) in male and female patients (N=110) suffering from depressive disorders. The results showed that maladaptive rumination mediated the relationship between illness perception and negative emotions in both male and female depressive patients. However, no mediating effects of adaptive rumination were found in the relationship between illness perception and negative emotion. Maladaptive rumination mediated the relationship between perceived identity, chronicity of illness, consequences of illness and emotional representation of illness and negative emotions in males. It also mediated the relationship between perceived identity and emotional representation of illness and negative emotions in females. The results, possible clinical implications and limitations of this study are also discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Patients with tattoo reactions have reduced quality of life and suffer from itch

    DEFF Research Database (Denmark)

    Hutton Carlsen, K; Serup, J

    2015-01-01

    Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). METHODS: Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients...... attending their routine consultations completed the ISS and DLQI questionnaires. RESULTS: Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases...... such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. CONCLUSION/DISCUSSION: Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated...

  16. The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y M; Sohng, K Y [Kangwon Tourism College, Kangwon-Do (Republic of Korea). Department of Nursing

    2005-12-15

    The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

  17. [The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis].

    Science.gov (United States)

    Lee, Young-Mee; Sohng, Kyeong-Yae

    2005-12-01

    The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

  18. Nutritional variations during chemotherapy for patients suffering from a locally advanced oesophagus cancer

    International Nuclear Information System (INIS)

    Duclos, A.; Blondin, V.; Quiesse, M.; Iwanicki-Caron, I.; Lecleire, S.; Michel, P.; Di Fiore, F.; Dubray, B.; Di Fiore, F.

    2010-01-01

    As de-nutrition is frequently noticed for patients suffering from a locally advanced oesophagus cancer, the authors report a study of the variations of nutritional parameters during chemotherapy and of their impacts of the treatment process and efficiency. Thus, different parameters have been studied at the beginning, during and at the end of the treatment: weight, albumin range, body weight index, calorie survey, and the nutritional support type. The authors observe very important variations with a significant impact on treatment tolerance and efficiency. Short communication

  19. Weight control and behavior rehabilitation in a patient suffering from Prader Willi syndrome.

    Science.gov (United States)

    Di Lorenzo, Rosaria; Sberveglieri, Sara; Marrama, Donatella; Landi, Giulia; Ferri, Paola

    2016-04-01

    This study reports a case of Prader Willi syndrome (PWS), a genomic imprinting disease related to chromosome regions 15q11.2-q13 15, which includes hypothalamic dysfunction leading to hyperphagia, obesity, shortness, sleep abnormalities. Our case is extremely severe, in comparison to other PWS cases described in literature, due to the association with severe emotional and psychiatric symptoms: oppositional behaviour, rigidity of thought, skin picking and pathological hoarding. We described the case of a Caucasian male patient suffering from PWS, treated in outpatient care by local Mental Health Centre and supported by Social Service, who was admitted to a residential rehabilitative facility. After a 2-year follow-up, the patient showed a global improvement in symptoms and functioning, as registered by the rating scales administered. At the end of observation period, we also reported an important improvement in weight control, reducing the risk of obesity and related diseases, therefore improving the prognosis of life. This case highlights the need for long-term, individualized and multi-professional treatment in patients suffering from a complex genetic syndrome with both organic and psychological alterations, for which medical care setting and pharmacological treatments are not sufficient. Clinical observation of this case leads us to compare PWS to drug addiction and indirectly endorse the neurophysiological hypothesis that food and drugs stimulate the same brain circuits in the limbic system.

  20. Associations of serumpotassiumlevels with mortality in chronic heart failure patients

    DEFF Research Database (Denmark)

    Aldahl, Mette; Caroline Jensen, Anne Sofie; Davidsen, Line

    2017-01-01

    Aims Medication prescribed to patients suffering from chronic heart failure carries an increased risk of impaired potassium homeostasis. We examined the relation between different levels of serum potassium and mortality among patients with chronic heart failure. Methods and results From Danish...... National registries, we identified 19 549 patients with a chronic heart failure diagnosis who had a measurement of potassium within minimum 90 days after initiated medical treatment with loop diuretics and angiotensin converting enzyme inhibitors or angiotensin-II receptor blockers. All-cause mortality......-cause mortality. Conclusion Levels within the lower and upper levels of the normal serum potassium range (3.5-4.1 mmol/L and 4.8-5.0 mmol/ L, respectively) were associated with a significant increased short-term risk of death in chronic heart failure patients. Likewise, potassium below 3.5 mmol/L and above 5...

  1. Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report.

    Science.gov (United States)

    Chu, Chun-Hung; Lee, Angeline Hui-Cheng; Zheng, Liwu; Mei, May Lei; Chan, Godfrey Chi-Fung

    2014-01-03

    Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation. A 14-year-old Chinese boy suffering from β-thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors. This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy.

  2. Factores sociales que contribuyen a la morbi-mortalidad en pacientes con Insuficiencia Renal Crónica sometidos a hemodiálisis. Un estudio necesario Social factors contributing to morbi-mortality in patients suffering from Chronical Kidney Insufficiency subjected to hemodialysis

    Directory of Open Access Journals (Sweden)

    María Mercedes Pérez Escobar

    2008-04-01

    Full Text Available Se realizó un estudio sobre los factores sociales que contribuyen a la morbi-mortalidad en pacientes crónicos sometidos a hemodiálisis en el servicio de nefrología del Hospital Provincial Manuel Ascunce Domenech de Camagüey. Entre los factores sociales más relevantes que atentan contra la calidad de vida y la supervivencia del paciente dialítico crónico se encontraron; la derivación tardía de los pacientes con Insuficiencia Renal Crónica a consultas Nefrológicas, las dificultades en la creación y supervivencia de los accesos vasculares, el escaso número de enfermeros por riñón artificial, las roturas de las máquinas de hemodiálisis, de las plantas de tratamiento del agua y las dificultades con transporte de los pacientes.It was carried out a study about the social factors contributing to the morbi-mortality in chronic patients subjected to hemodialysis in the service of nephrology of the "Manuel Ascunce DomEnech" Provincial Hospital, in Camagüey. They were among the most outstanding social factors that attempt against the quality of life and the survival of the chronic dialytic patient, the late derivation of the patients with Renal Chronic Insufficiency in Nephrologic consultations, the difficulties in the creation and survival of the vascular accesses, the scarce number of male nurses for artificial kidney, the breaks of the hemodialysis machines, of the plants of water treatment and the difficulties with the patients' transportation.

  3. Social provision and loneliness among older people suffering from chronic physical illness. A mixed-methods approach.

    Science.gov (United States)

    Kvaal, Kari; Halding, Anne-Grethe; Kvigne, Kari

    2014-03-01

    To describe and compare the perceived social provision for a group reporting never feeling lonely with that of a group reporting feeling lonely and to explore the meaning of loneliness. Participants (N = 101) were recruited from geriatric wards. Inclusion criteria were as follows: aged 65 years or more, the absence of dementia, one or more chronic physical disorders and plans to be discharged from the hospital to their home. The mean age was 81.3 years (range: 65-96 years), 68% were women, and 66% lived alone. Assessments of social provisions and loneliness were collected by a subjective report using the Social Provision Scale (SPS), and the Montgomery-Aasberg Depression Rating Scale (MADRS) was used to assess depression. The participants were also asked whether they felt lonely and were then asked to describe the meaning of loneliness if they had indicated feeling lonely. Narratives were then condensed by the participants into short sentences. Seventy-five per cent of the participants reported feeling lonely, of these 54% were living alone, and 18% identified with depression. Three subscales of SPS scores were significantly lower in the lonely group: attachment (p loneliness was dominated by emptiness and negative emotions. The following themes were identified: Emotions were dominated by sadness, anxiety and restlessness, anger and guilt. Relationships were dominated by being left alone, being confined and feeling useless. Existential dimensions were characterised by emptiness, endless boredom, isolation and the potential for change. The study shows that loneliness is prevalent among older people suffering from chronic physical illness and confirms the complexity of the concept. A mixed-methods design contributed to nuanced and detailed information about the meaning of loneliness. © 2013 Nordic College of Caring Science. Published by Blackwell Publishing Ltd.

  4. Factors Associated with Pain, Disability and Quality of Life in Patients Suffering from Frozen Shoulder

    Directory of Open Access Journals (Sweden)

    Farshid Bagheri

    2016-07-01

    Full Text Available Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder.  Methods: We enrolled 120 patients (37 men and 83 women with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS and, Short-Form Health Survey questionnaire (SF-36 as well as Disabilities of the Arm, Shoulder and Hand (DASH questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18, 53(17, 35(8.0, and 42(10 respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion.

  5. The core of love when caring for patients suffering from addiction.

    Science.gov (United States)

    Thorkildsen, Kari M; Eriksson, Katie; Råholm, Maj-Britt

    2015-06-01

    Drug addiction is a serious health problem. The aim of this study was to gain an understanding of the core of love when caring for patients suffering from addiction. The study had a hermeneutical approach. Four nurses working at a detoxification unit were interviewed. Data were interpreted using a hermeneutical text interpretation based on Gadamer's hermeneutics. The results revealed the core of love in four dimensions: love as an inner driving force, searching for the human being behind the addiction, faith in the inner power of human beings and love as a movement of giving and receiving. The hermeneutical interpretation revealed the core of love as sacrifice, showing that sacrifice is an ethical dimension and that sacrifice involves searching for the patient's ontological suffering. Sacrifice is connected to faith, and faith in love is decisive for a life without drugs. Sacrifice involves being mutual gifts to one another, a self-reinforcing motion of sacrifice that energizes the nurses to go on with their work. © 2014 Nordic College of Caring Science.

  6. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  7. A Measure of Suffering in relation to Anxiety and Quality of Life in IBS Patients: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Sanda Pletikosić Tončić

    2017-01-01

    Full Text Available Irritable bowel syndrome (IBS is a chronic gastrointestinal (GI disorder with a severe impact on quality of life (QoL. We explored the relationship of a visual measure of suffering, the PRISM-RII, with quality of life (QoL and anxiety measures in IBS patients. Participants were 44 IBS patients who completed several questionnaires and kept a symptom diary for two weeks. The measures used were PRISM-RII (self-illness separation (SIS; illness perception measure (IPM; IBS-36 (IBS health related QoL; SF-36 (physical and mental health related QoL; State-Trait Anxiety Inventory (STAI-T; Visceral Sensitivity Index (VSI; GI-specific anxiety; and a symptom diary. SIS was negatively correlated to VSI, while IPM was negatively correlated to SIS and the physical component of SF-36 and positively to VSI and symptom severity. We found significant differences between participants who perceive their illness as small and those who perceive it as medium in SIS, symptom severity, VSI, and the mental component of SF-36. Participants, who perceived their illness as small, represented their illness as more distant, showed lower average symptom severity, and had lower GI-specific anxiety and higher QoL. The results indicate that IPM and SIS can be useful in discriminating patients with more prominent psychological difficulties and QoL impairment.

  8. Coronary flow reserve/diastolic function relationship in angina-suffering patients with normal coronary angiography.

    Science.gov (United States)

    Anchisi, Chiara; Marti, Giuliano; Bellacosa, Ilaria; Mary, David; Vacca, Giovanni; Marino, Paolo; Grossini, Elena

    2017-05-01

    Coronary blood flow and diastolic function are well known to interfere with each other through mechanical and metabolic mechanisms. We aimed to assess the relationship between coronary flow reserve (CFR) and diastolic dysfunction in patients suffering from angina but with normal coronary angiography. In 16 patients with chest pain and angiographically normal coronary arteries, CFR was measured using transthoracic echo-Doppler by inducing hyperemia through dipyridamole infusion. Diastolic function (E/A, deceleration time, isovolumetric relaxation time [IVRT], propagation velocity [Vp]) and left ventricular mass were evaluated by means of two-dimensional transthoracic echocardiography. The patients were initially divided into two groups on the grounds of CFR only (ACFR: altered CFR, n = 9; NACFR: unaltered CFR, n = 7). Thereafter they were divided into four groups on the grounds of CFR and diastolic function (NN: normal; AA: altered CFR/diastole; AN: altered CFR/normal diastole; NA: normal CFR/altered diastole). Most of the subjects were scheduled in AA (n = 8) or NA (n = 5) groups, which were taken into consideration for further analysis. Patients were not different regarding various risk factors. ACFR and AA patients were older with normal body weight in comparison with NACFR and NA patients (P relationship between altered CFR and diastole.

  9. Structural olfactory nerve changes in patients suffering from idiopathic intracranial hypertension.

    Directory of Open Access Journals (Sweden)

    Christoph Schmidt

    Full Text Available BACKGROUND: Complications of idiopathic intracranial hypertension (IIH are usually caused by elevated intracranial pressure (ICP. In a similar way as in the optic nerve, elevated ICP could also compromise the olfactory nerve system. On the other side, there is growing evidence that an extensive lymphatic network system around the olfactory nerves could be disturbed in cerebrospinal fluid disorders like IIH. The hypothesis that patients with IIH suffer from hyposmia has been suggested in the past. However, this has not been proven in clinical studies yet. This pilot study investigates whether structural changes of the olfactory nerve system can be detected in patients with IIH. METHODOLOGY/PRINCIPAL FINDINGS: Twenty-three patients with IIH and 23 matched controls were included. Olfactory bulb volume (OBV and sulcus olfactorius (OS depth were calculated by magnetic resonance techniques. While mean values of total OBV (128.7±38.4 vs. 130.0±32.6 mm(3, p=0.90 and mean OS depth (8.5±1.2 vs. 8.6±1.1 mm, p=0.91 were similar in both groups, Pearson correlation showed that patients with a shorter medical history IIH revealed a smaller OBV (r=0.53, p<0.01. In untreated symptomatic patients (n=7, the effect was greater (r=0.76, p<0.05. Patients who suffered from IIH for less than one year (n=8, total OBV was significantly smaller than in matched controls (116.6±24.3 vs. 149.3±22.2 mm(3, p=0.01. IIH patients with visual disturbances (n=21 revealed a lower OS depth than patients without (8.3±0.9 vs. 10.8±1.0 mm, p<0.01. CONCLUSIONS/SIGNIFICANCE: The results suggest that morphological changes of the olfactory nerve system could be present in IIH patients at an early stage of disease.

  10. Meeting the ranging of informational needs of chronic low back pain sufferers: conceptual design and rationale of the interactive website ONESELF.

    Science.gov (United States)

    Schulz, Peter J; Rubinelli, Sara; Mariotti, Guido; Keller, Nicola

    2009-01-01

    Information plays an important role in the management and treatment of chronic pain conditions. Often, however, delivered information does not address specific difficulties of consumers. The present study illustrates the design and implementation of the website ONESELF - run by the Institute of Communication and Health of the University of Lugano - which has been created to meet the ranging of informational needs of chronic low back pain sufferers. ONESELF rests on an integrated idea of health literacy that highlights the kind of information consumers need to inform their decisions about back pain. This idea has been tested through a qualitative analysis of requests posted by users in the forum of ONESELF between July 2006 and December 2007. Users seek information to build their declarative (factual) and procedural knowledge, as well as to evaluate that knowledge and apply it to the context of their own life. Online interactional tools such as ONESELF are a promising source of health communication, provided that the content manager of the website and the health professionals collaborate in a rigorously structured manner. ONESELF can benefit traditional medical consultations in helping screen requests from patients that do not need to see a doctor, and in acting as a repository of background information that saves consultation time for more urgent matters.

  11. The impact of psychological testing on the patients suffering from stomatopyrosis.

    Science.gov (United States)

    Pokupec, Josipa Sanja Gruden; Gruden, Zdenka; Gruden, Vladimir

    2011-12-01

    Stomatopyrosis is commonly associated with stressful situations, which implies the importance of psychological conditions of the patients with this symptom. Patients suffering from burning mouth syndrome suffered from some psychical disturbances as well. The fact that depression and anxiety are closely connected with stomatopyrosis has been scientifically confirmed. The data which systematically led to this conclusion suggest the possibility of the existence of a psychogenic disturbance as an aetiological factor which leads to stomatopyrosis. Research which might be conducted in order to relate psychogenic disturbances with stomatopyrosis by means of various drugs and procedures, might provide an insight into the relatedness of these factors, which would enable us to treat the cause and not the consequence. This research has been directed towards establishing this "relatedness" by means of psychopharmatics and psychotherapy, and has been confirmed by means of psychological depression and anxiety tests. The research has been conducted on 120 respondents suffering from stomatopyrosis, who were also, as previously diagnosed, suffering from a psychical disturbance. The respondents were divided into 4 groups. Each group contained 30 respondents suffering from stomatopyrosis as the basic symptom, but with different psychogenic disturbances. These groups were: 1) antidepressants, 2) anxiolytics, 3) autogenic training and 4) control group. A detailed clinical and psychiatric check-up was conducted before the treatment started, and was repeated several times in different intervals: after a month, after two months and after four months. Respondents are still undergoing a therapy. Subjective assessment of the intensity of the burning sensation was obtained according to Visual analogue scale and two psychological questionnaires (depression test and anxiety test). Conclusion is: 1) Antidepressants and anxiolytic drugs have a prominent role in the treatment of stomatopyrosis

  12. The validation and the limits of SPECT for patients suffering from cerebrovascular accidents

    International Nuclear Information System (INIS)

    Mizukawa, Norihiko; Yano, Ichiro; Tenjin, Hiroshi

    1989-01-01

    Contemporaneous single photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed in 10 patients with cerebrovascular accidents (CVA), whose ages ranged from 11 to 67 years. I-123-isopropyl-iodoamphetamine (IMP) and/or Tc-99m hexamethylpropyleneamine oxime (HM-PAO) were used for SPECT. Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen (CMRO 2 ) were measured by an O-15 labelled gas continuous-inhalation method. SPECT images were quite similar to CBF and CMRO 2 during the chronic stage of CVA. Two patietns with vasospasm during the subacute stage had apparently low CBF and CMRO 2 on PET, but did not have low perfusion on SPECT. Luxury perfusion areas were detected in 4 subacute stage patients and one chronic stage patient. A redistribution of IMP was detected in two patients with infarction during subacute stage. CMRO 2 value in such an area was 2.0 ml/100 g/min. Low CBF and/or CMRO 2 areas were well visualized by IMP rather than by HM-PAO SPECT. (N.K.)

  13. Carers' interactions with patients suffering from severe dementia: a difficult balance to facilitate mutual togetherness.

    Science.gov (United States)

    Hansebo, Görel; Kihlgren, Mona

    2002-03-01

    1. A phenomenological-hermeneutic approach was used to illuminate carers' video-recorded interactions in connection with supervision for individualized nursing care. 2. In order to disclose any changes in the carers' interactions with patients suffering from severe dementia the video recordings were conducted before, during and after the intervention. 3. The content of the videos was transcribed as a text, mainly verbal communication. Due to the rich data the videos and text were kept together as a whole in every step of the analysis. 4. After an initial naïve understanding, different subthemes emerged in the structural analyses: promoting competence, struggling for co-operation, deep communication for communion, showing respect for the unique person, skills in balancing power, distance in a negative point of view, and fragmentary nursing situations. 5. The overall theme was 'Carers' balancing in their interactions, verbal as well as non-verbal, to promote a sense of mutual togetherness with the patient'. 6. The supervision intervention contributed to an improvement in carers' skills in balancing in their interactions. In the caring process carers' and patients' shared experiences and, due to patients' disabilities, interactions depended mainly on carers' qualities and capabilities for this confirming nursing care.

  14. Attitudes of Medical and Pharmacy Students Towards Patients Suffering from Schizophrenia

    Directory of Open Access Journals (Sweden)

    Ignjatovic-Ristic Dragana

    2017-03-01

    Full Text Available Research over the past twenty years has shown that the attitudes of health care workers and students towards people who are suffering from schizophrenia have become more negative. The aim of our study was to investigate the attitudes of medical and pharmacy students towards patients with schizophrenia and explore the differences in attitudes between study groups and students in different years. Materials and methods: Second- and fifth-year medical and pharmacy students from the Faculty of Medical Sciences at the University of Kragujevac were included in an observational, prospective, cross-sectional study. The sample consisted of 113 students from the pharmacy and medical schools who were chosen via random sampling. The students completed a two-part questionnaire. Th e first part contained questions about sociodemographic characteristics, whereas the second part was a translated version of the Mental Illness: Clinician’s Attitudes (MICA v4 scale. Results: There is a statistically significant difference (р<0.05 in the attitudes towards people with schizophrenia between second- and fifth-year medical and pharmacy students (with lower scores in both groups in fifth-year students. Of the total number of students who had lower summed scores on the Likert scale, 51.3% had previously finished medical high school, whereas 28.3% had previously finished regular high school. Conclusion: Our results showed a statistically significant difference in attitudes towards people with schizophrenia between second- and fifth-year students as well as a difference related to previous high school education. This stresses the importance of levels of knowledge about schizophrenia to reducing the stigmatization of patients who suffer from this disorder.

  15. Non-Motor Symptoms in Patients Suffering from Motor Neuron Diseases.

    Science.gov (United States)

    Günther, René; Richter, Nicole; Sauerbier, Anna; Chaudhuri, Kallol Ray; Martinez-Martin, Pablo; Storch, Alexander; Hermann, Andreas

    2016-01-01

    The recently postulated "disease spreading hypothesis" has gained much attention, especially for Parkinson's disease (PD). The various non-motor symptoms (NMS) in neurodegenerative diseases would be much better explained by this hypothesis than by the degeneration of disease-specific cell populations. Motor neuron disease (MND) is primarily known as a group of diseases with a selective loss of motor function. However, recent evidence suggests disease spreading into non-motor brain regions also in MND. The aim of this study was to comprehensively detect NMS in patients suffering from MND. We used a self-rating questionnaire including 30 different items of gastrointestinal, autonomic, neuropsychiatric, and sleep complaints [NMS questionnaire (NMSQuest)], which is an established tool in PD patients. 90 MND patients were included and compared to 96 controls. In total, MND patients reported significantly higher NMS scores (median: 7 points) in comparison to controls (median: 4 points). Dribbling, impaired taste/smelling, impaired swallowing, weight loss, loss of interest, sad/blues, falling, and insomnia were significantly more prevalent in MND patients compared to controls. Interestingly, excessive sweating was more reported in the MND group. Correlation analysis revealed an increase of total NMS score with disease progression. NMS in MND patients seemed to increase with disease progression, which would fit with the recently postulated "disease spreading hypothesis." The total NMS score in the MND group significantly exceeded the score for the control group, but only 8 of the 30 single complaints of the NMSQuest were significantly more often reported by MND patients. Dribbling, impaired swallowing, weight loss, and falling could primarily be connected to motor neuron degeneration and declared as motor symptoms in MND.

  16. General health and religious coping strategies in patients suffering from asthma

    Directory of Open Access Journals (Sweden)

    Seyyed Hassan Adeli

    2014-09-01

    Full Text Available Background and Objectives: Asthma is a chronic respiratory disease characterized by reversible contraction of airways. Coping strategies can reduce the negative impact of the disease in individuals or cause incompatible behaviors by negative effect. This study aimed to evaluate the religious coping strategies in asthma patients and the relationship of religious coping and general health. Methods: The study included 102 asthmatic patients referred to the pulmonary clinic of Shahid Beheshti hospital of Qom. Brief religious coping strategy questionnaire and the general health questionnaire were used in this study. Results: The mean positive religious coping strategy was 26.24±9.89 and 60% of the patients had higher than average scores. The mean negative religious coping strategy was 10.56±3.99 and 35% of patients had a mean score higher than average scores. The mean total general health score was 23.91±11.9. Conclusion: The study results showed that asthmatic patients are at greater risk of depression and a negative correlation exists between positive religious coping and general health scores. It can be concluded that in asthmatic patients, depression should be suspected sooner. Also, during the course of treatment and in cases of resistant to treatment, this issue should be considered. It can be concluded that the patients who use more positive coping strategies and have a strong spiritual beliefs may have higher mental health that leads to higher physical health and a better response to treatment. Religious coping strategies; general health; depression.

  17. The relation of autonomic function to physical fitness in patients suffering from alcohol dependence.

    Science.gov (United States)

    Herbsleb, Marco; Schulz, Steffen; Ostermann, Stephanie; Donath, Lars; Eisenträger, Daniela; Puta, Christian; Voss, Andreas; Gabriel, Holger W; Bär, Karl-Jürgen

    2013-10-01

    Reduced cardio-vascular health has been found in patients suffering from alcohol dependence. Low cardio-respiratory fitness is an independent predictor of cardio-vascular disease. We investigated physical fitness in 22 alcohol-dependent patients 10 days after acute alcohol withdrawal and compared results with matched controls. The standardized 6-min walk test (6 MWT) was used to analyze the relationship of autonomic dysfunction and physical fitness. Ventilatory indices and gas exchanges were assessed using a portable spiroergometric system while heart rate recordings were obtained separately. We calculated walking distance, indices of heart rate variability and efficiency parameters of heart rate and breathing. In addition, levels of exhaled carbon monoxide were measured in all participants to account for differences in smoking behaviour. Multivariate analyses of variance (MANOVA) were performed to investigate differences between patients and controls with regard to autonomic and efficiency parameters. Patients walked a significantly shorter distance in comparison to healthy subjects during the 6 MWT. Significantly decreased heart rate variability was observed before and after the test in patients when compared to controls, while no such difference was observed during exercise. The efficiency parameters indicated significantly reduced efficiency in physiological regulation when the obtained parameters were normalized to the distance. The 6 MWT is an easily applied instrument to measure physical fitness in alcohol dependent patients. It can also be used during exercise interventions. Reduced physical fitness, as observed in our study, might partly be caused by autonomic dysfunction, leading to less efficient regulation of physiological processes during exercise. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Dermatological diseases in patients with chronic kidney disease.

    Science.gov (United States)

    Gagnon1, Amy L; Desai, Tejas

    2013-04-01

    There are a variety of dermatological diseases that are more commonly seen in patients with chronic kidney disease (CKD) and renal transplants than the general population. Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched. Some cutaneous diseases are clearly unique to this population. Of them, Lindsay's Nails, xerosis cutis, dryness of the skin, nephrogenic systemic fibrosis and acquired perforating dermatosis have been described in chronic kidney disease patients. The most common malignancy found in all transplant recipients is non-melanoma skin cancer. It is important for patients and physicians to recognize the manifestations of skin disease in patients suffering from chronic kidney disease to mitigate the morbidity associated with these conditions.

  19. Comparison of Lumbosacral Alignment in Geriatric and Non-Geriatric patients suffering low back pain.

    Science.gov (United States)

    Kocyigit, Burhan Fatih; Berk, Ejder

    2018-01-01

    Lumbosacral alignment is a crucial factor for an appropriate spinal function. Changes in spinal alignment lead to diminished body biomechanics. Additionally, lumbosacral alignment may affect quality of life, sagittal balance and fall risk in elderly. In this study, we aimed to compare lumbosacral alignment in geriatric and non-geriatric patients suffering from low back pain. A total of 202 (120 male and 82 female) patients who visited to physical medicine and rehabilitation clinic with low back pain between January 2017 and August 2017 were enrolled in this study. Standing lateral lumbar radiographs were obtained from the electronic hospital database. Lumbar lordosis angle, sacral tilt, lumbosacral angle and lumbosacral disc angle were calculated on lateral standing lumbar radiographs. The mean age of the non-geriatric group was 43.02 ± 13.20 years, the geriatric group was 71.61 ± 6.42 years. In geriatric patients, lumbar lordosis angle, sacral tilt and lumbosacral disc angle were significantly smaller (p = 0.042, p = 0.017 and p = 0.017). No significant differences were observed in lumbosacral angle between the groups (p = 0.508). Our study indicates the specific changes in lumbosacral alignment with aging. Identifying these changes in lumbosacral alignment in the geriatric population will enable to create proper rehabilitation strategies.

  20. A pilot study and brief overview of rehabilitation via virtual environment in patients suffering from dementia.

    Science.gov (United States)

    Fasilis, Th; Patrikelis, P; Siatouni, A; Alexoudi, A; Veretzioti, A; Zachou, L; Gatzonis, S-St

    2018-01-01

    Dementia is one of the increasing problems of modern societies. The immediate cure is not a possible solution, at least at the moment, but science has found a number of new ways to retard and under specific conditions to halt its development. A potential, and constantly evolving scientific field is the use of Computerized Cognitive Rehabilitation (CCR) and Virtual Environments (Vr.E). According to the existing literature, subjecting patients to various neuro-rehabilitative conditions within 3D virtual environments, allows them to obtain significant therapeutic benefits in which both transferability and durations over time are observed, in relation to the training period of the intervention. In the present study we examine whether "Serious Games (SGs)" - (learning and rehabilitating games in virtual and augmented reality) - have utilitarian value in the field of cognitive neurorehabilitation, concerned with demented population. For research purposes, we have conducted a number of case studies, based on 10 elderly patients, suffering from moderate or mild severity impairment of higher cortical functions, attributed to various types of dementias (Vascular, Alzheimer's disease, DLB dementia and mixed dementia). Each participant underwent rehabilitative intervention through our SG for a total of 10 hours within 4-5 weeks period. At the end of the cognitive rehabilitation program, patients' performance was assessed based in standard neuropsychological tests (measuring: working memory, memory retention, attention, problem solving, rigid thinking and executive function) and the results were compared with measurements taken before, during, and at the end of the intervention. Our experimental hypothesis states that there will be a significant difference between the results of cognitive performance of the patients between the pre- and post- rehabilitative period, consequential of the Interactive Computer-based Training (ICT). In conclusion, a review and brief analysis of the

  1. Dissimilary in patients' and spouses' representations of chronic illness: exploration of relations to patient adaptation.

    NARCIS (Netherlands)

    Heijmans, M.; Ridder, D. de; Bensing, J.

    1999-01-01

    In this cross-sectional study, the illness representations of patients suffering from Chronic Fatigue Syndrome (n=49) and Addison's Disease (n=52) and those of their spouses were compared. Couples generally held similar views with regard to the dimensions of illness identity and cause but disagreed

  2. Sleeping problems in mothers and fathers of patients suffering from congenital central hypoventilation syndrome.

    Science.gov (United States)

    Paddeu, Erika Maria; Giganti, Fiorenza; Piumelli, Raffaele; De Masi, Salvatore; Filippi, Luca; Viggiano, Maria Pia; Donzelli, Gianpaolo

    2015-09-01

    Advanced medical technology has resulted in an increased survival rate of children suffering from congenital central hypoventilation syndrome. After hospitalization, these technology-dependent patients require special home care for assuring ventilator support and the monitoring of vital parameters mainly during sleep. The daily challenges associated with caring for these children can place primary caregivers under significant stress, especially at night. Our study aimed at investigating how this condition affects mothers and fathers by producing poor sleep quality, high-level diurnal sleepiness, anxiety, and depression. The study included parents of 23 subjects with congenital central hypoventilation syndrome and 23 healthy subjects. All parents filled out the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). A comparison between the two groups showed that parents of patients had poorer sleep quality, greater sleepiness, and higher BDI-II scores compared to that of parents of healthy subjects (respectively, PSQI score 6.5 vs 3.8, ESS score 6.2 vs 4.3, BDI-II score 8.4 vs 5.7). Specifically, mothers of patients showed poorer sleep quality and higher BDI-II scores compared to that of mothers of controls (respectively, PSQI score 7.5 vs 3.8, BDI-II score 9.3 vs 5.9), whereas fathers of patients showed greater levels of sleepiness with respect to fathers of healthy children (respectively, ESS score 6.8 vs 4.0). These differences emerged in parents of younger children. Congenital central hypoventilation syndrome impacts the family with different consequences for mothers and fathers. Indeed, while the patients' sleep is safeguarded, sleeping problems may occur in primary caregivers often associated with other psychological disorders. Specifically, this disease affects sleep quality and mood in the mothers and sleepiness levels in the fathers.

  3. Cortisol-dependent stress effects on cell distribution in healthy individuals and individuals suffering from chronic adrenal insufficiency.

    Science.gov (United States)

    Geiger, Ashley M; Pitts, Kenneth P; Feldkamp, Joachim; Kirschbaum, Clemens; Wolf, Jutta M

    2015-11-01

    Chronic adrenal insufficiency (CAI) is characterized by a lack of glucocorticoid and mineralocorticoid production due to destroyed adrenal cortex cells. However, elevated cortisol secretion is thought to be a central part in a well-orchestrated immune response to stress. This raises the question to what extent lack of cortisol in CAI affects stress-related changes in immune processes. To address this question, 28 CAI patients (20 females) and 18 healthy individuals (11 females) (age: 44.3 ± 8.4 years) were exposed to a psychosocial stress test (Trier Social Stress Test: TSST). Half the patients received a 0.03 mg/kg body weight injection of hydrocortisone (HC) post-TSST to mimic a healthy cortisol stress response. Catecholamines and immune cell composition were assessed in peripheral blood and free cortisol measured in saliva collected before and repeatedly after TSST. CAI patients showed norepinephrine (NE) stress responses similar to healthy participants, however, epinephrine (E) as well as cortisol levels were significantly lower. HC treatment post-TSST resulted in cortisol increases comparable to those observed in healthy participants (interaction effects--NE: F=1.05, p=.41; E: F=2.56, p=.045; cortisol: F=13.28, pcortisol's central involvement in post-stress lymphocyte migration from blood into immune-relevant body compartments. As such, future studies should investigate whether psychosocial stress exposure may put CAI patients at an increased health risk due to attenuated immune responses to pathogens. Copyright © 2015. Published by Elsevier Inc.

  4. Concept of unbearable suffering in context of ungranted requests for euthanasia: qualitative interviews with patients and physicians

    NARCIS (Netherlands)

    Pasman, H. R. W.; Rurup, M. L.; Willems, D. L.; Onwuteaka-Philipsen, B. D.

    2009-01-01

    Objective To obtain in-depth information about the views of patients and physicians on suffering in patients who requested euthanasia in whom the request was not granted or granted but not performed. Design In-depth interviews with a topic list. Setting Patients' homes and physicians' offices.

  5. Symptoms, unbearability and the nature of suffering in terminal cancer patients dying at home: a prospective primary care study

    NARCIS (Netherlands)

    Ruijs, C.D.M.; Kerkhof, A.J.F.M.; van der Wal, G.; Onwuteaka-Philipsen, B.D.

    2013-01-01

    Background: Primary care physicians provide palliative home care. In cancer patients dying at home in the Netherlands (45% of all cancer patients) euthanasia in about one out of every seven patients indicates unbearable suffering. Symptom prevalence, relationship between intensity of symptoms and

  6. Patient-experienced burden of treatment in patients suffering from multimorbidity data

    DEFF Research Database (Denmark)

    Rosbach, Michael; Andersen, John Sahl

    2017-01-01

    the multimorbid patients. In studies conducted in the US and Australia the financial burden and the time and travel burden were found most straining to patients with deprived socioeconomic status. The burden of treatment was found to be a complex concept consisting of many different components and factors...... interacting with each other. The size of the burden was associated to the workload of demands (number of conditions, number of medications and health status), the capacity (cognitive, physical and financial resources, educational level, cultural background, age, gender and employment conditions...

  7. /sup 133/Xe clearance of the knee joint of patients suffering from arthritis and osteoarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Balint, G.; Reviczky, L.A.; Lendvay, J.; Boehm, U.; Kucsera, K.; Genti, Gy. (Orszagos Reuma es Fizioterapias Intezet, Budapest (Hungary))

    1982-01-01

    65 inflammed and 13 non-inflammed knee joints of patients suffering from osteoarthrosis were examined by the Xe/sup 133/ clearance method. The control group consisted of 27 patients with exsudative arthritis of the knee. The counts of 80 ..mu..C /sup 133/Xe given intraarticcularly were measured above the knee joint by NK 350 energy selective counter. The time needed to halve the count rate measured in the 4th minute after administration (biological half life (T1/2)) was significantly different in the three groups. It was the longest in the non-inflammed arthrosis, the shortest in the exsudative arthritis group. Significant differences were apparent regarding joint pain and tenderness in all the three groups. Though the synovial protein level and the C/sub 3/ complement level were significantly different, in the three groups no relationship was found between the T1/2 and synovial/serum protein ratio or between the synovial/serum C/sub 3/ ratio. The authors concluded that /sup 133/Xe clearance, which measures the perfusion of the synovial membrane, can be used for measuring the inflammatory activity of knee joint synovitis.

  8. Study regarding the survival of patients suffering a traumatic cardiac arrest.

    Science.gov (United States)

    Georgescu, V; Tudorache, O; Nicolau, M; Strambu, V

    2015-01-01

    Severe trauma is the most frequent cause of death in young people, in civilized countries with major social and vital costs. The speed of diagnostic decision making and the precocity of treatment approaches are both essential and depend on the specialists' colaboration. The present study aims to emphasize the actual situation of medical interventions in case of cardiorespiratory arrest due to trauma. 1387 patients who suffered a cardio respiratory arrest both traumatic and non-traumatic were included in order to point out the place of traumatic arrest. Resuscitation of such patients is considered useless and resource consumer by many trauma practitioners who are reporting survival rates of 0%-3.5%. As the determinant of lesions, trauma etiology was as it follows car accidents - 43%, high falls - 30%, suicidal attempts - 3%, domestic violence - 3%, other causes - 21%. Hypovolemia remains the major cause of cardiac arrest and death and that is why the efforts of emergency providers (trauma team) must be oriented towards "hidden death" in order to avoid it. This condition could be revealed and solved easier with minimal diagnostic and therapeutic maneuvers in the emergency department.

  9. Changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation (AF)

    International Nuclear Information System (INIS)

    Zhang Suhua

    2003-01-01

    Objective: To study the changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation. Methods: Plasma ET and BNP contents were measured with IRMA in 130 patients with essential hypertension (48 with AF and 82 with out AF) and 56 controls. Results: The plasma contents of ET and BNP in patients with AF were significantly higher than those in controls (p<0.001). Conclusion: Further study in the changes of plasma ET and BNP contents in patients suffering from essential hypertension would be of great clinical importance in the prevention and treatment of the disease

  10. Primary headache diagnosis among chronic daily headache patients

    Directory of Open Access Journals (Sweden)

    Krymchantowski Abouch Valenty

    2003-01-01

    Full Text Available Chronic daily headache (CDH refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996. Five hundred seventy four patients (88.1% had episodic migraine as primary headache before turning into daily presentation, 52 (8% had chronic tension-type headache, 14 (2.2% had hemicrania continua and 11 patients (1.7% had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.

  11. [Information needs of people suffering from venous leg ulcer. Expertise of people concerned as a basis of patient-centered information].

    Science.gov (United States)

    Schmitz, Astrid

    2011-06-01

    Patient-centred information is orientated on the needs. The main objective of such information is coping with every-day life and learning to live with the chronic disease. Regarding the current knowledge, such information does not exist in German speaking countries for people suffering from venous leg ulceration. In order to generate the subject matter of such information, a literature search and a secondary analysis of 27 transcripts of interviews, given by people living with chronic leg ulceration, were conducted. Both analyses show the complex impact of leg ulceration on every-day live. The dimensions competences in every-day live, knowledge, techniques and skills and the meaning of family were generated. The secondary analysis points out that family members are an important part of the supporting system and are concerned by effects of chronic disease as well. After long-lasting disease-experience people consider themselves as experts. They obtain special competences in dealing with their disease and judge their experience-based knowledge higher than the knowledge of healthcare professionals. The participants describe individual concepts about their disease. Medical knowledge constitutes just one source of knowledge among others. People know about alternative medicine and use it. They feel that the healthcare professionals do not take them seriously in most cases. Patient-centred information can be a guide to people suffering from venous leg ulceration and their family members, but also a support for healthcare professionals to reflect their professional behaviour and understanding.

  12. Design, and participant enrollment, of a randomized controlled trial evaluating effectiveness and cost-effectiveness of a community-based case management intervention, for patients suffering from COPD

    DEFF Research Database (Denmark)

    Sørensen, Sabrina Storgaard; Pedersen, Kjeld Møller; Weinreich, Ulla Møller

    2015-01-01

    Background: Case management interventions are recommended to improve quality of care and reduce costs in chronic care, but further evidence on effectiveness and cost-effectiveness is needed. The objective of this study is the reporting of the design and participant enrollment of a randomized...... controlled trial, conducted to evaluate the effectiveness and cost-effectiveness of a community-based case management model for patients suffering from chronic obstructive pulmonary disease (COPD). With a focus on support for self-care and care coordination, the intervention was hypothesized to result...... patients were randomized into two groups: the case-managed group and the usual-care group. Participant characteristics were obtained at baseline, and measures on effectiveness and costs were obtained through questionnaires and registries within a 12-month follow-up period. In the forthcoming analysis...

  13. Routine administration of antibiotics to patients suffering accidental gallbladder perforation during laparoscopic cholecystectomy is not necessary.

    Science.gov (United States)

    Guzmán-Valdivia, Gilberto

    2008-12-01

    Accidental rupture of the gallbladder is an event which occurs in up to 20% of laparoscopic cholecystectomies, mainly in those where dissection is difficult, or during extraction when the gallbladder is withdrawn directly through the laparoscope port. It has been commonly assumed that contamination by bile in the abdominal cavity could be a cause of infection and lead to the formation of a residual abscess or even to surgical wound infection. It is common practice, therefore, for the surgeon to prescribe the application of an antibiotic at the moment when gallbladder perforation occurs. To compare 2 groups of similar patients, to determine whether administration of antibiotics, started during surgery, is actually useful in reducing the risk of residual abscess or infection in the surgical wound. The study considered a total of 166 patients who had suffered accidental perforation of the gallbladder during elective laparoscopic cholecystectomy. This total was divided at random into 2 groups: group A (80 patients) who received a dose of 1 g of Cefotaxime at the moment of gallbladder rupture, followed by 2 more doses at intervals of 8 hours in the immediate postoperative period; and group B (86 patients) who did not receive any antibiotic treatment at all. The dependent variables observed were surgical wound infection and residual abscess: and the control variables were age, sex, length of operation time, intercurrent illnesses, and American Society of Anesthesiologists (ASA) classification. Two patients (2.5%) in group A developed a surgical wound infection, against 3 cases (3.4%) in group B, the result having no statistical significance. No patients developed residual abscess. In a multivariant analysis, the following were identified as independent factors significantly associated with the onset of surgical wound infection (Pgallbladder during laparoscopic cholecystectomy is not necessary. In the case of patients with diabetes mellitus, those who are older than 60

  14. Adolescents with personality disorders suffer from severe psychiatric stigma: evidence from a sample of 131 patients

    Directory of Open Access Journals (Sweden)

    Catthoor K

    2015-05-01

    Full Text Available Kirsten Catthoor,1,3 Dine J Feenstra,2 Joost Hutsebaut,2 Didier Schrijvers,3 Bernard Sabbe3 1Department of Psychiatry, Psychiatrisch Ziekenhuis Stuivenberg, ZNA Antwerpen, Antwerp, Belgium; 2Viersprong Institute for Studies on Personality Disorders, Halsteren, the Netherlands; 3Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Wilrijk, Belgium Background: The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs. Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods: One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ and Perceived Devaluation–Discrimination Questionnaire (PDDQ. Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions: Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD

  15. Chronic appendicitis in a patient with 15 years abdominal pain

    Directory of Open Access Journals (Sweden)

    bizhan Khorasani

    2007-04-01

    Full Text Available Khorasani B1, Gholizadeh Pasha A2 1. Assistant professor, Department of surgery, Faculty of medicine, Tehran University of rehabilitation 2. Assistant professor, Department of surgery, Faculty of medicine, Babol University of medical sciences Abstract Background: Acute appendicitis is a completely known disease but for many physicians chronic appendicitis is unknown and some of them don believe in it. Although the number of people suffer from chronic appendicitis is much fewer than those who suffer from acute appendicitis, we shouldn ignore it. Clinical symptoms for these patients are chronic, longtime and recurrent abdominal pain, which is usually in the right lower quadrant of the abdomen. In the Para clinical examinations there isn any considerable pathological problem (in urine, stool, and sonography of the abdomen and pelvis. By recognizing appendicitis and appendectomy, the symptoms will be vanished and the patients will recover. Case presentation: The case was a 57-year-old man who has complained from chronic abdominal pain in the RLQ area since 15years ago. No pathological problem had been found in all diagnostic process. Conclusion: The problem was diagnosed as the chronic appendicitis and he underwent the appendectomy by laparoscopic procedure and was completely recovered.

  16. Influence of religion on sexual self-perception and sexual satisfaction in patients suffering from schizophrenia and depression.

    Science.gov (United States)

    Peitl, Marija Vucic; Peitl, Vjekoslav; Pavlovic, Eduard

    2009-01-01

    It is well documented that religion has an impact on mental health of both healthy people and mental health patients. However, scientific research regarding the influence of religion on sexual experiences and sexual self-perception in mental health patients and healthy people is very scarce. Therefore, our goal was to research how and in what measure religious and atheistic views of patients suffering from depression and schizophrenia and healthy people influence their sexual functions and sexual self-perception. This research was conducted on 100 patients suffering from schizophrenia and 100 patients suffering from depression, while 100 healthy individuals served as a control group. DMS-IV criteria were used when diagnosing schizophrenia and depression. In order to research the aspects of sexual self-perception we used Bezinović's questionnaire and Arizona sexual experience scale (ASEX) to research the aspects of sexual intercourse. Results show that Roman-Catholic patients suffering from schizophrenia experience greater sexual satisfaction than Eastern-Orthodox or atheist schizophrenic patients. Among patients suffering from depression in regard to their differing religious views there were no significant differences regarding sexual satisfaction or the aspects of sexual self-perception. Furthermore, there is a significant difference among healthy individuals when taking into consideration religious views. We established that Muslims have a significantly stronger sexual drive then atheists, Roman-Catholic or Eastern-Orthodox individuals. Compared to Roman-Catholic and Eastern-Orthodox individuals, atheists have better consciousness of their own sexuality. We can conclude that religious views have an influence on sexual functioning and sexual self-perception of patients suffering from depression and schizophrenia and also healthy individuals. Thus, further research on a bigger sample of participants--not only of those religious denominations covered in this

  17. Catheter-Related Urinary Tract Infection in Patients Suffering from Spinal Cord Injuries

    Directory of Open Access Journals (Sweden)

    Amela Dedeić-Ljubović

    2009-02-01

    Full Text Available Urinary tract infection is commoner in patients with spinal cord injuries because of incomplete bladder emptying and the use of catheters that can result in the introduction of bacteria into the bladder. 145 patients suffering from spinal cord injuries, admitted to the Institute for physical medicine and rehabilitation, Centre for paraplegia of the Clinical Centre of the University of Sarajevo, were included. The patients were divided in three groups according to the method of bladder drainage: Group A (n=61 consisted of patients on clean intermittent catheterization; Group B (n=54 consisted of patients with indwelling catheters; Group C (n=30 consisted of patients who had performed self-catheterization. From a total of 4539 urine samples, 3963 (87,3% were positive and 576 (12,7% were sterile. More than 90% of the infected patients were asymptomatic.The overall rate of urinary infection amounted to about 2,1 episodes, and bacteriuria to 8,1 episodes per patient. 77% of infections (113/145 were acquired within seven days from catheterization.Infection was usually polymicrobial; the greatest number of urine samples 1770/3943 (44,9% included more than one bacterium.The vast majority of cases of urinary tract infection and bacteriuria are caused by Gram-negative bacilli and enterococci, commensal organisms of the bowel and perineum, representative of those from the hospital environment. Providencia stuarti (18,9% being the most common, followed by Proteus mirabilis (16,3%, Escherichia coli (11,8%, Pseudomonas aeruginosa (10,2%, Klebsiella pneumoniae (8,1%, Morganella morgani (5,4%, Acinetobacter baumannii (4,6%, Providencia rettgeri (3,5%. 15,7% of isolates were Gram-positive with Enterococcus faecalis (8,6% as the most common. 55,3% of isolates were multidrug-resistant, and the highest rates of resistance were found among Acinetobacter baumannii (87,8%, Providencia rettgeri (86,7%, Pseudomonas aeruginosa (85,4%, Providencia stuarti (84,3% and

  18. 3Tesla magnetic resonance examination of a patient suffering from diffuse axonal injury

    International Nuclear Information System (INIS)

    Bonchev, S.; Zlatareva, D.; Hadjidekov, V.

    2016-01-01

    Diffuse axonal injury has been observed in traumatic brain injury. Both type of lesions - haemorrhagic and non-haemorrhagic, demonstrate on MRI. We would like to introduce you a 24 year old outpatient man, who was examined in our Department with a past medical history of severe traumatic brain injury, followed by two weeks of coma in Intensive care, discharged from hospital with good outcome. Subsequently cognitive impairments have developed and an episode of tonic-clonic seizure have been undergone by the patient. 3Tesla MRI was performed and lesions typical for diffuse axonal injury were found. MRI is the study of choice for demonstrating the lesions of diffuse axonal injury in the acute and chronic period

  19. Dolor y sufrimiento en el paciente con SIDA Pain and suffering of AIDS' patients

    Directory of Open Access Journals (Sweden)

    Martha Lucía Arroyave

    1989-02-01

    Full Text Available

    Se analizan algunos aspectos relacionados con el dolor y el sufrimiento de los pacientes con SIDA, así como su manejo médico y ético; se explican, además, los componentes del cuidado paliativo, a saber: control de la sintomatología, manejo administrativo, atención domiciliaria, atención hospitalaria, acción del voluntariado, ayuda espiritual, manejo de la aflicción y aspectos educativos y evaluativos.

    Pain and suffering of AIDS' patients are analyzed including medical and ethical implications; the following aspects of palliative care are reviewed: control of symptoms, administrative handling of the problem, home and hospital care, volunteer help, spiritual needs, management of affliction, as well as educational and evaluative Issues related with AIDS.

  20. Cardiovascular coupling analysis with high-resolution joint symbolic dynamics in patients suffering from acute schizophrenia

    International Nuclear Information System (INIS)

    Schulz, Steffen; Tupaika, Nadine; Voss, Andreas; Berger, Sandy; Bär, Karl-Jürgen; Haueisen, Jens

    2013-01-01

    Besides the well-known cardiac risk factors for schizophrenia, increasing concerns have been raised regarding the cardiac side-effects of antipsychotic medications. A bivariate analysis of autonomic regulation, based on cardiovascular coupling, can provide additional information about heart rate (HR) and blood pressure regulatory patterns within the complex interactions of the cardiovascular system. We introduce a new high-resolution coupling analysis method (HRJSD) based on joint symbolic dynamics (JSD), which is characterized by three symbols, a threshold (individual dynamic variability, physiological) for time series transformation and eight coupling pattern families. This is based on a redundancy reduction strategy used to quantify and characterize cardiovascular couplings. In this study, short-term (30 min) HR and systolic blood pressure (SP) time series of 42 unmedicated (UNMED) and 42 medicated patients (MED) suffering from acute schizophrenia were analysed to establish the suitability of the new method for quantifying the effects of antipsychotics on cardiovascular couplings. We were able to demonstrate that HRJSD, applying the threshold based on spontaneous baroreflex sensitivity (BRS) estimation, revealed eight significant pattern families that were able to quantify the anti-cholinergic effects of antipsychotics and the related changes of cardiovascular regulation (coupling) in MED in comparison to UNMED. This was in contrast to the simple JSD, BRS (sequence method) and only partly to standard linear HR variability indices. HRJSD provides strong evidence that autonomic regulation in MED seems to be, to some extent, predominated by invariable HR responses in combination with alternating SP values in contrast to UNMED, indicating an impairment of the baroreflex control feedback loop in MED. Surrogate data analysis was applied to test for the significance and nonlinearity of cardiovascular couplings in the original data due to medical treatment with

  1. Basic Body Awareness Therapy in patients suffering from fibromyalgia: A randomized clinical trial.

    Science.gov (United States)

    Bravo, Cristina; Skjaerven, Liv Helvik; Espart, Anna; Guitard Sein-Echaluce, Luisa; Catalan-Matamoros, Daniel

    2018-05-03

    The aim of this study is to assess whether Basic Body Awareness Therapy (BBAT) improves musculoskeletal pain, movement quality, psychological function, and quality of life. The effects of BBAT in addition to treatment as usual (TAU) were studied in a randomized controlled trial. Forty-one patients were randomly assigned to a control group (n = 21) and an intervention group (n = 20). Both groups received TAU including pharmacological therapy. The intervention group took part in 10 BBAT sessions. Outcome variables were measured regarding pain, movement quality, psychological function, and quality of life. Outcome measures were assessed before intervention, in posttest, and in follow-ups at 12 and 24 weeks. The BBAT group showed significant improvement in 'pain' at posttest (p = 0.037) and in 'movement quality' from baseline to 24 weeks (p = 0.000). Intragroup analysis showed significant improvements in the SF-36 body pain subscale at 12 and 24 weeks (p = 0.001, p = 0.014), Hospital Anxiety Depression scale in anxiety subscale at 12 weeks (p = 0.019), State-Trait Anxiety Inventory anxiety questionnaire at 12 and 24 weeks (p = 0.012, p = 0.002), and STAI state at 12 and 24 weeks (p = 0.042, p = 0.004). This study showed that BBAT might be an effective intervention in patients suffering from fibromyalgia in relation to pain, movement quality, and anxiety.

  2. Chiropractic chronic low back pain sufferers and self-report assessment methods. Part II. A reliability study of the Middlesex Hospital Questionnaire and the VAS Disability Scales Questionnaire.

    Science.gov (United States)

    Leboeuf, C; Love, A; Crisp, T C

    1989-04-01

    The subjective complaints of 41 chronic low back pain sufferers attending a chiropractic clinic were assessed twice prior to therapy with a widely used psychological self-report assessment tool, the Middlesex Hospital Questionnaire (MHQ) and a newly developed VAS Disability Scales Questionnaire (DISQ), both of which investigate various aspects of certain basic positions and activities. Reliability was generally acceptable with these two questionnaires. Subjects participating in the study were commonly found to score within the normal range on the MHQ, indicating that psychological disturbance was not a major feature of their presentation. However, mild mood disturbance was commonly reported, and a more sensitive tool may need to be developed for this type of mildly affected chronic low back pain sufferers. The DISQ generally indicated subjects were mildly to moderately affected by their low back trouble and that sitting and leisure activities were the most pain provoking. Recommendations for further development of the disability scale are made.

  3. Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: A cross-sectional study.

    NARCIS (Netherlands)

    Vollmann, Manja; Scharloo, Margreet; Langguth, Berthold; Kalkouskaya, Natallia; Salewski, Christel

    2014-01-01

    Objective: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between

  4. Caracterización de los pacientes con dengue Characterization of the patients suffering from dengue

    Directory of Open Access Journals (Sweden)

    Ivette González Fajardo

    2011-09-01

    Full Text Available Se revisaron las 31 historias clínicas de los pacientes ingresados en el Centro Diagnóstico Integral "Raúl Maza Mérida" del estado Delta Amacuro, municipio Tucupita con el diagnóstico positivo de dengue, confirmado de forma clínica e inmunológica (IgM positiva. Se analizaron las variables: sexo, edad, procedencia, incidencia por meses, síntomas, complicaciones, resultados analíticos e imagenológicos y evolución. El método estadístico utilizado fue el test Ji cuadrado de Pearson, considerando valores de p Thirty one clinical charts of the patients admitted at “Raul Maza Merida” Comprehensive Center of Diagnostic in Delta Amacuro State, Tucupita municipality were analyzed, these patients suffered from dengue which was verified immunological (IgM and clinically. Sex, age, origin, incidence per months, symptoms, complications, analytical and imaging results together with the follow up of evolution were the variables considered. The statistical method used was Pearson’s chi square test, taking into consideration the values of p< 0, 05 statistically significant along with other percentage values. Male sex (58,1%, 15 and 29 years old (48, 4% prevailed, and July (35,5% was the month showing the highest incidence, no cases were reported in November or December. General malaise and fever were present in 100% of the patient’s most frequent symptoms in the onset period, and headache the most lasting sign during the disease progress, observing a reduction of admissions on the second day of the onset of symptoms. The 62.5% of the cases of hemorrhagic dengue presented complications, only 4.3% of fevers due to dengue resulted in statistical significance. Megacaryopoietic series was the last to be recovered. Echo-sonographic alterations were detected in 25.8% of the cases and only 9.6% presented radiological alterations. The presence of ascitic fluids resulted the most frequent finding, 100% of the patients underwent parenteral hydration

  5. Healthcare professionals' dilemmas: judging patient's decision making competence in day-to-day care of patients suffering from Korsakoff's syndrome.

    Science.gov (United States)

    van den Hooff, Susanne; Buijsen, Martin

    2014-11-01

    Patient's decision making competence (PDMC) is a widely discussed subject. Issues of competence, autonomy, well-being and protection of the patient come up every day. In this article we analyse what role PDMC plays in Dutch legislation and what dilemmas healthcare professionals may experience, notably in patients suffering from Korsakoff's syndrome. Dilemmas emerge if professionals want to meet the requirements mentioned in Dutch law and the desires of their patients. The autonomy of the patient and the healthcare professionals' duty to take care of their patient's best interests, create a tension and lead to uncomfortable situations. Healthcare professionals describe difficulty finding a balance between these issues and assessing the degree of mental competence still present. In long term care situations, quality of the relationship between healthcare professionals and their patients seems to be of much more importance in decision making on minor issues of competence than simply relying on legal or house rules. In being committed to their cases, professionals will be more sensitive to individuals habits, abilities, welfare and dignity, which will make it easier to decide on issues of competence, and to find creative solutions to their dilemmas.

  6. Plasma YKL-40 and all-cause mortality in patients with chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Holmgaard, Dennis Back; Mygind, Lone; Titlestad, Ingrid Louise

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is hallmarked by inflammatory processes and a progressive decline of lung function. YKL-40 is a potential biomarker of inflammation and mortality in patients suffering from inflammatory lung disease, but its prognostic value in patients with COPD remains...... unknown. We investigated whether high plasma YKL-40 was associated with increased mortality in patients with moderate to very severe COPD....

  7. The analgesic effect of pregabalin in patients with chronic pain is reflected by changes in pharmaco-EEG spectral indices.

    NARCIS (Netherlands)

    Graversen, C.; Olesen, S.S.; Olesen, A.E.; Steimle, K.; Farina, D.; Wilder-Smith, O.H.G.; Bouwense, S.A.W.; Goor, H. van; Drewes, A.M.

    2012-01-01

    AIM: To identify electroencephalographic (EEG) biomarkers for the analgesic effect of pregabalin in patients with chronic visceral pain. METHODS: This was a double-blind, placebo-controlled study in 31 patients suffering from visceral pain due to chronic pancreatitis. Patients received increasing

  8. Economic evaluation of therapies for patients suffering from relapsed-refractory multiple myeloma in Greece

    Directory of Open Access Journals (Sweden)

    Fragoulakis V

    2013-04-01

    Full Text Available V Fragoulakis,1 E Kastritis,2 T Psaltopoulou,3 N Maniadakis1 1National School of Public Health, Athens, Greece; 2Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, School of Medicine, Athens, Greece; 3Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, School of Medicine, Athens, Greece Background: Multiple myeloma is a hematologic malignancy that incurs a substantial economic burden in care management. Since most patients with multiple myeloma eventually relapse or become refractory to current therapies (rrMM, the aim of this study was to assess the cost-effectiveness of the combination of lenalidomide–dexamethasone, relative to bortezomib alone, in patients suffering from rrMM in Greece. Methods: An international discrete event simulation model was locally adapted to estimate differences in overall survival and treatment costs associated with the two alternative treatment options. The efficacy data utilized came from three international trials (MM-009, MM-010, APEX. Quality of life data were extracted from the published literature. Data on resource use and prices came from relevant local sources and referred to 2012. The perspective of the analysis was that of public providers. Total costs for monitoring and administration of therapy to patients, management of adverse events, and cost of medication were captured. A 3.5% discount rate was used for costs and health outcomes. A Monte Carlo simulation was used to estimate probabilistic results with 95% uncertainty intervals (UI and a cost-effectiveness acceptability curve. Results: The mean number of quality-adjusted life years (QALYs was 3.01 (95% UI 2.81–3.20 and 2.22 (95% UI 2.02–2.41 for lenalidomide–dexamethasone and bortezomib, respectively, giving an incremental gain of 0.79 (95% UI 0.49–1.06 QALYs in favor of lenalidomide–dexamethasone. The mean cost of therapy per patient was estimated at €77,670 (95% UI €76,509

  9. Treatment and follow-up of patients suffering from the cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    Peter, R.U.; Gottloeber, P.; Heckmann, M.; Braun-FaIco, O.; Plewig, G.

    1996-01-01

    The hazards of acute radiation exposure are commonly addressed with respect to total body gamma or neutron irradiation, resulting primarily in bone marrow failure as the main clinically relevant aspect of the acute radiation disease. Under conditions of inhomogeneous exposure, as they are characteristic for many accident scenarios, other organ systems, such as the skin may become more important in determining clinical prognosis. This became especially obvious in the two worst radiation accidents since 1945, the Chernobyl accident in April 1986 and the Goiania accident in September 1987. The characteristic chronic sequelae of accidental cutaneous radiation exposure and therapeutic results have been described based on own clinical experience with treating patients with acute and late cutaneous effects after therapeutic irradiation, and a distinct group of patients having survived the Chernobyl nuclear power plant accident of April 26, 1986. Apart from clinical examination, histological analysis and high-frequency (20 MHz) ultrasound as well as a variety of functional tests have been used to determine the extent of radiation fibrosis and to exclude malignant transformation of keratoses and ulcers. Treatment included, apart from dermatosurgical procedures and plastic surgery for disabling contractures or ulcers, argon laser treatment of telangiectasias, topical tretinoin 0,005% (Epi-Aberel R , Cilag, Frankfurt), etretinate and acitretin (Tigason R , Neotigason R , Hoffmann LaRoche, Grenzach) for radiation keratoses, partly combined with a novel, nonatrophogenic steroid, Mometasonefuroate (Elocon R , Schering-Plough, New Jersey) to antagonize inflammatory reactions, and low-dose interferon-gamma (Polyferon R , Rentschler, Laupheim) for extensive radiation fibrosis. Basic dermatotherapy was performed with an ointment containing linoleic acid (Linola R , Wolff, Bielefeld). With this combination treatment, transepidermal water loss could be sustained, progression of

  10. Characterization of exercise limitations by evaluating individual cardiac output patterns : A prospective cohort study in patients with chronic heart failure

    NARCIS (Netherlands)

    Spee, R.F.; Niemeijer, V.M.; Wessels, B.; Jansen, J.P.; Wijn, P.F.F.; Doevendans, P.A.F.M.; Kemps, H.M.C.

    2015-01-01

    Background: Patients with chronic heart failure (CHF) suffer from exercise intolerance due to impaired central hemodynamics and subsequent alterations in peripheral skeletal muscle function and structure. The relative contribution of central versus peripheral factors in the reduced exercise capacity

  11. Characterization of exercise limitations by evaluating individual cardiac output patterns: a prospective cohort study in patients with chronic heart failure

    NARCIS (Netherlands)

    Spee, Ruud F.; Niemeijer, Victor M.; Wessels, Bart; Jansen, Jasper P.; Wijn, Pieter F. F.; Doevendans, Pieter A. F. M.; Kemps, Hareld M. C.

    2015-01-01

    Patients with chronic heart failure (CHF) suffer from exercise intolerance due to impaired central hemodynamics and subsequent alterations in peripheral skeletal muscle function and structure. The relative contribution of central versus peripheral factors in the reduced exercise capacity is still

  12. Acquired hemophilia in the patient suffering from rheumatoid arthritis: case report.

    Science.gov (United States)

    Drobiecki, Arkadiusz; Pasiarski, Marcin; Hus, Iwona; Sokołowska, Bożena; Wątek, Marzena

    2013-12-01

    Acquired hemophilia is a severe bleeding diathesis caused by autoantibodies against a coagulation factor VIII (FVIII inhibitor). Massive bleeding diathesis, often life threatening are observed in almost 90% of patients. In 50-60% of cases, inhibitor emerges spontaneously. However, there are some conditions like pregnancy, puerperium, autoimmune disorders or cancers that seem to induce acquired hemophilia. We report a case of a 49-year-old woman suffering from rheumatoid arthritis (RA) for several years, who was diagnosed with acquired hemophilia in September 2011. The patient had been treated by steroids and leflunomide during the last few months. At the time of diagnosis, diffuse bruising of the forearms and the trunk was observed. The patient was treated with recombinant activated factor VII, and the first-line immunosuppressive therapy was introduced (cyclophosphamide and prednisone). We observed the elimination of symptoms and the disappearance of diathesis. Significant reduction of the titer of inhibitor was achieved, but only partial remission was obtained. It lasted until the beginning of December 2011, when the titer of the inhibitor increased again and massive bleeding to the left lower limb occurred. It was necessary to administer recombinant factor VIIa together with the second-line immunosuppressive therapy based on the Budapest protocol. The rapid reduction of the diathesis and improvement of the patient's general condition was achieved as previously. However, still there was no complete remission. After 2 weeks of treatment, the titer of inhibitor diminished, and factor VIII activity increased slightly. Because of RA, the patient was treated with methylprednisolone in maintenance doses during the next few weeks. Unfortunately, after over a month, the increase of inhibitor titer and the decrease of FVIII level were observed again. Some bruises appeared. It was necessary to increase doses of corticosteroids to therapeutic levels and add cyclophosphamide

  13. Invited commentary on … When unbearable suffering incites psychiatric patients to request euthanasia: a qualitative study.

    Science.gov (United States)

    Pearce, Steve

    2017-10-01

    Although the paper in this issue by Verhofstadt et al sheds some light on the features of unbearable suffering stemming from psychiatric disorder leading to a request for euthanasia, this is limited. The bulk of the paper illustrates the particular ethical challenges posed by the policy of making euthanasia available in these circumstances. © The Royal College of Psychiatrists 2017.

  14. Pattern of injuries suffered by patients treated for alleged assault at ...

    African Journals Online (AJOL)

    The country experiences high levels of violence, with incidents of violence being reported in ... establish the type of injuries suffered by the victims of assault. Methods ... Senior family physician/senior lecturer, Department of Family Medicine, University of Pretoria, Mpumalanga Campus .... such a way that the profile of the as-.

  15. Delta-He, Ret-He and a New Diagnostic Plot for Differential Diagnosis and Therapy Monitoring of Patients Suffering from Various Disease-Specific Types of Anemia.

    Science.gov (United States)

    Weimann, Andreas; Cremer, Malte; Hernáiz-Driever, Pablo; Zimmermann, Mathias

    2016-01-01

    The present study was aimed to prove the usefulness of a new diagnostic plot (Hema-Plot), illustrating the relationship between the hemoglobin content of reticulocytes (Ret-He) as a marker of functional iron deficiency and the difference between the reticulocyte and erythrocyte hemoglobin content (Delta-He) as a marker of an impaired hemoglobinization of newly formed reticulocytes occurring during inflammatory processes, to differentiate between various disease-specific types of anemia. A complete blood and reticulocyte count was performed on routine EDTA blood samples from 345 patients with and without various disease-specific types of anemia using the Sysmex XN-9000 hematology analyzer: blood healthy newborns (n = 23), blood healthy adults (n = 31), patients suffering from anemia of chronic disease (ACD) due to diverse oncological, chronic inflammatory, or autoimmune diseases (total n = 138) with (n = 65) and without therapy (n = 73), patients with thalassemia and/or hemoglobinopathy (n = 18), patients with iron deficiency anemia (IDA) (n = 35), patients with a combination of ACD and IDA (n = 17), as well as patients suffering from sepsis (total n = 83) with (n = 32) and without therapy (n = 51). The results for Ret-He, Delta-He, and C-reactive protein (CRP) were statistically compared (Mann-Whitney U Test) between the particular patient groups and the diagnostic plots were drawn. Delta-Hemoglobin showed a statistically significant difference between blood healthy newborns and blood healthy adults (p ≤ 0.05), while Ret-He and C-reactive protein did not. In addition, of all three biomarkers only Delta-He showed a statistically significant difference (p ≤ 0.05) between the ACD/IDA and IDA cohort. Delta-He, Ret-He, and CRP showed a statistically significant difference between patient cohorts with and without therapy suffering from ACD, ACD/IDA, and sepsis before and after medical therapy (p ≤ 0.05). The Hema-Plot illustrated the dynamic character of Ret-He and

  16. Management of patients with chronic kidney disease

    African Journals Online (AJOL)

    management of the complications of CKD, e.g. renal anaemia, ... ARTICLE. Management of patients with chronic kidney disease. T Gerntholtz,1 FCP (SA); G Paget,2 ..... Telmisartan, ramipril, or both in patients at high risk for vascular events.

  17. Heart rate variability analysis in healthy subjects, patients suffering from congestive heart failure and heart transplanted patients

    Directory of Open Access Journals (Sweden)

    Argentina Leite

    2013-12-01

    Full Text Available This study aimed to find parameters to characterize heart rate variability (HRV and discriminate healthy subjects and patients with heart diseases. The parameters used for discrimination characterize the different components of HRV memory (short and long and are extracted from HRV recordings using parametric as well as non parametric methods. Thus, the parameters are: spectral components at low frequencies (LH and high frequencies (HF which are associated with the short memory of HRV and the long memory parameter (d obtained from autoregressive fractionally integrated moving average (ARFIMA models. In the non parametric context, short memory (α1 and long memory (α2 parameters are obtained from detrended fluctuation analysis (DFA. The sample used in this study contains 24-hour Holter HRV recordings of 30 subjects: 10 healthy individuals, 10 patients suffering from congestive heart failure and 10 heart transplanted patients from the Noltisalis database. It was found that short memory parameters present higher values for the healthy individuals whereas long memory parameters present higher values for the diseased individuals. Moreover, there is evidence that ARFIMA modeling allows the discrimination between the 3 groups under study, being advantageous over DFA.

  18. Surgical treatment of pain in patients with chronic pancreatitis.

    Science.gov (United States)

    Prochorov, Alexandermiddle Victorovich; Oldhafer, Karl-Jurgen; Tretyak, Stanislaw Ivanovich; Rashchynski, Siarhei Markovich; Donati, Marcello; Rashchynskaya, Nina Timofeevna; Audzevich, Dzmitry Anatolyevich

    2012-06-01

    The objectives of the research were to compare the outcomes of pancreatoduodenectomy (PD) (Kausch-Whipple or Traverso-Longmire) and resection with drainage operations (RDO) (Frey or Partingtone-Rochelle) in patients suffering from chronic pancreatitis (CP), in management of pain syndrome and quality of life provided by these kinds of surgical procedures. From 2002 to 2008 sixteen patients suffering from CP underwent PD and 16 underwent RDO. Treatment results for the two groups were analyzed with respect to postoperative complications and results of the questionnaire MOS SF-36 v.2(TM). In the immediate postoperative period more complications were observed in the PD group (a<0.05). In both groups a positive effect on removing the painful syndrome and improvement of the quality of life (p<0.01) were observed. In the PD group there were the best results of management by General Health difference criterion (a<0.01). A greater improvement of Physical Functiong value (a<0.01) was noticed in patients who underwent RDO. Both PD and RDO adequately remove pain syndrome and improve the quality of life in patients suffering from CP. Under equal conditions the preference should be given to RDO, as improvement in life quality of operated patients is greater.

  19. Pain management: the multidisciplinary roessingh back-school rehabilitation program and e-health interventions for chronic pain sufferers

    NARCIS (Netherlands)

    Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.; Wever, Daniel; Söderback, Ingrid

    2015-01-01

    Abstract Multidisciplinary team interventions aiming at breaking the vicious circle of impaired functioning are effective for clients with chronic pain. However, because of the growing number of people with such complaints, these interventions cannot be provided totally on a face-to-face basis.

  20. [Prolonged blockade of nervus ischiadicus in a system of complex treatment of patients, suffering complicated diabetic foot syndrome].

    Science.gov (United States)

    Shapoval, S D; Savon, I L; Sofilkanych, M M

    2015-03-01

    General principles of treatment in patients, suffering diabetic foot syndrome, are adduced. There was proved, that reconvalescence of the patients depends not only on quality of complex treatment, but from optimal choice of anesthesia method, its impact on postoperative period course. Application of prolonged blockade of n. ischiadicus gives possibility to perform operative intervention on the lower extremity in full volume, guarantees sufficient motor and sensory block, permits patients to reject from application of narcotic analgetics, to reduce the dose of strong nonnarcotic analgetics, the terms of transition of the wound process phase I into phase II, promotes early activization of patients postoperatively, constitutes alternative for other methods of anesthesiological support.

  1. Gallstones in Patients with Chronic Liver Diseases

    Directory of Open Access Journals (Sweden)

    Xu Li

    2017-01-01

    Full Text Available With prevalence of 10–20% in adults in developed countries, gallstone disease (GSD is one of the most prevalent and costly gastrointestinal tract disorders in the world. In addition to gallstone disease, chronic liver disease (CLD is also an important global public health problem. The reported frequency of gallstone in chronic liver disease tends to be higher. The prevalence of gallstone disease might be related to age, gender, etiology, and severity of liver disease in patients with chronic liver disease. In this review, the aim was to identify the epidemiology, mechanisms, and treatment strategies of gallstone disease in chronic liver disease patients.

  2. Metabolic activity of sodium, measured by neutron activation, in the hands of patients suffering from bone diseases: concise communication

    International Nuclear Information System (INIS)

    Spinks, T.J.; Bewley, D.K.; Paolillo, M.; Vlotides, J.; Joplin, G.F.; Ranicar, A.S.O.

    1980-01-01

    Turnover of sodium in the human hand was studied by neutron activation. Patients suffering from various metabolic abnormalities affecting the skeleton, who were undergoing routine neutron activation for the measurement of calcium, were investigated along with a group of healthy volunteers. Neutron activation labels the sodium atoms simultaneously and with equal probability regardless of the turnover time of individual body compartments. The loss of sodium can be described either by a sum of two exponentials or by a single power function. Distinctions between patients and normal subjects were not apparent from the exponential model but were brought out by the power function. The exponent of time in the latter is a measure of clearance rate. The mean values of this parameter in (a) a group of patients suffering from acromegaly; (b) a group including Paget's disease, osteoporosis, Cushing's disease, and hyperparathyroidism; and (c) a group of healthy subjects, were found to be significantly different from each other

  3. Reliability of the Life Satisfaction Questionnaire to assess patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    Boonstra, Anne M.; Reneman, Michiel F.; Posthumus, Jitze B.; Stewart, Roy E.; Schiphorst Preuper, Henrica R.

    The aim of this study was to determine the reliability of the Life Satisfaction Questionnaire, Dutch version (LSQ-DV), to assess chronic pain patients. The study was designed as test-retest. The setting was the general rehabilitation centre. There were 51 patients over 18 years of age, suffering

  4. The microorganisms in chronically infected end-stage and non-end-stage cystic fibrosis patients

    DEFF Research Database (Denmark)

    Rudkjøbing, Vibeke B; Thomsen, Trine R; Alhede, Morten

    2011-01-01

    Patients suffering from cystic fibrosis (CF) develop chronic lung infections because of highly viscous mucus, where bacteria can form biofilms. In this study, we investigated the microorganisms present in the lungs of end-stage and non-end-stage patients using standard culturing techniques and mo...

  5. [Tropical chronic pancreatitis in a young patient].

    Science.gov (United States)

    Reyes, J; Ginard, D; Barranco, L; Riera, J; Obrador, A

    2001-11-01

    Tropical chronic pancreatitis is a form of idiopathic chronic pancreatitis that has not previously been described in Spain. Typically it is related to dietary factors and malnutrition, although genetic factors may also play a significant role in the development of the disease. We report a case of chronic tropical pancreatitis in a 27-year-old woman from the Dominican Republic domiciled in Spain since 1992. The patient was admitted to our hospital for acute pancreatitis that fulfilled the diagnostic criteria (clinical and radiological) for chronic tropical pancreatitis. This case has led us to review this uncommon entity. Because of the increasing number of immigrants from tropical countries, chronic tropical pancreatitis will probably need to be taken into account in the differential diagnosis of chronic pancreatitis in our patients.

  6. Characteristics and outcome among patients suffering from out-of-hospital cardiac arrest: Factors associated with survival

    Directory of Open Access Journals (Sweden)

    Trpković S.

    2014-01-01

    Full Text Available The aim was to define factors associated with an improved outcome among patients suffering out-of-hospital cardiac arrest (OHCA using the Utstain style data collection. We examined 200 patients suffering from OHCA in a prospective study in a two years period. We determined survival from cardiac arrest (CA to discharge from hospital and the factors associated with survival. 78% of CA patients had a cardiac aetiology, 65% occurred at home, 3.7% received bystander CPR. 36% were found in VF/VT, 64% in asystole/PEA. 52% of patients were intubated in the field, survival to discharge from hospital was significantly higher among patients who were intubated in the field. The mean response time was 6.6 minutes. 66.7% of patients were given the shock after 4 minutes. 131 (65.5% were pronounced dead in the field, 69 patients were transported to the hospital. 53 (76.8% patients of them died during the transport or in the ED, 7 died after hospital admission and 9 survived to hospital discharge. Multivariate logistic regression analysis showed that variables significantly associated with survival to hospital discharge were: age, endotracheal intubation in the field and mean response time. The outcome of CPR was better in patients who were younger, who were intubated in the field and when the response time was shorter.

  7. Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

    Science.gov (United States)

    Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

    2009-01-01

    The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

  8. Utility of Brain SPECT 99mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia DA and dissociative motor disorders DMD (previously termed as hysteria)

    International Nuclear Information System (INIS)

    Ali, F.

    2007-01-01

    Full text: The aim of the study was to assess the utility of Brain SPECT 99 mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia (DA) and dissociative motor disorders (DMD) (previously termed as Hysteria). Materials and Methods: 20 patients were included in the study with a mean age of 26 years, 08 of them suffering from DA and 12 from DMDs. A consultant psychiatrist on the basis of ICD-10 criteria made the diagnosis. Patients were divided into two categories according to the duration of their illness. Category A; included 10 patients having less than six months duration of illness. Category B; included 10 patients having duration of illness more than six months. Ten normal controls having no signs and symptoms of any psychiatric disorder were also included in the study. Brain SPECT study was carried out using 99 mTc-HMPAO. Semiquantitative analysis was done by calculating cortical and cerebellar ratios in normals and comparing the same in the patients. Results: By comparing regional cerebral blood flow ratios of both the categories with normal group, patients suffering from DA showed hypoperfusion in bilateral temporal lobes, in both frontal association areas and both orbito frontal regions and patients suffering for more than 06 months showed a slightly more exaggerated pattern of hypoperfusion in the same cortical areas. On the other hand in DMD only the patients suffering for more than 06 months showed altered cerebral blood perfusion like hypoperfusion in both of the frontal motor areas, hypoperfusion in both temporal lobes and marked hyperperfusion in both orbito frontal areas. Conclusion: Patients of DA show abnormal cerebral perfusion pattern whether in acute or chronic stage while only chronic DMD states precipitate altered cerebral perfusion patterns and these can be visualized on a Brain SPECT study. (author)

  9. [IMPROVEMENT AND CHOICE OF COLOSTOMY METHOD IN THE TREATMENT OF PATIENTS, SUFFERING AN ACUTE OBTURATIVE IMPASSABILITY OF LARGE BOWEL].

    Science.gov (United States)

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times.

  10. Urea synthesis in patients with chronic pancreatitis

    DEFF Research Database (Denmark)

    Hamberg, Ole; Andersen, Vibeke; Sonne, J

    2001-01-01

    Up-regulation of urea synthesis by amino acids and dietary protein intake may be impaired in patients with chronic pancreatitis (CP) due to the reduced glucagon secretion. Conversely, urea synthesis may be increased as a result of the chronic inflammation. The aims of the study were to determine...

  11. Anxiety and Depression in Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    LU Dong-mei; MA Jun-peng; ZOU Shao-hong; LENG Qiu-ping; YANG Xiao-hong

    2017-01-01

    Background: Anxiety and depression may have deleterious effects on patients with chronic obstructive pulmonary disease (COPD). However, the evidence underlying the increased risks of anxiety and depression in COPD patients in Xinjiang are poorly defined. This study aimed to investigate the burden and related factors of depression and anxiety among patients with COPD in Xinjiang. Methods: The study included 62 patients with COPD, aged (64.48±9.83) years, 59 patients were hospitalized due to exacerbations, 3 patients were included due to periodically check-up in the hospital. Depression and anxiety in these patients were evaluated through the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). Stepwise multiple regression analysis was used to evaluate the clinical characteristics correlated to depression and anxiety. Results: The prevalences of depression and anxiety were higher (62.9% and 95.2%) in COPD patients in Xinjiang. Anxiety was more common in patients than depression. Respectively, the female population with COPD was differentiated from males by higher levels of depression score, female COPD patients were more strongly correlated with depression (correction for regression coefficient: β=0.87; P=0.04). Patients received university education level were more likely to suffer the pain of anxiety (correction for regression coefficient: β=0.61; P=0.002) than lower education level. In addition, patients with the average monthly income less than ¥1 000 was more likely to suffer both the pain of anxiety and depression (P<0.05). Conclusion: This study showed the high prevalence of anxiety and depression in COPD patients in Xinjiang, even in the condition of moderate COPD in terms of FEV1%. Both anxiety and depression were correlated with the lower monthly income. Female COPD patients were more exposed to depression in this group. Patients with higher educational level tended to be correlated with anxiety. Screening tools may help recognition of

  12. Why patients should give thanks for their disease: traditional Christianity on the joy of suffering.

    Science.gov (United States)

    Delkeskamp-Hayes, Corinna

    2006-08-01

    Patristic teaching about sin and disease allows supplementing well-acknowledged conditions for a Christian medicine with further personal challenges, widely disregarded in Western Christianities. A proper appreciation of man's vocation toward (not just achieving forgiveness but) deification reveals the need to cooperate with the Holy Spirit's offer of grace toward restoring man's pre-fallen nature. Ascetical exercises designed at re-establishing the spirit's mastery over the soul distance persons from (even supposedly harmless) passion. They thus inspire the struggle towards emulating Christ's (self-crucifying) kenotic love, and to accept even secularly "undeserved" suffering as spiritually deserved in view of his (forever) lacking fervor in that struggle. Only in the spirit of that love can the evil Adam's sin brought into this world work its therapeutic impact, the eschatological purpose of which explains God's lovingly permitting that evil. This therapeutic impact is physically manifested already in this life through the transforming energies granted the saints of the church.

  13. Epidemiology and Endoscopic Findings of the Patients Suffering from Upper Gastrointestinal System Bleeding

    Directory of Open Access Journals (Sweden)

    Mehmet Suat Yalçın

    2016-03-01

    Full Text Available Objective: In the present study, we aim to investigate general and endoscopic findings of the patients who were hospitalized in our clinic because of upper gastrointestinal system bleeding (UGSB. Methods: The files of 403 patients who applied to our clinic between January 2014 and December 2014 with UGSB diagnosis were scanned retrospectively. The de­mographic, laboratorial and endoscopic findings of the patients were examined. Results: The average age of 403 patients were 61.12±17.1 (min. 17- max. 96 and while 263 of these patients were male (65.3(%, 140 of them were female (34.7%. Of all, 234 patients had an additional disease. The most fre­quently observed diseases were hypertension, diabetes mellitus and coronary artery. 259 (64.3% of the patients used to take at least one drug and 212 (52.6% of the patients used to get non-steroid anti-inflammatory drugs and/or aspirin. The most common reasons of UGSB were duodenal ulcer in 158 patients (39.2%, stomach ulcer in 97 patients (24%, erosive gastroduodenitis in 66 patients (16.3% and esophageal varices in 38 patients (9.4%. Unfortunately, 18 of the patients died. Conclusion: The most common reason of UGSB is duo­denal ulcer bleeding. In spite of the technological devel­opment nowadays, it is a disease which has mortality.

  14. Diagnosing suffering: a perspective.

    Science.gov (United States)

    Cassell, E J

    1999-10-05

    The alleviation of suffering is crucial in all of medicine, especially in the care of the dying. Suffering cannot be treated unless it is recognized and diagnosed. Suffering involves some symptom or process that threatens the patient because of fear, the meaning of the symptom, and concerns about the future. The meanings and the fear are personal and individual, so that even if two patients have the same symptoms, their suffering would be different. The complex techniques and methods that physicians usually use to make a diagnosis, however, are aimed at the body rather than the person. The diagnosis of suffering is therefore often missed, even in severe illness and even when it stares physicians in the face. A high index of suspicion must be maintained in the presence of serious disease, and patients must be directly questioned. Concerns over the discomfort of listening to patients' severe distress are usually more than offset by the gratification that follows the intervention. Often, questioning and attentive listening, which take little time, are in themselves ameliorative. The information on which the assessment of suffering is based is subjective; this may pose difficulties for physicians, who tend to value objective findings more highly and see a conflict between the two kinds of information. Recent advances in understanding how physicians increase the utility of information and make inferences allow one to reliably use the subjective information on which the diagnosis and treatment of suffering depend. Knowing patients as individual persons well enough to understand the origin of their suffering and ultimately its best treatment requires methods of empathic attentiveness and nondiscursive thinking that can be learned and taught. The relief of suffering depends on physicians acquiring these skills.

  15. Study of lymphocyte sensitization to protein S-100 in the patients with cerebrovascular diseases, suffered due to Chernobyl NPP accident

    International Nuclear Information System (INIS)

    Khomenko, V.Yi.

    2004-01-01

    Among the persons with cerebrovascular diseases, suffered due to Chernobyl NPP accident two groups of patients were revealed: with DNA coloration coefficients in response to protein S-100 stimulation below and above 1. Patients with DNA coloration coefficients <1 were older, they had statistically significant lower monocytes and T-activated lymphocytes absolute counts as well as increased content of cholesterol-2 and circulating immune complexes. Charges found there suggested possible existence of different pathways of immune response to antigenic stimulation by S-100 protein

  16. Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study

    Science.gov (United States)

    Thienpont, Lieve; Verhofstadt, Monica; Van Loon, Tony; Distelmans, Wim; Audenaert, Kurt; De Deyn, Peter P

    2015-01-01

    Objectives To identify patterns in euthanasia requests and practices relating to psychiatric patients; to generate recommendations for future research. Design Retrospective analysis of data obtained through medical file review. Setting Outpatient psychiatric clinical setting in the Dutch-speaking region of Belgium, between October 2007 and December 2011; follow-up at the end of December 2012. Participants 100 consecutive psychiatric patients requesting euthanasia based on psychological suffering associated with psychiatric disorders (77 women, 23 men; mean age 47 years; age range 21–80 years). Main outcome measures Patient sociodemographic characteristics; diagnoses; decisions on euthanasia requests; circumstances of euthanasia procedures; patient outcomes at follow-up. Results Most patients had been referred for psychiatric counselling by their physician (n=55) or by LEIF (Life End Information Forum) (n=36). 90 patients had >1 disorder; the most frequent diagnoses were depression (n=58) and personality disorder (n=50). 38 patients required further testing and/or treatment, including 13 specifically tested for autism spectrum disorder (ASD); 12 received an ASD diagnosis (all Asperger syndrome). In total, 48 of the euthanasia requests were accepted and 35 were carried out. Of the 13 remaining patients whose requests were accepted, 8 postponed or cancelled the procedure, because simply having this option gave them enough peace of mind to continue living. In December 2012, 43 patients had died, including 35 by euthanasia; others died by suicide (6), palliative sedation (1) and anorexia nervosa (1). Conclusions Depression and personality disorders are the most common diagnoses in psychiatric patients requesting euthanasia, with Asperger syndrome representing a neglected disease burden. Further research is needed, especially prospective quantitative and qualitative studies, to obtain a better understanding of patients with psychiatric disorders who request

  17. MR tomography in patients suffering from Parkinson's disease and Parkinson plus syndromes

    International Nuclear Information System (INIS)

    Hierholzer, J.; Schrag, A.; Cordes, M.; Sander, B.; Schelosky, L.; Harisch, C.; Venz, S.; Keske, U.; Maeurer, J.; Poewe, W.; Felix, R.

    1996-01-01

    To define characteristic MR-findings in patients with clinically typical extrapyramidal movement disorders. 15 patients with Parkinson's disease (PD), 9 with multisystem atrophy (MSA), and 6 with progressive supranuclear palsy (PSP) underwent MRI using a 1.5 T. Magnetom unit. Two investigators analysed the images with special regard to global and/or focal atrophy and to changes in signal intensity of the CNS in the consensus mode. Normal images of 10 subjects served as controls to patient's images. In all patients with PSP and MSA characteristic pathological findings on MRI were observed including regional changes within the extrapyramidal nuclei. In contrast all patients with PD had an unremarkable MRI study of the CNS. MRI enables us to define characteristic morphological changes of the brain in patients with extrapyramidal movement disorders. Early recognition of these findings avoids misdiagnoses in patients who are difficult to diagnose. (orig.) [de

  18. [Symbolic meanings of patients with chronic diseases].

    Science.gov (United States)

    Muñoz, Luz Angélica; Price, Yocelyn; Gambini, Liliana; Stefanelli, Maguida Costa

    2003-12-01

    The investigation presents three cultural universes of those suffering from arterial hypertension, diabetes and arthrosis, describing the different dimensions and interpreting their meaning. The ethnographic method was utilized, using the ethnographic interview and participant observation and for the interpretation, the symbolic interactionism and other authors. Convergences in the dimensions arise in which the three diseases are perceived: the loss of well-being and social support, fear of disability and death. perception of the family and accepting the chronicity, interest in alternative medicine. The informants of this study perceive nursing care with ambiguity.

  19. Spiritual pain and suffering.

    Science.gov (United States)

    Brunjes, George B

    2010-01-01

    Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families. Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt, depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotional and spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for each patient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, in relationship to a deity or deities are important to understand. Cultural interpretations of pain and suffering may conflict with the goals of palliative care. Understanding the spiritual framework of the patient and family can help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peaceful death. Spiritual practices may help in the management of physical pain.

  20. Auditory brainstem response as a diagnostic tool for patients suffering from schizophrenia, attention deficit hyperactivity disorder, and bipolar disorder: protocol.

    Science.gov (United States)

    Wahlström, Viktor; Åhlander, Fredrik; Wynn, Rolf

    2015-02-12

    Psychiatric disorders, such as schizophrenia, attention deficit hyperactivity disorder (ADHD), and bipolar disorder, may sometimes be difficult to diagnose. There is a great need for a valid and reliable diagnostic tool to aid clinicians in arriving at the diagnoses in a timely and accurate manner. Prior studies have suggested that patients suffering from schizophrenia and ADHD may process certain sound stimuli in the brainstem in an unusual manner. When these patient groups have been examined with the electrophysiological method of brainstem audiometry, some studies have found illness-specific aberrations. Such aberrations may also exist for patients suffering from bipolar disorder. In this study, we will examine whether the method of brainstem audiometry can be used as a diagnostic tool for patients suffering from schizophrenia, ADHD, and bipolar disorder. The method includes three steps: (1) auditory stimulation with specific sound stimuli, (2) simultaneous measurement of brainstem activity, and (3) automated interpretation of the resulting brain stem audiograms with data-based signal analysis. We will compare three groups of 12 individuals with confirmed diagnoses of schizophrenia, ADHD, or bipolar disorder with 12 healthy subjects under blinded conditions for a total of 48 participants. The extent to which the method can be used to reach the correct diagnosis will be investigated. The project is now in a recruiting phase. When all patients and controls have been recruited and the measurements have been performed, the data will be analyzed according to a previously arranged algorithm. We expect the recruiting phase and measurements to be completed in early 2015, the analyses to be performed in mid-2015, and the results of the study to be published in early 2016. If the results support previous findings, this will lend strength to the idea that brainstem audiometry can offer objective diagnostic support for patients suffering from schizophrenia, ADHD, and

  1. Attitudes Toward Euthanasia for Patients Who Suffer From Physical or Mental Illness.

    Science.gov (United States)

    Levin, Kfir; Bradley, Graham L; Duffy, Amanda

    2018-01-01

    This study examined whether attitudes toward euthanasia vary with type of illness and with the source of the desire to end the patient's life. The study used a 3 (illness type: cancer, schizophrenia, depression) × 2 (euthanasia type: patient-initiated, family-initiated) between-groups experimental design. An online questionnaire was administered to 324 employees and students from a Australian public university following random assignment of participants to one of the six vignette-based conditions. Attitudes toward euthanasia were more positive for patients with a physical illness than a mental illness. For a patient with cancer or depression, but not schizophrenia, approval was greater for patient-, than, family-, initiated euthanasia. Relationships between illness type and attitudes were mediated by perceptions of patient autonomy and illness controllability. Findings have implications for debate, practices, and legislation regarding euthanasia.

  2. Trastornos oculares y otras enfermedades en casos con síndrome de Waardenburg Ocular disorders and other diseases in patients suffering from Waardenburg’s syndrome

    Directory of Open Access Journals (Sweden)

    Fidel Castro Pérez

    2012-12-01

    Full Text Available Introducción: el síndrome de Waardenburg es una entidad infrecuente, hereditaria, que presenta heterocromía del iris, Distopia cantorum y cursa con cierto grado de discapacidad cuando aparece la hipoacusia neurosensorial entre otras alteraciones. Objetivo: determinar las alteraciones oculares y otras enfermedades crónicas de una familia afectada con el síndrome de Waardenburg. Material y método: estudio de casos, observacional, transversal y descriptivo realizado a una familia con síndrome de Waardenburg en el municipio Sandino. Se confeccionó base de datos automatizada. Las variables utilizadas fueron los trastornos de la agudeza visual, refracción visual y otras alteraciones. Se utilizaron medidas de frecuencia: absolutas y relativas porcentuales. Resultados: entre las alteraciones visuales crónicas 17 presentaron trastornos de la refracción, cuatro individuos padecían glaucoma y uno cataratas, no se encontró ningún caso de discapacidad visual. Los 4 individuos con hipertensión arterial, dos coinciden con los que padecen de glaucoma y la otra es diabética. Conclusiones: fueron detectados varios trastornos de la refracción y la agudeza visual, sin llegar a la discapacidad.Introduction: Waardenburg’s syndrome is a rare, hereditary entity which presents heterochromia of the iris, dystopia canthorum and having a certain degree of disability when sensorineural hypoacusis appears; among other alterations. Objective: to determine ocular alterations and other chronic diseases that a family suffering from Waardenburg’s syndrome present. Material and Method: observational, cross-sectional and descriptive case study carried out with a family suffering from Waardenburg’s syndrome in Sandino municipality, Pinar del Rio. A database was created. The variables used were visual acuity, visual refraction and other alterations. Absolute and relative percentages were used as measures of frequency. Results: among these chronic visual

  3. Anorectal complications and function in patients suffering from inflammatory bowel disease: a series of patients with long-term follow-up

    NARCIS (Netherlands)

    Lam, T.J.; van Bodegraven, A.A.; Felt-Bersma, R.J.F.

    2014-01-01

    Aim: The aim of this study is to describe the long-term course of anorectal complains and function in a single centre cohort patients suffering from inflammatory bowel disease (IBD) with perianal lesions. Methods: Between 1993 and 2000, 56 IBD patients (43 Crohn's disease and 13 ulcerative colitis)

  4. Patient experiences of recovery after heart valve replacement: suffering weakness, struggling to resume normality

    DEFF Research Database (Denmark)

    Kikkenborg Berg, Selina; Zwisler, Ann-Dorthe; Pedersen, Birthe D.

    2013-01-01

    Heart valve disease is becoming a public health problem due to increasing life expectancy and new treatment methods. Patients are at risk of developing depression, anxiety or post-traumatic stress disorder after heart valve surgery. To better plan proper care, describing and understanding patients...

  5. Effects of vacuum compression therapy on skin microcirculation in patients suffering from lower limb ischaemia

    NARCIS (Netherlands)

    Ubbink, D. T.; van der Oord, B. M.; Sobotka, M. R.; Jacobs, M. J.

    2000-01-01

    We investigated the short-term effect of vacuum compression (VC) treatment on skin microcirculatory perfusion in the foot of patients with lower limb ischaemia and healthy controls. Ten patients with intermittent claudication or rest pain and 5 healthy controls underwent vacuum-compression treatment

  6. Emotional memory and perception of emotional faces in patients suffering from depersonalization disorder.

    NARCIS (Netherlands)

    Montagne, B.; Sierra, M.; Medford, N.; Hunter, E.; Baker, D.J.; Kessels, R.P.C.; Haan, E.H.F. de; David, A.S.

    2007-01-01

    Previous work has shown that patients with depersonalization disorder (DPD) have reduced physiological responses to emotional stimuli, which may be related to subjective emotional numbing. This study investigated two aspects of affective processing in 13 patients with DPD according to the DSM-IV

  7. FEATURES OF LIPID PEROXIDATION AND NEUROTROPHIC REGULATION IN PATIENTS SUFFERING FROM PARANOID SCHIZOPHRENIA

    Directory of Open Access Journals (Sweden)

    E.V. Kolesnichenko

    2008-09-01

    Full Text Available The article deals with the features of lipid peroxidation, activity of the antioxidative systems and level of brain-derived neurotrophic factor in patients with paranoid schizophrenia. Present study indicates associations between the studied parameters and type of progression, duration of disease and gender of patients.

  8. [Molecular and clinical characterization of Colombian patients suffering from type III glycogen storage disease].

    Science.gov (United States)

    Mantilla, Carolina; Toro, Mónica; Sepúlveda, María Elsy; Insuasty, Margarita; Di Filippo, Diana; López, Juan Álvaro; Baquero, Carolina; Navas, María Cristina; Arias, Andrés Augusto

    2018-05-01

    Type III glycogen storage disease (GSD III) is an autosomal recessive disorder in which a mutation in the AGL gene causes deficiency of the glycogen debranching enzyme. The disease is characterized by fasting hypoglycemia, hepatomegaly and progressive myopathy. Molecular analyses of AGL have indicated heterogeneity depending on ethnic groups. The full spectrum of AGL mutations in Colombia remains unclear. To describe the clinical and molecular characteristics of ten Colombian patients diagnosed with GSD III. We recruited ten Colombian children with a clinical and biochemical diagnosis of GSD III to undergo genetic testing. The full coding exons and the relevant exon-intron boundaries of the AGL underwent Sanger sequencing to identify mutation. All patients had the classic phenotype of the GSD III. Genetic analysis revealed a mutation p.Arg910X in two patients. One patient had the mutation p.Glu1072AspfsX36, and one case showed a compound heterozygosity with p.Arg910X and p.Glu1072AspfsX36 mutations. We also detected the deletion of AGL gene 3, 4, 5, and 6 exons in three patients. The in silico studies predicted that these defects are pathogenic. No mutations were detected in the amplified regions in three patients. We found mutations and deletions that explain the clinical phenotype of GSD III patients. This is the first report with a description of the clinical phenotype and the spectrum of AGL mutations in Colombian patients. This is important to provide appropriate prognosis and genetic counseling to the patient and their relatives.

  9. Resuscitation of patients suffering from sudden cardiac arrests in nursing homes is not futile

    DEFF Research Database (Denmark)

    Søholm, Helle; Bro-Jeppesen, John; Lippert, Freddy K

    2014-01-01

    and prognosis after OHCA in NH. METHODS: Consecutive Emergency Medical Service (EMS) attended OHCA-patients in Copenhagen during 2007-2011 were included. Utstein-criteria for pre-hospital data and review of individual patient charts for in-hospital post-resuscitation care were collected. RESULTS: A total...... survival rates as non-NH-patients when adjusting for known prognostic factors and pre-existing co-morbidity. A policy of not attempting resuscitation in nursing homes at all may therefore not be justified....

  10. Toxic plasma concentration of ropivacaine after a paravertebral block in a patient suffering from severe hypoalbuminemia.

    Science.gov (United States)

    Calenda, Emile; Baste, Jean Marc; Hajjej, Ridha; Danielou, Eric; Peillon, Christophe

    2014-03-01

    A case of systemic ropivacaine toxicity from a continuous thoracic paravertebral block in an adult patient who received a lobectomy is presented. The catheter was placed by the surgeon. Eleven hours after the start of the infusion, the patient experienced an arrhythmia leading to death. The total venous plasma concentration of ropivacaine was high (3.2 μg/mL). Furthermore, the patient had severe hypoalbuminemia (albumin 24 g/L), which resulted in the increase of the unbound ropivacaine plasma concentration that was responsible for the toxic side effects. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Exocrine and endocrine pancreatic function in 21 patients suffering from autoimmune pancreatitis before and after steroid treatment.

    Science.gov (United States)

    Frulloni, Luca; Scattolini, Chiara; Katsotourchi, Anna Maria; Amodio, Antonio; Gabbrielli, Armando; Zamboni, Giuseppe; Benini, Luigi; Vantini, Italo

    2010-01-01

    Autoimmune pancreatitis (AIP) responds rapidly and dramatically to steroid therapy. The aim of this study was to evaluate pancreatic exocrine and endocrine function in patients suffering from AIP both before and after steroid therapy. Fecal elastase 1 and diabetes were evaluated before steroid therapy and within 1 month of its suspension in 21 patients (13 males and 8 females, mean age 43 +/- 16.5 years) diagnosed as having AIP between 2006 and 2008. At clinical onset, fecal elastase 1 was 107 +/- 126 microg/g stool. Thirteen patients (62%) showed severe pancreatic insufficiency (insufficiency (100-200 microg/g stool), while 4 (19%) had normal pancreatic function (>200 microg/g stool). Before steroids, diabetes was diagnosed in 5 patients (24%), all of whom had very low levels of fecal elastase 1 (endocrine pancreatic insufficiency at clinical onset. These insufficiencies improve after steroid therapy. Copyright 2010 S. Karger AG, Basel.

  12. The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.M.; Sohng, K.Y. [Kangwon Tourism College, Kangwon-Do (Republic of Korea). Department of Nursing

    2005-12-15

    The purpose of this study was to determine the effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. This study was a quasi-experimental study of pre-test and post-test design in a non-equivalent control group. The subjects of this study consisted of both the experimental group of twenty-nine and the control group of thirty coal workers' pneumoconiosis patients. Data was collected from December 10, 2002 to February 15, 2003. Foot reflexology was performed for 60 minutes twice a week through five weeks in the experimental group, but none in the control group. To evaluate the effects of foot reflexology, the scores of fatigue and insomnia were measured before and after the experiment in both groups. Fatigue was evaluated by Fatigue Symptoms Inventory. Insomnia was measured with the visual analogue scale (VAS). Data of this experiment was analyzed by Chi-square test, t-test, unpaired t-test and Repeated Measures ANOVA with the SAS Program. The scores of fatigue and insomnia decreased in the experimental group but not in the control group. There was a significant difference of fatigue and insomnia between the two groups. It is suggested that foot reflexology might have beneficial effects on reducing fatigue and insomnia in patients suffering from coal workers' pneumoconiosis, and can be recommended as a nursing intervention program for patients with coal workers' pneumoconiosis.

  13. Functional capacity and work ability in patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    van der Meer, Suzan

    2014-01-01

    Patients suffering from chronic low back pain (CLBP) and whiplash associated disorders (WAD) may experience many problems, including in work. Work ability is considered a balance between work demands and personal resources. Functional Capacity Evaluations (FCE) can be used to measure aspects of work

  14. Estimation of serum concentration of parvovirus B19 DNA by PCR in patients with chronic anemia

    DEFF Research Database (Denmark)

    Hornsleth, A.; Carlsen, K. M.; Christensen, Laurids Siig

    1994-01-01

    Parvovirus B19 DNA was detected in serum samples from 10 out of 42 patients with chronic anaemia, the majority of whom suffered from aplastic anaemia, haemolytic anaemia, pure red cell anaemia or myelodysplastic syndrome. Nested PCR methods with sensitivities of 0.005-0.05 fg DNA were developed. ...

  15. Wallerian degeneration demonstrated by MRI and functional outcome in patients suffering from supratentorial cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Shirotani, Toshiki; Takahara, Takashi; Arimoto, Hirohiko; Inohara, Masashi; Ono, Kenichiro; Shimizu, Akira [Self-Defense Force Central Hospital, Tokyo (Japan)

    2002-07-01

    An early diagnosis of the outcome of patients with cerebrovascular disease is important for selecting the optimal treatment strategy. The purpose of this study was to estimate the prognosis of Wallerian degeneration on MRI in stroke patients with hemiparesis. The subjects consisted of 87 stroke patients, 50 hemorrhagic patients and 37 ischemic patients, who were evaluated by MRI at 1 to 6,275 days after stroke onset. Among the 36 patients who were evaluated by consecutive MRI, 161 films were obtained and analyzed. Wallerian degeneration was diagnosed when a small prolonged T2 lesion was seen in the corticospinal tract of the brainstem on at least two contiguous slices. The atrophic rate of the midbrain was calculated as: (the area of the unaffected side of the midbrain - the area of the affected side of the midbrain)/2 x (the area of the unaffected side of the midbrain). The patients' ability to perform the activities of daily living was scored by the Barthel index (BI). Wallerian degeneration in the ipsilateral brainstem was seen for two to three months in 32 cases (37%) and in 58 films (36%) and disappeared about 3 years after the onset of stroke. Wallerian degeneration correlated with the BI scores from 2 to 6 months after stroke (p<0.05), although no relationship was observed at 7 months or later. From 2 to 6 months after stroke, the shrinkage of the midbrain on MRI correlated with the BI scores (p<0.001), although no relationship was observed at 7 months or later. It was therefore both Wallerian degeneration and a shrunken midbrain observed on MRIs, evaluated from 2 to 6 months after stroke were thus suggested to indicate a poor outcome in such patients. (author)

  16. [Disease management for chronic heart failure patient].

    Science.gov (United States)

    Bläuer, Cornelia; Pfister, Otmar; Bächtold, Christa; Junker, Therese; Spirig, Rebecca

    2011-02-01

    Patients with chronic heart failure (HF) are limited in their quality of life, have a poor prognosis and face frequent hospitalisations. Patient self-management was shown to improve quality of life, reduce rehospitalisations and costs in patients with chronic HF. Comprehensive disease management programmes are critical to foster patient self-management. The chronic care model developed by the WHO serves as the basis of such programmes. In order to develop self-management skills a needs orientated training concept is mandatory, as patients need both knowledge of the illness and the ability to use the information to make appropriate decisions according to their individual situation. Switzerland has no established system for the care of patients with chronic diseases in particular those with HF. For this reason a group of Swiss experts for HF designed a model for disease management for HF patients in Switzerland. Since 2009 the Swiss Heart Foundation offers an education programme based on this model. The aim of this programme is to offer education and support for practitioners, patients and families. An initial pilot evaluation of the program showed mixed acceptance by practitioners, whereas patient assessed the program as supportive and in line with their requirements.

  17. [Characteristics of patients suffering from multiple sclerosis according to professional situation].

    Science.gov (United States)

    Abbas, D; Gehanno, J-F; Caillard, J-F; Beuret-Blanquart, F

    2008-06-01

    To describe the health and professional status of multiple sclerosis patients of working age and to compare a group of patients in work (group T1) with a group of unemployed patients (group T2). A case-controlled study was performed. In the course of a specific consultation with a neurologist, demographic, medical and professional data were gathering using a questionnaire. Descriptive and comparative statistical analyses were then performed. A total of 76 patients were included in the study: 54 were in work (group T1) and 22 were unemployed (group T2). Hence, the employment rate was 71%, with an average time since disease onset of nine years at the time of the study. Low educational level (p=0.02), disease progression (p=0.0001), the presence of motor symptoms (p=0.01), cerebellar symptoms (p=0.02) or cognitive symptoms (p=0.03), a worse EDSS (p=0.0001) and a job requiring force (p=0.05) or manual dexterity (p=0.05) were found to be negative factors. Employment in the public sector (p=0.003) or large companies (p=0.03) were found to be protective factors. Access to the workplace was better for currently employed patients (p=0.03). This study shows that differences exist within the MS patient population according to the professional situation. It underlines the importance of clinical and demographics variables as determinants of differences in employment status. Not surprisingly, unemployed patients are more likely to have been classified as handicapped workers. Factors linked to work-induced constraints did not emerge from the survey because the questionnaire items were not appropriate for addressing this latter issue.

  18. Optimization of treatment of patients with ischemic heart disease after suffering intervention in the coronary arteries

    Directory of Open Access Journals (Sweden)

    Y. I. Karpenko

    2016-08-01

    Odesa national medical university, Odesa, Ukraine   Abstract Each year increase number of patients with ischemic heart disease (IHD, according to this  rising costs of treating this group of patients and increase amount of complications of IHD. Also is actual question of management of patients with IHD  after surgery interventions, particularly after stenting or coronary artery bypass grafting (CABG. Risk factors are strongly increase in the patients with diabetes mellitus (DM type 2. For them is more common damaging the coronary artery on big distance, violation of microcirculation and silent form of IHD. All this often lead to late diagnosis of IHD. Given the above, developing new methods of treatments for this cohort of patients. One of them - a method of cardiac shock wave therapy (CSWT. The mechanism of action of CSWT is based on a direct effect of shock waves at a specific segment of the heart, and remote influence on neoangiogenesis and improving the microvascularization.  We compared the efficacy of treatment in patients with IHD and DM  type 2 after CABG or stenting conducted on background of standard therapy compared with use in the treatment method CSWT. The effectiveness of treatment at this stage of work was evaluated by the number of angina attacks and contractile capacity of left ventricular according data of Echocardioscopy.  The maximum efficiency of the method observed at 6 months of treatment with using CSWT. Long-term results in a reduction in angina and improving myocardial contractile capacity recorded in the group of patients treated with CSWT. Keywords: cardiac shock wave therapy, ischemic heart disease, diabetes mellitus type 2.

  19. CEFTRIAXONE EFFICIENCY AMONG PATIENTS, SUFFERING FROM JUVENILE ARTHRITIS AND RECEIVING IMMUNOSUPPRESSIVE THERAPY

    Directory of Open Access Journals (Sweden)

    A.M. Chomakhidze

    2007-01-01

    Full Text Available The article is dedicated to diagnostics and treatment of infectious complications among children with juvenile rheumatoid arthritis, receiving immunosuppressive therapy. The research involves 92 children with different variants of the illness run, who received immunosuppressive therapy. All the patients showed development of the systemic inflammatory response manifestations. The researchers used the definition of the procalcytonine levels as a marker for the bacterial infectiondevelopment. All the patients showed it higher than 0,5 ng/ml, while 7 patients — higher than 10 ng/ml. keeping in mind several courses of the antibacterial therapy in the anamnesis and presence of the combined bacterial infection, ceftriaxone was prescribed to all the children. As a result of the ceftriaxone based therapy, reduction of the clinical and laboratory manifestations of the bacterial infection was noted among more than 90% of patients. The development of the allergic reaction was noted in 1 case, and leukopenia was also found in 1 patient.Key words: children, juvenile rheumatoid arthritis, ceftriaxone.

  20. Prevalence of Diabetes Type 1 in Patients Suffered From Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Dayer

    2016-04-01

    Full Text Available Background Because IL2RA is considered a predisposing factor in the incidence of both type I diabetes and multiple sclerosis (MS, and considering that both are autoimmune diseases, some studies suggest a correlation between type I diabetes and MS. Objectives The aim of this study was to examine the prevalence of type I diabetes among people with MS. Patients and Methods The study subjects comprised 100 patients with MS from the Khuzestan multiple sclerosis center at rehabilitation school of Jundishapur University of Medical Sciences, whose diagnosis of MS had been confirmed by a specialist, and were not being treated with steroids. Subjects were selected from patients younger than 30 years old. After filling out an application form, 5 mL fasting venous blood and 5 mL after 2 hours were taken. The blood glucose level was measured with a kit (Zist Shimi using the enzymatic method. Results The mean age of the participants was 24.28 years. The rate of type I diabetes was equal to 4% of the total sample, while 18% of all patients had impaired fasting glucose. Conclusions Given the high level of impaired fasting glucose among patients in this study, it is likely that MS provides the basis for the incidence of glucose metabolism disorders. To prove this, further studies with larger sample sizes are required.

  1. Disturbance of serotonin 5HT2 receptors in remitted patients suffering from hereditary depressive disorder

    International Nuclear Information System (INIS)

    Larisch, R.; Vosberg, H.; Tosch, M.; Mueller-Gaertner, H.W.; Klimke, A.; Gaebel, W.; Mayoral, F.; Rivas, F.; Hamacher, K.; Coenen, H.H.; Herzog, H.R.

    2001-01-01

    Aim: The characteristics of 5HT 2 receptor binding were investigated in major depression in vivo using positron emission tomography and the radioligand F-18-altanserin. Methods: Twelve patients from families with high loading of depression living in a geographically restricted region were examined and compared with normal control subjects. At the time of the PET measurement all patients were remitted; in some of them remission was sustained by antidepressive medication. Binding potential was assessed by Logan's graphical analysis method. Results: The binding of F-18-altanserin was about 38% lower in patients than in healthy controls (p 2 receptors are altered in depression. We present evidence for a reduction of the receptor density, which might be usable as trait marker of subjects susceptible for depressive illness. (orig.) [de

  2. Disturbance of serotonin 5HT2 receptors in remitted patients suffering from hereditary depressive disorder.

    Science.gov (United States)

    Larisch, R; Klimke, A; Mayoral, F; Hamacher, K; Herzog, H R; Vosberg, H; Tosch, M; Gaebel, W; Rivas, F; Coenen, H H; Müller-Gärtner, H W

    2001-08-01

    The characteristics of 5HT2 receptor binding were investigated in major depression in vivo using positron emission tomography and the radioligand F-18-altanserin. Twelve patients from families with high loading of depression living in a geographically restricted region were examined and compared with normal control subjects. At the time of the PET measurement all patients were remitted; in some of them remission was sustained by antidepressive medication. Binding potential was assessed by Logan's graphical analysis method. The binding of F-18-altanserin was about 38% lower in patients than in healthy controls (p depression rather than by medication. The data suggest that 5HT2 receptors are altered in depression. We present evidence for a reduction of the receptor density, which might be usable as trait marker of subjects susceptible for depressive illness.

  3. Why patients suffering from diabetes do not adhere to the prescribed diet?

    Directory of Open Access Journals (Sweden)

    Tomić Sanja

    2017-01-01

    Full Text Available Introduction: Diabetes mellitus is serious health problem with a prevalence of 9% in the population older than 18 years. The World Health Organization provided information that global mortality rate caused by diabetes in 2012 was 2.7%, while in Serbia this figure was 3.4%. Most patients with diabetes comply in adequately or not at all with the prescribeddiet. Previous studies found significant impact of the diet itself on prevention of complications of cardiovascular diseases and diabetes in general population. Objective: The aim of this study was to establish the theory, which will allow us to understand why patients with diabetes in Serbia do not comply with prescribeddiet, and what are the factors affecting this non-compliance. Materials and Methods: The study was of a qualitative type, using grounded theory method. Unstructured interviews with the study participants were carried out and audio-recorded with their consent. Results: After analyzing thirteen transcripts the following categories were formulated: 'the awareness of patients about their illness and other psychological factors', 'stress', 'business and obligations' 'economic aspect', 'social aspect', 'character traits of the patients', 'feeling hunger and the inability to fast', 'ignorance,' 'age of the patient', 'lack of motivation', 'impact of comorbidity,' 'unavailability of a products for diabetics' and 'cultural-religious influences and adopted habits.' Conclusion: Based on the collected data and the analysis, the theory was formed and a multitude of factors was shown to affect non-compliance with the prescribed diet. However, the most important factors were lack of awareness about seriousness of the disease by both patients and the society, and cultural heritage.

  4. Characterizing older adult patients suffering from epilepsy in two hospitals in Bogotá (Colombia

    Directory of Open Access Journals (Sweden)

    Gutiérrez-Álvarez AM

    2011-12-01

    Full Text Available Epilepsy’s overall prevalence in Colombia is 1.13%. Its prevalence in patients aged over 65 could be around 1.5%. Objective: describe demographic and clinical characteristics of patients older than 65 years of age with epilepsy. Materials and methods: A cross-sectional descriptive study was carried out in two high complexity hospitals in Bogotá, Colombia during 2005-2008. Demographic data were compiled and patients characterized regarding the type, frequency and diagnosis of seizures (based on ILAE classification, probable etiology, having a family background of epilepsy, and current pharmacological management. Results: 211 clinical histories were reviewed and 179 of them selected. Mean patient age was 75 (65-98 and average age at onset of epilepsy was 67.5 (7-93. 84% of the seizures were classified as being focal. The most frequently occurring diagnosis was symptomatic focal epilepsy (94.4%. 74 cases (41.3% had an etiological diagnosis. The most important cause was cerebrovascular disease (61 patients. First generation anti-epileptic drugs were the most used ones (99%. 81/104 patients were found not to be free from epileptic episodes. Conclusions: Most seizures have a partial beginning, resulting from symptomatic partial epilepsy as a consequence of a vascular lesion. Pharmacological treatment must be considered following the first seizure. Treatment with second generation anti-epileptic drugs such as Lamotrigine, Gabapentin, Levetiracetam and Topiramate must be begun for minimizing secondary effects and low doses must be maintained from the start of treatment. Costs may limit the use of the above antiepileptic drugs, in such cases Phenytoin and Carbamazepine may be used with extreme caution.

  5. Perception of climate change in patients with chronic lung disease

    Science.gov (United States)

    Götschke, Jeremias; Mertsch, Pontus; Bischof, Michael; Kneidinger, Nikolaus; Matthes, Sandhya; Renner, Ellen D.; Schultz, Konrad; Traidl-Hoffmann, Claudia; Duchna, Hans-Werner; Behr, Jürgen; Schmude, Jürgen; Huber, Rudolf M.

    2017-01-01

    Background Climate change affects human health. The respective consequences are predicted to increase in the future. Patients with chronic lung disease are particularly vulnerable to the involved environmental alterations. However, their subjective perception and reactions to these alterations remain unknown. Methods In this pilot study, we surveyed 172 adult patients who underwent pulmonary rehabilitation and 832 adult tourists without lung disease in the alpine region about their perception of being affected by climate change and their potential reaction to specific consequences. The patients’ survey also contained the COPD Assessment Test (CAT) to rate the severity of symptoms. Results Most of the patients stated asthma (73.8%), COPD (9.3%) or both (11.0%) as underlying disease while 5.8% suffered from other chronic lung diseases. Patients and tourists feel equally affected by current climate change in general, while allergic subjects in both groups feel significantly more affected (p = 0.04). The severity of symptoms assessed by CAT correlates with the degree of feeling affected (p<0.01). The main disturbing consequences for patients are decreased air quality, increasing numbers of ticks and mosquitos and a rising risk for allergy and extreme weather events such as thunderstroms, while tourists are less disturbed by these factors. Increasing number of heat-days is of little concern to both groups. Conclusion Overall patients are more sensitive to health-related consequences of climate change. Yet, the hazard of heat-days seems underestimated and awareness should be raised. PMID:29045479

  6. Serum Endoglin Levels in Patients Suffering from Systemic Sclerosis and Elevated Systolic Pulmonary Arterial Pressure

    Directory of Open Access Journals (Sweden)

    Paola Ximena Coral-Alvarado

    2010-01-01

    Full Text Available Background. Pulmonary arterial hypertension (PAH is the main cause of morbimortality in systemic sclerosis (SSc. Increased Eng expression has been demonstrated in SSc patients. Objective. Ascertaining serum levels of Eng in SSc patients with and without elevated systolic pulmonary arterial pressure (sPAP and comparing them with that of healthy volunteers. Methods. A cross-sectional study was carried out. A commercial ELISA kit was used for measuring serum concentrations of Eng in 60 subjects: 40 patients with SSc with and without elevated sPAP, compared to 20 healthy control subjects. Elevated sPAP was detected by echocardiogram. Results. No association between positive Eng and elevated sPAP was found when compared to the SSc without elevated sPAP group (OR=2.85; 0.65–12.88 95% CI; P=.11; however, an association was found between positive Eng and elevated sPAP compared to healthy controls (OR=23.22; 2.46–1050.33 95% CI; P=.001, and weak association was found between the positive Eng with SSc without elevated sPAP group compared to healthy controls (OR=8.14, 0.8–393.74 95% CI; P=.046. Conclusion. Raised serum levels of Eng in SSc patients compared to healthy controls were found, suggesting a role for Eng in SSc vasculopathy and not just in elevated sPAP. However, prospective studies are needed to verify such observations.

  7. Pattern of injuries suffered by the patients treated for alleged assault ...

    African Journals Online (AJOL)

    South African Family Practice ... In South Africa, violence plays a detrimental role in our daily lives, affecting almost everybody, directly or indirectly. ... From 29th October 1999 to 1st May 2000, the patients who attended for injuries due to alleged assault (interpersonal violence) and met the inclusion criteria were included in ...

  8. On some verbal short-term and working memory properties in patients suffering from clinical depression

    Directory of Open Access Journals (Sweden)

    Lalović Dejan

    2012-01-01

    Full Text Available Clinical depression with verbal short-term memory relation research does not yield unequivocal results. While short-term memory (STM deficits in depressed patients are consistently displayed in working memory (WM and executive attention tasks, for STM passive memorizing tasks this holds less correct. Objective. Primary goal was to collect initial data on depressed patients treated in Serbian institutions WM/ STM. In addition, we estimated the power of WAIS IV WM subtests to discriminate depressed patients from normal subjects. Method. Depressed patients' sample was contrasted with the parallel group in WAIS' IV Arithmetic, Digit Span, and Letter- Number Sequencing; free word recall task, semantic fluency task, without and with category switching. Results. All the WM measures, with the exception of Digit Span Backward score, discriminate depressed from no depressed subjects. On the other hand, STM tasks, with the exception of short-term word free recall, fail to do the same. We suggest explanation for both the exceptions in terms of WM efficiency. WAIS IV Arithmetic, Digit Span Sequencing and Letter-Number Sequencing can be used to discriminate depressed from control subjects. Performance in STM/WM tasks is in moderate to strong negative correlation with depression severity as assessed with the Hamilton scale. Conclusion. STM deficits in the depressed are likely to be observed in tasks requiring executive attention and WM efficiency rather than in standard STM span tasks. The deficits are inertly related to depression severity.

  9. Influenza vaccination is safe and effective in patients suffering from fibromyalgia syndrome

    Directory of Open Access Journals (Sweden)

    J. N. Ablin

    2015-09-01

    Full Text Available The fibromyalgia syndrome (FMS is considered to result from the exposure of a genetically susceptible individual to various triggers, such as physical trauma, stress, viral infections etc. A possible role of vaccination in FMS etiology has been suspected. Our objective was to evaluate the efficacy and safety of influenza vaccination in FMS patients. Nineteen FMS patients underwent physical and dolorimetric examinations and answered the fibromyalgia impact questionnaire (FIQ, the widespread pain index (WPI checklist and the symptoms severity scale (SSS, which are part of the 2010 diagnostic criteria. Thirty-eight healthy subjects were recruited as controls. All participants were vaccinated with the inactivated split virion influenza vaccine. Serum was collected for antibody titration. Six weeks after vaccination, sera were tested by hemagglutination (HI against A/California (H1N1, A/Perth (H3N2 and B/Brisbane. Humoral response was defined as either a fourfold or greater increase in titer, or an increase from a non-protective baseline level of <1/40 to a level of 1/40. No severe vaccination reactions were observed. No significant change was observed between WPI, SSS and FIQ values before and after vaccination, indicating no worsening of FMS symptoms. Vaccine immunogenicity: Six weeks after vaccination, FMS patients showed a significant increase in geometric mean titers of HI antibody. The rates of sero-protection increased from 22.9% for H1N1 to 89.5% post-vaccination. A significant increase in HI antibody titers was also demonstrated among healthy controls. Influenza vaccination was both safe and effective in FMS patients. In view of these results, FMS patients should be encouraged to undergo influenza vaccination according to the standard WHO recommendations.

  10. Effect of repetitive transcranial magnetic stimulation on reducing spasticity in patients suffering from HTLV-1-associated myelopathy.

    Science.gov (United States)

    Amiri, Mostafa; Nafissi, Shahriar; Jamal-Omidi, Shirin; Amiri, Motahareh; Fatehi, Farzad

    2014-12-01

    Human T-lymphotropic virus type 1 has been implicated in human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Regarding its endemicity in Iran and the role of repetitive transcranial magnetic stimulation in reducing spasticity, we decided to evaluate the efficacy of repetitive transcranial magnetic stimulation in reducing spasticity (as primary outcome) and pain, muscle power, and quality of life (as secondary outcomes) in patients suffering from HAM/TSP. In this pretest-posttest study, nine definite patients with HAM/TSP (according to WHO guidelines) were recruited. All patients underwent five consecutive daily sessions of active repetitive transcranial magnetic stimulation (each session consisting of 20 trains of 10 pulses at 5 Hz and an intensity of 90% of resting motor threshold for the biceps brachii muscle). Main outcome measures including spasticity (by modified Ashworth scale), pain (by visual analog scale), muscle power, and quality of life (by SF 36) were measured before the study and days 5, 7, 30 after the termination of the sessions. Seven (77.8%) females and 2 (22.2%) males were recruited with the mean age of 52 ± 12.67 years, and the mean duration of the disease was 5 ± 3.94. Comparison of the repeated measures showed a statistically significant decrease in pain and spasticity in lower limbs. The decrement in spasticity was persistent even 30 days after the intervention; however, the pain reduction was seen only 5 days after the procedure. No change in quality of life, and muscle power was detected. It seems that repetitive transcranial magnetic stimulation could decrease spasticity and pain in patients with HAM/TSP, and this effect could persistently continue by 1 month, but it did not influence patients' muscle power and quality of life, and it could be used as an adjuvant therapy in patients suffering from human T-lymphotropic virus type 1-associated HAM/TSP.

  11. The Effectiveness of Practicing Pranayama Yoga on Some Respiratory Indicators in Patients Suffering from Bronchial Disease

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    Khue Ai Thi HOANG

    2015-06-01

    Full Text Available Bronchial asthma is considered as a large burden of disease cross the world wasting billions of dollars each year. Using drug for treatment is not only expensive but also causes many adverse health affect. The study aim s to assess the effects of pranayama yoga practice on lung functions in patients with bronchial diseases. This is a controlled trial study. After three months of yoga practice, breath indicators such as FVC, FEV 1, FEV1/FVC, PEFR of intervention group sign ificantly improved with p value < .01 to .001 in comparison wi th the previous three months of the control group. Practicing pranayama yoga is beneficial to patients with bronchial asthma.

  12. Nursing students' alternative beliefs regarding care for patients suffering from depression.

    Science.gov (United States)

    Arrue, Marta; Zarandona, Jagoba; Hoyos Cillero, Itziar

    2018-03-01

    Depression is an illness that constitutes a major challenge for Public Health worldwide. Therefore, there is a clear need to receive training to care for this type of patient. This study sets out to identify alternative non-scientific beliefs among nursing students regarding the topic of depression after studying the module of Psychopathology. This study enrolled 102 third year undergraduate nursing students. The students resolved a case on an individual basis in written form which was analysed qualitatively. In this study, we have found that, despite having undergone information-transfer educational training in relation to the physiopathology of depression, nursing students persist in holding unscientific beliefs about this condition. On the basis that the opinions of nurses about depression can influence the care of their future patients, it is important to consider these alternative beliefs as learning difficulties in order to design an effective teaching instruction. Copyright © 2018. Published by Elsevier Ltd.

  13. Prospective study on 12 patients of salivary glands radiotherapy as treatment of salivary stasis in patients suffering from amyotrophic lateral sclerosis

    International Nuclear Information System (INIS)

    Assouline, A.; Delanian, S.; Lenglet, T.; Bruneteau, G.; Le Forestier, N.; Salachas, F.; Lebouteux, M.; Abdelnour, M.; Meininger, V.; Pradat, P.F.

    2011-01-01

    The authors report a study which aimed at assessing the efficiency and tolerance of salivary gland radiotherapy in patients suffering from amyotrophic lateral sclerosis. Twelve patients have been treated by conformational irradiation after a planning scanography with support mask. Results are discussed in terms of salivary discomfort (almost immediate disappearance in 11 cases), and other minor effects. Although a greater number of patients is still needed, the treatment gives promising results. Short communication

  14. [Individual psychological features in patients with computer game addiction suffering and predisposed persons].

    Science.gov (United States)

    Kardashian, R A

    2018-01-01

    To study personality characteristics in adolescents with computer game addiction. The study included students of grades 7 to 10 at the age of 12-17 years (14.6±2.4 years), their parents and school teachers. The results of a study showed the following combination in patients: 'genophilic' type of DPT with schizoid personality accentuation and 'projection' type of psychological protection, and 'dignitophilic' type of DPT with labile personality accentuation and 'denial' type of PP.

  15. Morphologic and neuropsychological patterns in patients suffering from Alzheimer's disease

    International Nuclear Information System (INIS)

    Chapuis, Pierre; Banciu, Eldda; Sauvee, Mathilde; Serra, Amelie; Moreaud, Olivier; Medici, Maud; Moreau-Gaudry, Alexandre; Krainik, Alexandre

    2016-01-01

    We conducted a retrospective study to identify morphological subgroups of patients referred for AD or aMCI and to seek for differences across neuropsychological performances. One hundred forty-five patients (mean age = 76.01, 88 women and 57 men) referred for AD, either at the stage of dementia or aMCI, were examined using structural MRI. Five observers reviewed blindly twice all examinations. We rated microangiopathy, hippocampal, parietal atrophies, including a gradient of fronto-parietal atrophy (GFPA). A multiple component analysis (MCA) followed by a hierarchical ascending classification was conducted to identify morphologically distinct subgroups. Among these, 76 patients completed all the neuropsychological tests. Univariate and multivariate analyses were further conducted on these data across morphological subgroups. The institutional review board approved the research protocol. Inter- and intra-raters' agreements were excellent and very good for microangiopathy and hippocampal atrophy ratings. They were higher for GFPA than for the parietal atrophy scale. MCA without priors identified three groups: group 1 was characterized by no/discrete microangiopathy, severe hippocampal, and predominant parietal atrophy; group 2 had significant microangiopathy, severe hippocampal atrophy, and no predominant parietal atrophy; group 3 had a mild hippocampal atrophy and parietal atrophies. In group 1, working memory profile was less impaired than in group 2 (p = 0.01). Neuropsychological performances of group 3 were higher in most domains. Combined characterization of microangiopathy, hippocampal, parietal, and GFPA allows identifying morphological subgroups among patients referred for AD and at risk. These groups have some neuropsychological differences, suggesting different pathophysiological mechanisms or co-existing conditions. (orig.)

  16. Image formation of brain function in patients suffering from knee osteoarthritis treated with moxibustion.

    Science.gov (United States)

    Xie, Hongwu; Xu, Fangming; Chen, Rixin; Luo, Tianyou; Chen, Mingren; Fang, Weidong; Lü, Fajin; Wu, Fei; Song, Yune; Xiong, Jun

    2013-04-01

    Functional magnetic resonance imaging (fMRI) technology was used to study changes to the resting state blood flow in the brains of patients with knee osteoarthritis (KOA) before and after treatment with moxibustion at the acupoint of the left Dubi (ST 35) and to probe the cerebral mechanism underlying the effect of moxibustion. The resting state brain function of 30 patients with left KOA was scanned with fMRI before and after treatment with moxibustion. The analytic methods of fractional amplitude of low frequency fluctuation (fALFF) and regional homogeneity (ReHo) were used to observe changes in resting state brain function. The fALFF values of the right cerebrum, extra-nucleus, left cerebellum, left cerebrum and white matter of patients after moxibustion treatment were higher than before treatment, and the fALFF values of the precentral gyrus, frontal lobe and occipital lobe were lower than before treatment (P or = 85). The ReHo values of the thalamus, extra-nucleus and parietal lobe of patients were much higher than those before moxibustion treatment, and the ReHo values of the right cerebrum, left cerebrum and frontal lobe were lower than before treatment (P or = 85). The influence of moxibustion on obvious changes in brain regions basically conforms to the way that pain and warmth is transmitted in the body, and the activation of sensitive systems in the body may be objective evidence of channel transmission. The regulation of brain function by moxibustion is not in a single brain region but rather in a network of many brain regions.

  17. Morphologic and neuropsychological patterns in patients suffering from Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Chapuis, Pierre; Banciu, Eldda [University Hospital of Grenoble, Department of Neuroradiology and MRI, Grenoble (France); Sauvee, Mathilde; Serra, Amelie; Moreaud, Olivier [University Hospital of Grenoble, Department of Neurology, Grenoble (France); Medici, Maud [CIT803, University Hospital of Grenoble, Grenoble (France); Moreau-Gaudry, Alexandre [CIT803, University Hospital of Grenoble, Grenoble (France); Joseph Fourier University, Grenoble (France); Krainik, Alexandre [University Hospital of Grenoble, Department of Neuroradiology and MRI, Grenoble (France); INSERM U 836, Grenoble Institute of Neurosciences, Grenoble (France)

    2016-05-15

    We conducted a retrospective study to identify morphological subgroups of patients referred for AD or aMCI and to seek for differences across neuropsychological performances. One hundred forty-five patients (mean age = 76.01, 88 women and 57 men) referred for AD, either at the stage of dementia or aMCI, were examined using structural MRI. Five observers reviewed blindly twice all examinations. We rated microangiopathy, hippocampal, parietal atrophies, including a gradient of fronto-parietal atrophy (GFPA). A multiple component analysis (MCA) followed by a hierarchical ascending classification was conducted to identify morphologically distinct subgroups. Among these, 76 patients completed all the neuropsychological tests. Univariate and multivariate analyses were further conducted on these data across morphological subgroups. The institutional review board approved the research protocol. Inter- and intra-raters' agreements were excellent and very good for microangiopathy and hippocampal atrophy ratings. They were higher for GFPA than for the parietal atrophy scale. MCA without priors identified three groups: group 1 was characterized by no/discrete microangiopathy, severe hippocampal, and predominant parietal atrophy; group 2 had significant microangiopathy, severe hippocampal atrophy, and no predominant parietal atrophy; group 3 had a mild hippocampal atrophy and parietal atrophies. In group 1, working memory profile was less impaired than in group 2 (p = 0.01). Neuropsychological performances of group 3 were higher in most domains. Combined characterization of microangiopathy, hippocampal, parietal, and GFPA allows identifying morphological subgroups among patients referred for AD and at risk. These groups have some neuropsychological differences, suggesting different pathophysiological mechanisms or co-existing conditions. (orig.)

  18. Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment

    DEFF Research Database (Denmark)

    Abrahamsen, B; Rubin, K H; Eiken, Pia Agnete

    2013-01-01

    .03-1.06, for each drug). Dementia (HR 1.81, 95 % CI 1.18-2.78), prior fracture (one: HR 1.17, 95 % CI 1.02-1.34; multiple: HR 1.34, 95 % CI 1.08-1.67), and ulcer disease (HR 1.45, 95 % CI 1.04-2.03) also increased the risk. Diabetes did not influence fracture risk, nor did rheumatic disorders. The risk was lower...... and associations may not be causal, it may be prudent to include dementia, ulcer disease, and Parkinson's disease to capture the risk of fractures on treatment. Lower risk in patients treated with glucocorticoids and in men probably reflects a lower treatment threshold related to guidelines.......Antiresorptive treatment reduces the risk of fractures, but most patients remain at elevated risk. We used health registers to identify predictors of new major osteoporotic fractures in patients adhering to alendronate. Risk factors showed a different pattern than in the general population...

  19. Cryptococcosis mimicking cutaneous cellulitis in a patient suffering from rheumatoid arthritis: a case report

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    Probst Corina

    2010-08-01

    Full Text Available Abstract Background Cryptococcus neoformans is an encapsulated yeast and the most frequent cryptococcal species found in humans. Cryptococcosis is considered an opportunistic infection as it affects mainly immunosuppressed individuals. In humans, C. neoformans causes three types of infections: pulmonary cryptococcosis, cryptococcal meningitis and wound or cutaneous cryptococcosis. Case Presentation An 81-year-old woman developed severe necrotizing cellulitis on her left arm without any preceding injury. The patient had been treated with systemic corticosteroids over twenty years for rheumatoid arthritis (RA. Skin biopsies of the wound area were initially interpreted as cutaneous vasculitis of unknown etiology. However, periodic acid Schiff staining and smear analysis later revealed structures consistent with Cryptococcus neoformans, and the infection was subsequently confirmed by culture. After the initiation of therapy with fluconazole 400 mg per day the general condition and the skin ulcers improved rapidly and the patient was discharged to a rehabilitation facility. Subsequently surgical debridement and skin grafting were performed. Conclusions Opportunistic infections such as cryptococcosis can clinically and histologically mimic cutaneous vasculitis and have to be investigated rigorously as a differential diagnosis in immunosuppressed patients.

  20. Prevalence of Coinfection with Gastric Non-Helicobacter pylori Helicobacter (NHPH) Species in Helicobacter pylori-infected Patients Suffering from Gastric Disease in Beijing, China.

    Science.gov (United States)

    Liu, Jie; He, Lihua; Haesebrouck, Freddy; Gong, Yanan; Flahou, Bram; Cao, Qizhi; Zhang, Jianzhong

    2015-08-01

    The Helicobacter heilmannii sensu lato (H. heilmannii s.l.) group consists of long, spiral-shaped bacteria naturally colonizing the stomach of animals. Moreover, bacteria belonging to this group have been observed in 0.2-6% of human gastric biopsy specimens, and associations have been made with the development of chronic gastritis, peptic ulceration, and gastric MALT lymphoma in humans. To gain insight into the prevalence of H. heilmannii s.l. infections in patients suffering from gastric disease in China, H. heilmannii s.l. species-specific PCRs were performed on DNA extracts from rapid urease test (RUT)-positive gastric biopsies from 1517 patients followed by nucleotide sequencing. At the same time, Helicobacter pylori cultivation and specific PCR was performed to assess H. pylori infection in these patients. In total, H. heilmannii s.l. infection was detected in 11.87% (178/1499) of H. pylori-positive patients. The prevalence of H. suis, H. felis, H. bizzozeronii, H. heilmannii sensu stricto (s.s.), and H. salomonis in the patients was 6.94%, 2.20%, 0.13%, 0.07%, and 2.54%, respectively. Results revealed that all patients with H. heilmannii s.l. infection were co-infected with H. pylori, and some patients were co-infected with more than two different Helicobacter species. Helicobacter heilmannii s.l. infections are fairly common in Chinese patients. This should be kept in mind when diagnosing the cause of gastric pathologies in patients. Helicobacter suis was shown to be by far the most prevalent H. heilmannii s.l.species. © 2014 John Wiley & Sons Ltd.

  1. Multidimensional features of pain in patients with chronic neck pain

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    Fabianna Resende de Jesus-Moraleida

    Full Text Available Abstract Introduction: Chronic neck pain is associated with significant health costs and loss of productivity at work. Objective: to assess pain and disability in individuals with chronic neck pain. Methods: 31 volunteers with chronic neck pain, mean age 29, 65 years, were assessed using the McGill Pain Questionnaire in Brazilian version (Br-MPQ and Neck Disability Index (NDI. The Br-MPQ analysis was performed based on the numerical values associated with the words selected to describe the experience of pain (Pain Rating Index - PRI, and present pain intensity (PPI. NDI was used to evaluate the influence of neck pain in performance of everyday tasks. Finally, we investigated the association between PPI and NDI. Results: PRI revealed that the most significant dimension was the sensory pain (70%, and the number of chosen words was 10 (2,62 out of 20 words. Mean PPI value was 1,23 (0,76 in five points; 40% of participants described pain intensity as moderate. NDI score was 9,77 (3,34, indicating mild disability. There was a positive association between disability and pain intensity (r = 0,36; p =0,046. Pain intensity and duration of pain were not associated. Conclusions: Findings of this study identified important information related to neck pain experienced by patients when suffering from chronic neck pain, moreover, the association between disability and pain intensity reinforces the importance of complementary investigation of these aspects to optimize function in them.

  2. The quality of life of the patients suffering from thyroid cancer

    International Nuclear Information System (INIS)

    Igumnov, S.A.; Grigorieva, I.V.

    2007-01-01

    Complete text of publication follows. A comparative analysis is given of the results of the assessment of the quality of patients who were operated on oncological pathology of thyroid gland and obtained life-time substitute of therapy by L-thyroxin, and the sample group, which consisted of people, who didn't have any pathology of thyroid. We examined 56 patients, who were operated on oncological pathology of thyroid (operation was performed from 1 to 10 years ago). The patients took the course of radioiodine therapy and obtained life-time substitutional therapy with L-thyroxin. To assess the quality of life during the after operation period we used the Russian language version of the questionnaire SF (36 (Medical Outcomes Study Short Form) (Ware J.E., 1993). The quality of life in case of cancer of thyroid gland, as compared to the sample group, appeared to be significantly decreased in all the scales of the questionnaire SF-36. With reliability of P<0,05, as compared to the sample group, the following indices decreased: physical functioning (69,1±2,8 and 92,1±2,4); the role of physical problems in the restriction of vital activity (22,3±4,0 and 70,2±6,8); social functioning (42,0±1,6 and 52,8±2,3); the role of emotional problems in the restriction of vital activity (19,6±5,4 and 73,1±8,9). These data indicate to the prolonged effect of the psychotraumatic experience and the changes of subjective perception of one's social status. On this background we noticed a reliable increase of indices of perception of physical pain (65,4±2,2 and 37,6±3,6; P<0,05) and indices of the general perception of health (65,4±2,2 and 37,6±3,6; P<0,05) in the patients operated, which characterizes subjective raise of attention towards such patients. The data obtained show the significant influence of psychological aspects of the perception of the case of cancer of thyroid gland on the level of subjective assessment of vital activity and, as a result, social adaptation.

  3. Prevalence of periodontopathogenic bacteria in patients suffering from periodontitis using culture and PCR methods

    Directory of Open Access Journals (Sweden)

    Amir Aliramezani

    2012-01-01

    Full Text Available Background and Aims: Periodontitis is one of the most common oral diseases with the various incidence rates in different populations. A number of bacteria are considered as the major etiologic agents of periodontitis. The aim of the present study was to determine the prevalence of periodontopathogen bacteria in patients using both PCR and culture techniques.Materials and Methods: In this study, one-hundred patients (including 62 females and 38 males with an average age of 49±11.5 years with adult periodontitis referred to periodontics department of School of Dentistry/Tehran University of Medical Sciences were investigated. The samples were taken and sent immediately to the laboratory for culture and molecular evaluation. The PCR was performed using specific primers and the statistical analysis of data was performed using SPSS statistic software and McNemar test.Results: The results demonstrated that the total detection rate in culture method was 64%. The rate of Aggregatibacter actinomycetemcomitans (Aa was 28% which was significantly higher than that of Porphyromonas gingivalis (Pg (6% and Prevotella intermedia (Pi (3%. 27% of cases showed mixed bacterial growth. 65% of patients were positive using molecular method. The rate of Aa (30% was significantly higher than that of Pg (7% and Pi (5%. The mixed PCR positive rate containing of Aa, Pg and Pi was (23%.Conclusion: In this study, it was found that most of the bacteria isolated using culture and molecular methods were Aa, Pg and Pi, respectively. Although the detection frequencies of both techniques were similar, the specificity, sensitivity and bacterial detection speed of the PCR technique is obviously higher. Therefore, the use of molecular techniques is strongly recommended. However, both techniques seem to be suitable for microbiological diagnostics.

  4. Differential effects of childhood trauma and cannabis use disorders in patients suffering from schizophrenia.

    Science.gov (United States)

    Baudin, G; Godin, O; Lajnef, M; Aouizerate, B; Berna, F; Brunel, L; Capdevielle, D; Chereau, I; Dorey, J M; Dubertret, C; Dubreucq, J; Faget, C; Fond, G; Gabayet, F; Laouamri, H; Lancon, C; Le Strat, Y; Tronche, A M; Misdrahi, D; Rey, R; Passerieux, C; Schandrin, A; Urbach, M; Vidalhet, P; Llorca, P M; Schürhoff, F

    2016-08-01

    Childhood trauma (CT) and cannabis use are both environmental and modifier risk factors for schizophrenia. However, little is known about how they interact in schizophrenia. We examined the main effect of each of these two environmental factors on the clinical expression of the disease using a large set of variables, and we tested whether and how cannabis and CT interact to influence the course and the presentation of the illness. A sample of 366 patients who met the DSM-IV-TR criteria for schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced Centre of Expertise - Schizophrenia) network. Patients completed a large standardized clinical evaluation including Structured Clinical Interview for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), and Medication Adherence Rating Scale (MARS). We assessed CT with the Childhood Trauma Questionnaire and cannabis status with SCID-I. CT significantly predicted the number of hospitalizations, GAF, and S-QoL-18 scores, as well as the PANSS total, positive, excitement, and emotional distress scores. Cannabis use disorders significantly predicted age of onset, and MARS. There was no significant interaction between CT and cannabis use disorders. However, we found evidence of a correlation between these two risk factors. CT and cannabis both have differential deleterious effects on clinical and functional outcomes in patients with schizophrenia. Our results highlight the need to systematically assess the presence of these risk factors and adopt suitable therapeutic interventions. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. ENCAINIDE REDUCES HEART RATE VARIABILITY FRACTAL DIMENSION AMONG ARRHYTHMIC PATIENTS WHO SUFFERED ACUTE MYOCARDIAL INFARCT

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    Luis García Domínguez

    2005-01-01

    Full Text Available ABSTRACTThe Autoregressive Dimensional Index (ARDI was measured in a subset of R-R recordings corresponding to 257 patients from the Cardiac Arrhythmia Suppression Trial (CAST-study, both before, and during treatment with the anti-arrhythmic drug Encainide (E. Encainide induced an average ARDI increase of 47% (PA similar analysis with 127 patients treated with Flecainide (F did not reveal statistical differences related to treatment. Since ARDI is negatively correlated to the Fractal Dimension (FD of HRV data (Hernandez et al, Electron J Biomed 2004;1:4-15 we conclude that E exerts a reduction in FD among these patients. Since changes suggesting FD reduction are predictive of health worsening and sudden death, our results may provide an explanation for the reported increase in mortality induced by E among CAST patients. The lack of effect from F may be in agreement with recent reports suggesting that this drug does not increase the risk of sudden death.RESUMENEl Índice Dimensional Autorregresivo (Autoregressive Dimensional Index ARDI fue evaluado sobre un subconjunto de registros de intervalos R-R correspondientes a 257 pacientes incluidos en el estudio "CAST", un conocido ensayo de supresión de arritmia en pacientes que sufrieron infarto agudo del miocardio. Los registros fueron obtenidos tanto antes como durante el tratamiento con el medicamento antiarrítmico Encainida (E. La Encainida inducía un incremento en el valor de ARDI de aproximadamente un 47% (P<0.001, prueba de la "t" pareada.Un análisis similar realizado con 127 pacientes tratados con Flecainida (F no mostró ningún cambio significativa asociada al tratamiento. Por cuanto ARDI se correlaciona negativamente con la Dimensión Fractal (FD de los datos de variabilidad de la frecuencia cardiaca (Hernández et al, Electrón J Biomed 2004;1:4-15, concluimos que E ejerce una acción reductora de la FD en ese grupo de pacientes. Por cuanto la reducción de la FD predice acerca del

  6. Eradication of Helicobacter pylori in patients without gastric symptoms suffering from recurrent aphthous stomatitis: A pilot study

    Directory of Open Access Journals (Sweden)

    Latković Marina

    2017-01-01

    Full Text Available Background/Aim. Helicobacter (H. pylori is a widespread bacterium and its involvement in pathogenesis of gastric diseases is well-known. However, H. pylori role in etiology of other histologically similar conditions, especially recurrent aphthous stomatitis (RAS is still controversial. Research regarding H. pylori and its association with RAS, as well as the treatment options were always conducted on patients with diagnosed gastric problems. The aim of this study was to determine whether H. pylori is present in the oral cavity of patients suffering from RAS but without any symptoms or medical history of gastric disease. Methods. A total of 15 patients with RAS participated in the study. None of the participants suffered from any gastrointestinal disorders. Two dental plaque samples from each participant were collected. The first was analyzed using rapid urease test and the second one was put in transport medium and sent for cultivation. The sensitivity of H. pylori to antibiotics was established using disk diffusion method of sensitivity testing for every patient individually and adequate therapy was prescribed. Results. Before the treatment the mean annual recurrence rate of RAS was 8.1 ± 2.1, with the average number of lesions being 3.9 ± 1.9. During the 12-month observation period after the eradication therapy, none of the patients reported recurrence of aphthous lesions. The treatment was successful in all cases. Conclusion. This study shows that RAS can be effectively treated by successful eradication of oral H. pylori, and that RAS could be possibly considered as an early warning sign of potential gastric infection by H. pilory.

  7. Struggling With Adversities of Life: The Role of Forgiveness in Patients Suffering from Fibromyalgia.

    Science.gov (United States)

    Offenbaecher, Martin; Dezutter, Jessie; Kohls, Niko; Sigl, Claudia; Vallejo, Miguel A; Rivera, Javier; Bauerdorf, Felix; Schelling, Jörg; Vincent, Ann; Hirsch, Jameson K; Sirois, Fuschia M; Webb, Jon R; Toussaint, Loren L

    2017-06-01

    We compared the magnitude and direction of associations between forgiveness and pain, mental and physical health, quality of life, and anger in a sample of fibromyalgia syndrome (FM) participants and healthy controls. In addition, we compared FM and controls on mean levels of these variables. A total of 173 individuals with FM and 81 controls completed this study. FM participants and controls were residents of Germany recruited with the support of the German Fibromyalgia Patient Association and several self-help groups. FM participants and controls were about 53 years of age, mostly married (70%), Christians (81%), with levels of education ranging from 9 to 13+ years. All participants completed assessments of forgiveness, pain, health, quality of life, and anger. Analyses revealed that FM participants reported higher pain and anger and poorer health and quality of life. FM participants also reported lower levels of both forgiveness of self and others. Size and direction of associations of forgiveness with pain, health, quality of life, and anger in were not significantly different between healthy individuals and individuals with FM. Forgiveness of self and others is beneficially associated with pain, health, quality of life, and anger in FM participants at levels that are of similar size and direction as in healthy controls. However, FM participants manifest lower levels of forgiveness of self and others. Therapeutic promotion of forgiveness as a psychosocial coping strategy may help patients with FM to better manage psychological and physical symptoms, thereby enhancing well-being.

  8. Leukocytapheresis Therapy Improved Cholestasis in a Patient Suffering from Primary Sclerosing Cholangitis with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Minoru Itou

    2009-04-01

    Full Text Available Primary sclerosing cholangitis (PSC is an autoimmune disease of the hepatobiliary system for which effective therapy has not been established. Leukocytapheresis (LCAP therapy is known to effective in patients with ulcerative colitis (UC. In addition, effects of LCAP therapy were reported on some autoimmune diseases such as Crohn’s disease, rheumatoid arthritis and rapidly progressive glomerulonephritis. Here we report the case of a 29-year-old man with PSC associated with UC who was treated with LCAP therapy. He had a 16-year history of UC and a 12-year history of PSC. Although he was under treatment with prednisolone and ursodeoxycholic acid, exacerbation of UC and PSC-associated cholestasis were seen. Since he showed side effects of prednisolone, he was treated with LCAP. Not only improvement of UC, but also decreased serum alkaline phosphatase, γ-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP. Our experience with this case suggests that LCAP therapy could be a new effective therapeutic strategy for patients with PSC associated with UC.

  9. Whole-body muscle MRI in 20 patients suffering from late onset Pompe disease: Involvement patterns.

    Science.gov (United States)

    Carlier, Robert-Yves; Laforet, Pascal; Wary, Claire; Mompoint, Dominique; Laloui, Kenza; Pellegrini, Nadine; Annane, Djillali; Carlier, Pierre G; Orlikowski, David

    2011-11-01

    To describe muscle involvement on whole-body MRI scans in adult patients at different stages of late-onset Pompe disease. Twenty patients aged 37 to 75 were examined. Five were bedridden and required ventilatory support. Axial and coronal T1 turbo-spin-echo sequences were performed on 1.5T or 3T systems. MRI was scored for 47 muscles using Mercuri's classification. Whole-body scans were obtained with a mean in-room time of 29 min. Muscle changes consisted of internal bright signals of fatty replacement without severe retraction of the muscles' corpus. Findings were consistent with previous descriptions of spine extensors and pelvic girdle, but also provided new information on recurrent muscle changes particularly in the tongue and subscapularis muscle. Moreover thigh involvement was more heterogeneous than previously described, in terms of distribution across muscles as well as with respect to the overall clinical presentation. Whole-body MRI provides a very evocative description of muscle involvement in Pompe disease in adults. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Benefit of brain prophylactic irradiation in patients suffering from a small-cell bronchial cancer: retrospective study on 289 cases

    International Nuclear Information System (INIS)

    Assouline, A.; Tai, P.; Jancewicz, M.; Joseph, K.; Krzisch, C.; Yu, E.

    2011-01-01

    The authors report a study which aimed at determining the benefit of a brain prophylactic irradiation for patients suffering from a localized small-cell bronchial cancer and in partial response to the local-regional treatment of their disease. A retrospective analysis has been performed on a set of 289 patients who had been treated by chemo-radiotherapy with or without brain prophylactic irradiation between 1981 and 2007. Data are discussed in terms of remission level, survival with respect to the level of response to the local-regional treatment. Depending on this response level the irradiation increases or not the probability of global survival, or the probability of specific survival. Short communication

  11. Pain and suffering as viewed by the Hindu religion.

    Science.gov (United States)

    Whitman, Sarah M

    2007-08-01

    Religion and spiritual practices are among the resources used by patients to cope with chronic pain. The major concepts of Hinduism that are related to pain and suffering are presented. Ways that Hindu traditions deal with pain and suffering are reviewed, including the concept of acceptance, which has been studied in the pain medicine literature. By becoming more familiar with Hindu views of pain and suffering, pain medicine practitioners can offer potentially helpful concepts to all patients and support Hindus' spirituality as it relates to pain and suffering. Religion or spirituality is often important to patients. This article will inform the pain medicine practitioner how pain and suffering are viewed in Hinduism, the third largest religion in the world. It is hoped that these concepts will prove helpful when treating not only followers of Hinduism but all patients.

  12. Dose-dependent efficacy of the Vitex agnus castus extract Ze 440 in patients suffering from premenstrual syndrome.

    Science.gov (United States)

    Schellenberg, Ruediger; Zimmermann, Christian; Drewe, Jürgen; Hoexter, Godehard; Zahner, Catherine

    2012-11-15

    Preparations of Vitex agnus castus L. (VAC) have been shown to be effective to treat irregular menstrual cycles, cyclical mastalgia and symptoms of the premenstrual syndrome (PMS). However, the dose-effect relationship for the treatment of PMS has not yet been established. This study aimed to investigate the clinical effects of three different doses of the VAC extract Ze 440 in comparison to placebo in patients suffering from PMS. In a multicenter, double-blind, placebo-controlled, parallel-group study, 162 female patients with PMS (18-45 years) were randomized to either placebo or different doses of Ze 440 (8, 20 and 30 mg) over three menstrual cycles. PMS symptoms' severity was assessed by patients using visual analog scales (VAS) for the symptoms irritability, mood alteration, anger, headache, bloating and breast fullness. Each of the treatments was well tolerated. Improvement in the total symptom score (TSS) in the 20mg group was significantly higher than in the placebo and 8 mg treatment group. The higher dose of 30 mg, on the other hand, did not significantly decrease symptom severity compared to the 20mg treatment, providing a rational for the usage of 20mg. Corresponding results were observed with the single PMS symptom scores. This study demonstrated that the VAC extract Ze 440 was effective in relieving symptoms of PMS, when applied in a dose of 20mg. Therefore, for patients suffering from PMS, 20mg Ze 440 should be the preferred daily dose. Copyright © 2012 Elsevier GmbH. All rights reserved.

  13. The Effect of a Program Using Some Therapeutic Methods to Rehabilitate Patients Suffering from Neck Pain

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    Ayad O MAR

    2015-09-01

    Full Text Available Neck pain is one of the common physical problems of the adults which needs to be taken seriously in order to prevent further health problems. As the daily life of the modern people leads physical in activity, and the use of electronic devices causes imprope r effect on certain parts of the body, specials programs have to be developed as preventive treatment. Therapeutic methods can also be listed through such preventive methods. The purpose of this study was to i dentify the impact of the proposed program usin g some natural methods of treatment for the rehabilitation of people with neck pain , to i dentify the improved range of motion in all directions to the neck area , and also t o identify the extent of improvement in muscle strength for the neck and back. Twelv e patients in Ain Zara Physiotherapy Center and Tripoli Clinic (in Tripoli city were chosen as voluntarily whose age ranged from 30 to 50 years, and the subjects were divided into two groups , as experimental and control groups. This study proved that pro posed therapeutic methods help the treatment of neck pain.

  14. [One year prognosis after suffering the onset of cerebrovascular disease in patients from a public hospital in Lima, Peru].

    Science.gov (United States)

    Alvarado-Dulanto, C Martín A; Lazo, María de los Ángeles; Loza-Herrera, Javier D; Málaga, Germán

    2015-01-01

    In Latin America, there is almost nonexistense information about the prognosis of patients with stroke. We tried to find one- year vital and functional prognosis from patients with "first-ever stroke". We did a prospective cohort study, recruiting patients in the medicine service of a public hospital, and follow them up to one year after their first-ever stroke. We collected baseline data, such as previous medical history and information about their stroke. We found mortality proportions, differences among subgroups, and compared their actual and initial functionality. We included 101 patients, 20.8% of whom died during the follow-up, with higher mortality in people over 65 years old and those severely disabled after the stroke. The functionality did not improve after one year. One out of five patients with a first-ever stroke dies a year after it, with higher mortality in elders and in people with severe disability. We conclude it is mandatory to develop a follow-up and support program to prevent unfavorable outcomes in patients who suffer stroke.

  15. Smear grading and the Mantoux skin test can be used to predict sputum smear conversion in patients suffering from tuberculosis

    Directory of Open Access Journals (Sweden)

    Saffari, Mahmood

    2017-08-01

    Full Text Available Purpose: Smear scores and induration sizes resulting from the PPD (tuberculin purified protein derivative test can serve as indicators of whether a patient suffering from tuberculosis shows smear conversion or not. Methods: Using microbiological methods smear and sputum tests, patients diagnosed as infected with between 2002 and 2015 were included in this study. All of the assumed factors that may have a role in smear conversion were studied, in addition to the prolongation of tuberculosis. Results: 398 of 512 patients fulfilled all the inclusion criteria and formed the basis of this study. 215 patients (54% were females and 183 (46% were males. The median age for both men and women was 36 years. We found a statistically significant difference between the size of induration resulting from the PPD skin test and the rate of non-conversion (=0.002. Further univariate analysis also showed that smear grading and an induration size of ≥10 mm were independently associated with delayed smear conversion. Patients with cavitary lesions showed a higher rate of non-conversion after two months, which was not significant. We could not find any association between some of the variables, such as age, sex, weight, smoking, alcoholism, addictions, respiratory diseases, diabetes mellitus, alternative anti-TB treatment, and smear conversion. Conclusion: Intensified treatment and precautions against transmission should be especially considered for TB patients with high smear grading and an induration size of more than 10 mm.

  16. Why is it necessary to examine retina when the patient suffers from aplastic anemia?

    Science.gov (United States)

    Tomcikova, D; Gerinec, A; Busanyova, B; Gresikova, M; Biskup, S; Hortnagel, K

    2018-01-01

    To inform about a case of Revesz syndrome (RS) with initial ophthalmological symptomatology of severe proliferative vitreoretinopathy of the left eye (LE). After the aplastic anemia had developed, RS was established. The exudative retinopathy was successfully treated with photocoagulation on the right eye (RE). RS is characterized by fatal bone marrow failure, exudative retinopathy, neuroradiographic abnormalities, neurodevelopmental delay and skin abnormalities. Non-treated exudative retinopathy leads to blindness. We report ophthalmological findings as follows: fundus photography and fluorescein angiography (FA) acquired by examinations under general anesthesia in patient with RS. Results of genetic tests helped to establish the diagnosis. Two‑year old Caucasian male was examined due to total retinal detachment on LE and signs of chorioretinal scarring on RE. In preoperative screening, thrombocytopenia was detected; later, severe pancytopenia developed. Considering the hematological findings and clinical appearance, we suspected RS, which was confirmed by genetic tests. We found a pathogenic mutation in gene TINF2 (variant c.865C>T;p.Pro289Ser) in a mosaic state with autosomal dominant mode of inheritance. This mutation has not been described in RS yet. Blind LE was enucleated because of dolorous neovascular glaucoma. FA of RE shows excessive areas of capillary nonperfusion with vascular abnormalities and exudation. After the photocoagulation, the visual acuity (VA) on RE remains 0.9 at the age of 7 years. RS is an extremely rare condition.  The initial symptomatology could be ophthalmological or hematological. The positive finding of TINF2 gene mutation helped in establishing the correct diagnosis. The ischemic retinopathy was successfully treated by photocoagulation (Fig. 6, Ref. 6). Text in PDF www.elis.sk.

  17. A comprehensive approach in hospice shared care in Taiwan: Nonelderly patients have more physical, psychosocial and spiritual suffering

    Directory of Open Access Journals (Sweden)

    Chiu-Hsien Yang

    2013-08-01

    Full Text Available While symptomatic differences exist between younger and older advanced cancer patients, few studies have examined the differences in their care with respect to age. Our goals were to examine the influences of age differences on physical, psychosocial and spiritual distress among advanced cancer patients. Advanced cancer patients who resided in Kaohsiung Medical University Hospital during 2007–2008 were recruited. Data were collected through professional consultants. The influences of age variations on physical, psychosocial and spiritual distress in nonelderly (<60 years old and elderly (≧60 years old patients were analyzed. A total of 1013 advanced cancer patients were included in the analyses with 467 nonelderly patients and 546 elderly patients. Nonelderly patients were identified to have a higher baseline pain level (4.0 vs. 2.8, p<0.001, breakthrough pain (19.3% vs. 9.9%, p<0.01, insomnia (6.4% vs. 2.7%, p=0.006, emotional distress (69.0% vs. 60.6%, p=0.013, and unwillingness to pass away because of concern for loved ones (18.8% vs. 11.9%, p=0.003 with significant difference. Elderly ones were concerned about unfulfilled wishes (29.7% vs. 18.4%, p<0.001 in spiritual concerns. After adjustments in regression models, nonelderly age (<60 years old still revealed significant positive or negative impact on all categories of distress. Patients aged under 60 years have more physical, psychosocial and spiritual suffering. This study suggested that professional practitioners should provide intensive care for vulnerable terminally ill cancer patients.

  18. Implicit associations between pain and self-schema in patients with chronic pain.

    Science.gov (United States)

    Van Ryckeghem, Dimitri M L; De Houwer, Jan; Van Bockstaele, Bram; Van Damme, Stefaan; De Schryver, Maarten; Crombez, Geert

    2013-12-01

    Chronic pain often interferes with daily functioning, and may become a threat to an individual's sense of self. Despite the development of a recent theoretical account focussing upon the relationship between the presence of chronic pain and a person's self, research investigating this idea is limited. In the present study we aimed to (1) compare the strength of association between self- and pain schema in patients with chronic pain and healthy control subjects and (2) research whether the strength of association between self- and pain-schema is related to particular pain-related outcomes and individual differences of patients with chronic pain. Seventy-three patients with chronic pain (M(age) = 49.95; SD = 9.76) and 53 healthy volunteers (M(age) = 48.53; SD = 10.37) performed an Implicit Association Test (IAT) to assess the strength of association between pain- and self-schema. Patients with chronic pain also filled out self-report measures of pain severity, pain suffering, disability, depression, anxiety, acceptance, and helplessness. Results indicated that the pain- and self-schema were more strongly associated in patients with chronic pain than in healthy control subjects. Second, results indicated that, in patients with chronic pain, a stronger association between self- and pain-schema, as measured with the IAT, is related to a heightened level of pain severity, pain suffering, anxiety, and helplessness. Current findings give first support for the use of an IAT to investigate the strength of association between self- and pain-schema in patients with chronic pain and suggest that pain therapies may incorporate techniques that intervene on the level of self-pain enmeshment. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  19. Configurations of time, the body, and verbal communication: Temporality in patients who express their suffering through the body.

    Science.gov (United States)

    Fischbein, José Eduardo

    2017-04-01

    This paper focuses on the study of temporality used as a clinical pointer to processes of affect regulation in patients who express their suffering through a discourse driven by bodily allusions. Differences between symptoms revealed by body language that conveys an experience of conflict (psychoneurotic symptoms) and somatizations are reviewed. Somatization is examined as a benchmark for the failure to resolve states of tension. The body in the session is conceptualized as a speech event. The body is considered as a psychical construction organized in the exchanges with a fellow human-being. It is thus established as a support for subjectivity. Two discourse registers are described: the discourse of the evoked body and the discourse of the perceived body. The study of Greek mythology allows us to distinguish two different types of temporality: Chronos and Kairos. Chronos represents chronological whereas Kairos subjective time. Both are present in the subject; but if greater mental disorganization supervenes, Chronos predominates as it paves the way for a defence against suffering, designed to avoid the unbearable meaning of ceasing to be. Adherence to one or other mode of temporality signals different conceptions of analytic work. The topics addressed are illustrated by various clinical vignettes. Copyright © 2016 Institute of Psychoanalysis.

  20. Studies on certain exons in the P53 gene in Egyptian patients suffering from laryngeal cancer concerning some biochemical aspects

    International Nuclear Information System (INIS)

    Hagag, S.A.

    2010-01-01

    Human head and neck cancer disease is the most common respiratory cancer that population suffering from its symptoms all over the world. This type of malignancy is connected with drinking alcohol and smoking tobacco beside other factors concerning the type of nutrition, age, gender as well as environmental factors such as ionizing radiation and toxic chemicals. These factors can lead to genetic changes in one or more tissue cells which begin to proliferate due to the inflammatory stimulus. The immune inflammatory state serves as a key mediator of the middle stages of tumor development. Cancer begins with a series of genetic changes that prompt group of cells which begin to over replicate and then invade surrounding tissues (metastases) and lately the malignancy spread to the blood and lymph nodes. Genetic changes which cause cancer can be considered as the match that lights the fire and the inflammation is the fuel that feed it. The antiinflammatory cancer therapy will prevent the premalignant cells from turning fully to cancerous or it will impede an existing tumor from spreading to other sites in the body. Chronic inflammation can play an important role in the progression of some types of tumors. So there is a close link between tumor and inflammation

  1. [DIET CHARACTERISTICS IN PATIENTS WITH CHRONIC KIDNEY DISEASE].

    Science.gov (United States)

    Bašić-Marković, N; Šutić, I; Popović, B; Marković, R; Vučak, J

    2016-12-01

    Because of the increasing number of patients, chronic kidney disease (CKD) has become a significant public health problem. As kidney function decreases, it is necessary to introduce certain dietary modifications. The aim was to investigate what is the appropriate approach to diet of CKD patients, which could contribute to slowing down progression of the disease. Dietary recommendations are individual for each patient, but also vary in the same patient depending on the stage of disease progression because special attention must be paid to appropriate intake of macronutrients (protein, carbohydrates and fats), micronutrients (sodium, potassium, calcium, phosphorus, zinc, selenium, various vitamins), and water. In newly diagnosed patients, it is necessary to assess their nutritional status and energy requirements. It has been shown that protein-energy malnutrition, muscle loss and cachexia are strong predictors of mortality in CKD. Comparing different dietary approaches in everyday life of patients suffering from CKD, it was found that the most effective diet is Mediterranean food style. Studies confirm that Mediterranean diet has a preventive effect on renal function and reduces progression of the disease. Preventive measures, correct identification and early intervention can increase survival of patients and improve their quality of life. Mediterranean diet tailored to individual stages of CKD has been confirmed as the best choice in CKD patients.

  2. Ethical considerations on the value of patient knowledge in long-term care: a qualitative study of patients suffering from Korsakoff 's syndrome.

    Science.gov (United States)

    van den Hooff, Susanne L; Goossensen, Anne

    2015-05-01

    This study explores experiences of patients suffering from Korsakoff's syndrome. It contributes to improved reflection on the value of patient knowledge. An ethics of care perspective states the importance of moving to patients in their vulnerable state of being, and to figure out patients' individual needs necessary to provide good care. The information given by patients suffering from Korsakoff's syndrome might be mistaken, invented and even not true. The value of these patients' experiences and knowledge had not been researched to date. Data from six in-depth interviews were analysed concurrently through the constant comparative method. The principles of voluntariness, confidentiality and anonymity were respected during the research process. Four important themes within patients' knowledge emerged: health condition, involuntary admission into the nursing home, the daily routine and interpretation of the caring abilities of healthcare professionals. The findings show that our respondents were able to provide a window into their inner perspective. This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients' unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the - unintended - effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of

  3. Validation and the limits of SPECT for patients suffering from cerebrovascular accidents. Evaluations based on simultaneous PET and SPECT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Mizukawa, Norihiko; Yano, Ichiro; Tenjin, Hiroshi (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1989-02-01

    Contemporaneous single photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed in 10 patients with cerebrovascular accidents (CVA), whose ages ranged from 11 to 67 years. I-123-isopropyl-iodoamphetamine (IMP) and/or Tc-99m hexamethylpropyleneamine oxime (HM-PAO) were used for SPECT. Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen (CMRO{sub 2}) were measured by an O-15 labelled gas continuous-inhalation method. SPECT images were quite similar to CBF and CMRO{sub 2} during the chronic stage of CVA. Two patietns with vasospasm during the subacute stage had apparently low CBF and CMRO{sub 2} on PET, but did not have low perfusion on SPECT. Luxury perfusion areas were detected in 4 subacute stage patients and one chronic stage patient. A redistribution of IMP was detected in two patients with infarction during subacute stage. CMRO{sub 2} value in such an area was 2.0 ml/100 g/min. Low CBF and/or CMRO{sub 2} areas were well visualized by IMP rather than by HM-PAO SPECT. (N.K.).

  4. Distinct subcutaneous emphysema following surgical wisdom tooth extraction in a patient suffering from 'Gilles de la Tourette syndrome'.

    Science.gov (United States)

    Tomasetti, Patrick; Kuttenberger, Johannes; Bassetti, Renzo

    2015-06-14

    Subcutaneous emphysema is a rare complication in oral surgery. In most cases, it resolves spontaneously. However, air might disperse into deeper facial spaces causing life-threatening complications such as compression of the tracheobronchial tree or the development of pneumomediastinum. Moreover, microorganisms might spread from the oral cavity into deeper spaces. Hence, rapid diagnosis of subcutaneous emphysema is important. Characteristic signs are both a shiftable swelling and crepitation. In this case report, a 30-year-old man, suffering from the Gilles de la Tourette Syndrome, with a distinct subcutaneous emphysema after bilateral surgical wisdom tooth extraction is presented. Induced by a specific motor tic, air accumulated from the periorbital through to the parapharyngeal region. Applying a 10-cm-long Redon drainage tube as air valve, 10 days after wisdom teeth extraction, the patient was asymptomatic with complete resolution of the emphysema. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author 2015.

  5. FEATURES OF DYNAMIC CHANGE OF INNER DISEASE-RELATION TYPE IN COHORT OF PATIENTS SUFFERING FROM ADDICTIONS

    Directory of Open Access Journals (Sweden)

    A. Z. Grigoryan

    2014-12-01

    Full Text Available Aim. Pathoplastic modification of addictive disorders with affective spectrum violations, leads to the formation of the psychopathological cluster that have specific structural and dynamic features.Methods and results. In order to assess the dynamics of change of disease-relation type by LOBY questionnaire, 100 patients from «Zaporozhye Regional Narcological Dispensary» suffering from polydrug usage and affective spectrum disorders were examined in the following clinical periods: withdrawal state, further inpatient and outpatient follow-up.Conclusion. The solidity of background psychopathological disorders in perspective of their affiliation to somatogenically-organic register, for the entire study contingent was found. Dynamics of change of disease-relation type illustrates partially reversible character of these disorders.

  6. Comparison of the effect of Olanzapine and Sertraline on patients suffering from personality disorder, receiving methadone maintenance therapy

    Directory of Open Access Journals (Sweden)

    mozhgan Jariani

    2009-03-01

    Full Text Available Background: Borderline Personality disorder is a disabling disease affecting 2% of general population. Various drugs have been suggested for treatment of borderline Personality disorder. If a drug could alleviate a wide range of symptoms, it would be more suitable. In these disorders drug addiction is very common. This fact makes the symptoms complicated and the treatment more difficult. This study is designed to evaluate the effect of Olanzapine and Sertraline in patients suffering from personality disorders who are on methadone maintenance therapy. Materials and Methods: This clinical trial study was carried out on 120 male and female cases chosen for methadone maintenance therapy through interview by a psychiatrist based on DSM-IV-TR diagnostic criteria for BPD. Afterwards they were randomly divided into two groups. These groups separately received Olanzapine (5-10 mg daily and Sertraline (50-100 mg daily therapy. The SCL-90 questionnaire was filled out by the participants before treatment and at the 4th, 8th and 12th weeks of the treatment. Results: According to this clinical trial, Olanzapine and Sertraline were effective in ameliorating symptoms of depression, anxiety and aggression, reducing sensitivity in interpersonal relationship and alleviating obsessive symptoms, pessimistic behaviors and somatization disorders in patients with personality disorders on methadone maintenance therapy. Conclusion: As results of this study stated that Olanzapine and Sertraline are definitely effective in alleviating symptoms of patients with personality disorder, prescribing theses drugs are highly recommended for these patients. .

  7. The efficacy of group metacognitive therapy on self-esteem and mental health of patients suffering from major depressive disorder.

    Science.gov (United States)

    Farahmand, Vahid; Hassanzadeh, Ramezan; Mirzaian, Bahram; Fayyazi Bordbar, Mohammad Reza; Feizi, Jaleh

    2014-01-01

    The present research aims to analyze the efficacy of group metacognitive therapy (MCT) on self-esteem and mental Health of those who suffer from major depressive disorder. The research was a randomized clinical controlled trial, using pretest and posttest with 2 months of follow-up. Twenty-two patients with major depressive disorder based on DSM-IV-TR criteria were selected through available sampling from patients of two psychiatric hospitals of Mashhad, Iran, in 2011. They were allocated randomly into two groups of trial (n = 11) and control (n = 11). Citalopram and sertraline were prescribed as antidepressant to both groups. The experimental group also attended nine 90-minute sessions of MCT (a 5-week program). Eysenck self-esteem scale (ESES) and Mental Health Checklist (MHC) were used in pretest, posttest, and follow-up as the study instrument. The data were analyzed by analysis of covariance (ANCOVA) using SPSS. ANCOVA revealed that the patients receiving group MCT had significantly increased (p self-esteem in posttest, which remained significant in the follow up (p self-steam and recuperation of mental health in MDD patients.

  8. Determinants of anxiety in patients with advanced somatic disease: differences and similarities between patients undergoing renal replacement therapies and patients suffering from cancer.

    Science.gov (United States)

    Janiszewska, Justyna; Lichodziejewska-Niemierko, Monika; Gołębiewska, Justyna; Majkowicz, Mikołaj; Rutkowski, Bolesław

    2013-10-01

    Anxiety is the most frequent emotional reaction to the chronic somatic disease. However, little is known about anxiety and coping strategies in patients with end-stage renal disease (ESRD) undergoing renal replacement therapies (RRTs). The purpose of the study was to assess the intensity and determinants of anxiety in patients treated with different RRTs in comparison with end-stage breast cancer patients and healthy controls. The study involved (1) ESRD patients undergoing different RRTs: 32 renal transplant recipients, 31 maintenance haemodialysis and 21 chronic peritoneal dialysis patients, (2) women with end-stage breast cancer (n = 25) and (3) healthy persons (n = 55). We used State-Trait Anxiety Inventory, Scale of Personal Religiousness, Mental Adjustment to Cancer Scale, Rotterdam Symptom Checklist with reference to medical history. The data thus obtained were analysed using the analysis of variance, the Tukey's HSD post hoc test and Spearman's rank correlation coefficient. Both ESRD and breast cancer patients revealed higher level of anxiety state and trait than healthy controls; however, there was no statistically significant difference found between both findings. There was a tendency towards higher levels of anxiety state in breast cancer patients when compared to ESRD patients undergoing the RRT treatment and for both groups non-constructive coping strategies correlated with the levels of anxiety state. With ESRD patients undergoing RRTs, the intensity of anxiety state did not depend on the mode of treatment but on the correlation between the levels of anxiety and the general quality of their life, psychological condition and social activity. In patients with advanced somatic disease (ESRD and end-stage breast cancer), non-constructive strategies of coping with the disease require further evaluation and possibly psychological support.

  9. Do patient characteristics predict outcome in the outpatient treatment of chronic tinnitus?

    OpenAIRE

    Kr?ner-Herwig, Birgit; Zachriat, Claudia; Weigand, Doreen

    2006-01-01

    Various patient characteristics were assessed before offering a treatment to reduce tinnitus related distress to 57 individuals suffering from chronic idiopathic tinnitus. Patients were randomly assigned to a cognitive-behavioral tinnitus coping training (TCT) and a habituation-based training (HT) modelled after Tinnitus Retraining Therapy (TRT) as conceived by Jastreboff. Both trainings were conducted in groups. It was hypothesized that comorbidity regarding mental disorders or psychopatholo...

  10. [Wireless device for monitoring the patients with chronic disease].

    Science.gov (United States)

    Ciorap, R; Zaharia, D; Corciovă, C; Ungureanu, Monica; Lupu, R; Stan, A

    2008-01-01

    Remote monitoring of chronic diseases can improve health outcomes and potentially lower health care costs. The high number of the patients, suffering of chronically diseases, who wish to stay at home rather then in a hospital increasing the need of homecare monitoring and have lead to a high demand of wearable medical devices. Also, extended patient monitoring during normal activity has become a very important target. In this paper are presented the design of the wireless monitoring devices based on ultra low power circuits, high storage memory flash, bluetooth communication and the firmware for the management of the monitoring device. The monitoring device is built using an ultra low power microcontroller (MSP430 from Texas Instruments) that offers the advantage of high integration of some circuits. The custom made electronic boards used for biosignal acquisition are also included modules for storage device (SD/MMC card) with FAT32 file system and Bluetooth device for short-range communication used for data transmission between monitoring device and PC or PDA. The work was focused on design and implementation of an ultra low power wearable device able to acquire patient vital parameters, causing minimal discomfort and allowing high mobility. The proposed wireless device could be used as a warning system for monitoring during normal activity.

  11. Comparative analysis of salivary sialic acid levels in patients with chronic obstructive pulmonary disease and chronic periodontitis patients: A biochemical study

    Directory of Open Access Journals (Sweden)

    Surekha Rathod

    2018-01-01

    Full Text Available Aim: Sialic acid plays a central role in the functioning of biological systems, in stabilizing the glycoproteins and cellular membranes, assisting in cell–cell recognition and interaction. The aim of this study is to evaluate and compare the periodontal health status and salivary Sialic acid levels in patients suffering from chronic obstructive pulmonary diseases (COPD and chronic periodontitis patients. Materials and Methods: Ninety subjects were included in the study, which were divided into the following groups, 30 in each group. Group 1: patients suffering from COPD and chronic periodontitis, Group 2: periodontitis patients without any systemic diseases Group 3: healthy subjects. Unstimulated whole saliva samples were collected around 9–10 AM; 2 h after the subjects had breakfast. The sialic acid content was determined by a combined modification of the thiobarbituric acid method of Skoza and Mohos. Results: The mean salivary sialic acid levels were least in the healthy group followed by the periodontitis group, and it was highest in the COPD group. Conclusions: We can thus conclude that promotion of dental care knowledge is very much essential in the prevention and treatment of COPD. Thus, estimation of levels of salivary sialic acid can be used as an adjunct to diagnose the current periodontal disease status and to assess the treatment outcomes in subjects with COPD and chronic periodontitis.

  12. A molecular study on the prevalence and virulence potential of Aeromonas spp. recovered from patients suffering from diarrhea in Israel.

    Directory of Open Access Journals (Sweden)

    Yigal Senderovich

    Full Text Available BACKGROUND: Species of the genus Aeromonas are native inhabitants of aquatic environments and have recently been considered emerging human pathogens. Although the gastrointestinal tract is by far the most common anatomic site from which aeromonads are recovered, their role as etiologic agents of bacterial diarrhea is still disputed. Aeromonas-associated diarrhea is a phenomenon occurring worldwide; however, the exact prevalence of Aeromonas infections on a global scale is unknown. METHODOLOGY/PRINCIPAL FINDINGS: The prevalence and virulence potential of Aeromonas in patients suffering from diarrhea in Israel was studied using molecular methods. 1,033 diarrheal stools were sampled between April and September 2010 and Aeromonas species were identified in 17 (∼2% patients by sequencing the rpoD gene. Aeromonas species identity and abundance was: A. caviae (65%, A. veronii (29% and Aeromonas taiwanensis (6%. This is the first clinical record of A. taiwanensis as a diarrheal causative since its recent discovery from a wound infection in a patient in Taiwan. Most of the patients (77% from which Aeromonas species were isolated were negative for any other pathogens. The patients ranged from 1 to 92 years in age. Aeromonas isolates were found to possess different virulence-associated genes: ahpB (88%, pla/lip/lipH3/apl-1 (71%, act/hlyA/aerA (35%, alt (18%, ast (6%, fla (65%, lafA (41%, TTSS ascV (12%, TTSS ascF-ascG (12%, TTSS-dependent ADP-ribosylating toxins aexU (41% and aexT (6% in various combinations. Most of the identified strains were resistant to beta-lactam antibiotics but susceptible to third-generation cephalosporin antibiotics. CONCLUSIONS: Aeromonas may be a causative agent of diarrhea in patients in Israel and therefore should be included in routine bacteriological screenings.

  13. Chronic kidney disease in HIV patients

    Science.gov (United States)

    Bakri, S.; Rasyid, H.; Kasim, H.; Katu, S.

    2018-03-01

    Chronic kidney disease (CKD) is a health problem in human immunodeficiency virus (HIV) population. Prediction of CKD in HIV patients needsto have done. This study aimis to identify the prevalence of CKD in HIV patients.Thisis a cross-sectional studyofmale and female, age 18-60 years old, diagnosedHIVat Wahidin Sudirohusodo & Hasanuddin University Hospital Makassar. Diagnosed as CKD if estimated glomerular filtration rate (eGFR) HIV patients included in the analyses. Distribution of CKD, showed 3 (3.5%) subjects with eGFRHIV populations in Makassar is still quite low.

  14. Cognitive and functional impairment in patients suffering from stroke: the importance of cognitive assessment for Occupational Therapy intervention

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    Andressa de Oliveira Ferro

    2013-12-01

    Full Text Available Abstract: Introduction: Stroke (CVA can generate motor, sensory and cognitive development deficits, affecting the individual’s performance in daily activities. Changes in any cognitive area can affect the individual’s occupational engagement. Objective: To evaluate the cognitive and functional capacity in patients suffering from stroke, showing the importance of cognitive assessment for occupational therapy intervention. Method: A comparative study with cross-sectional sampling of 44 subjects aged 30-80 years, both sexes. The subjects were divided in three groups: Adult: 11 individuals affected by stroke, 30-59 years old; Elderly: 10 individuals affected by stroke, 60-80 years old; Control: 23 normal subjects, 30-80 years old. Tests applied: MMSE, Clock Test, Test of tracks A and B, and functional capacity (BOMFAQ. Results: Cognitive changes were identified in the Adult and Elderly groups. The Adult group showed poorer performance on the Clock test (visuospatial and executive functions compared with the Control group. The Adult and Elderly groups presented worse performance in the Track A test (attention compared with the Control group. In the Track B test (visual attention, graphomotor skills, and mental flexibility, applied with absolute numbers, no significant differences were observed between the Adult and Elderly groups and the Control group, but cognitive impairment was perceived when the test was applied with categories. The Adult group showed higher prevalence of moderate/severe impairment in the carrying out of daily activities. Conclusion: As a rule, individuals suffering from stroke, in addition to having impaired functional capacity, present cognitive impairments that can negatively impact the performance of daily tasks, whether they are occupational, leisure or self-care activities. Accordingly, we observed the need to evaluate cognitive rehabilitation for better targeting and quality of life improvement.

  15. BoNT-A related changes of cortical activity in patients suffering from severe hand paralysis with arm spasticity following ischemic stroke.

    Science.gov (United States)

    Veverka, Tomáš; Hluštík, Petr; Tomášová, Zuzana; Hok, Pavel; Otruba, Pavel; Král, Michal; Tüdös, Zbyněk; Zapletalová, Jana; Herzig, Roman; Krobot, Alois; Kaňovský, Petr

    2012-08-15

    Investigations were performed to localize and analyze the botulinum toxin (BoNT-A) related changes of cerebral cortex activation in chronic stroke patients suffering from severe hand paralysis with arm spasticity. Effects on task- related cerebral activation were evaluated by functional magnetic resonance imaging (fMRI). 14 patients (5 males, 9 females, mean age 55.3 years) suffering from upper limb post-stroke spasticity were investigated. The change of arm spasticity was assessed by using the modified Ashworth scale (MAS). FMRI sessions were performed before (W0), four weeks (W4) and 11 weeks (W11) after BoNT-A application. Patients were scanned while performing imaginary movement with the impaired hand. Group fMRI analysis included patient age as a covariate. BoNT-A treatment was effective in alleviation of arm spasticity. Mean MAS was at Week 0: 2.5 (SD 0.53), at Week 4: 1.45 (SD 0.38), at Week 11: 2.32 (SD 0.44). Task-related fMRI prior to the treatment showed extensive activation of bilateral frontoparietal sensorimotor cortical areas, anterior cingulate gyrus, pallidum, thalamus and cerebellum. Effective BoNT-A treatment (W4) resulted in partial reduction of active network volume in most of the observed areas, whereas BoNT-free data (W11) revealed further volume reduction in the sensorimotor network. On direct comparison, significant activation decreases associated with BoNT-A treatment were located in areas outside the classical sensorimotor system, namely, ipsilesional lateral occipital cortex, supramarginal gyrus and precuneus cortex. On comparison of W4 and W11, no activation increases were found, instead, activation further decreased in ipsilesional insular cortex, contralesional superior frontal gyrus and bilateral frontal pole. Whole brain activation patterns during BoNT-A treatment of post-stroke arm spasticity and further follow up document predominantly gradual changes both within and outside the classical sensorimotor system. Copyright © 2012

  16. Validation of bio markers for diagnosis of Hepatocellular Carcinoma (H and c) in Egyptian patients suffering from hepatitis - C virus

    International Nuclear Information System (INIS)

    Moawed, F.S.M.

    2013-01-01

    The differential diagnosis between chronic liver diseases (CLD) and hepatocellular carcinoma (HCC) is a challenge. The aim of this study is to identify new bio markers related to HCV metabolic changes, which are altered during tumorigenesis, and combine them with tumor specific markers in order to improve HCC surveillance among patients with chronic hepatitis C (CHC). Methods: This study included 137 patients with CHC, 107 of them with proven diagnosis of HCC with no metastasis. The tumor markers studied included AFP and AGP. Fibrosis markers, liver function tests, oxidative stress, antioxidant enzymes, Cu, and zinc serum levels were determined as transition markers. Results: We were able to differentiate 100% between CLD and HCC by applying a new marker “[(log_1_0 AFP x zinc + log_1_0 AGP) / SOD] x100 ” “AZAS”, with a cut-off value of 9.2. The results were applicable for both genders with or without bilharzia. Conclusion: We were able to discriminate between HCC and CLD by combining their markers simultaneously. We suggest that in cancer validation studies, it is imperative to search for markers that link to the preneoplastic process, and to determine what type of mechanism is active in each stage albumin (C), and bilirubin (D)

  17. Chronic Pain and PTSD: A Guide for Patients

    Science.gov (United States)

    ... Chronic Pain and PTSD: A Guide for Patients PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... here Enter ZIP code here Chronic Pain and PTSD: A Guide for Patients Public This section is ...

  18. Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

    Science.gov (United States)

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

    Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

  19. [Condition of neurohumoral regulation of bronchial tone and gallbladder in patients with chronic cholecystitis and chronic obstructive pulmonary disease].

    Science.gov (United States)

    Dudka, T V; Khukhlina, O S; Dudka, I V

    2014-01-01

    SUMMARY The paper presents data from a study of the neuroendocrine regulation of nonstriated muscles, bronchial tree and the gallbladder tones by means of an assessment of the adrenergic and cholinergic systems state in patients, suffering from chronic obstructive pulmonary disease and chronic acalculous cholecystitis. Adrenergic and cholinergic activities as well as cortisol secretion have significantly changed. To study the features of adrenergic and cholinergic regulations of bronchial tone and that of the gallbladder in patients with combined course of chronic acalculous cholecystitis and chronic obstructive pulmonary disease. 92 patients were involved in the study: 30 patients with COPD (1st group), 30 patients with COPD of comorbid CAC in the acute phase (2nd group), 32 patients with CAC in the acute phase (3rd group) and a control group--30 practically healthy individuals (PHI) of the respective age. All the patients with COPD and COPD combined with CAC had a marked predominance of the parasympathetic nervous system, as evidenced by the established significant decrease of CDE (Table) in patients with isolated COPD is 1.4 times (p instance, the CDA in the individuals of groups 1 and 2 was lower by 1.6 and 2.4 times respectively (p instance, the first group patients' blood contained 2.7 times (p base of regulatory neuroendocrine and paracrine mecganisms imbalance, contributing to a development of COPD, is the cholinergic imbalance (reduction in blood acetylcholinesterase activity, hypertensive sphincter of Oddi dysfunction), adrenergic imbalance, reduction in catecholamine-depositing erythrocytes function, hypokinetic gallbladder dysfunction, adrenal dysfunction (decreased cortisol levels) that contribute to the development and progression of chronic cholecystitis against a background of hypokinetic gallbladder dysfunction.

  20. Clinical validation of the CHRONIOUS wearable system in patients with chronic disease.

    Science.gov (United States)

    Bellos, Christos; Papadopoulos, Athanassios; Rosso, Roberto; Fotiadis, Dimitrios I

    2013-01-01

    The CHRONIOUS system defines a powerful and easy to use framework which has been designed to provide services to clinicians and their patients suffering from chronic diseases. The system is composed of a wearable shirt that integrate several body sensors, a portable smart device and a central sub-system that is responsible for the long term storage of the collected patient's data. A multi-parametric expert system is developed for the analysis of the collected data using intelligent algorithms and complex techniques. Apart for the vital signals, dietary habits, drug intake, activity data, environmental and biochemical parameters are recorded. The CHRONIOUS platform is validated through clinical trials in several medical centers and patient's home environments recruiting patients suffering from Chronic Obstructive pulmonary disease (COPD) and Chronic Kidney Disease (CKD) diseases. The clinical trials contribute in improving the system's accuracy, while Pulmonologists and Nephrologists experts utilized the CHRONIOUS platform to evaluate its efficiency and performance. The results of the utilization of the system were very encouraging. The CHRONIOUS system has been proven to be a well-validated real-time patient monitoring and supervision platform, providing a useful tool for the clinician and the patient that would contribute to the more effective management of chronic diseases.

  1. Hyperplastic Processes of the Thyroid Gland in Type 2 Diabetic Patients Who Suffered from the Chornobyl Disaster

    Directory of Open Access Journals (Sweden)

    I.M. Muraviova

    2016-02-01

    Full Text Available To study the clinical correlations between diabetes mellitus (DM type 2 and hyperplastic processes of the thyroid gland (TG, we conducted a survey of the participants of Chernobyl accident consequences elimination — 125 men aged 61.95 ± 0.66 years and 24 women aged 62.13 ± 1.34 years (group I, evacuees — 6 men aged 56.00 ± 6.45 years and 18 women aged 58.56 ± 2.07 years (group II, residents of contaminated territories — 32 men aged 59.69 ± 2.13 years and 67 women aged 58.39 ± 1.23 years (group III. The control group consisted of Kyiv residents — 18 men aged 59.00 ± 2.45 years and 34 women aged 57.88 ± 2.61 years diagnosed with DM type 2 and pathology of the TG. Results. The incidence of hyperplastic processes of the TG in patients with DM type 2, who suffered from the disaster, was higher among women (79.2 % than among men — 45.6 % (χ2 = 9.078; p = 0.003, similarly to the group control — 55.9 and 16.7 %, respectively (χ2 = 7.415; p = 0.007, it was significantly higher among male victims of the accident than in the control group (χ2 = 5.41; p = 0.02. We had established a strong direct correlation between the level of thyroid stimulating hormone (TSH and body mass index (BMI (r = 0.799; p = 0.031, glycated hemoglobin (r = 0.999; p = 0.027 among men in the control group. During multivariate analysis, we have found the probable model of the duration of DM type 2 and development of hyperplastic processes in the TG (F = 6.6947; p = 0.00022 and its absence for other indicators, namely: BMI (F = 1.7351; p = 0.15969, TSH (F = 0.29968; p = 0.82559, the C-peptide (F = 0.09665; p = 0.96160 and glycated hemoglobin (F = 0.17955; p = 0.90996. Conclusions. In patients with DM type 2, who suffered from the Chornobyl disaster, the incidence of hyperplastic processes in the TG statistically significantly exceeds the rate in unirradiated individuals and depends on the gender, duration of the underlying disease and its decompensation.

  2. Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group.

    Directory of Open Access Journals (Sweden)

    Lucie Gailledrat

    Full Text Available Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61], 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3, the use of laxatives (OR = 49.8, a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7, a higher minimum body mass index (OR = 1.73, and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74. These results are consistent with previous studies, and highlight the importance of denial.

  3. Self-reported quality of life measure is reliable and valid in adult patients suffering from schizophrenia with executive impairment.

    Science.gov (United States)

    Baumstarck, Karine; Boyer, Laurent; Boucekine, Mohamed; Aghababian, Valérie; Parola, Nathalie; Lançon, Christophe; Auquier, Pascal

    2013-06-01

    Impaired executive functions are among the most widely observed in patients suffering from schizophrenia. The use of self-reported outcomes for evaluating treatment and managing care of these patients has been questioned. The aim of this study was to provide new evidence about the suitability of self-reported outcome for use in this specific population by exploring the internal structure, reliability and external validity of a specific quality of life (QoL) instrument, the Schizophrenia Quality of Life questionnaire (SQoL18). cross-sectional study. age over 18 years, diagnosis of schizophrenia according to the DSM-IV criteria. sociodemographic (age, gender, and education level) and clinical data (duration of illness, Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia); QoL (SQoL18); and executive performance (Stroop test, lexical and verbal fluency, and trail-making test). Non-impaired and impaired populations were defined for each of the three tests. For the six groups, psychometric properties were compared to those reported from the reference population assessed in the validation study. One hundred and thirteen consecutive patients were enrolled. The factor analysis performed in the impaired groups showed that the questionnaire structure adequately matched the initial structure of the SQoL18. The unidimensionality of the dimensions was preserved, and the internal/external validity indices were close to those of the non-impaired groups and the reference population. Our study suggests that executive dysfunction did not compromise the reliability or validity of self-reported disease-specific QoL questionnaire. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. [Rehabilitation of women suffering chronic cystitis in the postmenopausal period with the use of an AMUS-01 - Intramag apparatus equipped with a Rektomassazher device].

    Science.gov (United States)

    Azizov, A P; Azizova, P A; Beliaev, A A; Konova, A N; Raĭgorodskiĭ, Iu M

    2011-01-01

    The objective of the present study was to develop a rationale for the local treatment of chronic recurring cystitis in the postmenopausel period. To this effect, 76 patients at the mean age of 66.4 years with this pathology were examined and the data obtained were compared with observations of control postmenopausel women receiving traditional local substitution hormonal therapy. In the patients of the study group, this treatment was supplemented by intravaginal vibro-magnetotherapy and the conventional antibacterial therapy was replaced by local electrophoresis. All local physiotherapeutic procedures were performed with the use of a AMUS-01 - Intramag apparatus equipped with a Rektomassazher device an AMUS-01 - Intramag apparatus equipped with a Rektomassazher device. The immunological analysis of vaginal secretion coupled to bacterial and clinical investigations have demonstrated the advantages of the combined local treatment including physiotherapy. The integral efficacy index was by a factor of 1.8 higher than in the control group.

  5. [The use of motivational interviewing (MI) in patients with chronic renal failure].

    Science.gov (United States)

    Zawadzka, Barbara; Kleja, Justyna

    2014-01-01

    Patients suffering from chronic kidney disease must submit to numerous medical procedures and burdensome changes in lifestyle that make it difficult to adapt to the disease. Therefore, an important issue is to stimulate the patients motivation to comply with medical recommendations. This article describes a therapy tool for developing patient's motivation to change, called therapy or motivational interview (MI), the type of approach that is increasingly being used inhealth care, as an aid to chronically ill patients. Characteristics of this approach generally relies on the assumption that the Motivation for a change should come from a patient, not the provider, and a patient should articulate arnd resolve ambivalence provider persuassion is not effective and enhance resistance from a change. Persuasion by a person healing can only strengthen and enhance the patient's resistance to unwanted habits.

  6. Social and Psychological Aspects of Dental Trauma, Behavior Management of Young Patients Who have Suffered Dental Trauma.

    Science.gov (United States)

    Arhakis, Aristidis; Athanasiadou, Eirini; Vlachou, Christina

    2017-01-01

    Injuries concerning the skull, the mouth and thus potentially involving the mouth and teeth are characterized as major public health problems due to their high prevalence and very serious functional and aesthetic consequences. Pain, aesthetic and functional problems arising from dental trauma significantly disrupt normal function, and impact, often dramatically, on young patients' quality of life. With regards to the behavior management approach to a child who has suffered a dental trauma, dentist's first step is to be to reassure child and parents. They should feel that the emergency is being properly treated on the part of the dentist and feel safe. The dentist should offer psychological support to child and parents and focus on alleviating any possible pain the child may feel. But, before that, a good level of communication with the child should be established. This can be achieved through the tell-show-do technique, a presentation of the special session's structure, the positive reinforcement method, the attention distraction method and exploiting the child's imagination. The detailed description of the treatment to be followed is crucial for reducing the child's level of stress, as well as that of the parents. Immediately after the completion of treatment, dentist should give listening time to the parents for any queries and include the child who probably wants to share their experience.

  7. Predicting falls in elderly patients with chronic pain and other chronic conditions.

    Science.gov (United States)

    Lazkani, Aida; Delespierre, Tiba; Bauduceau, Bernard; Benattar-Zibi, Linda; Bertin, Philippe; Berrut, Gilles; Corruble, Emmanuelle; Danchin, Nicolas; Derumeaux, Geneviève; Doucet, Jean; Falissard, Bruno; Forette, Francoise; Hanon, Olivier; Pasquier, Florence; Pinget, Michel; Ourabah, Rissane; Piedvache, Celine; Becquemont, Laurent

    2015-10-01

    The aim was to identify fall predictors in elderly suffering from chronic pain (CP) and to test their applicability among patients with other chronic conditions. 1,379 non-institutionalized patients aged 65 years and older who were suffering from CP (S.AGE CP sub-cohort) were monitored every 6 months for 1 year. Socio-demographic, clinical and pain data and medication use were assessed at baseline for the association with falls in the following year. Falls were assessed retrospectively at each study visit. Logistic regression analyses were performed to identify fall predictors. The derived model was applied to two additional S.AGE sub-cohorts: atrial fibrillation (AF) (n = 1,072) and type-2 diabetes mellitus (T2DM) (n = 983). Four factors predicted falls in the CP sub-cohort: fall history (OR: 4.03, 95 % CI 2.79-5.82), dependency in daily activities (OR: 1.81, 95 % CI 1.27-2.59), age ≥75 (OR: 1.53, 95 % CI 1.04-2.25) and living alone (OR: 1.73, 95 % CI 1.24-2.41) (Area Under the Curve: AUC = 0.71, 95 % CI 0.67-0.75). These factors were relevant in AF (AUC = 0.71, 95 % CI 0.66-0.75) and T2DM (AUC = 0.67, 95 % CI 0.59-0.73) sub-cohorts. Fall predicted probability in CP, AF and T2DM sub-cohorts increased from 7, 7 and 6 % in patients with no risk factors to 59, 66 and 45 % respectively, in those with the four predictors. Fall history was the strongest predictor in the three sub-cohorts. Fall history, dependency in daily activities, age ≥75 and living alone are independent fall predictors in CP, AF and T2DM patients.

  8. Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients

    Directory of Open Access Journals (Sweden)

    Jacob N. Ablin

    2016-09-01

    Full Text Available Objective The current study is an innovative exploratory investigation, aiming at identifying differences in personality profiles within Fibromyalgia Syndrome (FMS and Chronic Fatigue Syndrome (CFS patients. Method In total, 344 participants (309 female, 35 male reported suffering from FMS and/or CFS and consented to participate in the study. Participants were recruited at an Israeli FM/CFS patient meeting held in May 2013, and through an announcement posted on several social networks. Participants were asked to complete a research questionnaire, which included FMS criteria and severity scales, and measures of personality, emotional functioning, positivity, social support and subjective assessment of general health. In total, 204 participants completed the research questionnaire (40.7% attrition rate. Results A cluster analysis produced two distinct clusters, which differed significantly on psychological variables, but did not differ on demographic variables or illness severity. As compared to cluster number 2 (N = 107, participants classified into cluster number 1 (N = 97 showed a less adaptive pattern, with higher levels of Harm Avoidance and Alexithymia; higher prevalence of Type D personality; and lower levels of Persistence (PS, Reward dependence (RD, Cooperation, Self-directedness (SD, social support and positivity. Conclusion The significant pattern of results indicates at least two distinct personality profiles of FM and CFS patients. Findings from this research may help improve the evaluation and treatment of FM and CFS patients, based on each patient’s unique needs, psychological resources and weaknesses, as proposed by the current trend of personalized medicine.

  9. Multicenter, open-label, exploratory clinical trial with Rhodiola rosea extract in patients suffering from burnout symptoms

    Directory of Open Access Journals (Sweden)

    Kasper S

    2017-03-01

    the end of the study. The incidence of adverse events was low with 0.015 events per observation day.Discussion: The trial reported here was the first to investigate clinical outcomes in patients suffering from burnout symptoms when treated with R. rosea. During administration of the study drug over the course of 12 weeks, a wide range of outcome measures associated with the syndrome clearly improved.Conclusion: The results presented provide an encouraging basis for clinical trials further investigating the clinical outcomes of R. rosea extract in patients with the burnout syndrome. Keywords: burnout, clinical study, Rhodiola rosea

  10. Ganglion impar block in patients with chronic coccydynia

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    Nitesh Gonnade

    2017-01-01

    Full Text Available Introduction: Coccydynia refers to pain in the terminal segment of the spinecaused by abnormal sitting and standing posture. Coccydynia is usually managed conservatively, however in nonresponsive patients, ganglion impar block is used as a good alternate modality for pain relief. This article studies the effect of ganglion impar block in coccydynia patients who were not relieved by conservative management. Materials and Methods: The study was carried out at the pain clinic in the departments of Physical Medicine and Rehabilitation and Radiology in a tertiary centre in India.It was a prospective hospital-based study, in which 35 patients with coccydynia were considered for fluoroscopy-guided trans-sacro-coccygeal ganglion impar block. The outcome assessment was done using Numerical Rating Scale (NRS and Oswestry Disability Index (ODI scores for a follow-up period of 6 months. Of the 35 patients, 4 were lost to follow-up. Analysis was done usingthe data from the remaining 31 patients. Results: The mean age of the patients suffering from chronic coccydynia was 42.9 ± 8.39 years, and patients' age range was 28–57 years. The mean score of NRS and ODI before the procedure was 7.90 ± 0.16 and 48.97 ± 1.05, respectively. The interquartile range (IQR of NRS score remained almost unchanged during pre and postprocedure, however, IQR of ODI varied during the pre and post procedural events. The NRS and ODI scores immediately after the procedure decreased drastically showing significant pain relief in patients, and the difference of scores till the end of study was statistically significant. Conclusion: This study recommends the trans-sacro-coccygeal “needle inside needle” technique for local anesthetic block of the ganglion impar for pain relief in patients with coccydynia. This should be integrated with rehabilitative measures including ergonomical modification for prolonging pain free period.

  11. Patient-Assessed Chronic Illness Care (PACIC scenario in an Indian homeopathic hospital

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    Munmun Koley

    2016-01-01

    Full Text Available Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC 0.57–0.75; positive to strong positive correlations; p0.05; however, monthly household income had a significant influence (p<0.05 on the subscales except for “delivery system or practice design.” Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital.

  12. Cutaneous manifestations in patients with chronic renal failure on hemodialysis

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    Udayakumar P

    2006-01-01

    Full Text Available Background: Chronic renal failure (CRF presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF undergoing hemodialysis. Methods: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%, followed by pallor (60%, pruritus (53% and cutaneous pigmentation (43%. Other cutaneous manifestations included Kyrle′s disease (21%; fungal (30%, bacterial (13% and viral (12% infections; uremic frost (3%; purpura (9%; gynecomastia (1%; and dermatitis (2%. The nail changes included half and half nail (21%, koilonychia (18%, onychomycosis (19%, subungual hyperkeratosis (12%, onycholysis (10%, splinter hemorrhages (5%, Mees′ lines (7%, Muehrcke′s lines (5% and Beau′s lines (2%. Hair changes included sparse body hair (30%, sparse scalp hair (11% and brittle and lusterless hair (16%. Oral changes included macroglossia with teeth markings (35%, xerostomia (31%, ulcerative stomatitis (29%, angular cheilitis (12% and uremic breath (8%. Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi′s sarcoma were also observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.

  13. Health care experiences and preferences of Dutch chronic pain patients: a call for coordination and continuity.

    NARCIS (Netherlands)

    Krol, M.; Boer, D. de; Plass, A.M.C.; Rademakers, J.

    2013-01-01

    Background: In Europe, about one in five adults suffer from chronic pain, a third of whom suffer from severe chronic pain. Although lower than the European average, in The Netherlands, chronic pain prevalence is still estimated at 15% of the population. Nevertheless, relatively little is known about

  14. Cost-effectiveness of available treatment options for patients suffering from severe COPD in the UK: a fully incremental analysis

    Directory of Open Access Journals (Sweden)

    Hertel N

    2012-03-01

    Full Text Available Nadine Hertel1, Robert W Kotchie1, Yevgeniy Samyshkin1, Matthew Radford1, Samantha Humphreys2, Kevin Jameson21IMS Consulting Group, London, UK; 2MSD Ltd, Hoddesdon, UKPurpose: Frequent exacerbations which are both costly and potentially life-threatening are a major concern to patients with chronic obstructive pulmonary disease (COPD, despite the availability of several treatment options. This study aimed to assess the lifetime costs and outcomes associated with alternative treatment regimens for patients with severe COPD in the UK setting.Patients and methods: A Markov cohort model was developed to predict lifetime costs, outcomes, and cost-effectiveness of various combinations of a long-acting muscarinic antagonist (LAMA, a long-acting beta agonist (LABA, an inhaled corticosteroid (ICS, and roflumilast in a fully incremental analysis. Patients willing and able to take ICS, and those refusing or intolerant to ICS were analyzed separately. Efficacy was expressed as relative rate ratios of COPD exacerbation associated with alternative treatment regimens, taken from a mixed treatment comparison. The analysis was conducted from the UK National Health Service (NHS perspective. Parameter uncertainty was explored using one-way and probabilistic sensitivity analysis.Results: Based on the results of the fully incremental analysis a cost-effectiveness frontier was determined, indicating those treatment regimens which represent the most cost-effective use of NHS resources. For ICS-tolerant patients the cost-effectiveness frontier suggested LAMA as initial treatment. Where patients continue to exacerbate and additional therapy is required, LAMA + LABA/ICS can be a cost-effective option, followed by LAMA + LABA/ICS + roflumilast (incremental cost-effectiveness ratio [ICER] versus LAMA + LABA/ICS: £16,566 per quality-adjusted life-year [QALY] gained. The ICER in ICS-intolerant patients, comparing LAMA + LABA + roflumilast versus LAMA + LABA, was £13

  15. Altered resting state EEG in chronic pancreatitis patients: toward a marker for chronic pain

    NARCIS (Netherlands)

    Vries, M. de; Wilder-Smith, O.H.G.; Jongsma, M.L.A.; Broeke, E.N. van den; Arns, M.W.; Goor, H. van; Rijn, C.M. van

    2013-01-01

    OBJECTIVES: Electroencephalography (EEG) may be a promising source of physiological biomarkers accompanying chronic pain. Several studies in patients with chronic neuropathic pain have reported alterations in central pain processing, manifested as slowed EEG rhythmicity and increased EEG power in

  16. Altered resting state EEG in chronic pancreatitis patients: toward a marker for chronic pain

    NARCIS (Netherlands)

    Vries, M. de; Wilder-Smith, O.H.G.; Jongsma, M.L.A.; Broeke, E.N. van den; Arns, M.W.; Goor, H. van; Rijn, C.M. van

    2013-01-01

    Objectives: Electroencephalography (EEG) may be a promising source of physiological biomarkers accompanying chronic pain. Several studies in patients with chronic neuropathic pain have reported alterations in central pain processing, manifested as slowed EEG rhythmicity and increased EEG power in

  17. Profile of sexuality in Moroccan chronic low back pain patients

    Directory of Open Access Journals (Sweden)

    Bahouq Hanane

    2013-02-01

    Full Text Available Abstract Background Sexual life had an important role in preserving the good quality of life for patients and for their partner. Chronic Low Back Pain (CLBP as other musculoskeletal diseases may affect all aspects of life including sexual functioning. The purpose of this study is to describe the impact of CLBP on the sexual life of patients and to identify the factors that affect their Sexual Quality of Life (SQOL. Methods One hundred CLBP sexually active patients were included. Patients and disease Characteristics were collected. Impact on sexual life (sexual intercourse and SQOL was also assessed. Univariate and multivariate analysis were performed to analyze significant determinants associated with the SQOL disturbance. Results Eighty one percent of our patients complained about sexual difficulties related to CLBP. Libido decrease and painful intercourse position were reported respectively in 14.8 and 97.5% of cases. The most pain generating position was supine. Mean of sexual intercourse frequency decrease was at −10.4 ± 4.8 per month. SQOL score mean was at 44.6 ± 17.4%. Men suffered more than women from sexual problems (respectively 90% vs. 72%; p = 0.02. Men had worse SQOL than women (respectively 38.9 ± 17.2 vs. 50.3 ± 15.7%; p = 0.001. Univariate and multivariate analysis showed that advanced age (p = 0.009, poor functional status (p = 0.03, male gender (p = 0.03 and sexual intercourse frequency decrease (p = 0.005 were the independent variables associated with the SQOL disturbance. Conclusion Our study suggests that sexuality is profoundly disturbed in CLBP patients; both their sexual intercourse and SQOL were affected. This disturbance seems to be associated with patient and disease characteristics. Sexuality should be taken into account in managing CLBP patients.

  18. Risk of chronic anxiety in implantable defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J

    2011-01-01

    Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...... anxiety....

  19. Barriers and facilitators to palliative care of patients with chronic heart failure in Germany: a study protocol

    Directory of Open Access Journals (Sweden)

    Stefan Köberich

    2015-07-01

    Full Text Available Background. Despite its high prevalence, similar symptoms and symptom burden, people suffering from chronic heart failure receive less palliative care than patients with malignant diseases. Internationally, numerous barriers to palliative care of patients with chronic heart failure are known, however, there are no credible data regarding barriers and facilitators to palliative care of people suffering from chronic heart failure available for Germany. Design and Methods. Tripartite study. First part of this study evaluates health care providers’ (physicians and nurses perceived barriers and facilitators to palliative care of patients with chronic heart failure using a qualitative approach. At least 18 persons will be interviewed. In the second part, based on the results of part one, a questionnaire about barriers and facilitators to palliative care of patients with chronic heart failure will be designed and applied to at least 150 physicians and nurses. In the last part a classic Delphi method will be used to develop specific measures to improve the palliative care for chronic heart failure patients. Expected Impact for Public Health. The results of this study will help to understand why patients with heart failure are seldom referred to palliative care and will provide solutions to overcome these barriers. Developed solutions will be the first step to improve palliative care in patients with heart failure in Germany. In addition, the results will help health care providers in other countries to take action to improve palliative care situations for heart failure patients.

  20. Efectividad de la fitoterapia en pacientes con asma bronquial The effectiveness of herbal medicine in patients suffering from bronchial asthma

    Directory of Open Access Journals (Sweden)

    Margarita García Quiala

    2012-02-01

    Full Text Available La medicina tradicional y la medicina complementaria y alternativa están adquiriendo más atención dentro del contexto de la provisión de atención sanitaria y la reforma del sector salud. Se han alcanzado importantes logros en cuanto a la efectividad de este procedimiento en los pacientes portadores de asma bronquial. Se realizó un estudio observacional descriptivo longitudinal con el objetivo de determinar la efectividad de la fitoterapia como uno de los tratamientos de la medicina natural y tradicional en 48 pacientes que padecen asma bronquial, pertenecientes al consultorio médico popular "La Amapola", Petare, del municipio Sucre en el año 2009. Se tuvieron en cuenta la edad, sexo, síntomas y signos presentes al momento del tratamiento, el período o estadio de la enfermedad, efectividad del tratamiento, la evolución y control de la enfermedad después de iniciado el tratamiento, obteniéndose como principales resultados que la mayoría pertenecían al sexo femenino y al grupo de edades de 10-14 años, seguidos de 5-9 años, los síntomas presentes en los pacientes fueron falta de aire y tos, el tratamiento utilizado en los pacientes atendidos por crisis de asma resultó efectivo en todas las variantes usadas, con predominio de la combinación de ajo más orégano más manzanilla; en solo 6-10 días habían mejorado los síntomas y en el transcurso de 3 meses la mayoría no habían presentado otra crisis de asma.An observational, descriptive and longitudinal study aimed at determining the effectiveness of herbal medicine as one of the treatments in Natural and Traditional Medicine for patients that suffered from Bronchial Asthma was conducted at "Amapola" Doctor's Office in Petare, Sucre District during 2009. Venezuela. The sample was chosen by means of a non-probabilistic per convenience sampling; selecting 48 asthmatic patients with inclusion criteria. The variables related to the objectives of the study were: age, sex, symptoms

  1. Prescription for antidepressant in reducing future alcohol-related readmission in patients suffering from depression and alcohol use disorder: a retrospective medical record review.

    Science.gov (United States)

    Chan, Patrick; Yomen, Katie; Turcios, Jennifer; Richman, Mark

    2015-12-21

    Patients suffering from major depressive disorder are more likely to suffer from alcohol use disorder. The data is inconclusive for the effectiveness of antidepressant treatment of patients suffering from both illnesses in regards to improving sobriety and reducing alcohol-related healthcare expenses such as hospitalizations. The objective of this study is to determine if a new prescription of an antidepressant upon inpatient discharge is associated with a reduction in the number of future acute alcohol-related hospital readmissions to the same institution in patients suffering from major depressive disorder and alcohol-use disorder. A retrospective, medical record review study was conducted at a publicly-supported hospital in Sylmar, CA. A query was performed for adult patients admitted between 1/1/2005-12/31/2013 who had ICD-9 codes for both alcohol-use disorder and depression. Index admission was the first hospitalization in which the patient was currently consuming alcohol and had depression as identified by physician documentation as a problem. Acute alcohol-related admissions were those for alcohol intoxication or withdrawal (indicating current alcohol use). Patients were excluded if they were receiving an antidepressant on index admission, depressive disorder with a prescription for an antidepressant is not associated with a reduction in future readmissions, nor significantly increase the number of days to readmission. The study does not support the concept of antidepressants in reducing acute alcohol-related readmissions.

  2. Panic disorder in patients with chronic heart failure.

    Science.gov (United States)

    Müller-Tasch, Thomas; Frankenstein, Lutz; Holzapfel, Nicole; Schellberg, Dieter; Löwe, Bernd; Nelles, Manfred; Zugck, Christian; Katus, Hugo; Rauch, Bernhard; Haass, Markus; Jünger, Jana; Remppis, Andrew; Herzog, Wolfgang

    2008-03-01

    Our objective was to assess the prevalence of panic disorder, its influence on quality of life (QoL), and the presence of further anxiety and depressive comorbid disorders in outpatients with chronic heart failure (CHF). In a cross-sectional study, anxiety and depressive disorders were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria in patients with CHF who were aged > or =18 years and had New York Heart Association (NYHA) Functional Classes I-IV, using the Patient Health Questionnaire. Health-related QoL was evaluated using the Short-Form 36 Health Survey (SF-36). Of the 258 participating patients, 24 (9.3%) fulfilled diagnostic criteria for panic disorder. Seven of these (29.2%) were diagnosed with comorbid anxiety disorders, 11 (47.3%) were diagnosed with comorbid depressive disorder, and 5 (20.8%) were diagnosed with other anxiety disorders and any depressive disorder. Female gender [odds ratio (OR)=3.1; 95% confidence interval (95% CI)=1.2-7.8; P=.02] and a lower level of education (OR=0.3; 95% CI=0.1-0.9; P=.04) were associated with the presence of panic disorder. In patients with panic disorder, QoL was significantly more restricted on all subscales of the SF-36 as compared to those without panic disorder, even when age, gender, and NYHA functional class were controlled for (P=.05 to <.01). Approximately 1 of 10 patients with CHF suffers from panic disorder, many of whom also have additional anxiety or depressive comorbid disorders. Female gender and a low level of education are positively associated with the presence of panic disorder. QoL is severely limited by the presence of panic disorder. Diagnosis of mental disorders and treatment offers for affected patients should be available in patient care.

  3. [18F]FDG PET/MRI of patients with chronic pain alters management: early experience

    International Nuclear Information System (INIS)

    Biswal, Sandip; Behera, Deepak; Yoon, Dae Hyun; Holley, Dawn; Ith, Ma Agnes Martinez; Carroll, Ian; Smuck, Matthew; Hargreaves, Brian

    2015-01-01

    The chronic pain sufferer is currently faced with a lack of objective tools to identify the source of their pain. The overarching goal is to develop clinical [18F]FDG PET/MRI methods to more accurately localize sites of increased neuronal and muscular metabolism or inflammation as it relates to neurogenic sources of pain and to ultimately improve outcomes of chronic pain sufferers. The aims are to 1) correlate imaging findings with location of pain symptomology, 2) predict location of symptoms based on imaging findings alone and 3) to determine whether the imaging results affect current management decisions. Six patients suffering from chronic lower extremity neuropathic pain (4 complex regional pain syndrome, 1 chronic sciatica and 1 neuropathic pain) have been imaged with a PET/MRI system (time-of-flight PET; 3.0T bore) from mid thorax through the feet. All patients underwent PET/MR imaging one hour after a injection of 10mCi [18F]FDG. Two radiologists evaluated PET/MR images (one blinded and the other unblinded to patient exam/history). ROI analysis showed focal increased [18F]FDG uptake in affected nerves and muscle (approx 2-4 times more) over background tissue in various regions of the body in 5 of 6 patients at the site of greatest pain symptoms and other areas of the body (SUVmax of Target 0.9-4.2 vs. Background 0.2-1.2). The radiologist blind to the patient history/exam was able to correctly identify side/location of the symptoms in 5 out of 6 patients. Imaging results were reviewed with the referring physician, who then determined whether a modification in the management plan was needed: 1/6 no change, 2/6 mild modification (e.g., additional diagnostic test ordered) and 3/6 significant modification.

  4. [18F]FDG PET/MRI of patients with chronic pain alters management: early experience

    Energy Technology Data Exchange (ETDEWEB)

    Biswal, Sandip; Behera, Deepak; Yoon, Dae Hyun; Holley, Dawn; Ith, Ma Agnes Martinez; Carroll, Ian; Smuck, Matthew; Hargreaves, Brian [Stanford University School of Medicine, California (United States)

    2015-05-18

    The chronic pain sufferer is currently faced with a lack of objective tools to identify the source of their pain. The overarching goal is to develop clinical [18F]FDG PET/MRI methods to more accurately localize sites of increased neuronal and muscular metabolism or inflammation as it relates to neurogenic sources of pain and to ultimately improve outcomes of chronic pain sufferers. The aims are to 1) correlate imaging findings with location of pain symptomology, 2) predict location of symptoms based on imaging findings alone and 3) to determine whether the imaging results affect current management decisions. Six patients suffering from chronic lower extremity neuropathic pain (4 complex regional pain syndrome, 1 chronic sciatica and 1 neuropathic pain) have been imaged with a PET/MRI system (time-of-flight PET; 3.0T bore) from mid thorax through the feet. All patients underwent PET/MR imaging one hour after a injection of 10mCi [18F]FDG. Two radiologists evaluated PET/MR images (one blinded and the other unblinded to patient exam/history). ROI analysis showed focal increased [18F]FDG uptake in affected nerves and muscle (approx 2-4 times more) over background tissue in various regions of the body in 5 of 6 patients at the site of greatest pain symptoms and other areas of the body (SUVmax of Target 0.9-4.2 vs. Background 0.2-1.2). The radiologist blind to the patient history/exam was able to correctly identify side/location of the symptoms in 5 out of 6 patients. Imaging results were reviewed with the referring physician, who then determined whether a modification in the management plan was needed: 1/6 no change, 2/6 mild modification (e.g., additional diagnostic test ordered) and 3/6 significant modification.

  5. [Scales to evaluate pain in elderly patients suffering from dementia. Help-tools for the physiotherapist, doctor, nurse and occupational therapist].

    Science.gov (United States)

    Rodríguez-Mansilla, Juan; Jiménez-Palomares, María; González-López-Arza, María Victoria

    2014-01-01

    The purpose of this study was to determine which scales are being used to evaluate pain in old people suffering from dementia. A search strategy was developed to retrieve all articles (randomized controlled trials and clinical trials without randomization) published in MEDLINE, Cochrane Library Plus, PEDro and Dialnet and BMC Geriatrics from January 2000 to January 2012. Exclusion criteria were articles that did not use scales for evaluating pain in elderly patients suffering from dementia, and other type of articles (case studies, reviews...). Finally, 13 studies were included in this review. From the results obtained it appears that more studies are needed to confirm the pain scales used for the elderly suffering from dementia. Observational scales may be useful to evaluate pain in these patients. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  6. Novel combined management approaches to patients with diabetes, chronic kidney disease and cardiovascular disease.

    Science.gov (United States)

    Spaak, J

    2017-03-01

    Most patients we care for today suffer from more than one chronic disease, and multimorbidity is a rapidly growing challenge. Concomitant cardiovascular disease, renal dysfunction and diabetes represent a large proportion of all patients in cardiology, nephrology and diabetology. These entities commonly overlap due to their negative effects on vascular function and an accelerated atherosclerosis progression. At the same time, a progressive subspecialisation has caused the cardiologist to treat 'only' the heart, nephrologists 'only' the kidneys and endocrinologists' 'only' diabetes. Studies and guidelines follow the same pattern. This often requires patients to visit specialists for each field, with a risk of both under-diagnosis and under-treatment. From the patient's perspective, there is a great need for coordination and facilitation of the care, not only to reduce disease progression but also to improve quality of life. Person-centred integrated clinics for patients with cardiovascular disease, renal dysfunction and diabetes are a promising approach for complex chronic disease management.

  7. [Early exercise training after exacerbation in patients with chronic respiratory failure].

    Science.gov (United States)

    Takahashi, Hiromitsu; Molleyres, Sandrine; Dousse, Nicolas; Contal, Olivier; Janssens, Jean-Paul

    2011-11-23

    Patients who suffered from an exacerbation of a chronic respiratory disorder are often very limited in terms of their exercise capacity because of severe dyspnea and amyotrophy of peripheral muscles. Early implementation of pulmonary rehabilitation may help these patients to avoid the complications of a prolonged bedridden period, and increase more rapidly their mobility. Early rehabilitation has become more frequent, but requires special skills from the care givers (chest therapists). Techniques which enhance muscular performance and motility of patients who are recovering from an exacerbation such as electromoystimulation or mobilisation under non-invasive ventilation, give encouraging results; their impact on length of hospital stay requires further studies.

  8. Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia

    International Nuclear Information System (INIS)

    Kuroda, Satoshi; Sakuragi, Mitsugi; Motomiya, Mineo; Nakagawa, Tango; Mitsumori, Kenji; Tsuru, Mitsuo; Takigawa, Shugo; Kamiyama, Hiroyasu; Abe, Hiroshi.

    1990-01-01

    To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with 99m Tc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by 133 Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor completed stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with 99m Tc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with 133 Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r= -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with 133 Xe SPECT and 99m Tc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease. (author)

  9. Ethical Challenges for an Understanding of Suffering: Voluntary Stopping of Eating and Drinking and the Wish to Hasten Death in Advanced Patients

    Directory of Open Access Journals (Sweden)

    Andrea Rodríguez-Prat

    2018-03-01

    Full Text Available Some persons with advanced disease but no significant cognitive impairments consciously decide to stop taking food and fluids orally, even though they remain physically able to do so. The question is to what extent voluntarily stopping eating and drinking (VSED may be considered an expression of a wish to hasten death, in the sense that the latter has been defined recently. We analyze the data reported in some studies in relation to primary care patients who died as a result of VSED and examine their results in light of the qualitative findings of patients that expressed a wish to die. In our view, VSED can be understood as a response to physical/psychological/spiritual suffering, as an expression of a loss of self, a desire to live but not in this way, a way of ending suffering, and as a kind of control over one’s life. Thus, VSED is consistent with the wish to hasten death. Prior to interpreting this act as a deliberate expression of personal autonomy, it is important to explore all possible areas of suffering, including physical symptoms, psychological distress, existential suffering, and social aspects. Failure to do so will mean that we run the risk of abandoning a fellow human being to his or her suffering.

  10. Evaluation of Methacholine Challenge Test Results in Chronic Cough Patients Referring to Clinic of Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Derakhshan Deilami Gholamreza

    2009-10-01

    Full Text Available Chronic cough is a common problem in patients visiting physicians and its prevalence in different populations range from 3 to 40%. Postnasal drip, asthma and gastroesophageal reflux are the known cause of chronic cough. Although diagnosis of asthma is usually made by clinical signs and spirometeric results, methacholine challenge test is a good diagnostic test in patients who show normal physical examination and spirometeric results. In this study, the results of methacholine challenge test in chronic cough patients are investigated. This is a cross sectional study performed on patients suffering from chronic cough (over 8 weeks, who went to Pulmonary Disease Clinic of Imam Khomeini Hospital in 2006. Postnasal drip, gastroesophageal reflux was evaluated and ruled out in all patients. Then they were tested by methacholine inhalation using low to high doses of methacholine. The results of test was defined as 20% fall in FEV1 and its relationship with age, sex, history of allergic disease, family history of asthma and smoking status was investigated. 81 patients (36 female and 45 male entered this study who had mean age of 32.5 ± 13.06 years. 81.5% of patients had never smoked or closed contact with smokers, 6.2% were passive smokers, 8.6% were smokers and 3.7% had quit smoking. 37% had suffered from chronic cough less than 6 months, 11% for 6-11 months and 52% for more than 12 months. In 26% of patients, family history of asthma was present and 34.5% had a history of one type of allergy. In 29.5% the results of methacholine challenge test was positive, among them 45.8% showed an intense response and 54.2% a moderate response. The test results and its intensity had no statistically significant relationship with age, sex, smoking status, the duration of cough and family history of asthma, but the relationship between methacholine challenge test and the history of allergic disease was significant. Methacholine challenge test can be used as a

  11. Patients with heart failure and their partners with chronic illness: interdependence in multiple dimensions of time.

    Science.gov (United States)

    Nimmon, Laura; Bates, Joanna; Kimel, Gil; Lingard, Lorelei

    2018-01-01

    Informal caregivers play a vital role in supporting patients with heart failure (HF). However, when both the HF patient and their long-term partner suffer from chronic illness, they may equally suffer from diminished quality of life and poor health outcomes. With the focus on this specific couple group as a dimension of the HF health care team, we explored this neglected component of supportive care. From a large-scale Canadian multisite study, we analyzed the interview data of 13 HF patient-partner couples (26 participants). The sample consisted of patients with advanced HF and their long-term, live-in partners who also suffer from chronic illness. The analysis highlighted the profound enmeshment of the couples. The couples' interdependence was exemplified in the ways they synchronized their experience in shared dimensions of time and adapted their day-to-day routines to accommodate each other's changing health status. Particularly significant was when both individuals were too ill to perform caregiving tasks, which resulted in the couples being in a highly fragile state. We conclude that the salience of this couple group's oscillating health needs and their severe vulnerabilities need to be appreciated when designing and delivering HF team-based care.

  12. Immediate effect of mind sound resonance technique on state anxiety and cognitive functions in patients suffering from generalized anxiety disorder: A self-controlled pilot study

    Directory of Open Access Journals (Sweden)

    Vipin Dhansoia

    2015-01-01

    Conclusion: This pilot study suggests that MSRT may have a potential role in reducing state anxiety and enhancing psychomotor performance in patients suffering from GAD immediately after the practice. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future.

  13. Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan

    Directory of Open Access Journals (Sweden)

    Jung-An Lin

    2014-10-01

    Conclusion: Our study shows that the SVR rates are similar in hemophilic and nonhemophilic patients with chronic HCV infection who receive PEG-IFN-α-2a plus RBV in Taiwan. The rate of AEs also resembled other studies in nonhemophilic patients in Taiwan. No patient suffered from severe bleeding. However, large-scale, well-conducted studies are still needed to verify the treatment efficacy and safety.

  14. [Management of high blood pressure in patients with chronic kidney disease : Summary of recent guidelines].

    Science.gov (United States)

    Hougardy, J M; Leeman, M

    Chronic kidney disease and high blood pressure are two common diseases that mutually maintain during their evolution. In the advanced stages of chronic kidney disease, most pat ients are hypertensive and show signs of vascular disease (coronary artery disease, cerebrovascular or peripheral). Almost one third of the patients with advanced chronic kidney disease exhibit resistant hypertension that requires complex therapeutic management. In chronic kidney disease, antihypertensive treatment is conditioned by comorbidities, but also by proteinuria, which is an independent cardiovascular risk factor in addition to the rate of glomerular filtration rate. The treatment of high blood pressure is a cornerstone of the management of the chronic kidney disease. It limits the risk of cardiovascular events (eg. myocardial infarction, stroke), but also slows the progression of chronic kidney disease. Various recommendations have been recently published on the subject in order to offer assistance to the therapeutic management of hypertension in the patient suffering from chronic kidney disease. The purpose of this article is to highlight these main key elements.

  15. Clinical Characteristics of Dry Eye Patients With Chronic Pain Syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Smitt-Kamminga, Nicole Sillevis; Kozareva, Diana; Nibourg, Simone A.; Hammond, Christopher J.

    PURPOSE: To investigate clinical characteristics of dry eye disease (DED) patients with a chronic pain syndrome. DESIGN: Cross-sectional. study. METHODS: Four hundred twenty-five patients of a tertiary care DED patient cohort in the Netherlands were included. Chronic pain syndromes irritable bowel

  16. Nephropathy and Neuropathy in Diabetic Patients with Chronic ...

    African Journals Online (AJOL)

    Introduction: Several reports described an association between type 2 diabetes mellitus (DM) and chronic hepatitis C virus (HCV) infection. Chronic HCV infection is prevalent in Egypt. The present work aimed to evaluate the prevalence of proteinuria and neuropathy among diabetic patients with and without chronic HCV ...

  17. Incidence rate of mild traumatic brain injury among patients who have suffered from an isolated limb fracture: Upper limb fracture patients are more at risk.

    Science.gov (United States)

    Jodoin, Marianne; Rouleau, Dominique M; Charlebois-Plante, Camille; Benoit, Benoit; Leduc, Stéphane; Laflamme, G-Yves; Gosselin, Nadia; Larson-Dupuis, Camille; De Beaumont, Louis

    2016-08-01

    This study compares the incidence rate of mild traumatic brain injury (mild TBI) detected at follow-up visits (retrospective diagnosis) in patients suffering from an isolated limb trauma, with the incidence rate held by the hospital records (prospective diagnosis) of the sampled cohort. This study also seeks to determine which types of fractures present with the highest incidence of mild TBI. Retrospective assessment of mild TBI among orthopaedic monotrauma patients, randomly selected for participation in an Orthopaedic clinic of a Level I Trauma Hospital. Patients in the remission phase of a limb fracture were recruited between August 2014 and May 2015. No intervention was done (observational study). Standardized semi-structured interviews were conducted with all patients to retrospectively assess for mild TBI at the time of the fracture. Emergency room related medical records of all patients were carefully analyzed to determine whether a prospective mild TBI diagnosis was made following the accident. A total of 251 patients were recruited (54% females, Mean age=49). Study interview revealed a 23.5% incidence rate of mild TBI compared to an incidence rate of 8.8% for prospective diagnosis (χ(2)=78.47; plimb monotrauma (29.6%; n=42/142) are significantly more at risk of sustaining a mild TBI compared to lower limb fractures (15.6%; n=17/109) (χ(2)=6.70; p=0.010). More specifically, patients with a proximal upper limb injury were significantly more at risk of sustaining concomitant mild TBI (40.6%; 26/64) compared to distal upper limb fractures (20.25%; 16/79) (χ(2)=7.07; p=0.008). Results suggest an important concomitance of mild TBI among orthopaedic trauma patients, the majority of which go undetected during acute care. Patients treated for an upper limb fracture are particularly at risk of sustaining concomitant mild TBI. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Comparison of peripheral nerve blockade characteristics between non-diabetic patients and patients suffering from diabetic neuropathy: a prospective cohort study.

    Science.gov (United States)

    Baeriswyl, M; Taffé, P; Kirkham, K R; Bathory, I; Rancati, V; Crevoisier, X; Cherix, S; Albrecht, E

    2018-06-02

    Animal data have demonstrated increased block duration after local anaesthetic injections in diabetic rat models. Whether the same is true in humans is currently undefined. We, therefore, undertook this prospective cohort study to test the hypothesis that type-2 diabetic patients suffering from diabetic peripheral neuropathy would have increased block duration after ultrasound-guided popliteal sciatic nerve block when compared with patients without neuropathy. Thirty-three type-2 diabetic patients with neuropathy and 23 non-diabetic control patients, scheduled for fore-foot surgery, were included prospectively. All patients received an ultrasound-guided popliteal sciatic nerve block with a 30 ml 1:1 mixture of lidocaine 1% and bupivacaine 0.5%. The primary outcome was time to first opioid request after block procedure. Secondary outcomes included the time to onset of sensory blockade, and pain score at rest on postoperative day 1 (numeric rating scale 0-10). These outcomes were analysed using an accelerated failure time regression model. Patients in the diabetic peripheral neuropathy group had significantly prolonged median (IQR [range]) time to first opioid request (diabetic peripheral neuropathy group 1440 (IQR 1140-1440 [180-1440]) min vs. control group 710 (IQR 420-1200 [150-1440] min, p = 0.0004). Diabetic peripheral neuropathy patients had a time ratio of 1.57 (95%CI 1.10-2.23, p peripheral neuropathy group 0 (IQR 0-1 [0-5]) vs. control group 3 (IQR 0-5 [0-9]), p = 0.001). In conclusion, after an ultrasound-guided popliteal sciatic nerve block, patients with diabetic peripheral neuropathy demonstrated reduced time to onset of sensory blockade, with increased time to first opioid request when compared with patients without neuropathy. © 2018 The Association of Anaesthetists.

  19. Suicidal ideation and the risk of suicide in patients with fibromyalgia: a comparison with non-pain controls and patients suffering from low-back pain

    Directory of Open Access Journals (Sweden)

    Jimenez-Rodriguez I

    2014-04-01

    Full Text Available Irene Jimenez-Rodríguez,1 Juan Miguel Garcia-Leiva,1 Beatriz M Jimenez-Rodriguez,2 Emilia Condés-Moreno,3 Fernando Rico-Villademoros,1 Elena P Calandre11Instituto de Neurociencias, Universidad de Granada, Granada, Spain; 2Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain; 3Departamento de Especialidades Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, SpainAbstract: Fibromyalgia is associated with an increased rate of mortality from suicide. In fact, this disease is associated with several characteristics that are linked to an increased risk of suicidal behaviors, such as being female and experiencing chronic pain, psychological distress, and sleep disturbances. However, the literature concerning suicidal behaviors and their risk factors in fibromyalgia is sparse. The objectives of the present study were to evaluate the prevalence of suicidal ideation and the risk of suicide in a sample of patients with fibromyalgia compared with a sample of healthy subjects and a sample of patients with chronic low-back pain. We also aimed to evaluate the relevance of pain intensity, depression, and sleep quality as variables related to suicidal ideation and risks. Logistic regression was applied to estimate the likelihood of suicidal ideation and the risk of suicide adjusted by age and sex. We also used two logistic regression models using age, sex, pain severity score, depression severity, sleep quality, and disease state as independent variables and using the control group as a reference. Forty-four patients with fibromyalgia, 32 patients with low-back pain, and 50 controls were included. Suicidal ideation, measured with item 9 of the Beck Depression Inventory, was almost absent among the controls and was low among patients with low-back pain; however, suicidal ideation was prominent among patients with fibromyalgia (P<0.0001. The risk of suicide, measured with the Plutchik Suicide Risk Scale, was also

  20. Patient-reported outcomes (PROs) in chronic urticaria

    DEFF Research Database (Denmark)

    Moestrup, Kristian; Ghazanfar, Misbah N.; Thomsen, Simon F.

    2017-01-01

    Chronic urticaria is an itching skin disease which persists for more than 6 weeks. Chronic urticaria has great impact on the daily life of the patient, and the fluctuating nature of the symptoms complicates the monitoring and treatment of the disease. Currently, there are no reliable biomarkers...... to identify and measure disease activity in chronic spontaneous urticaria. Consequently, use of patient-reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and quality of life. We present an overview...... of seven different PROs used in chronic urticaria and highlight their strengths, limitations, and use in clinical practice and research....

  1. Perceptions and types of support coming from families caring for patients suffering from advanced illness in Kinshasa, Democratic Republic of Congo.

    Science.gov (United States)

    Lofandjola, Jacques Masumbuku; Sumaili, Ernest Kiswaya; Mairiaux, Philippe; Petermans, Jean

    2017-08-01

    Perceptions of families who take care of patients suffering from advanced illness are rarely considered in Kinshasa medical practices; nevertheless, these families are the main actors involved in such care. The objective of this present study was to illustrate, in a Congolese context, the perceptions of families on the care of patients suffering from advanced illness, and to identify the possible aids provided by healthcare facilities. A qualitative study was performed among focus groups in six hospitals in Kinshasa. Each group included eight members. We gathered factors that could negatively influence the care of a patient suffering from advanced disease. Such factors included: scarcity of and inaccessibility to painkillers, economic resilience, poor quality treatment, lack of psychological counselling, seeking alternative solutions and poor communication between caregivers and patients. In contrast, the study also showed that relatives caring for these patients often receive support from the wider family and from cult members. This study focuses on the miscommunication between healthcare workers and patients, poor management in advanced illness as well as a lack of psychological support from caregivers. The findings can serve as basis for further research in palliative care.

  2. Clinical significance of changes of serum gastrin levels in patients with chronic eczema or chronic urticaria

    International Nuclear Information System (INIS)

    Zheng Xianghong; Jiang Xiaoling; Chen Wei; Wang Jinglin

    2005-01-01

    Objective: To study the clinical significance of changes of serum levels of gastrin in patients with chronic eczema or chronic urticaria. Methods: Serum gastrin levels were, 37 patients with chromic urticaria and 43 controls. Results: Serum gastrin levels in patients with chronic exzema (102.95 ± 27.33 ng/L) and patients with chronic urticaria (109.87 ± 33.64 ng/L) were both significantly higher than those in controls (61.72 ± 20.38 ng/L, both P<0.01). Difference between the levels in the two patients groups was not significant. Conclusion: The high gastrin levels in those patients might reflect the presence of helicobacter pylori infections; eradication of which might be helpful for treatment of these chronic dermatologic disorders. (authors)

  3. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    Salem, E.S; Tawfik, M.S; ELaseily, E.S.

    2013-01-01

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  4. Sleep in Patients with Chronic Migraine.

    Science.gov (United States)

    Yang, Chun-Pai; Wang, Shuu-Jiun

    2017-09-01

    The biological and pathophysiological interaction between sleep and chronic migraine (CM) remains to be fully elucidated. In this article, we provide a narrative review of the literature on sleep disturbance and CM, highlighting recent advances in sleep research and insights into mechanisms that could mediate a role of sleep disturbances in migraine chronification. We discuss the potential for cognitive-behavioral insomnia therapy (CBTi) as an intervention for CM with comorbid insomnia. Finally, we propose a model of the mechanisms underlying the interactions among sleep physiology, maladaptive migraine-coping behaviors, and coexisting factors which contribute to sleep disturbances in CM based on conceptual models used in sleep research. Insomnia is the most common sleep complaint among patients with CM. CM patients experience more frequent and severe insomnia symptoms than patients with episodic migraine (EM). It has been suggested that sleep disturbances may predispose individuals to migraine attacks, which may affect the pain-processing trigeminovascular system and thus play a role in migraine progression. Encouraging but limited evidence suggests that management of insomnia via behavioral sleep therapy may reverse CM to EM and possibly prevent migraine chronification. Migraine has a complex relationship with sleep. The use of objective sleep study such as polysomnographic microstructural sleep analysis and actigraphy could help connect sleep disturbances and processes related to CM. Future longitudinal studies should examine whether effective behavioral treatments such as CBTi can reverse migraine chronification.

  5. Firstline treatment for chronic phase chronic myeloid leukemia patients should be based on a holistic approach.

    Science.gov (United States)

    Breccia, Massimo; Alimena, Giuliana

    2015-02-01

    New selective and more potent drugs for the cure of chronic phase chronic myeloid leukemia patients are now available: physicians in some countries must decide the best option, selecting one of the drugs available. What the main prognostic factors are in order to make this selection remains a matter of discussion. Introducing a 'holistic approach' for the first time in chronic myeloid leukemia, as practiced in other diseases, and looking at the patient in a complete picture, considering several variables, such as comorbidities, age, concomitant drugs, lifestyle and patient expectations, may be of help to understand, patient by patient, the best therapeutic strategy.

  6. Individual and dyadic coping in chronic pain patients

    Directory of Open Access Journals (Sweden)

    Burri A

    2017-03-01

    Full Text Available Andrea Burri,1–3 Michèle Blank Gebre,4 Guy Bodenmann1 1Department of Psychology, University of Zurich, Zurich, Switzerland; 2Health and Rehabilitation Research Institute, Auckland University of Technology, 3Waitemata Pain Service, Department of Anaesthesia and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand; 4Private Practice, Zurich, Switzerland Abstract: The purpose of the current cross-sectional study was to test the associations between individual coping responses to pain, dyadic coping, and perceived social support, with a number of pain outcomes, including pain intensity, functional disability, and pain adjustment, in a sample of N = 43 patients suffering from chronic pain in Switzerland. In contrast to previous research, we were interested not only in specific pain coping but also in more general stress coping strategies and their potential influence on pain outcomes. Analyses were performed using correlation and regression analyses. “Praying and hoping” turned out to be an independent predictor of higher pain intensity and higher anxiety levels, whereas both “coping self-instructions” and “diverting attention” were associated with higher well-being, less feelings of helplessness, and less depression and anxiety. We further found a link between “focusing on and venting emotions” and “worse pain adjustment”. No significant relationship between dyadic coping and social support with any of our pain outcomes could be observed. Overall, our results indicate that individual coping strategies outweigh the effects of social support and dyadic coping on pain-related outcomes and pain adjustment. However, results need to be interpreted with caution given the small sample size. Keywords: individual coping, dyadic coping, social support, chronic pain

  7. Non-specific chronic orofacial pain patients' experiences of everyday life situations: a qualitative study.

    Science.gov (United States)

    Wolf, Eva; Nilner, Maria; Petersson, Kerstin

    2016-01-01

    Chronic orofacial pain is a complex condition with consequences that affect daily living. The aim was to analyse nonspecific chronic orofacial pain patients'experiences of everyday life situations, using a qualitative approach. Eleven women and 3 men (21 to 77years) were selected through a purposive sampling among chronic orofacial pain patients referred to the Faculty of Odontology's orofacial pain unit at Malmö University, Malmö Sweden. All selected subjects agreed to participate. Data were obtained via two thematic in-depth interviews with each subject. Interviews were taped and transcribed verbatim.Text dealing with the subjects' daily experiences was identified in all interviews and analysed using qualitative content analysis that focused on manifest content. In everyday life situations, the analysis of nonspecific chronic orofacial pain patients' narrations exposed a fear of conflict, of personal weakness, and of the intangible; they also exposed self-blame and avoidance of fear-triggering situations. Eight of the 14 subjects did not spontaneously mention any situation in which they were content during daily living. When the patients spoke about everyday life experiences, the main finding was that unpleasant emotions dominated the subjects'experiences. In conclusion, the chronic orofacial pain condition cannot be understood as an isolated phenomenon; it must be considered in rela- tion to the person who is suffering from the condition.

  8. Using Illness Perceptions to Cluster Chronic Pain Patients

    DEFF Research Database (Denmark)

    Frostholm, Lisbeth; Hornemann, Christina; Ørnbøl, Eva

    2018-01-01

    to participation in a lay-led Chronic Pain Self-Management Program (CPSMP). METHODS: Four hundred and twenty-four participants in a randomized controlled trial on the CPSMP completed a questionnaire on their perceptions of their chronic pain condition at baseline. In addition, they completed a range of health......OBJECTIVES: The aims of our study were (1) To identify possible subgroups of chronic pain sufferers based on their illness perceptions (IPs); (2) To examine whether these subgroups differed in health status and health expenditure, and (3) To examine whether the subgroups differed in their response...... status measures at baseline and three months after end of participation in the CPSMP. Health care expenditure was obtained from Danish health registers. We performed cluster analyses to identify possible subgroups based on the participants' perceptions of their chronic pain condition. RESULTS: Cluster...

  9. The effect of chronic lymphocytic thyroiditis on patients with thyroid cancer.

    Science.gov (United States)

    Zhang, Yi; Ma, Xiao-Peng; Deng, Fu-Sheng; Liu, Zheng-Rong; Wei, Hou-Qing; Wang, Xi-Hong; Chen, Hao

    2014-09-01

    The purpose of this study was to investigate the association between chronic lymphocytic thyroiditis (CLT) and malignant tumors of the thyroid. A retrospective review of 647 patients who underwent thyroid surgery at the Department of Breast and Thyroid Surgery in Anhui Provincial Hospital, China in 2012 was performed. The clinicopathological characteristics of patients with thyroid malignancies and CLT were collected. CLT was diagnosed by histopathological method. Among 647 patients, 144 patients had thyroid malignancies and 108 patients had been diagnosed with CLT. Moreover, in total, 44 patients had thyroid malignancies coexistent with CLT: forty-one (93.2%) patients had been diagnosed with the papillary thyroid cancer (PTC); two (4.5%) patients suffered from medullary carcinoma; and one (2.3%) patient suffered from lymphoma. The morbidity of thyroid malignancies in patients with CLT was significantly higher than that in patients without CLT (40.7% versus 18.6%; P CLT compared with those without CLT (P CLT and without CLT. Female predominance was observed in patients with CLT. CLT may have no effect on the progression of thyroid malignant tumor. Nevertheless, the influences of CLT on the prognosis of the thyroid carcinoma still need to be investigated with a larger sample size.

  10. Vacuum therapy for chronic wounds

    Directory of Open Access Journals (Sweden)

    Ekaterina Leonidovna Zaytseva

    2012-09-01

    Full Text Available Chronic wound in patients with diabetes mellitus (DM is one of the most urgent problems of modern diabetology and surgery. Numberof patients suffering from different types of chronic wounds follows increase in DM incidence. Vacuum therapy is a novel perspectivemethod of topical treatment for non-healing chronic wounds of various etiology. Current review addresses experimental and clinicalevidence for this method.

  11. Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana.

    Science.gov (United States)

    Feingold, Daniel; Brill, Silviu; Goor-Aryeh, Itay; Delayahu, Yael; Lev-Ran, Shaul

    2017-08-15

    High rates of depression and anxiety have been consistently reported among patients suffering from chronic pain. Prescription opioids are one of the most common modalities for pharmacological treatment of pain, however in recent years medical marijuana(MM) has been increasingly used for pain control in the US and in several countries worldwide. The aim of this study was to compare levels of depression and anxiety among pain patients receiving prescription opioids and MM. Participants were patients suffering from chronic pain treated with prescription opioids (OP,N=474), MM (N=329) or both (OPMM,N=77). Depression and anxiety were assessed using the depression module of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7). Prevalence of depression among patients in the OP, MM and OPMM groups was 57.1%, 22.3% and 51.4%, respectively and rates of anxiety were 48.4%, 21.5% and 38.7%, respectively. After controlling for confounders, patients in the OP group were significantly more likely to screen positive for depression (Adjusted Odds Ratio(AOR)=6.18;95%CI=4.12-9.338) and anxiety(AOR=4.12;CI=3.84-5.71)) compared to those in the MM group. Individuals in the OPMM group were more prone for depression (AOR for depression=3.34;CI=1.52-7.34)) compared to those in the MM group. Cross-sectional study, restricting inference of causality. Levels of depression and anxiety are higher among chronic pain patients receiving prescription opioids compared to those receiving MM. Findings should be taken into consideration when deciding on the most appropriate treatment modality for chronic pain, particularly among those at risk for depression and anxiety. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. The research of Proactive Coping Behavior of Patients with Chronic Non-Specific Lung Disease

    Directory of Open Access Journals (Sweden)

    Marija A. Yaroslavskaya

    2011-01-01

    Full Text Available The purpose of the research was to study the patterns of using proactive coping and adherences to it's different types in patients with chronic non-specifi c lung diseases. Participants of the study (N=180 were 30 to 60 years old. The Proactive Coping Inventory was used to assess the patients' psychological status. According to the results of the study patients with chronic non-specifi c lung diseases use dif-ferent types of proactive coping behavior while solving problematic and stressful situations. The research revealed that patients with bronchial asthma don't have the skills of independent decision making, definition of objectives, considering of options in solving conflicts or other inconvenient situations sufficiently developed. Patients with chronic obstructive pulmonary disease are less satisfied with the emotional support that they receive from their relatives and closest people, it's harder for them to reveal their feelings and emotions than for those who suffer from bronchial asthma and healthy ones. The results of the study may be useful in developing educational systems of proactive coping behavior skills for patients with chronic non-specific lung diseases for their health and well-being support.

  13. [Function in patients with chronic fibrocavernous tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, residual volume (RV), R(aw), R(in), R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 62 patients with chronic fibrocavernous tuberculosis. Lung dysfunctions were detected in 96.8% of the patients. Changes in lung volumes and capacities were found in 90.3%, impaired bronchial patency was in 90.3%, and pulmonary gas exchange dysfunction was in 79.0%. The lung volume and capacity changes appeared as decreased VC and FVC, decreased and increased TLC, TGV, RV; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, and FEV1/VC%; and increased R(aw), R(in), R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, PaO2, and decreased and increased PaCO2. The magnitude of the observed functional changes ranges from slight to significant and drastic with a predominance of considerable and drastic changes in lung volumes and capacities and mild impairments of bronchial patency and pulmonary gas exchange function.

  14. Adaptation and validation of the patient assessment of chronic illness care in the French context.

    Science.gov (United States)

    Krucien, Nicolas; Le Vaillant, Marc; Pelletier-Fleury, Nathalie

    2014-06-19

    Chronic diseases are major causes of disability worldwide with rising prevalence. Most patients suffering from chronic conditions do not always receive optimal care. The Chronic Care Model (CCM) has been developed to help general practitioners making quality improvements. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was increasingly used in several countries to appraise the implementation of the CCM from the patients' perspective. The objective of this study was to adapt the PACIC questionnaire in the French context and to test the validity of this adaptation in a sample of patients with multiple chronic conditions. The PACIC was translated into French language using a forward/backward procedure. The French version was validated using a sample of 150 patients treated for obstructive sleep apnea syndrome (OSAS) and having multiple chronic co-morbidities. Several forms of validity were analysed: content; face; construct; and internal consistency. The construct validity was investigated with an exploratory factorial analysis. The French-version of the PACIC consisted in 18 items, after merging two pairs of items due to redundancy. The high number of items exhibiting floor/ceiling effects and the non-normality of the ratings suggested that a 5-points rating scale was somewhat inappropriate to assess the patients' experience of care. The construct validity of the French-PACIC was verified and resulted in a bi-dimensional structure. Overall this structure showed a high level of internal consistency. The PACIC score appeared to be significantly related to the age and self-reported health of the patients. A French-version of the PACIC questionnaire is now available to evaluate the patients' experience of care and to monitor the quality improvements realised by the medical structures. This study also pointed out some methodological issues about the PACIC questionnaire, related to the format of the rating scale and to the structure of the

  15. Gastric emptying in patients with chronic liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ishizu, Hirotaka; Shiomi, Susumu; Kawamura, Etsushi; Iwata, Yoshinori; Nishiguchi, Shuhei; Kawabe, Joji; Ochi, Hironobu [Osaka City Univ. (Japan). Graduate School of Medicine

    2002-05-01

    There have been a number of reports of gastric emptying in cirrhosis, all with unconfirmed results. Moreover, the mechanism for delayed emptying in cirrhotic patients in unclear. We evaluated gastric emptying in patients with chronic hepatitis and cirrhosis by means of gastric emptying scintigraphy. The subjects were 18 normal controls and 75 patients with chronic viral hepatitis (50 patients had chronic hepatitis and 25 patients had cirrhosis). Tc-99m diethyltriamine pentaacetic acid labeled solid meals were used to evaluate gastric emptying; the half-time (T 1/2) of which was calculated. Digestive symptom scores were determined at the time of gastric emptying tests. Fourteen (28%) of 50 patients with chronic hepatitis and 16 (64%) of 25 patients with cirrhosis had delayed gastric emptying. T 1/2 in patients with cirrhosis was significantly higher than that in normal controls and patients with chronic hepatitis (p=0.0001 and 0.0003, respectively). The difference between T 1/2 in patients with chronic hepatitis and that in normal controls was not significant. On regression analysis, two indices, the serum albumin level and platelet count, were found to be significantly related to delayed gastric emptying. Gastric emptying was more delayed in cirrhotic patients than in those with chronic hepatitis and normal controls. Delayed gastric emptying may be related to liver function and portal hypertension. (author)

  16. Heart rate variability among caregivers of chronically bedridden patients

    Directory of Open Access Journals (Sweden)

    Amrith Pakkala

    2013-01-01

    Full Text Available Background: Caregivers of chronically bedridden patients are likely to suffer from mental and physical exhaustion leading to stress. This is important in view of the prevailing socioeconomic as well as the healthcare system available in a developing country like India. Therefore, the present study is designed to measure heart rate variability (HRV among this special group of population who give care to long-term bedridden patients. Materials and Methods: Fifteen female subjects were enrolled from among attendants of patients admitted with an immediate history of a cerebrovascular accident with locomotor deficits, who required constant care. They were free from any type of physical and mental health issues, nonsmokers and nonaddicts. Each care giver was subjected to HRV analysis on three occasions: The first record was performed in the 1 st week of their arrival in the hospital as caregivers. The second observation was recorded after 3 months of caregiving. The final HRV analysis was done after 6 months of care giving. Two types of parameters were analyzed: Time domain and frequency domain. Statistical analysis was done using paired t-test. Results: Both the HRV parameters: Time and frequency domain, showed decreased values during the 3 rd and 6 th month recording as compared to the 1 st week recording. The decrease is much more during the 6 th month recording as compared to the 3 rd month recording. Statistically significant decrease is observed in mean RR interval, heart rate, very low frequency (VLF, and LF only when the 1 st week recording is compared with the 3 rd month recording, but when the 1 st week recording was compared with the 6 th month recording significant decrease was found in mean RR interval and heart rate. Conclusion: Subjects involved in taking care of chronically ill bedridden patients are likely to undergo a lot of physical and mental stress, thus affecting their autonomic status. HRV analysis using short term

  17. Intranasal Ketamine Administration for Narcotic Dose Decrement in Patients Suffering from Acute Limb Trauma in Emergency Department: a Double-Blind Randomized Placebo-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Ali Mohammadshahi

    2018-04-01

    Full Text Available Introduction: pain management is an important and challenging issue in emergency medicine. Despite the conduct of several studies on this topic, pain is still handled improperly in many cases. Objective: This study investigated the effectiveness of low-dose IN ketamine administration in reducing the need for opiates in patients in acute pain resulting from limb injury. Method: This randomized, double-blind, placebo-controlled trial was conducted to assess the possible effect of low-dose intranasal (IN ketamine administration in decreasing patients' narcotic need. Patients in emergency department suffering from acute isolated limb trauma were included. One group of patients received 0.5 mg/kg intravenous morphine sulfate and 0.02 ml/kg IN ketamine. The other group received the same dose of morphine sulfate and 0.02 ml/kg IN distilled water. Pain severity was measured using the 11 points numerical rating scale at 0, 10, 30, 60, 120, and 180 minutes. Results: Ninety-one patients with mean age of 31.62 ± 9.13 years were enrolled (54.9% male. The number of requests for supplemental medication was significantly lower in patients who received ketamine (12 patients (30% than those who received placebo (27 patients (67.5% (p = 0.001. Conclusion: It is likely that low-dose IN ketamine is effective in reducing the narcotic need of patients suffering from acute limb trauma.

  18. Burnout in Patients with Chronic Whiplash-Associated Disorders

    Science.gov (United States)

    Clementz, Gunilla; Borsbo, Bjorn; Norrbrink, Cecilia

    2012-01-01

    This study sought to assess burnout and its relation to pain, disability, mood and health-related quality of life in a group of patients with chronic whiplash-associated disorders (WAD). Forty-five patients with chronic WAD ([greater than or equal to] 3 months) referred to a multidisciplinary rehabilitation centre were included. A questionnaire…

  19. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E

    2012-01-01

    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...

  20. Evaluation of Nutritional Status and Hydration in Patients on Chronic ...

    African Journals Online (AJOL)

    Background: Nutrition and hydration of the dialysis patients have major influences on the outcomes of chronic hemodialysis. Purpose: To characterize the states of nutrition and hydration in patients on chronic hemodialysis at Jos University Teaching Hospital (JUTH) and to evaluate the usefulness of measurements by ...

  1. Patients with chronic pancreatitis are at increased risk for osteoporosis.

    LENUS (Irish Health Repository)

    Duggan, SN

    2012-10-01

    Patients with chronic pancreatitis may be at an increased risk of low bone density because of malabsorption of vitamin D and calcium, poor diet, pain, alcoholism, and smoking. We investigated the rates of osteoporosis in patients with chronic pancreatitis compared to matched controls.

  2. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and

  3. Electrocardiographic Characteristics of Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Warnier, M.J.; Rutten, F.H.; Numans, M.E.; Kors, J.A.; Tan, H.L.; de Boer, A.; Hoes, A.W.; de Bruin, M.L.

    2013-01-01

    Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis, but studies comparing ECG characteristics between patients with and without COPD are lacking. We related ECG

  4. An assessment of the performance of the immunity system in iron and steel workers exposed to hazardous industrial factors. Pt. 2. Regulation of immuno-deficiencies in iron and steel workers suffering from chronic bronchitis. Die Beurteilung der Leistung des Immunsystems bei Huettenarbeitern unter Einwirkung schaedlicher industrieller Faktoren. T. 2. Regulierung von Immundefiziten bei Erzhuettenarbeitern mit chronischer Bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Scheller, S.; Czuba, Z.; Krol, W.; Nikodemowicz, E.; Aleksandrowicz, J.; Zydowicz, G. (Inst. for Microbiology, Medical Academy, Zabrze-Rokitnica (Poland)); Shani, J. (Univ. of South California, School of Pharmacy, Los Angeles, CA (USA)); Malinowska, B. (Sanatorium for Lung Diseases and Tuberculosis, Bystra Slaska (Poland))

    1991-05-01

    147 iron and steel workers suffering from chronic bronchitis underwent a 24 days climatic treatment. A local antibacterial treatment was empolyed as well as local and systemic regulation of the immunosystem. Significant immuno-deficiencies were found in the patients concerned. EEP in an isotonic saline solution was applied locally by means of inhalations as a remedy with antibacterial and immunotropic effects. The systematic immunotherapy was carried out by administering Propolin tablets, Dolomit, Methindol (Indomethazin), Biostymina, and Decaris (Levamisole). After the treatment we stated a favorable change of several parameters. (orig.).

  5. 'Do you think you suffer from depression?' Reevaluating the use of a single item question for the screening of depression in older primary care patients

    DEFF Research Database (Denmark)

    Ayalon, Liat; Goldfracht, Margalit; Bech, Per

    2010-01-01

    OBJECTIVES: The majority of older adults seek depression treatment in primary care. Despite impressive efforts to integrate depression treatment into primary care, depression often remains undetected. The overall goal of the present study was to compare a single item screening for depression...... to existing depression screening tools. METHODS: A cross sectional sample of 153 older primary care patients. Participants completed several depression-screening measures (e.g. a single depression screen, Patient Health Questionnaire-9, Major Depression Inventory, Visual Analogue Scale). Measures were......: An easy way to detect depression in older primary care patients would be asking the single question, 'do you think you suffer from depression?'...

  6. Ten years' of experience in patient education of families with a child/adolescent suffering from cystic fibrosis

    DEFF Research Database (Denmark)

    Bregnballe, Vibeke

    2007-01-01

    Aims: The patient education programme for families with children or adolescents with cystic fibrosis (the CF school) was established ten years ago to enable patients to make choices in their lives as CF patients. The CF school provides patients with knowledge about cystic fibrosis (CF), teaches...

  7. Exhaled breath analysis using electronic nose in cystic fibrosis and primary ciliary dyskinesia patients with chronic pulmonary infections

    DEFF Research Database (Denmark)

    Joensen, Odin; Paff, Tamara; Haarman, Eric G

    2014-01-01

    The current diagnostic work-up and monitoring of pulmonary infections may be perceived as invasive, is time consuming and expensive. In this explorative study, we investigated whether or not a non-invasive exhaled breath analysis using an electronic nose would discriminate between cystic fibrosis...... (CF) and primary ciliary dyskinesia (PCD) with or without various well characterized chronic pulmonary infections. We recruited 64 patients with CF and 21 with PCD based on known chronic infection status. 21 healthy volunteers served as controls. An electronic nose was employed to analyze exhaled......, this method significantly discriminates CF patients suffering from a chronic pulmonary P. aeruginosa (PA) infection from CF patients without a chronic pulmonary infection. Further studies are needed for verification and to investigate the role of electronic nose technology in the very early diagnostic workup...

  8. Cryptosporidiosis and other intestinal parasitic infections in patients with chronic diarrhea.

    Science.gov (United States)

    Mahdi, Nadham K; Ali, Naeel H

    2004-09-01

    To consider the relationship of the parasitic infections including cryptosporidium with chronic diarrhea. Also the effect of chronic disease as pulmonary tuberculosis (TB) and nosocomial infection on the occurrence rate of parasites in cases of chronic diarrhea. Stool samples were collected from 205 patients in teaching, general, child and maternity hospitals in Basrah, Iraq, suffering from chronic diarrhea during 2000. Out of these patients, there were 40 patients with pulmonary TB and 50 inpatients with nosocomial infection. Also 175 apparently healthy individuals who have no episodes of diarrhea for at least 2-months were served as a control group. Direct smear method and then formalin ether sedimentation method were carried out for stool samples to detect intestinal parasites. Fecal smears were prepared from the sediment and stained by the modified Ziehl Neelsen stain for the recovery of red pink oocysts of cryptosporidium. Out of the 205 examined patients, cryptosporidium oocysts were found to be excreted in 20 (9.7%) patients in comparing to 1.1% of the control group. The difference is statistically significant. There were 109 (53.2%) patients found to be positive for intestinal parasitic infections compared to 26 (14.8%) of the control group. The difference is also statistically significant. Out of the 40 TB patients, 2 (5%) were found to excrete cryptosporidium oocysts and also 27 (67.3%) were positive for intestinal parasites. In addition, there were 4 (8%) excreting cryptosporidium oocysts and 23 (46%) infecting by intestinal parasites among the in patients with nosocomial infection. Both acid and non-acid fast parasites should be considered in the differential diagnosis of undiagnosed chronic diarrhea especially among patients with pulmonary TB or nosocomial infection.

  9. Intradialytic parenteral nutrition in maintenance hemodialysis patients suffering from protein-energy wasting. Results of a multicenter, open, prospective, randomized trial.

    Science.gov (United States)

    Marsen, Tobias A; Beer, Justinus; Mann, Helmut

    2017-02-01

    Protein-energy wasting (PEW) is increasingly becoming a clinical problem in maintenance hemodialysis patients and guidelines call for nutritional interventions. Serum prealbumin (transthyretin) represents a critical nutritional marker positively correlated with patient survival and negatively correlated with morbidity. Nutritional counseling, oral supplementation as well as intradialytic parenteral nutrition (IDPN) are recommended to fight PEW, however clinical trials on their use are scarce. We conducted a prospective, multicenter, randomized, open-label, controlled, parallel-group Phase IV clinical trial in 107 maintenance hemodialysis patients suffering from PEW to assess the impact of IDPN on prealbumin and other biochemical and clinical parameters reflecting nutritional status. Patients randomized to the intervention group received standardized nutritional counseling plus IDPN three times weekly over 16 weeks followed by a treatment-free period of 12 weeks. The control group received standardized nutritional counseling only. Main trial inclusion criteria included moderate to severe malnutrition (SGA score B or C), maintenance hemodialysis therapy (3 times per week) for more than six months, and presence of two out of the following three criteria: albumin 30 mg/L at week 16 (48.7% vs. 31.8%). Prealbumin response to IDPN therapy was more prominent in patients suffering from moderate malnutrition (SGA score B) compared to patients with severe malnutrition (SGA score C). The results of this trial demonstrate for the first time that IDPN therapy, given three times weekly in a 16-week short-term intervention, results in a statistically significant and clinically relevant increase in mean serum prealbumin, a surrogate marker for outcome and survival in hemodialysis patients suffering from PEW, and is superior to nutritional counseling. Clinical trial registry:www.clinicaltrials.gov (NCT00501956). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights

  10. [Christian dimension of suffering].

    Science.gov (United States)

    Kubik, K

    1999-01-01

    Human existence is marked by imperfection, whose expression--among other things--is suffering. The problem of answering the question about the meaning of suffering for human life in its entirety is of great significance in philosophy and theology. In the Old Testament it meant God's punishment for the evil done by man. In Christianity this bleak notion of suffering has found a new dimension--suffering is creative, redemptive in character; it enables a man to surpass his limits. The understanding of suffering and its sense has a profound meaning in building a suitable attitude of a sick person towards his own weakness.

  11. Airway inflammation in nonobstructive and obstructive chronic bronchitis with chronic haemophilus influenzae airway infection. Comparison with noninfected patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Bresser, P.; Out, T. A.; van Alphen, L.; Jansen, H. M.; Lutter, R.

    2000-01-01

    Nonencapsulated Haemophilus influenzae often causes chronic infections of the lower respiratory tract in both nonobstructive and obstructive chronic bronchitis. We assessed airway inflammation in clinically stable, chronically H. influenzae-infected patients with nonobstructive (CB-HI, n = 10) and

  12. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  13. Relationship between sleep quality and mental health according to demographics of 850 patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Eslaminejad, Alireza; Safa, Mitra; Ghassem Boroujerdi, Fatemeh; Hajizadeh, Farzaneh; Pashm Foroush, Maryam

    2017-10-01

    We aimed to study sleep problems in hospitalized chronic obstructive pulmonary disease patients and assess the relationship of sleep quality with mental health and demographics of patients. Our study sample consisted of 850 chronic obstructive pulmonary disease patients hospitalized in Masih Daneshvari Hospital. Demographic data were collected and the Pittsburgh Sleep Quality and mental health questionnaires were filled out for patients. The results showed that 5.9 percent were suffering from severe sleep problems, while 4.7 percent had severe mental problems. A strong positive correlation was found between the total scores of mental health and sleep quality ( p mental health problems was higher in females compared to males. Mental health and sleep quality play important roles in quality of life of chronic obstructive pulmonary disease patients.

  14. Psychosocial factors and adherence to drug treatment in patients on chronic haemodialysis.

    Science.gov (United States)

    Huertas-Vieco, María P; Pérez-García, Rafael; Albalate, Marta; de Sequera, Patricia; Ortega, Mayra; Puerta, Marta; Corchete, Elena; Alcázar, Roberto

    2014-11-17

    The daily pill burden in hemodialysis patients is one of the highest reported to date in any chronic disease. The adherence to prescribed treatment has implications on the quality of life, the survival of patients, and the economic cost of their treatment, this being a priority public health issue. To evaluate the adherence to pharmacological treatment examining, among the possible causes of non-adherence, psychosocial factors such as depression, anxiety, cognitive impairment and social support. Transversal-observational study of thirty five patients that suffer from chronic renal disease and who are on manteinance hemodialysis, evaluated by self-reported measures. Non-adherent patients have significant higher depression index than adherent patients. Anxiety, cognitive impairment and social support do not show a significant relation with the degree of adherence or compliance with farmacological treatment. These results suggest that psychological intervention in chronic haemodialysis patients with a severe depression index could increase the degree of fulfillment and general well-being of renal patients.

  15. Altered duodenal microbiota composition in celiac disease patients suffering from persistent symptoms on a long-term gluten-free diet.

    Science.gov (United States)

    Wacklin, Pirjo; Laurikka, Pilvi; Lindfors, Katri; Collin, Pekka; Salmi, Teea; Lähdeaho, Marja-Leena; Saavalainen, Päivi; Mäki, Markku; Mättö, Jaana; Kurppa, Kalle; Kaukinen, Katri

    2014-12-01

    A significant fraction of celiac disease patients suffer from persistent symptoms despite a long-term gluten-free diet (GFD) and normalized small bowel mucosa. The commonly suggested reasons, such as inadvertent gluten-intake or presence of other gastrointestinal disease, do not explain the symptoms in all these patients. Recently, alterations in intestinal microbiota have been associated with autoimmune disorders, including celiac disease. This led us to test a hypothesis that abnormal intestinal microbiota may be associated with persisting gastrointestinal symptoms in treated celiac disease patients. Duodenal microbiota was analyzed in 18 GFD-treated patients suffering from persistent symptoms and 18 treated patients without symptoms by 16S rRNA gene pyrosequencing. The celiac disease patients had been following a strict GFD for several years and had restored small bowel mucosa and negative celiac autoantibodies. Their symptoms on GFD were assessed with Gastrointestinal Symptom Rating Scale. The results of several clustering methods showed that the treated celiac disease patients with persistent symptoms were colonized by different duodenal microbiota in comparison with patients without symptoms. The treated patients with persistent symptoms had a higher relative abundance of Proteobacteria (P=0.04) and a lower abundance of Bacteroidetes (P=0.01) and Firmicutes (P=0.05). Moreover, their microbial richness was reduced. The results indicated intestinal dysbiosis in patients with persistent symptoms even while adhering to a strict GFD. Our findings indicate that dysbiosis of microbiota is associated with persistent gastrointestinal symptoms in treated celiac disease patients and open new possibilities to treat this subgroup of patients.

  16. Electroconvulsive therapy (ECT) and aerobic exercise training (AET) increased plasma BDNF and ameliorated depressive symptoms in patients suffering from major depressive disorder.

    Science.gov (United States)

    Salehi, Iraj; Hosseini, Seyed Mohammad; Haghighi, Mohammad; Jahangard, Leila; Bajoghli, Hafez; Gerber, Markus; Pühse, Uwe; Holsboer-Trachsler, Edith; Brand, Serge

    2016-05-01

    To treat patients suffering from major depressive disorder (MDD), research has focused on electroconvulsive therapy (ECT) and aerobic exercise training (AET). Brain derived neurotrophic factor (BDNF) seems to be key in MDD. The aims of the present study were therefore two-fold, to investigate in a three-arm interventional study the differential effects of ECT, ECT plus AET, and AET alone in patients suffering from TR-MDD on 1. depressive symptoms and 2. plasma BDNF (pBDNF). 60 patients with MDD (mean age: 31 years; 31.6% female patients) were randomly assigned either to the ECT, ECT + AET, or AET condition. The AET condition consisted of treadmill exercise for 45 min, three times a week. Both depression severity and pBDNF levels were assessed at baseline and 4 weeks later. All patients were further treated with an SSRI standard medication. pBDNF levels increased over time in all three study conditions, though, highest increase was observed in the ECT + EAT condition, and lowest increase was observed in the AET condition. Depressive symptoms decreased in all three conditions over time, though, strongest decrease was observed in the ECT + AET condition. The combination of ECT + AET led to significantly greater remission rates than in either the ECT or AET alone conditions. BDNF levels were not associated with symptoms of depression. The pattern of results suggests that ECT, AET and particularly their combination are promising directions for the treatment of patients suffering from MDD, and that it remains unclear to what extent pBDNF is key and a reliable biomarker for MDD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Prospective radiological study concerning a series of patients suffering from conductive or mixed hearing loss due to superior semicircular canal dehiscence.

    Science.gov (United States)

    Martin, Christian; Chahine, Pierre; Veyret, Charles; Richard, Céline; Prades, Jean Michel; Pouget, Jean François

    2009-08-01

    The aim of this study is to appreciate the incidence of patients with isolated conductive hearing loss with normal drum due to superior semicircular canal dehiscence (SCD). It is a prospective radiological study. Two hundred and seventy-two patients with a normal drum suffering from isolated unilateral or bilateral conductive or mixed hearing loss were included in a prospective radiological study. A high resolution computerized tomography (HRCT) was performed in all the patients. Those who were found to have a unilateral or bilateral SCD underwent further etiological, clinical, audiologic evaluation. Ten patients with conductive or mixed hearing loss were found to have a unilateral or bilateral SCD. The disease was bilateral in five cases, and most often associated with a dehiscence of the tegmen tympani on both sides, supporting the theory of the congenital nature of the disease. There was no clear correlation between symptoms and the size of the SCD. Because patients were not suffering from incapacitating vestibular symptoms, they were not operated for surgical occlusion of the SCD, and were referred to a hearing aid specialist to improve hearing. Conductive or mixed hearing loss due to SCD is relatively frequent, justifying in our opinion that a systematic HRCT be carried out before surgery of any patient with conductive hearing loss.

  18. Transvascular lipoprotein transport in patients with chronic renal disease

    DEFF Research Database (Denmark)

    Jensen, Trine Krogsgaard; Nordestgaard, Børge Grønne; Feldt-Rasmussen, Bo

    2004-01-01

    BACKGROUND: While increased plasma cholesterol is a well-established cardiovascular risk factor in the general population, this is not so among patients with chronic renal disease. We hypothesized that the transvascular lipoprotein transport, in addition to the lipoprotein concentration in plasma......, determines the degree of atherosclerosis among patients with chronic renal disease. METHODS: We used an in vivo method for measurement of transvascular transport of low-density lipoprotein (LDL) in 21 patients with chronic renal disease and in 42 healthy control patients. Autologous 131-iodinated LDL...... was reinjected intravenously, and the 1-hour fractional escape rate was taken as index of transvascular transport. RESULTS: Transvascular LDL transport tended to be lower in patients with chronic renal disease than in healthy control patients [3.3 (95% CI 2.4-4.2) vs. 4.2 (3.7-4.2)%/hour; NS]. However...

  19. A cross-sectional study to assess the incompatible dietary behavior of patients suffering from skin diseases: A pilot study

    Directory of Open Access Journals (Sweden)

    Meghana Kulkarni

    2016-04-01

    Conclusion: Scores for consumption of incompatible diet and dietary habits were found to be higher in acne and psoriasis patients compared to controls. Patients with fungal infections had higher scores for the presence of incompatible dietary habits but similar scores for the consumption of incompatible diet, whereas both scores in patients of vitiligo were similar to controls.

  20. Patients with heart failure and their partners with chronic illness: interdependence in multiple dimensions of time

    Directory of Open Access Journals (Sweden)

    Nimmon L

    2018-03-01

    Full Text Available Laura Nimmon,1,2 Joanna Bates,1,3 Gil Kimel,4,5 Lorelei Lingard6 On behalf of the Heart Failure/Palliative Care Teamwork Research Group 1Centre for Health Education Scholarship, 2Department of Occupational Science and Occupational Therapy, 3Department of Family Practice, Faculty of Medicine, University of British Columbia, 4Palliative Care Program, St Paul’s Hospital, 5Department of Medicine, Division of Internal Medicine, University of British Columbia, Vancouver, BC, 6Centre for Education Research and Innovation, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada Background: Informal caregivers play a vital role in supporting patients with heart failure (HF. However, when both the HF patient and their long-term partner suffer from chronic illness, they may equally suffer from diminished quality of life and poor health outcomes. With the focus on this specific couple group as a dimension of the HF health care team, we explored this neglected component of supportive care. Materials and methods: From a large-scale Canadian multisite study, we analyzed the interview data of 13 HF patient–partner couples (26 participants. The sample consisted of patients with advanced HF and their long-term, live-in partners who also suffer from chronic illness. Results: The analysis highlighted the profound enmeshment of the couples. The couples’ interdependence was exemplified in the ways they synchronized their experience in shared dimensions of time and adapted their day-to-day routines to accommodate each other’s changing health status. Particularly significant was when both individuals were too ill to perform caregiving tasks, which resulted in the couples being in a highly fragile state. Conclusion: We conclude that the salience of this couple group’s oscillating health needs and their severe vulnerabilities need to be appreciated when designing and delivering HF team-based care. Keywords

  1. The Chronic Illness Problem Inventory as a measure of dysfunction in chronic pain patients.

    Science.gov (United States)

    Romano, J M; Turner, J A; Jensen, M P

    1992-04-01

    Assessment of physical and psychosocial dysfunction is recognized as essential in chronic pain patient evaluation. One instrument, the Sickness Impact Profile (SIP), has demonstrated good reliability and validity as a measure of dysfunction among chronic pain patients. An alternate measure, the Chronic Illness Problem Inventory (CIPI), is shorter and more easily scored than the SIP, but as yet has not been applied widely to chronic pain problems. In the present study, 95 chronic low back pain patients completed the SIP, the CIPI, activity diaries, the McGill Pain Questionnaire (MPQ), and the Center for Epidemiologic Studies-Depression scale (CES-D), before participating in a chronic pain treatment study. Overt pain behaviors were also coded from videotapes of a standardized assessment protocol. Seventy-five subjects completed the measures post-treatment. The results indicate that although the SIP and the CIPI are significantly correlated and appear to be measuring similar constructs, there is also substantial unshared variance between them, suggesting that they may tap somewhat different aspects of dysfunction in chronic pain. The CIPI shows promise as a useful alternative measure of dysfunction in chronic low back pain patients, but requires further validation for this purpose.

  2. Retrospective study of the evolution of nutritional, inflammatory and bacteriological profiles of patients suffering from inoperable aero-digestive duct tumour during sequential or concomitant chemo-radiotherapy

    International Nuclear Information System (INIS)

    Martin, L.; Brocard, C.; Coudray, C.; Pavlovitch, J.M.

    2010-01-01

    The authors report a retrospective study which aimed at analysing a cohort of consecutive patients in terms of clinic and biological aspects reflecting their nutritional and inflammatory status as well as the status of their buccal bacterial flora during a sequential or concomitant chemo-radiotherapy. The objective was to detect a possible difference between these both therapeutic modalities, and a possible relationship with toxicity. Several data have been collected for patients suffering from inoperable aero-digestive tract tumour: weight, body mass index, prealbumin, albumin, orosomucoid, C-reactive protein, PINI index, and buccal bacterial flora. The evolution of these nutritional biological criteria appears to depend on the treatment modality. Short communication

  3. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite.

    Science.gov (United States)

    Khan, Mohammad Iqbal; Tariq, Mohammad; Rehman, Ahmed; Zafar, Afsheeen; Sheen, Salman Najam

    2008-01-01

    Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene ofdistal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p frost bite.

  4. [Clinical effect of clarithromycin therapy in patients with chronic rhinosinusitis].

    Science.gov (United States)

    Luo, Qing; Deng, Jie; Xu, Rui; Zuo, Kejun; Li, Huabin; Shi, Jianbo

    2014-02-01

    To evaluate the efficacy of clarithromycin (CAM) treatment in adult Chinese patients suffering from chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP). A prospective, open and self-controlled clinical trial on patients with CRS was conducted. Fifty patients met inclusion criteria. Of 50 patients, there were 33 patients with CRSsNP and 17 patients with CRSwNP. CAM was administered at 250 mg/d and the duration of administration was 12 weeks. Outcome measures included assessments of visual analogue scale (VAS), the sino-nasal outcome test-20(SNOT-20), the medical outcomes study short-form 36 items(SF-36), Lund-Kennedy endoscopy score, and Lund-Mackay computed tomography score. Before starting the treatment, 2 months after treatment and at the end of treatment, each patient had to complete all the measures except Lund-Mackay computed tomography score, which was only conducted before and after treatment. In order to evaluate the safety of CAM, liver function and renal function in all patients were detected before and after treatment. SPSS 16.0 software was used to analyze the data. Forty-five patients completed 3 months follow-up and 5 patients withdrew due to different reasons. The results were as follows: (1) Thirty-three patients with CRSsNP's VAS scores of four time point were 5.81 ± 1.69, 3.76 ± 1.94, 2.98 ± 1.95, 2.06 ± 2.13, respectively, there were statistically significant improvements in turn (t values were 5.910, 8.090, 8.932, all P 0.05). Endoscopy score of four time point were 10.65 ± 1.77, 9.35 ± 1.93, 8.65 ± 2.76, 8.47 ± 2.76, respectively, there were statistically significant improvements in turn(t values were 4.068, 4.863, 5.156, all P CAM treatment, 1 patient reported a tolerable headache and weakness and 1 patient had abdominal pain after two months treatment, all the symptoms disappeared while they were asked to stop the drug. Liver function and renal function were detected in 40 patients, the differences

  5. Chronic Inflammatory Periodontal Disease in Patients with Human Immunodeficiency Virus.

    OpenAIRE

    Vania López Rodríguez; Emilio Carpio Muñoz; Vicente Fardales Macías; Iralys Benítez Guzmán

    2009-01-01

    Background: The Chronic Inflammatory Periodontal Disease is related with multiple risk factors. Those patients with human immunodeficiency virus have higher risk of presenting this disease and it is usually more serious in these cases. Objective: To describe the prevalence of Chronic Inflammatory Periodontal Disease in patients with HIV. Methods: Descriptive, observational, cross-sectional study including patients with HIV in Sancti Spiritus province. The occurrence of the disease was determi...

  6. [Vitamins and microelements in patients with chronic kidney disease].

    Science.gov (United States)

    Małgorzewicz, Sylwia; Jankowska, Magdalena; Kaczkan, Małgorzata; Czajka, Beata; Rutkowski, Bolesław

    2014-01-01

    The supply of vitamins and microelements in patients with chronic kidney disease (CKD) is very important and requires special attention. CKD patients presented deficiency of these substances in the diet and in organism, but also excess of fat-soluble vitamins or trace elements is observed. Studies indicate that deficiency of vitamins and antioxidants in diet and also enhanced oxidative stress are cause of many complications for example: accelerated process of arteriosclerosis in patients with chronic kidney disease.

  7. Personal prayer in patients dealing with chronic illness: a review of the research literature.

    Science.gov (United States)

    Jors, Karin; Büssing, Arndt; Hvidt, Niels Christian; Baumann, Klaus

    2015-01-01

    Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1) why do people turn to prayer in times of illness?, (2) what are the main topics of their prayers?, and (3) how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1) participants in the study were patients dealing with an illness, (2) the study examined the use of private rather than intercessory prayer, and (3) the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1) disease-centered prayer, (2) assurance-centered prayer, (3) God-centered prayer, (4) others-centered prayer, and (5) lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness.

  8. Personal Prayer in Patients Dealing with Chronic Illness: A Review of the Research Literature

    Directory of Open Access Journals (Sweden)

    Karin Jors

    2015-01-01

    Full Text Available Background. Prayer is commonly used among patients for health purposes. Therefore, this review focused on three main questions: (1 why do people turn to prayer in times of illness?, (2 what are the main topics of their prayers?, and (3 how do they pray? Method. We undertook a systematic review of the literature by searching the databases PubMed, Medline, and PsycINFO. The following inclusion criteria were used: (1 participants in the study were patients dealing with an illness, (2 the study examined the use of private rather than intercessory prayer, and (3 the content and purpose of prayer rather than its effects were investigated. Results. 16 articles were included in the final review. Participants suffered from a variety of chronic diseases, mostly cancer. Five main categories for the reasons and topics of prayer were found: (1 disease-centered prayer, (2 assurance-centered prayer, (3 God-centered prayer, (4 others-centered prayer, and (5 lamentations. Among these, disease-centered prayer was most common. Conclusions. Although most patients with chronic diseases do pray for relief from their physical and mental suffering, the intention of their prayers is not only for healing. Rather, prayer can be a resource that allows patients to positively transform the experience of their illness.

  9. Experiences of patients with chronic gastrointestinal conditions: in their own words

    Directory of Open Access Journals (Sweden)

    McCormick Jennifer B

    2012-03-01

    Full Text Available Abstract Background Irritable bowel syndrome (IBS and inflammatory bowel disease (IBD are chronic conditions affecting millions of individuals in the United States. The symptoms are well-documented and can be debilitating. How these chronic gastrointestinal (GI conditions impact the daily lives of those afflicted is not well documented, especially from a patient's perspective. Methods Here we describe data from a series of 22 focus groups held at three different academic medical centers with individuals suffering from chronic GI conditions. All focus groups were audio recorded and transcribed. Two research team members independently analyzed transcripts from each focus group following an agreed upon coding scheme. Results One-hundred-thirty-six individuals participated in our study, all with a chronic GI related condition. They candidly discussed three broad themes that characterize their daily lives: identification of disease and personal identity, medications and therapeutics, and daily adaptations. These all tie to our participants trying to deal with symptoms on a daily basis. We find that a recurrent topic underlying these themes is the dichotomy of experiencing uncertainty and striving for control. Conclusions Study participants' open dialogue and exchange of experiences living with a chronic GI condition provide insight into how these conditions shape day-to-day activities. Our findings provide fertile ground for discussions about how clinicians might best facilitate, acknowledge, and elicit patients' stories in routine care to better address their experience of illness.

  10. Chronic Neuropathic Pain in Spinal Cord Injury: The Patient's Perspective

    Directory of Open Access Journals (Sweden)

    Penelope Henwood

    2004-01-01

    Full Text Available BACKGROUND: Chronic neuropathic pain (CNP in spinal cord injury (SCI is recognized as severely compromising, in both adjustment after injury and quality of life. Studies indicate that chronic pain in SCI is associated with great emotional distress over and above that of the injury itself. Currently, little is known about the SCI patient's perception of the impact of living with chronic neuropathic pain.

  11. 'Do you think you suffer from depression?' Reevaluating the use of a single item question for the screening of depression in older primary care patients

    DEFF Research Database (Denmark)

    Ayalon, Liat; Goldfracht, Margalit; Bech, Per

    2010-01-01

    evaluated against a depression diagnosis made by the Structured Clinical Interview for DSM-IV. RESULTS: Overall, 3.9% of the sample was diagnosed with depression. The most notable finding was that the single-item question, 'do you think you suffer from depression?' had as good or better sensitivity (83......%) than all other screens. Nonetheless, its specificity of 83% suggested that it has to be followed up by a through diagnostic interview. Additional sensitivity analyses concerning the use of a single depression item taken directly from the depression screening measures supported this finding. CONCLUSIONS......: An easy way to detect depression in older primary care patients would be asking the single question, 'do you think you suffer from depression?'...

  12. Examining the Predictive Role of Emotional Self-Regulation in Quality of Life and Perception of Suffering among Patients with Breast Cancer

    Directory of Open Access Journals (Sweden)

    Zahra Nikmanesh

    2017-04-01

    Full Text Available Background: Breast cancer is the most common type of cancer and second leading cause of death in women after lung cancer. The World Health Organization has reported that breast cancer, with 502,000 deaths in 2005, surpassed lung, stomach, colorectal, and cervical cancers as the leading cause of death in women. The main objective of the current study was to examine the predictive role of emotional selfregulation in quality of life and perception of suffering among patients with breast cancer. Methods: This was a descriptive-analytical study followed by a correlational design. The sample population consisted of 42 patients with breast cancer selected by the census method. Participants completed questionnaires on emotional self-regulation, quality of life (Aaronson et al., 1987, and perception of suffering. The obtained data was statistically analyzed using the Pearson correlation coefficient and regression analysis via SPSS 22. Results: There was a significant, positive association between emotional selfregulation and the functional and general dimensions of quality of life. A significant, inverse correlation existed between emotional self-regulation and the symptoms dimension of quality of life. The results of the enter regression analysis showed that selfregulation respectively predicted 0.18 of variance in the functional, 0.26 in symptoms, and 0.37 of the variance in the general health dimensions of the quality of life. Emotional self-regulation had a significant, diverse relationship to the physical, psychological, and existential dimensions of perception of suffering. The results of the regression analysis carried out to predict perception of suffering indicated that emotional self-regulation respectively predicted 0.33 of variance in the physical, 0.19 in psychological, and 0.06 of the variance in the existential dimensions of perception of suffering. Conclusion: A major step forward can be taken towards improving the level of quality of

  13. Change of the level of adiponectin and metabolic indices in modification of life style of the patients suffering from abdominal obesity

    Directory of Open Access Journals (Sweden)

    A. V. Beresina

    2015-01-01

    Full Text Available The paper studied nutritional habits, physical loads, anthropometric and metabolic perfromances, and revealed the changes required to increase the level of adiponectine under drug-free modalities of treatment of patients suffering from abdominal obesity. A 3-year randomized lifestyle intervention trial was performed in 153 patients with AO, age 30-53 yrs, 74 patients (group 1 performed individual hypocaloric diet balanced in fat intake, 79 patients (group 2 performed diet and individual aerobic exercise All patients received individual recommendations on changing their life style. Dynamics of anthropometric, metabolic parameters, physical capacity and adiponectin level were measured. Relation between low level of adiponectin and some metabolic disorders, and sedentary life were revealed. The rate of improving anthropometric parameters, physical capacity, and nutritionassociated with increasing adiponectin was established.

  14. [Campylobacter spp.: prevalence and pheno-genotypic characterization of isolates recovered from patients suffering from diarrhea and their pets in La Pampa Province, Argentina].

    Science.gov (United States)

    Tamborini, Ana L; Casabona, Luis M; Viñas, María R; Asato, Valeria; Hoffer, Alicia; Farace, María I; Lucero, María C; Corso, Alejandra; Pichel, Mariana

    2012-01-01

    The prevalence of Campylobacter spp. was investigated in 327 patients suffering from diarrhea and in 36 animals (dogs, cats and chickens) owned by the patients that presented infection by Campylobacter in Santa Rosa, La Pampa, Argentina. Campylobacter spp. was isolated in 50/327 patients and in 12/36 animals, being Campylobacter jejuni the most common species. Resistance to ciprofloxacin (65 %) and tetracycline (32 %) was found among 35 isolates of human origin studied. Seven genetic subtypes were observed among 13 C. jejuni isolates by pulsed field gel electrophoresis. Two subtypes grouped isolates belonging to patients and their respective dogs whereas another subtype grouped one isolate of human origin and two isolates from the patient's chickens. The results of this investigation highlight the need to strengthen surveillance of Campylobacter spp. not only in poultry, which is recognized as the main reservoir, but also in pets, which were shown to be asymptomatic carriers of the pathogen.

  15. Diagnostic agreement of schizophrenia spectrum disorders among chronic patients with functional psychoses

    DEFF Research Database (Denmark)

    Jakobsen, K D; Frederiksen, J N; Parnas, J

    2006-01-01

    of 100 individuals (35 women and 65 men) were randomly sampled and assessed using the Operational Criteria Checklist for Psychotic Illness and Affective Illness (OPCRIT). Based on the OPCRIT diagnoses the subjects suffering from schizophrenia and schizophrenia spectrum disorders according to seven...... function previous to the onset of illness. Similarly high pairwise CR were observed for schizophrenia spectrum disorders across all diagnostic systems. CONCLUSIONS: This study demonstrates that diagnostic agreement is higher among chronic patients than that observed in subjects with a recent onset...... serious epistemological consequences, thus underlining the conventional nature of the present schizophrenia diagnoses and the need for biologically founded diagnostic criteria....

  16. Suffering from Alopecia Areata

    Directory of Open Access Journals (Sweden)

    mitra Safa

    2008-02-01

    Full Text Available Safa M1, Jebraili2, Momen-nasab M3 1. Assistant Professor, Department of Psychiatry, School of Medicine, Lorestan University of Medical Sciences 2. Assistant Professor, Department of Dermatology, Faculty of Medicine, Lorestan University of Medical Sciences 3. Instructor, Department of Nursing, Lorestan University of Medical Sciences Abstract Background: Some of the skin diseases cause severe stress in patients and relieving these stresses greatly helps to treat the underlying disease. Alopecia areata is one of the common causes of alopecia which is an autoimmune disease. Other factors like genetics and psychological factors have important roles in the beginning or exacerbation of the disease. This study aimed to determine the frequency of depression and anxiety disorders in patient suffering from alopecia areata. Materials and methods: In this descriptive study, 80 patients with alopecia areata who had referred to dermatologic clinic of Shohaday-e Ashayer hospital in Khorramabad from 1382 to 1383(Hj. were evaluated. After filling the questionnaires, the patients were referred to the Psychiatric Clinic and the cases were diagnosed by interviews using SCL-90 test and DSM-IV-IIIR scale. The analysis of data was done by the SPSS software. Results: 80 patients were selected as the subjects of the study. including 52 men (65% and 28 women (35%. 43 patients (53.8% were less than 25 years old and 54 (67.5% were unmarried. 56 patients (70% had a family history of alopecia areata and 45 (56.25% had no history of drug intake. In most of the patients (63.8% the site of the first lesion was the scalp. Out of 80 patients, 64 (80% had anxiety and 60 (75% had depression. 27 (33.3% had major depressive disorders. These findings were statistically significant. Major depressive disorders were more in women. No correlation was found between education, marital status, family history, and the history of drug intake, and the site of first lesion. Conclusion: The

  17. Lipoproetin pattern in patients with chronic renal failure and those ...

    African Journals Online (AJOL)

    Background: Vascular disease is common in patients with chronic renal failure as well as in patients with renal transplantation. It is a common cause of death in these patients. One possible factor for this increased incidence of vascular disease is hyperlipidaemia that frequently occurs in these patients. Purpose: To ...

  18. Short- and Long-Term Effects of CBT-I in Groups for School-Age Children Suffering From Chronic Insomnia: The KiSS-Program.

    Science.gov (United States)

    Schlarb, Angelika A; Bihlmaier, Isabel; Velten-Schurian, Kerstin; Poets, Christian F; Hautzinger, Martin

    2018-01-01

    This intervention study evaluates the short- and long-term effects of cognitive behavior therapy for insomnia (CBT-I) in groups for school-age children and their parents, named the KiSS-program. CBT-I was implemented in three sessions for children and three sessions for parents. All in all, 112 children with chronic childhood insomnia were randomly assigned to a wait-list (WL) control or treatment condition. According to subjective measures as well as objective wrist actigraphy, children in the CBT-I condition reported greater improvements in sleep behavior immediately after the treatment compared to the WL group. Improvements in sleep behavior after CBT-I persisted over the 3-, 6-, and 12-month follow-up assessments. The present study is the first randomized controlled trial that provides evidence for the long-term effectiveness of CBT-I in treating school-age children with chronic insomnia.

  19. [Treatment motivation in patients with chronic cardiorenal syndrome].

    Science.gov (United States)

    Efremova, E V; Shutov, A M; Borodulina, E O

    2015-01-01

    To study treatment motivation in patients with chronic heart failure (CHF) and in those with CHF concurrent with chronic kidney disease (CKD). A total of 203 patients (130 men and 73 women; mean age, 61.8±9.6 years) with CHF diagnosed and assessed in accordance with the National Guidelines of the All-Russian Research Society of Cardiology and the Heart Failure Society for the diagnosis and treatment of CHF (third edition, 2009) were examined. CKD was diagnosed according to the 2012 National Guidelines of the Research Nephrology Society of Russia. A group of patients with chronic cardiorenal syndrome (CRS) included those with CHF and CKD with a glomerular filtration rate (GFR) of motivation for non-drug and drug treatments were assessed in patients with chronic CRS. CFR was 67.7±17.2 ml/min/1.73 m2; chronic CRS was observed in 89 (44%) patients. Psychological functioning assessment showed that the patients with chronic CRS as compared with those with CHF without CKD had high anxiety and maladaptive disease attitudes. CHF treatment motivation (compliance with lifestyle modification and medication) was proved inadequate and detected only in 31 (15.3%) patients with CHF regardless of the presence of CKD. The specific features of psychological functioning, which affected treatment motivation, were seen in patients with chronic CRS: those who were lowly motivated had a euphoric attitude towards their disease (p=0.03); those who were satisfactorily motivated showed an emotive accentuation of character (p=0.002). The presence of CKD aggravates the clinical course of CHF and negatively affects the psychological functioning of patients with CHF. The patients with chronic CRS are characterized by a low level of motivation for both drug and non-drug treatments, which should be taken into account when managing this cohort of patients.

  20. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating raynaud,s syndrome after frost bite

    International Nuclear Information System (INIS)

    Khan, M.I.; Rehman, A.; Tariq, M.; Sheen, S.N.

    2008-01-01

    Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS (version 11). Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene of distal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy (p<0.05) as compared to conservative management. Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite. (author)

  1. [Living with advanced chronic obstructive pulmonary disease: The impact of dyspnoea on patients and caregivers].

    Science.gov (United States)

    Costa, Xavier; Gómez-Batiste, Xavier; Pla, Margarida; Martínez-Muñoz, Marisa; Blay, Carles; Vila, Laura

    2016-12-01

    To understand the experiences of patients and caregivers living with advanced chronic obstructive pulmonary disease, the impact of their symptoms and care needs arising from a functional, emotional, and social context. Qualitative study. Phenomenological perspective. Data were collected during 2013-2015. Primary, secondary and intermediate care. Osona (Barcelona). The study included 10 Primary Care patients with advanced chronic obstructive pulmonary disease, their respective 10 caregivers, and 19 primary care professionals, as well as 2 lung specialists, 2 palliative care professionals involved in their care, and one clinical psychologist. Theoretical sampling. Semi-structured and in-depth interviews with patients, caregivers, and professionals (47 interviews). The emergent topics identified in patients and caregivers interviews refer to dyspnoea, the predominant symptom without effective treatment and with a major impact on patients and caregivers lives. A symptom with great functional, emotional and social repercussions to which they need to adapt in order to survive. Beyond pharmacological measures to control respiratory symptoms, proper care of patients with chronic obstructive pulmonary disease, requires understanding of suffering, the losses and limitations that it causes in their lives and those of their caregivers. A palliative, holistic and closer approach to their real experiences, together with an empowerment to adapt to debilitating symptoms, could contribute to a better life in the end-stages of the disease. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Complementary and alternative medicine use by primary care patients with chronic pain.

    Science.gov (United States)

    Rosenberg, Eric I; Genao, Inginia; Chen, Ian; Mechaber, Alex J; Wood, Jo Ann; Faselis, Charles J; Kurz, James; Menon, Madhu; O'Rorke, Jane; Panda, Mukta; Pasanen, Mark; Staton, Lisa; Calleson, Diane; Cykert, Sam

    2008-11-01

    To describe the characteristics and attitudes toward complementary and alternative medicine (CAM) use among primary care patients with chronic pain disorders and to determine if CAM use is associated with better pain control. Cross-sectional survey. Four hundred sixty-three patients suffering from chronic, nonmalignant pain receiving primary care at 12 U.S. academic medical centers. Self-reported current CAM usage by patients with chronic pain disorders. The survey had an 81% response rate. Fifty-two percent reported current use of CAM for relief of chronic pain. Of the patients that used CAM, 54% agreed that nontraditional remedies helped their pain and 14% indicated that their individual alternative remedy entirely relieved their pain. Vitamin and mineral supplements were the most frequently used CAM modalities. There was no association between reported use of CAM and pain severity, functional status, or perceived self-efficacy. Patients who reported having at least a high school education (odds ratio [OR] 1.1, 95% confidence interval [CI] 1.02-1.19, P = 0.016) and high levels of satisfaction with their health care (OR 1.47, 95% CI 1.13-1.91, P = 0.004) were significantly more likely to report using CAM. Complementary and alternative therapies were popular among patients with chronic pain disorders surveyed in academic primary care settings. When asked to choose between traditional therapies or CAM, most patients still preferred traditional therapies for pain relief. We found no association between reported CAM usage and pain severity, functional status, or self-efficacy.

  3. Assessing the Construct Validity and Internal Reliability of the Screening Tool Test Your Memory in Patients with Chronic Pain

    Science.gov (United States)

    Ojeda, B.; Salazar, A.; Dueñas, M.; Torres, L. M.; Mico, J. A.; Failde, I.

    2016-01-01

    Patients with chronic pain often complain about cognitive difficulties, and since these symptoms represent an additional source of suffering and distress, evaluating the cognitive status of these patients with valid and reliable tests should be an important part of their overall assessment. Although cognitive impairment is a critical characteristic of pain, there is no specific measure designed to detect these effects in this population. The objective was to analyze the psychometric properties of the “Test Your Memory” (TYM) test in patients with chronic pain of three different origins. A cross-sectional study was carried out on 72 subjects free of pain and 254 patients suffering from different types of chronic pain: neuropathic pain (104), musculoskeletal pain (99) and fibromyalgia (51). The construct validity of the TYM was assessed using the Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADs), Index-9 from MOS-sleep, SF-12, and through the intensity (Visual Analogical Scale) and duration of pain. An exploratory factor analysis was also performed and internal reliability was assessed using Cronbach’s alpha. After adjusting for potential confounders the TYM could distinguish between pain and pain-free patients, and it was correlated with the: MMSE (0.89, pmental components (0.55, p valid and reliable screening instrument to assess cognitive function in chronic pain patients that will be of particular value in clinical situations. PMID:27119165

  4. Assessing the Construct Validity and Internal Reliability of the Screening Tool Test Your Memory in Patients with Chronic Pain.

    Science.gov (United States)

    Ojeda, B; Salazar, A; Dueñas, M; Torres, L M; Mico, J A; Failde, I

    2016-01-01

    Patients with chronic pain often complain about cognitive difficulties, and since these symptoms represent an additional source of suffering and distress, evaluating the cognitive status of these patients with valid and reliable tests should be an important part of their overall assessment. Although cognitive impairment is a critical characteristic of pain, there is no specific measure designed to detect these effects in this population. The objective was to analyze the psychometric properties of the "Test Your Memory" (TYM) test in patients with chronic pain of three different origins. A cross-sectional study was carried out on 72 subjects free of pain and 254 patients suffering from different types of chronic pain: neuropathic pain (104), musculoskeletal pain (99) and fibromyalgia (51). The construct validity of the TYM was assessed using the Mini-Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADs), Index-9 from MOS-sleep, SF-12, and through the intensity (Visual Analogical Scale) and duration of pain. An exploratory factor analysis was also performed and internal reliability was assessed using Cronbach's alpha. After adjusting for potential confounders the TYM could distinguish between pain and pain-free patients, and it was correlated with the: MMSE (0.89, pmental components (0.55, p reliable screening instrument to assess cognitive function in chronic pain patients that will be of particular value in clinical situations.

  5. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients.

    Science.gov (United States)

    Lazović, Biljana; Svenda, Mirjana Zlatković; Mazić, Sanja; Stajić, Zoran; Delić, Marina

    2013-01-01

    Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36%) low QRS (50%) and p pulmonale (14.54%). Left axis deviation was observed in 27.27% patients. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  6. Lymphocyte Proliferation Response in Patients with Acute and Chronic Brucellosis

    Directory of Open Access Journals (Sweden)

    Khadijeh Khosravi

    2016-05-01

    Full Text Available Abstract Background: Brucella is an intracellular bacterium that causes chronic infection in humans and domestic animals. The underlying mechanisms that cause prolonged illness are complex and not fully understood. Immune responses may have an important role in the chronicity of infection. Here, we evaluated the lymphocyte proliferation responses in patients with chronic and acute brucellosis. Materials and Methods: This descriptive - analytical study was performed on 22 patients with acute brucellosis, 21 patients with chronic brucellosis and 21 healthy people with the similar age, sex and genetic background as control group. Peripheral lymphocytes were isolated using Ficoll and the cellular proliferation was quantified in presence of antigen and phytohemaglutinin-A by MTT method. Results: The brucella antigen-specific stimulation index in patients with chronic brucellosis was significantly lower than the acute brucellosis patients (p=0.001. Also, stimulating the lymphocytes with phytohemaglutinin-A has shown that proliferative response in patients with chronic brucellosis was lower than the other groups (p=0.04. Conclusion: The results indicated that chronic brucellosis inhibits lymphocyte proliferation. This inhibition of lymphocyte proliferation may be due to the induction of anergy.

  7. Bile acid malabsorption in patients with chronic diarrhoea

    DEFF Research Database (Denmark)

    Wildt, S; Nørby Rasmussen, S; Lysgård Madsen, Jan

    2003-01-01

    Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic diarrhoea...

  8. Attitudes of Irish patients with chronic pain towards medicinal cannabis.

    Science.gov (United States)

    Rochford, Ciaran; Edgeworth, Deirdre; Hashim, Mohammad; Harmon, Dominic

    2018-02-08

    Medicinal cannabis use is topical in the media in Ireland. A recent Health Products Regulatory Authority review, however, has recommended against its use for patients with chronic pain. This is despite evidence for its effectiveness in this patient's cohort and the inadequate pain management of these patients. The aim of this study was to evaluate the attitudes of Irish patients with chronic pain towards medicinal cannabis. After institutional ethics committee approval, a 12-item questionnaire (excluding demographics) was randomly assigned to patients attending a chronic pain clinic (University Hospital Limerick). The questionnaire was designed to incorporate patient's attitudes on a variety of medicinal cannabis related topics. Ninety-six adult patients were surveyed. 88.54% agreed that cannabis should be legalised for chronic pain medicinal purposes. 80.21% believed it would have health benefits for them and 73.96% agreed it would be socially acceptable to use cannabis for this purpose. 33.33% perceived cannabis to be addictive while 68.75% would be willing to try it if prescribed by a medical professional. The study highlights the attitudes of chronic pain patients in Ireland towards medicinal cannabis. It shows their desire to have medical cannabis legalised for chronic pain and that they view it as a reasonable pain management option.

  9. Clinical problems of the patients with subarachnoid hemorrhage which had not been diagnosed until they suffered ischemic neurological deficits and/or rebleeding

    International Nuclear Information System (INIS)

    Fukui, Issei; Ishikawa, Tatsuya; Moroi, Junta

    2011-01-01

    A small part of the patients with subarachnoid hemorrhage (SAH) are not properly diagnosed until they suffer ischemic neurological deficits and/or rebleeding during vasospasm. We therefore investigated the clinical profile of such patients. We retrospectively analyzed 581 patients with aneurysmal SAH experienced in our institute between 2001 and 2009. Patient's characteristics, presence and severity of headache before final diagnosis, imaging investigations they received, their World Federation of Neurological Surgeons (WFNS) grades at admission, the location of aneurysm, treatment, and outcome at discharge were investigated. Five patients were not correctly diagnosed until they presented neurological deficits due to vasospasm or experienced simultaneous rebleeding. Their mean age was 69.4, and all were female. Although all patients had a bad headache, they did not undergo any imaging examinations. Immediate coil embolization was performed for 2 patients, 1 died due to rupturing during embolization procedure. The other 3 were treated by open clipping surgery (2 delayed and 1 immediate). Four patients had some disability as a sequel, and their outcomes were significantly worse compared with 53 patients with SAH in WFNS Grade II. The patients with SAH who had not been properly diagnosed in the acute stage had a poor outcome. We should be very careful when we see patients complaining of severe headache. (author)

  10. Comparing the Effect of Open and Closed Kinetic Chain Exercises in Patients Suffering From Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Zahra Firoozkoohi Moghadam

    2016-11-01

    Full Text Available Introduction: Patellofemoral pain syndrome is one of the most prevalent problems in physically active people. The syndrome is a multifactorial disorder with different therapeutic approaches. Conservative treatment of the syndrome has been a crucial matter in different studies. Quadriceps muscle strengthening exercise is a recommended approach which is performed in forms of open and closed kinetic chain exercises. This study was designed to compare the efficacy of these exercises on this syndrome. Methods: Totally 30 women suffering from the syndrome aged 30-40 were randomly allocated into three groups: open, and closed kinetic chain exercises, and control group, as groups A, B, and C, respectively. Groups A and B participated in 28 sessions of exercises in a period of four weeks and group C did not do any exercise in this period. Before and after the period, pain and function of the participants were assessed using visual analog scale (VAS and Kujala patellofemoral scale, respectively. Data were analyzed using independent t test, dependent t test, and univariate variance analysis, while significance of data was determined at P < 0.05. Results: The study indicated that open kinetic chain exercises (group A for 4 weeks brought significant changes in relieving the pain along with improving the function (P = 0.001. Likewise, it was revealed a significant pain relief as well as function improvement in group B (P = 0.001. Comparing two groups illustrated that benefits of open kinetic chain exercises outweigh closed ones (P = 0.001. Conclusion: Overall, both exercises were efficient in relieving pain as well as improving function, however open kinetic chain exercises were more contributory.

  11. Post-bronchoscopy pneumonia in patients suffering from lung cancer: Development and validation of a risk prediction score.

    Science.gov (United States)

    Takiguchi, Hiroto; Hayama, Naoki; Oguma, Tsuyoshi; Harada, Kazuki; Sato, Masako; Horio, Yukihiro; Tanaka, Jun; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Takihara, Takahisa; Niimi, Kyoko; Nakagawa, Tomoki; Masuda, Ryota; Aoki, Takuya; Urano, Tetsuya; Iwazaki, Masayuki; Asano, Koichiro

    2017-05-01

    The incidence, risk factors, and consequences of pneumonia after flexible bronchoscopy in patients with lung cancer have not been studied in detail. We retrospectively analyzed the data from 237 patients with lung cancer who underwent diagnostic bronchoscopy between April 2012 and July 2013 (derivation sample) and 241 patients diagnosed between August 2013 and July 2014 (validation sample) in a tertiary referral hospital in Japan. A score predictive of post-bronchoscopy pneumonia was developed in the derivation sample and tested in the validation sample. Pneumonia developed after bronchoscopy in 6.3% and 4.1% of patients in the derivation and validation samples, respectively. Patients who developed post-bronchoscopy pneumonia needed to change or cancel their planned cancer therapy more frequently than those without pneumonia (56% vs. 6%, ppneumonia, which we added to develop our predictive score. The incidence of pneumonia associated with scores=0, 1, and ≥2 was 0, 3.7, and 13.4% respectively in the derivation sample (p=0.003), and 0, 2.9, and 9.7% respectively in the validation sample (p=0.016). The incidence of post-bronchoscopy pneumonia in patients with lung cancer was not rare and associated with adverse effects on the clinical course. A simple 3-point predictive score identified patients with lung cancer at high risk of post-bronchoscopy pneumonia prior to the procedure. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  12. HFS-14, a Specific Quality of Life Scale Developed for Patients Suffering from Hand–Foot Syndrome

    Science.gov (United States)

    Dalenc, Florence; Chevreau, Christine; Roché, Henri; Delord, Jean-Pierre; Mourey, Loïc; Lacaze, Jean-Louis; Rahhali, Nora; Taïeb, Charles

    2011-01-01

    Background. Hand–foot syndrome (HFS) is a common reaction to certain chemotherapies and new targeted therapies, impairing patient quality of life (QoL). However, there is currently no specific tool to measure QoL in patients with HFS. Objective. The objective was to develop and validate a HFS-specific QoL questionnaire (HFS-14). Patients and Methods. From a list of 31 items identified from a literature review and patient interview notes, item reduction and pilot testing by cognitive debriefing resulted in a final 14-item questionnaire with excellent internal reliability. Clinical validity was assessed in 43 patients with HFS by comparing the HFS-14 score according to HFS clinical grade based on the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, and by measuring its correlation with the Dermatology Life Quality Index (DLQI), Skindex-16, and short-form 12 health-related questionnaires and pain measurement. Results. The mean HFS-14 score was significantly higher in patients with clinical grade 2 and grade 3 HFS than in those with grade 1 HFS. The higher the HFS-14 score, the greater the QoL impairment. The HFS-14 score was highly correlated with the DLQI and Skindex-16 scores. In the population of patients with severe grade 3 NCI-CTCAE HFS, the HFS-14 score was significantly higher in patients having both hands and feet severely involved than in those with severe involvement of one limb (hands or feet) with the other one less severely affected. Conclusions. This scale specifically developed for patients with HFS is a valid and valuable tool for measuring HFS-related QoL impairment. PMID:21964002

  13. Patients with tattoo reactions have reduced quality of life and suffer from itch: Dermatology Life Quality Index and Itch Severity Score measurements.

    Science.gov (United States)

    Hutton Carlsen, K; Serup, J

    2015-02-01

    Tattoos are a trend with increasing side-effects. The burden of local reaction with swelling, itching and discomfort may impel sufferers to consult medical assistance. To assess tattoo reactions and their influence on quality of life and itching by utilizing the Dermatology Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients attending their routine consultations completed the ISS and DLQI questionnaires. Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated with itch. Tattoo reactions warrant diagnosis and treatment with same professional intent shared with other skin diseases. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Assessment of Some Adipo cytokines Levels In Serum of Egyptian Patients Suffering From Non-Alcoholic Steatohepatitis (NASH)

    International Nuclear Information System (INIS)

    Mohammed, A.A.

    2011-01-01

    In the present study, thirty five patients with biopsy proven NASH and twenty age and sex matched healthy individuals were enrolled. Serum adiponectin, ghrelin, TNF-α and leptin levels were estimated in the serum of NASH patients and control subjects. Also, fasting insulin and blood glucose levels were measured and insulin resistance (IR) were calculated. In addition, liver function enzymes (AST, ALT), total cholesterol and triglycerides were measured, and body mass index (BMI) was calculated. The results showed significant decrease in adiponectin and ghrelin levels and significant increase in TNF-α and leptin levels in NASH group as compared to controls. Ten patients were diabetic and seven patients had BMI > 30 kg/m 2 . Also, significant positive relationship was recorded between adiponectin and ghrelin and AST/ALT ratio in the NASH group, and significant negative relationship between them and BMI and HOMA-IR

  15. The effect of acupuncture treatment for insomnia in chronic hemodialysis patients

    Science.gov (United States)

    Widjaja, J. A.; Simadibrata, C.; Srilestari, A.; Marbun, M. B. H.

    2017-08-01

    Insomnia is a problem often experienced by patients on chronic dialysiswhich reduces their quality of life. Current management of insomnia with this specific group of patients has yet to produce optimum results. In this study, we explored the roleof acupuncture as a treatment for symptoms of insomnia in patients on chronic dialysis. Twenty-eight hemodialysis patients suffering from insomnia were divided randomly into two groups, an acupuncture group (n = 15) who received acupuncture treatment at the points HT7 Shenmen, PC6 Neiguan, GV20 Baihui, and EX-HN1 Sishenchong, anda control group (n = 13) who underwenta sham procedure in which a needle was inserted into an elastic bandage at the same points. The acupuncture treatment was done during hemodialysis twice a week for five weeks. PSQI scores and the WHOQOL-BREF were assessed before treatment, after the fifth treatment, and at the end of the treatment. Significant differences were found in the PSQI score ((4.20±2.27 vs. 11.23±3.37) p = 0.000) and in the WHOQOL-BREF ((94.53±10.08 vs. 82.69±11.90) p = 0.008) between the acupuncture group and the control group by the end of the period of treatment. Acupuncture treatment effectively improved the quality of sleep and the quality of life for these chronic hemodialysis patients.

  16. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  17. Total IgE and eotaxin (CCL11) contents in tears of patients suffering from seasonal allergic conjunctivitis.

    Science.gov (United States)

    Eperon, Simone; Berguiga, Marouen; Ballabeni, Pierluigi; Guex-Crosier, Catherine; Guex-Crosier, Yan

    2014-09-01

    To prospectively investigate patients with seasonal allergic conjunctivitis (SAC) during the pollen season and test associations between tears total IgE, eotaxin concentrations, and SAC severity. Enrolled patients presented ocular symptoms and clinical signs of SAC at the time of presentation. Ocular itching, hyperaemia, chemosis, eyelid swelling, and tearing were scored, and the sum of these scores was defined as the clinical score. Conjunctival papillae were separately graded. We measured eotaxin concentration in tears by an enzyme-linked immunosorbent assay (ELISA) and total tear IgE by Lacrytest strip. Among thirty patients (30 eyes), 11 showed neither tear IgE nor tear eotaxin, while 15 out of 19 patients with positive IgE values presented a positive amount of eotaxin in their tears (Fisher's test: p tear IgE, we observed a lower conjunctival papilla grade than in patients whose tears contained some amount of IgE (trend test: p = 0.032). In the 15 patients whose tear eotaxin concentration was null, tear IgE concentration was 5.3 ± 3.5 arbitrary units; in the other 15 patients whose eotaxin was positive, IgE reached 21 ± 4.3 arbitrary U (Mann-Whitney: p tear IgE concentrations of both groups did not differ statistically significantly (p = 0.947). If IgE and eotaxin secreted in tears are major contributors in SAC pathogenesis, they however act at different steps of the process.

  18. Comparative study of patients suffering sore throat after general anesthesia using laryngeal mask airway and cuffed pharyngeal tube in adults

    Directory of Open Access Journals (Sweden)

    Hassani V

    2001-09-01

    Full Text Available Post-operative sore throat is one of the most common complications and complaints of patients after general anesthesia especially in operations that need endotracheal intubations. Its causes are: size of endotracheal tube and type of its cuff, inadequate airway humidification, trauma during intubation and suctioning, high flow of inspiratory gases, surgical manipulation of airway and adjacent organs, ect. Use of instruments with less invasion to upper respiratory tract, for example, face mask and airway, LMA or CPT are methods, used for decreasing the rate of post-operative sore throat. This study was performed to compare the rate of sore throat after general anesthesia between Laryngeal Mask Airway (LMA and Cuffed Pharyngeal Tube (CPT. From the patients, 120 ASA: PS-I cases, were selected, who were candidates for elective surgery of Orthopedics, Urology, General surgery and Gynecology in Hazrat Rasool-Akram Hospital Complex in the year 2000. Their operation were performed in supine position and did not need muscle relaxation and the patients had spontaneous breathing. Duration of surgery was less than 2 hours. The patients were randomly allocated into two groups: LMA was used for one group and CPT for others. Immediately after operation, in the recovery room and at 6, 12, 18 and 24 hours after removing the tube, the patients were asked about sore throat and the results were recorded in the related sheets. The results was 31.7 percent of patients in group LMA and 0 percent of patients in group CPT, had sore throat. There were significant difference between groups (LMA and CPT in presentation of sore throat (P<0.001.

  19. Radotinib and its clinical potential in chronic-phase chronic myeloid leukemia patients: an update.

    Science.gov (United States)

    Eskazan, Ahmet Emre; Keskin, Dilek

    2017-09-01

    Although imatinib has dramatically improved major outcomes in patients with chronic myeloid leukemia (CML), there are newer tyrosine kinase inhibitors (TKIs) approved worldwide for the treatment of resistant cases, and two second-generation TKIs (dasatinib, nilotinib) are approved in some nations for treating patients in the upfront setting. Radotinib (IY5511HCL, Supect® ) is a novel and selective second-generation BCR-ABL1 TKI, which is currently approved in Korea for the treatment of patients with CML both in the upfront and salvage settings. This review mainly focuses on the clinical potential of radotinib in patients with CML in chronic phase in terms of efficacy and safety.

  20. Patients suffering from rheumatic disease describing own experiences from participating in Basic Body Awareness Group Therapy: A qualitative pilot study.

    Science.gov (United States)

    Olsen, Aarid Liland; Skjaerven, Liv Helvik

    2016-01-01

    Rheumatic diseases have physical and psychological impact on patients' movement and function. Basic Body Awareness Therapy focuses on promoting more functional movement quality in daily life. The purpose of this study was to describe patient experiences from participating in Basic Body Awareness Group Therapy for inpatients with rheumatic disease. A phenomenological design included data collection in two focus group interviews with seven patients. Giorgi's four-step phenomenological method was used for data analysis. Four main themes emerged: (1) "Movement exploration-being guided in movement" described informants' exploration of bodily signals and movement habits; (2) "Movement awareness training in a relational perspective" informants described experiences from being in a group setting; (3) "Movement awareness-integration and insight" described informants' reflections on movement experiences; and (4) "Integrating and practicing new movement habits" informants described how they used their movement experiences in daily life. The study described perspectives in movement learning experienced by patients. The results support the view that contact with the body can help patients exploring and cultivating their own resources for a more functional movement quality. Descriptions of relational movement learning aspects can contribute to our understanding of physiotherapy group design.

  1. Cephalometric risk factors associated with myocardial infarction in patients suffering from obstructive sleep apnea: A pilot case-control study.

    Science.gov (United States)

    Davoudmanesh, Zeinab; Bayat, Mohamad; Abbasi, Mohsen; Rakhshan, Vahid; Shariati, Mahsa

    2017-01-01

    Obstructive sleep apnea (OSA) and its craniofacial anatomic risk factors might play a role in several cardiovascular diseases, including myocardial infarction (MI). However, there are no data about cephalometric findings among OSA patients with MI. In this pilot case-control study, about 2000 individuals referred to the sleep center were evaluated according to apnea - hypopnea index (AHI) and other inclusion criteria. Included were 62 OSA male patients (AHI > 10), of whom 6 had an MI history. In both control (n = 56) and MI groups (n = 6), 18 cephalometric parameters were traced. Data were analyzed using independent samples t-test. Compared with control OSA patients, OSA patients with MI showed a significantly larger tongue length (p = 0.015). The other cephalometric variables were not significantly different between the two groups. An elongated tongue might be considered a risk factor for MI in OSA patients. The role of other variables remains inconclusive and open to investigation with larger samples (determined based on pilot studies such as this report) collected in longitudinal fashion.

  2. Transition theory and its relevance to patients with chronic wounds.

    Science.gov (United States)

    Neil, J A; Barrell, L M

    1998-01-01

    A wound, in the broadest sense, is a disruption of normal anatomic structure and function. Acute wounds progress through a timely and orderly sequence of repair that leads to the restoration of functional integrity. In chronic wounds, this timely and orderly sequence goes awry. As a result, people with chronic wounds often face not only physiological difficulties but emotional ones as well. The study of body image and its damage as a result of a chronic wound fits well with Selder's transition theory. This article describes interviews with seven patients with chronic wounds. The themes that emerged from those interviews were compared with Selder's theory to describe patients' experience with chronic wounds as a transition process that can be identified and better understood by healthcare providers.

  3. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  4. Phenotypes selected during chronic lung infection in cystic fibrosis patients

    DEFF Research Database (Denmark)

    Ciofu, Oana; Mandsberg, Lotte F; Wang, Hengzhuang

    2012-01-01

    During chronic lung infection of patients with cystic fibrosis, Pseudomonas aeruginosa can survive for long periods of time under the challenging selective pressure imposed by the immune system and antibiotic treatment as a result of its biofilm mode of growth and adaptive evolution mediated by g...... the importance of biofilm prevention strategies by early aggressive antibiotic prophylaxis or therapy before phenotypic diversification during chronic lung infection of patients with cystic fibrosis....

  5. [Anesthetic Management of a Patient Complicated with Marfan Syndrome and Suffering from Stanford Type A Aortic Dissection during Pregnancy].

    Science.gov (United States)

    Uozaki, Nako; Mizuno, Kaori; Shiraishi, Yoshito; Doi, Matsuyuki; Sato, Shigehito

    2015-04-01

    We report a case of a 36-year-old woman at 34 weeks of gestation complicated with Marfan syndrome who underwent Bentall type aortic replacement surgery due to Stanford type A aortic dissection after undergoing caesarean section. Since this patient exhibited severe hypotension before coming to the operating room, it was very difficult to determine whether the cardiac surgery or caesarean section should be performed first. In this case, the caesarean section was performed first, followed by Bentall's surgery. Although intra-aortic balloon pumping and percutaneous cardiopulmonary support were required after weaning from the cardiopulmonary bypass, she was discharged on post-operative day (POD) 40 and the baby was discharged on POD 60, without signs of cerebral palsy. Unfortunately, this patient died on POD 57, due to heart failure. We discuss how to determine the priority of surgeries for patients who require emergency surgery for cardiovascular disease during pregnancy.

  6. Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs

    Directory of Open Access Journals (Sweden)

    Abdukhakim Khadjibaev

    2015-06-01

    Full Text Available In recent years, fall from a height (FFH has been a relatively frequent cause of injury and death in the urban environment. The purpose of this study was to optimize the risk stratification of FFH victims with combined injuries of the abdominal organs by using Injury Severity Score (ISS scale. The study included 111 patients (aged between 15 and 80 years injured by FFH. All the falls were accidental and occurred mainly among males (82%. The height of the fall ranged from 2 to 5 meters. Combined injuries were found in 98 patients and isolated injuries in 13 patients. The combination of the 6 injured body regions was identified in 5 patients, 5 regions in 17, 4 in 35, 3 in 23, and 2 in 18. The abdomen trauma was most commonly associated with the following injured body regions: head and neck-chest-extremities and pelvis (13.3%, head and neck-chest-extremities (12.2%, and head and neck-chest-pelvis (9.2%. Among the combined injuries of the abdomen, ruptures of parenchymal organs (liver, spleen and kidneys were predominant. To assess the severity of the injury, the ISS scale was applied. The injuries of abdominal parenchymal organs were evaluated according to the AAST (American Association for the Surgery of Trauma classification. Comparative analysis of the assessment of the severity of a patient's condition according to the traditional scale and the ISS scale showed that the ISS scale promotes the active and timely detection of the extremely severe and terminal condition in patients with injuries due to FFH with combined trauma of the abdominal organs. Objective assessment of the severity of trauma and the dominant injury region allows determining the optimal treatment algorithm and predicting the outcome of the injury.

  7. Predictors of 30-day mortality and the risk of recurrent systemic thromboembolism in cancer patients suffering acute ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Ki-Woong Nam

    Full Text Available Stroke in cancer patients is not rare but is a devastating event with high mortality. However, the predictors of mortality in stroke patients with cancer have not been well addressed. D-dimer could be a useful predictor because it can reflect both thromboembolic events and advanced stages of cancer.In this study, we evaluate the possibility of D-dimer as a predictor of 30-day mortality in stroke patients with active cancer.We included 210 ischemic stroke patients with active cancer. The 30-day mortality data were collected by reviewing medical records. We also collected follow-up D-dimer levels in 106 (50% participants to evaluate the effects of treatment response on D-dimer levels.Of the 210 participants, 30-day mortality occurred in 28 (13% patients. Higher initial NIHSS scores, D-dimer levels, and CRP levels as well as frequent cryptogenic mechanism, systemic metastasis, multiple vascular territory lesion, hemorrhagic transformation, and larger infarct volume were related to 30-day mortality. In the multivariate analysis, D-dimer [adjusted OR (aOR = 2.19; 95% CI, 1.46-3.28, P < 0.001] predicted 30-day mortality after adjusting for confounders. The initial NIHSS score (aOR = 1.07; 95% CI, 1.00-1.14, P = 0.043 and hemorrhagic transformation (aOR = 3.02; 95% CI, 1.10-8.29, P = 0.032 were also significant independent of D-dimer levels. In the analysis of D-dimer changes after treatment, the mortality group showed no significant decrease in D-dimer levels, despite treatment, while the survivor group showed the opposite response.D-dimer levels may predict 30-day mortality in acute ischemic stroke patients with active cancer.

  8. Predictors of 30-day mortality and the risk of recurrent systemic thromboembolism in cancer patients suffering acute ischemic stroke.

    Science.gov (United States)

    Nam, Ki-Woong; Kim, Chi Kyung; Kim, Tae Jung; An, Sang Joon; Oh, Kyungmi; Mo, Heejung; Kang, Min Kyoung; Han, Moon-Ku; Demchuk, Andrew M; Ko, Sang-Bae; Yoon, Byung-Woo

    2017-01-01

    Stroke in cancer patients is not rare but is a devastating event with high mortality. However, the predictors of mortality in stroke patients with cancer have not been well addressed. D-dimer could be a useful predictor because it can reflect both thromboembolic events and advanced stages of cancer. In this study, we evaluate the possibility of D-dimer as a predictor of 30-day mortality in stroke patients with active cancer. We included 210 ischemic stroke patients with active cancer. The 30-day mortality data were collected by reviewing medical records. We also collected follow-up D-dimer levels in 106 (50%) participants to evaluate the effects of treatment response on D-dimer levels. Of the 210 participants, 30-day mortality occurred in 28 (13%) patients. Higher initial NIHSS scores, D-dimer levels, and CRP levels as well as frequent cryptogenic mechanism, systemic metastasis, multiple vascular territory lesion, hemorrhagic transformation, and larger infarct volume were related to 30-day mortality. In the multivariate analysis, D-dimer [adjusted OR (aOR) = 2.19; 95% CI, 1.46-3.28, P mortality after adjusting for confounders. The initial NIHSS score (aOR = 1.07; 95% CI, 1.00-1.14, P = 0.043) and hemorrhagic transformation (aOR = 3.02; 95% CI, 1.10-8.29, P = 0.032) were also significant independent of D-dimer levels. In the analysis of D-dimer changes after treatment, the mortality group showed no significant decrease in D-dimer levels, despite treatment, while the survivor group showed the opposite response. D-dimer levels may predict 30-day mortality in acute ischemic stroke patients with active cancer.

  9. Thicker carotid intima-media thickness and increased plasma VEGF levels suffered by post-acute thrombotic stroke patients

    Directory of Open Access Journals (Sweden)

    Yueniwati Y

    2016-12-01

    Full Text Available Yuyun Yueniwati,1 Ni Komang Darmiastini,1 Eko Arisetijono2 1Radiology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia; 2Neurology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia Background and objectives: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4 as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT against plasma VEGF levels in patients with post-acute thrombotic stroke. Materials and methods: CIMT was assessed sonographically using GE Logiq S6 with 13 MHz frequency linear probe. VEGF-A plasma levels were measured using enzyme-linked immunosorbent assay (ELISA method. Differences among variables were compared statistically. The data were analyzed using Pearson correlation. Results: A total of 25 patients with post-acute thrombotic stroke were identified in days 7 to 90. CIMT thickening was indicated in 88% of patients (1.202 ± 0.312 mm, while an increase in plasma VEGF was identified in all patients (178.28 ± 93.96 ng/mL. There was no significant correlation between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke (p=0.741. A significant correlation was recognized between CIMT and total cholesterol (p=0.029 and low-density lipoprotein (p=0.018. Conclusion: There were no significant correlations between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke. However, plasma VEGF increased in patients with thrombotic stroke. CIMT measurement is a promising noninvasive modality to assess the vascular condition of patients with stroke and diabetes, while plasma VEGF

  10. Determination of the radioimmunologic concentration of 5-androstene-3β-17β-diole in the blood plasma of patients suffering from common psoriasis

    International Nuclear Information System (INIS)

    Ehlen, M.

    1979-01-01

    A new radioimmunologic method for the determination of ADIOL in the blood plasma was developed. The author produced the antiserum herself and she examined it on cross-reactions. This method resulted to be very sensitive and in the standard curve a linear range of 0.04 ng to 1.5 ng was obtained. Moreover, the ADIOL concentration was determined in the blood plasma of 16 control subjects and of 35 patients suffering from psoriasis. The result was a far-reaching correlation with the results described in literature, although they were obtained by means of differing determination procedures. (orig./MG) [de

  11. Overgeneral autobiographical memory in patients with chronic pain.

    Science.gov (United States)

    Liu, Xianhua; Liu, Yanling; Li, Li; Hu, Yiqiu; Wu, Siwei; Yao, Shuqiao

    2014-03-01

    Overgenerality and delay of the retrieval of autobiographical memory (AM) are well documented in a range of clinical conditions, particularly in patients with emotional disorder. The present study extended the investigation to chronic pain, attempting to identify whether the retrieval of AM in patients with chronic pain tends to be overgeneral or delayed. With an observational cross-sectional design, we evaluated the AM both in patients with chronic pain and healthy controls by Autobiographical Memory Test. Pain conditions were assessed using the pain diagnostic protocol, the short-form McGill Pain Questionnaire (SF-MPQ), and the Pain Self-Efficacy Questionnaire (PSEQ). Emotion was assessed using the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory. Subjects included 176 outpatients with chronic pain lasting for at least 6 months and 170 healthy controls. 1) Compared with the healthy group, the chronic pain group had more overgeneral memories (OGMs) (F = 29.061, P OGM were significant (P OGM scores could be predicted by the BDI score (9.7%), pain chronicity (4.3%), PSEQ score (7.1%), and Affective Index (of SF-MPQ) score (2.7%). 3) In the chronic pain group, the stepwise multiple regression models for variables predicting latency were significant (P < 0.05). Specifically, the variance in latency could be predicted by age (3.1%), pain chronicity (2.7%), pain duration (4.3%), and PSEQ score (2.0%). The retrieval of AM in patients with chronic pain tends to be overgeneral and delayed, and the retrieval style of AM may be contributed to negative emotions and chronic pain conditions. Wiley Periodicals, Inc.

  12. The effectiveness of cognitive behavioral therapy with respect to psychological symptoms and recovering autobiographical memory in patients suffering from post-traumatic stress disorder

    Science.gov (United States)

    Akbarian, Fatemehsadat; Bajoghli, Hafez; Haghighi, Mohammad; Kalak, Nadeem; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Objectives Given the persistence of post-traumatic stress disorder (PTSD) and its major impact on everyday life, it is important to identify effective treatments. In additional to pharmacological treatments, psychotherapeutic treatments are also highly effective. The aim of the present study was to investigate, among a sample of patients suffering from PTSD, the influence of an additional cognitive behavioral therapy (CBT) intervention on their symptoms of PTSD, depression, and anxiety, and on autobiographical memory. Methods A total of 40 patients suffering from PTSD (mean age: 31.64 years; 78.6% female patients) and under psychopharmacological treatment were randomly assigned to an intervention or control condition. The intervention consisted of ten group sessions (one 60–90 minute session per week) of CBT. At baseline and 10 weeks later, a series of self-rating and experts’-rating questionnaires were completed. Results Over time, symptoms of PTSD, depression, and anxiety decreased; however, greater improvement was observed in the experimental than the control condition. Likewise, as a general pattern of results, memory performance improved over time, though again this improvement was greater in the experimental condition. Conclusion Compared to a control condition, additional CBT improves the treatment of PTSD, with respect to both symptoms and autobiographical memory. PMID:25737635

  13. Chronic eczema patients on β-therapy (32P)

    International Nuclear Information System (INIS)

    Vlakhov, N.; Parusheva, D.; Vankova, V.

    1985-01-01

    β-therapy with 32 P was provided to 22 chronic eczema patients. A dose of 25 Gy given in 5 sessions resulted in a cure of 19 patients within 3 years of follow-up. Hyperpigmentation of the skin was noted in 2 patients

  14. Prevalence of symptoms of depression among patients with chronic ...

    African Journals Online (AJOL)

    Objective: Depression is the most common psychiatric illness in patients with chronic kidney disease (CKD). Depression has been shown to affect mortality in end-stage renal disease patients. The objective of this study was to determine prevalence of depressive symptoms among CKD patients. Materials and Methods: A ...

  15. Hormones and arterial stiffness in patients with chronic kidney disease.

    Science.gov (United States)

    Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

    2013-01-01

    Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population.

  16. [Neuro-otological Studies of Patients Suffering from Dizziness with Cerebrospinal Fluid Hypovolemia after Traffic Accident-associated Whiplash Injuries].

    Science.gov (United States)

    Yokota, Jun-Ichi; Shimoda, Satoe

    2015-05-01

    Vertigo and dizziness are common clinical manifestations after traffic accident-associated whiplash injury. Recently, Shinonaga et al. (2001) suggested that more than 80% of patients with whiplash injury complaining of these symptoms showed cerebrospinal (CSF) hypovolemia on radioisotope (RI) cisternography (111In-DTPA). However, neuro-otological studies to investigate the pathophysiological mechanisms underlying these symptoms have been insufficient. In the present study, patients complaining of these symptoms with CSF hypovolemia after traffic accidents were investigated with posturography and electronystagmography (ENG). Fourteen patients (4 men, 10 women; 24-52 yr) were examined with posturography and showed parameters (tracking distance & area) significantly (p<0.01) larger than those of healthy subjects. Among them, five cases (1 man, 4 women; 31-52 yr) were further investigated with ENG. The slow phase peak velocities of optokinetic nystagmus (OKN) and optokinetic-after nystagmus (OKAN) were significantly (p<0.01) reduced (62.64±6.9 SD deg/sec, 60.76±10.74 SD deg/sec, respectively) and frequencies of OKN were reduced (139.7±10.75 SD), while the ocular smooth pursuit was relatively preserved. Magnetic resonance images (sagittal view) of these five patients demonstrated the downward displacement of the cerebellar tonsils and flattening of the pons, which are characteristic features of CSF hypovolemia, called "brain sagging." Our results suggest that brain sagging due to CSF hypovolemia impairs vestibular and vestibulocerebellar functions, which may cause dizziness and vertigo.

  17. A controlled clinical study on the new topical dosage form of DHEP plasters in patients suffering from localized inflammatory diseases.

    Science.gov (United States)

    Rosenthal, M; Bahous, I

    1993-01-01

    In this clinical study the efficacy and the tolerability of a new topical formulation, DHEP plaster, have been evaluated. The plaster consists of an auto-adhesive medicated gauze pad of standard dimensions (10 x 15 cm) containing 180 mg DHEP. The reference drug was a well-known topical drug, diclofenac diethylammonium (DDA) emulgel at 1.16%. Treatments were applied to the affected area for 14 days: DHEP plaster b.i.d. and DDA emulgel q.i.d. A total of 190 patients, affected by various inflammatory diseases, participated in this clinical study. In both treatment groups (DHEP n = 96 patients, DDA n = 94 patients) a clear improvement in the disease and a rapid reduction in pain were observed. The statistical comparison between the two treatments showed a significant difference in favour of DHEP. However a comparison of the results, according to the different diagnoses, did not reveal any statistical significance. Both treatments were well tolerated, although five (DHEP n = 2, DDA n = 3) out of the 190 patients (2.6%) showed transient side effects (pruritus or erythema, both of light intensity).

  18. The Comparative Study of ECG Findings in the Patients Suffered from Subarachnoid Hemorrhage and Control Group in Northeastern Iran

    Directory of Open Access Journals (Sweden)

    Karim Nikkhah

    2015-04-01

    Full Text Available Introduction: Subarachnoid Hemorrhage (SAH which accounts for (5% to 10% of cerebrovascular accidents is an important cause of mortality and disability. It can be complicated by many neurological and medical conditions including cardiovascular complications. During the course of SAH morphologic Electrocardiography (ECG changes, arrhythmias, myocardial injury and elevation of cardiac enzymes, subendocardial hemorrhage and necrosis may be observed. Materials and Methods:102 SAH patients, without any history of Ischemic heart Disease (IHD, admitted in Ghaem Hospital were studied. Their clinical and radiological parameters were evaluated. Three serial ECGs were performed within the first 72 hours for each patient and the ECG findings were analyzed. The control group consisted of 102 elective patients of Ghaem hospital without any expected heart disease. Results: ECG changes were observed in 60.8% of SAH patients with average age of (53.4±14.2 years and in (2.9% of control group. The ECG findings were as follows: chamber abnormalities (6.9%, conduction abnormalities (7.8%, repolarization abnormalities (49%, rhythm abnormalities (22.5% and pathologic Q wave (6.9%. According to this study, ECG changes are related to subarachnoid hemorrhage (p

  19. Assessment of left ventricular torsion and untwisting in patients suffering from dilated cardiomyopathy by velocity vector imaging

    Directory of Open Access Journals (Sweden)

    Xiao-juan ZHANG

    2015-10-01

    Full Text Available Objective To evaluate the characteristics of left ventricular twisting (LVtw and untwisting (LVuntw in patients with dilated cardiomyopathy (DCM. Methods Nineteen DCM patients (aged 18-82 years, mean 50.52±17.52 years, 2 females and 21 normal controls (aged 18-80 years, mean 49.05±16.94 years, 5 females were enrolled in present study. Basal and apical short axis view of two-dimensional images of left ventricle were obtained to analyze LV rotation, and the LV rotation velocity was detected by velocity vector imaging (VVI. LVtw, LVtw velocity, untwisting velocity and untwisting rate (untwR were calculated. Results The rotated degree and velocity of the basal and apical parts of LV myocardium were irregularly changed along with the cardiac cycle in the DCM group. The rotation degree and rotation velocity at the basal and apex axis decreased in DCM group compared with that in normal group, while the peak of twisting (Ptw [(6.49±1.82°] and the peak of twisting velocity (PTV [(67.84±15.60°/s] decreased significantly in DCM group. The untwR and peak of untwisting velocity (PUV were also decreased significantly in DCM patients. Conclusion The Ptw, PTV and PUV decrease significantly, and the LV untwR, impacted by the preload, is also decreased significantly in DCM patients. DOI: 10.11855/j.issn.0577-7402.2015.09.13

  20. [Susceptibility of induced sickle in samples of heterozygous hemoglobin S patients (sickle cell trait) suffering diabetes mellitus type 2].

    Science.gov (United States)

    Díaz-Piedra, Pablo; Cervantes-Villagrana, Alberto Rafael; Ramos-Jiménez, Raúl; Presno-Bernal, José Miguel; Cervantes-Villagrana, Rodolfo Daniel

    2015-01-01

    Hemoglobin S is an abnormal protein that induces morphological changes in erythrocyte in low-oxygen conditions. In Mexico, it is reported that up to 13.7% of the population with mutation in one allele are considered asymptomatic (sickle cell trait). The sickle cell trait and diabetes mellitus are conditions that occur together in more than one million patients worldwide. Both diseases possibly produce microvascular changes in retinopathy and acute chest syndrome. The aim of this study was to evaluate the induction of sickle cells in samples of diabetic patients with sickle cell trait to identify altered red cell parameters. We obtained samples of diabetic patients to determine hemoglobin A1c and S; furthermore, red blood cell biometrics data were analyzed. We found that older men with diabetes were susceptible to generate sickle cells and this correlated with reduced red blood cell count and an increase in media cell volume. In samples of women diabetes, there were no differences. We conclude that samples from patients with sickle cell trait and diabetes can cause sickle cells with high frequency in men, with lower red blood cells count and increased mean corpuscular volume as susceptibility parameters.

  1. Improvement of orthopedic dental treatment of patients suffering post-surgery defects of the maxilla of cancer genesis

    Directory of Open Access Journals (Sweden)

    A. S. Arutyunov

    2015-01-01

    Full Text Available The paper presents a comprehensive study identifying the key issuesand giving the mathematical, and clinical and microbiological substantiation of modern principles of providing orthopedic dental care to patients with acquired defects of the upper jaw of cancer genesis.

  2. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

    Directory of Open Access Journals (Sweden)

    Homayoun Tabesh

    2015-01-01

    Full Text Available Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH straight leg raising (SLR test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and Methods: All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Results: Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47% and L4-L5 (42%, respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined . The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007. Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001. The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001. Conclusion: Age, sex (male, and disk level had statistically the effect on SLR positive test.

  3. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    , incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...... long-term opioid treatment, and specialised treatment facilities for pain management or addiction medicine should be consulted in these cases....

  4. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    , incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...... treatment as addiction may result in poor pain control. Several screening tools were identified, but only a few were thoroughly validated with respect to validity and reliability. Most of the identified guidelines mention addiction as a potential problem. The guidelines in cancer pain management...

  5. Effects of advanced life support on patients who suffered cardiac arrest outside of hospital and were defibrillated.

    Science.gov (United States)

    Hagihara, Akihito; Onozuka, Daisuke; Nagata, Takashi; Hasegawa, Manabu

    2018-01-01

    The effects and relative benefits of advanced airway management and epinephrine on patients with out-of-hospital cardiac arrest (OHCA) who were defibrillated are not well understood. This was a prospective observational study. Using data of all out-of-hospital cardiac arrest cases occurring between 2005 and 2013 in Japan, hierarchical logistic regression and conditional logistic regression along with time-dependent propensity matching were performed. Outcome measures were survival and minimal neurological impairment [cerebral performance category (CPC) 1 or 2] at 1month after the event. We analyzed 37,873 cases that met the inclusion criteria. Among propensity-matched patients, advanced airway management and/or prehospital epinephrine use was related to decreased rates of 1-month survival (adjusted odds ratio 0.88, 95% confidence interval 0.80 to 0.97) and CPC (1, 2) (adjusted odds ratio 0.56, 95% confidence interval 0.48 to 0.66). Advanced airway management was related to decreased rates of 1-month survival (adjusted odds ratio 0.89, 95% confidence interval 0.81to 0.98) and CPC (1, 2) (adjusted odds ratio 0.54, 95% confidence interval 0.46 to 0.64) in patients who did not receive epinephrine, whereas epinephrine use was not related to the outcome measures. In defibrillated patients with OHCA, advanced airway management and/or epinephrine are related to reduced long-term survival, and advanced airway management is less beneficial than epinephrine. However, the proportion of patients with OHCA who responded to an initial shock was very low in the study subjects, and the external validity of our findings might be limited. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk.

    Science.gov (United States)

    Yarnitsky, David; Crispel, Yonathan; Eisenberg, Elon; Granovsky, Yelena; Ben-Nun, Alon; Sprecher, Elliot; Best, Lael-Anson; Granot, Michal

    2008-08-15

    Surgical and medical procedures, mainly those associated with nerve injuries, may lead to chronic persistent pain. Currently, one cannot predict which patients undergoing such procedures are 'at risk' to develop chronic pain. We hypothesized that the endogenous analgesia system is key to determining the pattern of handling noxious events, and therefore testing diffuse noxious inhibitory control (DNIC) will predict susceptibility to develop chronic post-thoracotomy pain (CPTP). Pre-operative psychophysical tests, including DNIC assessment (pain reduction during exposure to another noxious stimulus at remote body area), were conducted in 62 patients, who were followed 29.0+/-16.9 weeks after thoracotomy. Logistic regression revealed that pre-operatively assessed DNIC efficiency and acute post-operative pain intensity were two independent predictors for CPTP. Efficient DNIC predicted lower risk of CPTP, with OR 0.52 (0.33-0.77 95% CI, p=0.0024), i.e., a 10-point numerical pain scale (NPS) reduction halves the chance to develop chronic pain. Higher acute pain intensity indicated OR of 1.80 (1.28-2.77, p=0.0024) predicting nearly a double chance to develop chronic pain for each 10-point increase. The other psychophysical measures, pain thresholds and supra-threshold pain magnitudes, did not predict CPTP. For prediction of acute post-operative pain intensity, DNIC efficiency was not found significant. Effectiveness of the endogenous analgesia system obtained at a pain-free state, therefore, seems to reflect the individual's ability to tackle noxious events, identifying patients 'at risk' to develop post-intervention chronic pain. Applying this diagnostic approach before procedures that might generate pain may allow individually tailored pain prevention and management, which may substantially reduce suffering.

  7. Self-care follows from compassionate care - chronic pain patients' experience of integrative rehabilitation.

    Science.gov (United States)

    Arman, Maria; Hök, Johanna

    2016-06-01

    The long-term outcome of any intervention for people suffering from chronic pain relies on the patient's ability for self-care. This study explores patient experiences of self-care in relation to a rehabilitation programme at an anthroposophic clinic. In a qualitative interview study with a hermeneutic approach, individual interviews were conducted, recorded, transcribed verbatim and analysed. Interviews were conducted with ten women who were taking part in a year-long rehabilitation programme for chronic pain and overlapping illness. The women told stories of suffering with a focus on lives that were not functioning well. In this context, pain is like secondary. For many, the experience of loving care at the clinic became a turning point, a chance to be vulnerable, to be recognised, to reflect and to begin life anew. Signs of self-care could then be witnessed. The women described a process whereby they regained contact with their bodies and their fellow human beings; they were able to identify their needs and when to stand up for them. Everyday life at the clinic is guided by universal aspects of love, life and meanings. The care gives patients glimpses of a move towards community in contrast to past isolation, towards love in contrast to past alienation, and towards joy and inspiration in contrast to past suffering. Through receiving caritative and compassionate care, these women were able to identify their needs as a first step towards self-care. In the context of chronic pain, self-care needs to be more than advice, education and training. Health can be attained when the sufferer experiences what it is to be cared for. This study supports the potential of a caritative caring culture to help patients participate in a compassionate community both with others and with the self. This forms the basis for the reawakening of their natural self-care ability. © 2015 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of

  8. Effect of Hydroxyethyl Starch Solution on Incidence of Acute Kidney Injury in Patients Suffering from Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Kieninger, Martin; Unbekannt, Daniel; Schneiker, André; Sinner, Barbara; Bele, Sylvia; Prasser, Christopher

    2017-02-01

    The application of third-generation hydroxyethyl starch (HES) solutions in critically ill patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) was often part of the treatment of delayed cerebral ischemia (DCI). However, there is increasing evidence showing a correlation between the application of HES and the incidence of acute kidney injury (AKI). In a single-center retrospective analysis including 81 patients without a preexisting renal disorder suffering from aSAH who had received higher volumes of 6 % HES 130/0.4 due to standard treatment of DCI, the incidence of AKI during intensive care unit (ICU) stay was recorded using AKIN criteria. Furthermore, the course of serum creatinine after discharge from ICU was observed. 6 % HES 130/0.4 was given over a period of 12.9 ± 7.1 days resulting in a cumulative dose of 12543.2 ± 7743.6 mL. Four patients (4.9 %) fulfilled AKIN criteria stage 1 during ICU stay. In two of these patients, serum creatinine was within normal range again on day of discharge. Five patients showed elevated levels of serum creatinine within 1 to 22 months after hospitalization. A correlation between the amount of HES given and the incidence of AKI could not be found. The application of 6 % HES 130/0.4 did not lead to an elevated incidence of AKI in patients without an elevated baseline serum creatinine. However, there is still a lack of high-level evidence as prospective randomized trials are missing yet.

  9. [Ozone therapy and phototherapy with polarized polychromatic light in treatment of patients suffering from lower limb critical ischaemia].

    Science.gov (United States)

    Drozhzhin, E V; Sidorkina, O N

    2012-01-01

    The authors generalized their experience in treating a total of 77 patients presenting with atherosclerosis of the arteries of lower limbs with degree III-IV ischaemia according to the A.V. Pokrovsky-Fontain classification. The patients were subjected to comprehensive treatment including the impact of piler-light (apparatus Bioptron 2) and ozone therapy. The control group was composed of 66 people receiving conventional therapy. The two groups were comparable by the nosological entity of the disease, gender, age, and the nature of accompanying pathology. Despite carried out classical anticoagulation therapy there was a tendency towards hypercoagulation in phase I (formation of prothrombinase) and phase III (formation of fibrin) of plasma haemostasis, as well as insufficiency of the fibrinolytic system. The obtained results showed direct influence of ozone therapy and piler light on phase I and III plasmatic haemostasis, as well as enhanced fibrinolytic activity of blood on the background of their administration thereof.

  10. Transcranial direct current stimulation (tDCS) and its influence on analgesics effectiveness in patients suffering from migraine headache.

    Science.gov (United States)

    Przeklasa-Muszyńska, Anna; Kocot-Kępska, Magdalena; Dobrogowski, Jan; Wiatr, Maciej; Mika, Joanna

    2017-08-01

    Headache is one of the most common conditions troubling nearly 45% of the world's population. Migraine headache itself, being more common among women, affects 7-18% of people. As much as 20-30% of the population report accompanying aura and neurological symptoms. In many cases, migraine headache can be effectively treated with suitably selected pharmacotherapies which include drugs used in symptomatic treatment. Frequent occurrence of the condition is treated with prophylaxis, which often fails. Neuromodulating methods are part of the multidirectional treatment and they may be valuable complement to pharmacotherapy. Our study evaluates the impact of the transcranial direct current stimulation (tDCS) on the consumption of drugs and on pain conditions (frequency, duration, intensity). We recruited 50 patients with migraine headache (30 with aura, 20 without aura) refractory to pharmacological therapy. In 30 patients (18 with aura, 12 without aura) previous unsatisfactory treatment was supplemented with tDCS performed tenfold. 20 patients (12 with aura, 8 without aura) from a control group were treated with pharmacological methods The observation continued for 30 days after the stimulation. After tDCS, a reduction in the consumption of analgesics and triptans was reported. Additionally, we monitored pain intensity decrease during pain episodes, duration of episodes and the number of pain days. The subjective assessment of pain reduction in migraine patients encompassed 36-40% after tDCS much more effective in comparison to group with only pharmacotherapy (10-12.5%). The study suggests that tDCS may be safe and useful clinical tool in migraine prophylaxis and treatment. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  11. Daily life, experience and needs of persons suffering from homozygous familial hypercholesterolaemia: insights from a patient survey.

    Science.gov (United States)

    Bruckert, Eric; Saheb, Samir; Bonté, Juliette Roth; Coudray-Omnès, Carole

    2014-09-01

    Homozygous familial hypercholesterolaemia (HoFH) is a rare and severe hereditary lipid disorder that is typically associated with high serum levels of low-density lipoprotein cholesterol (LDL-C). Excessive exposure to high levels of LDL-C puts affected individuals at very high risk of premature onset coronary heart disease, and this considerably limits life expectancy. Although the clinical features and treatment of HoFH have been extensively researched, societal and socio-psychological impacts of the disease have not been reported to date. The current study was conducted to investigate the burden of disease and treatment from the patient's perspective by means of semi-structured interviews with 24 HoFH patients. The findings of the survey indicate that HoFH represents a considerable burden for patients, not only due to physical signs and limitations caused by the disease but also a number of psychosocial factors, treatment-related issues and impact on their education and employment situation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Patients suffering from restless legs syndrome have low internal locus of control and poor psychological functioning compared to healthy controls.

    Science.gov (United States)

    Brand, Serge; Beck, Johannes; Hatzinger, Martin; Holsboer-Trachsler, Edith

    2013-01-01

    Restless legs syndrome (RLS) is a disturbing sensorimotor disorder negatively influencing both sleep and psychological functioning. The aim of the present study was to assess RLS patients with respect to locus of control, sleep-related personality traits, quality of life, and sleep as compared to healthy controls. Thirty-eight patients (18 females and 20 males; mean age: 56.06 years) diagnosed with RLS and an age- and gender-matched control group (n = 42) were recruited. Participants completed a series of questionnaires related to locus of control, personality traits, quality of life, and sleep. Compared to healthy controls, RLS patients had a lower internal locus of control, unfavourable sleep-related personality traits such as low self-confidence and higher mental arousal, poorer quality of life, and more depressive symptoms. Sleep was also affected. Multiple regression analyses showed that a low internal and a high external locus of control were predicted by RLS. The pattern of results suggests that RLS is associated with a low locus of control, negative personality traits, and poor quality of life as compared to healthy controls. Copyright © 2013 S. Karger AG, Basel.

  13. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  14. Anti-LC1 autoantibodies in patients with chronic hepatitis C virus infection.

    Science.gov (United States)

    Béland, Kathie; Lapierre, Pascal; Marceau, Gabriel; Alvarez, Fernando

    2004-03-01

    Various autoantibodies have been reported in patients chronically infected by hepatitis C virus. 2% to 10% of theses patients have anti-liver-kidney microsome type 1 (anti-LKM1) autoantibodies. In type 2 autoimmune hepatitis, anti-LKM1 autoantibodies are frequently associated with anti-liver-cytosol type 1 (anti-LC1) autoantibodies. To determine the prevalence of anti-LC1 autoantibodies in a hepatitis C-positive population and characterize their reactivity. 146 patients suffering from liver diseases, of which 99 were chronically infected by hepatitis C virus, were tested by Western blotting and immunoprecipitation to detect and characterize anti-LC1 autoantibodies. 12% of this hepatitis C population had anti-LC1 autoantibodies. LC1 positivity by Western blotting was 30% of LC1+ sera. Epitopes were found throughout the protein but linear epitopes were situated in the 395-541 amino acid region of formiminotransferase cyclodeaminase. Three putative conformational epitopes were identified by phage display. Anti-LC1 autoantibodies are as prevalent as anti-LKM1 autoantibodies in patients infected with hepatitis C virus and their production is not dependent of anti-LKM1 autoantibodies formation. Autoantibody reactivity against the anti-LC1 antigen is different in hepatitis C than in type 2 autoimmune hepatitis. Anti-LC1 autoantibodies can now be regarded as a serological marker of autoimmunity in chronic hepatitis C infection.

  15. Psychiatric morbidity in patients with chronic whiplash-associated disorder.

    Science.gov (United States)

    Kivioja, Jouko; Själin, Mikael; Lindgren, Urban

    2004-06-01

    Prospective cohort with age- and gender-matched controls. To compare psychiatric morbidity between two groups: patients having chronic symptoms after a whiplash injury and patients who recovered completely. Psychiatric morbidity may influence the outcome of somatic diseases, and it has been suggested that psychological factors are often involved in the development of chronic symptoms after whiplash injuries, but there is no study assessing psychiatric morbidity in whiplash-associated disorder (WAD) using the Structured Clinical Interview for DSM-IV. We studied a consecutive sample of 278 patients with a whiplash injury. Eighty-five had persisting neck pain after 1 year, and 38 of these participated in this study. For each patient with chronic neck pain at the 1 year follow-up, a gender- and age-matched recovered patient was selected from the study cohort of 278 cases. Psychiatric morbidity was determined using the Structured Clinical Interview for DSM-IV (SCID). The interview was conducted at 1 year after the accident (360 days, SD 2 days). The chronic WAD group had a significantly (P factor for chronic symptoms after a whiplash injury. The development of chronic symptoms after awhiplash injury seems to be associated with psychiatric vulnerability.

  16. Participation of chronic patients in medical consultations: patients' perceived efficacy, barriers and interest in support

    NARCIS (Netherlands)

    Henselmans, Inge; Heijmans, Monique; Rademakers, Jany; van Dulmen, Sandra

    2015-01-01

    Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and barriers,

  17. Diagnosis of respiratory epithelial clearance abnormality in patients suffering from chemo-resistant pulmonary tuberculosis with comorbidity of bronchial mucosa O. M. Raznatovska, V. M. Khlystun

    Directory of Open Access Journals (Sweden)

    O. M. Raznatovska

    2018-04-01

    Full Text Available Respiratory epithelial clearance timely and early disorder diagnosis in patients suffering from chemo-resistant pulmonary tuberculosis (CRPTB concomitant pathology of the bronchial mucosa is an actual problem of modern phthisiology, the solution of which will allow the timely application of rational correction, which will increase the effectiveness of this category treatment among patients. Objective is to investigate the nature and features of respiratory epithelial clearance disorders among patients suffering from CRPTB with comorbidity of the bronchi mucous membrane by using the developed method of these disorders diagnosis. Materials and methods. The respiratory epithelial clearance state diagnosis was carried out among 133 patients with CRPTB at the beginning of the intensive phase of antimycobacterial therapy during fibrobronchoscopy, provided there is a concomitant specific pathology of the mucous membrane (including its combination with non-specific endobronchitis. Average age of patients was 36.5 ± 1.1 years old. There were 89 (66.9 % men and 44 (33.1 % women. The tracheobronchial tree diagnostic fibrobronchoscopy with further study of the respiratory epithelial clearance condition among patients suffering from CRPTB was carried out by V. M. Khlystun at Phthisiology and Pulmonology Department of Zaporizhzhia State Medical University in CI “Zaporizhzhia Regional Antituberculous Clinical Dispensary”. Criteria of patients including into the research: existence of resistance of tuberculosis mycobacteria to anti-mycobacterial drugs in patients with new and repeated cases of tuberculosis, existence of pathology of the mucosa of bronchi confirmed during fiberoptic bronchoscopy. Serious associated diseases (HIV infection/AIDS, diabetes mellitus, etc. were criteria of exception. The condition of bronchial mucosa was studied under narcotic anaesthesia by fiberoptic bronchoscopes of Olympus (Japan. Pathology of a bronchial tree was described

  18. Disturbance of serotonin 5HT{sub 2} receptors in remitted patients suffering from hereditary depressive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Larisch, R.; Vosberg, H.; Tosch, M.; Mueller-Gaertner, H.W. [Kliniken fuer Nuklearmedizin der Heinrich-Heine-Univ., Duesseldorf (Germany); Klimke, A.; Gaebel, W. [Kliniken fuer Psychiatrie der Heinrich-Heine-Univ., Duesseldorf (Germany); Mayoral, F.; Rivas, F. [Psychiatrische Klinik des Hospital Civil Carlos Haya, Malaga (Spain); Hamacher, K.; Coenen, H.H. [Inst. fuer Nuklearchemie des Forschungszentrums Juelich GmbH (Germany); Herzog, H.R. [Inst. fuer Medizin des Forschungszentrums Juelich GmbH (Germany)

    2001-08-01

    Aim: The characteristics of 5HT{sub 2} receptor binding were investigated in major depression in vivo using positron emission tomography and the radioligand F-18-altanserin. Methods: Twelve patients from families with high loading of depression living in a geographically restricted region were examined and compared with normal control subjects. At the time of the PET measurement all patients were remitted; in some of them remission was sustained by antidepressive medication. Binding potential was assessed by Logan's graphical analysis method. Results: The binding of F-18-altanserin was about 38% lower in patients than in healthy controls (p<0.001). A multiple regression analysis revealed that this difference was mainly induced by depression rather than by medication. Conclusions: The data suggest that 5HT{sub 2} receptors are altered in depression. We present evidence for a reduction of the receptor density, which might be usable as trait marker of subjects susceptible for depressive illness. (orig.) [German] Ziel: Die vorliegende Studie untersucht die 5HT{sub 2}-Rezeptorbindung bei depressiven Patienten in vivo mit der Positronen-Emissionstomographie und dem Radioliganden F-18-Altanserin. Methoden: Zwoelf Patienten aus Familien mit hoher Inzidenz fuer Depressionen, die in einer geographisch abgeschlossenen Region leben, wurden untersucht und mit gesunden Kontrollpersonen verglichen. Zum Zeitpunkt der PET-Messung waren alle Patienten klinisch remittiert, was bei einigen den Einsatz von Antidepressiva erforderlich machte. Das Bindungspotenzial wurde mit Logans graphischer Methode bestimmt. Ergebnisse: Die Altanserinbindung war bei den Patienten um ca. 38% niedriger als bei den Kontrollpersonen (p<0,001). Eine multiple Regressionsanalyse zeigte, dass dieser Unterschied in erster Linie durch die Erkrankung und nicht durch Praemedikation hervorgerufen wurde. Schlussfolgerung: Die Studie zeigt, dass die 5HT{sub 2}-Rezeptoren an der Depression beteiligt sind. Die

  19. Effect of rehabilitation on a patient suffering from a tuberculous brain abscess with Gerstmann's syndrome: case report

    Directory of Open Access Journals (Sweden)

    Kuo CL

    2012-05-01

    Full Text Available Chih-Lan Kuo1, Sui-Foon Lo1,2, Chun-Lin Liu3, Chia-Hui Chou4, Li-Wei Chou1,2,5¹Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; ²School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 3Department of Neurosurgery, China Medical University Hospital, Taichung, Taiwan; 4Department of Infectious disease, China Medical University Hospital, Taichung, Taiwan; 5Department of Physical Therapy, China Medical University, Taichung, TaiwanAbstract: There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.Keywords: tuberculous brain abscess, Gerstmann's syndrome, rehabilitation

  20. Hemodynamic Alteration of the Cervical Venous Circulation in a Patient Suffering From Atlantoaxial Degenerative Osteoarthritis with Subluxation: A Case Report

    International Nuclear Information System (INIS)

    Lee, Hyun; Jang, Yi Sheng; Lee, Sang Jin; Hwang, Byeong Wook; Lee, Sang Ho; Choi, Won Gyu

    2010-01-01

    A 52-year-old female patient was admitted to our hospital with severe occipitocervical pain. The radiographic examination revealed degenerative osteoarthritis and subluxation of the right atlantoaxial joint. Her pain was completely and immediately relieved after occipitocervical reduction and fusion. The marked dilatation of the extradural venous plexus around the vertebral artery and the enlarged deep cervical veins seen on the preoperative MR images had returned to normal dimensions on the postoperative MR images, and this explained the observed rapid pain relief. We report here on this case together with a review of the relevant literature

  1. Conceptualizing suffering and pain.

    Science.gov (United States)

    Bueno-Gómez, Noelia

    2017-09-29

    This article aims to contribute to a better conceptualization of pain and suffering by providing non-essential and non-naturalistic definitions of both phenomena. Contributions of classical evidence-based medicine, the humanistic turn in medicine, as well as the phenomenology and narrative theories of suffering and pain, together with certain conceptions of the person beyond them (the mind-body dichotomy, Cassel's idea of persons as "intact beings") are critically discussed with such purpose. A philosophical methodology is used, based on the review of existent literature on the topic and the argumentation in favor of what are found as better definitions of suffering and pain. Pain can be described in neurological terms but cognitive awareness, interpretation, behavioral dispositions, as well as cultural and educational factors have a decisive influence on pain perception. Suffering is proposed to be defined as an unpleasant or even anguishing experience, severely affecting a person at a psychophysical and existential level. Pain and suffering are considered unpleasant. However, the provided definitions neither include the idea that pain and suffering can attack and even destroy the self nor the idea that they can constructively expand the self; both perspectives can b e equally useful for managing pain and suffering, but they are not defining features of the same. Including the existential dimension in the definition of suffering highlights the relevance of suffering in life and its effect on one's own attachment to the world (including personal management, or the cultural and social influences which shape it). An understanding of pain and suffering life experiences is proposed, meaning that they are considered aspects of a person's life, and the self is the ever-changing sum of these (and other) experiences. The provided definitions will be useful to the identification of pain and suffering, to the discussion of how to relieve them, and to a better understanding

  2. Use of alternative product in patients with chronic viral hepatitis

    Directory of Open Access Journals (Sweden)

    Mahmut Dulger

    2014-09-01

    Full Text Available Objectives: Some of the patients with chronic hepatitis use both alternative product and/or antiviral treatment. These herbal products sometimes lead to clinical deterioration. In this study we aimed to determine the purpose of alternative product utilization and rate among the chronic hepatitis B (CHB and C (CHC patients. Methods: This prospective cohort study included 200 consecutive adult patients with chronic hepatitis B and C at the Department of Infectious Diseases, Ondokuz Mayis University, between 1 March 2012 and 30 July 2012. At enrollment, clinical information, demographics, laboratory variables and knowledge about alternative products were recorded. Results: Of the patients 150 had CHB, 50 had CHC. 54% of patients were male. Use of alternative products was 26%. Antiviral treatment rate was 48.5% for all patients. The most used alternative products were artichoke extract and honey. 67.3% of patients were using single alternative product whereas the others were using two or more alternative products. 46.2% of patients who use alternative product provided information about the alternative product usage, but the others did not. Conclusions: Majority of patients used alternative products. More than half of these patients did not give information to their physicians about their use of alternative medicine. Use of alternative product should be asked in all patients with chronic hepatitis. Herbal product usage was detected in majority of patients and also approximately half of these patients did not give information to their doctors about taking alternative medicine. In conclusion, it is necessary to take detailed information about herbal product usage in patients with chronic hepatitis. J Microbiol Infect Dis 2014; 4(3: 102-106

  3. [Manegement and countermeasures against tuberculous patients with chronic positive sputum].

    Science.gov (United States)

    Sato, K

    1996-01-01

    We studied measures for the prevention and treatment of chronic positive-sputum tuberculosis. Most physicians treating chronic intractable pulmonary tuberculosis are concerned about treatment and control measures. However, both the medical and social aspects of the disease must be dealt with. The study of the medical aspects of tuberculosis used data on patients at the Tokyo National Chest Hospital and other sanitoria in Japan. The socioeconomic study employed data from a health center in Tokyo. Recently, new cases of tuberculosis are concentrated in socioeconomically high risk groups, such as the homeless and illegal aliens, in a few large cities. Patients in these groups often have multidrug-resistant tuberculosis (MDRTB), including many patients with relapsing tuberculosis. However, it is dificult to keep such patients under treatment because of poor compliance and patient dropout. The results of our study are summarized as follows: 1. Prevention and treatment of chronic intractable tuberculosis should involve both the medical and socioeconomic aspects of the disease. 2. Surgical treatment offers benefits for patients with chronically positive sputum. Therefore, surgery should be recommended to patients with chronic intractable MDRTB. 3. If resistance to both isoniazid and rifampin is demonstrated, it is better to replace all ineffective drugs with a new effective regimen than to add a single drug to a failing regimen.

  4. Priority Settings in patients with Chronic Diseases and Cancer

    DEFF Research Database (Denmark)

    Arreskov, Anne Beiter; Graungaard, Anette Hauskov; Søndergaard, Jens

    Priority setting in patients with cancer and comorbidities Background and aim As both the cancer incidence and the number of patients diagnosed with chronic diseases are increasing, a growing population of cancer survivors will also deal with comorbid chronic diseases. The period after completed...... to comorbidities. Some studies show that participation in regular follow-up consultations concerning comorbid chronic diseases and lifestyle are lower among cancer survivors than non-cancer patients. This could be explained by changes in the patient’s priority setting or in the doctor’s priority and attempt...... to spare the patient for further treatment burden, perhaps resulting in comorbidities falling down the agenda. The overall purpose is to explore patients’ and doctors’ priority settings of comorbidities in patients who have been diagnosed with non-metastatic cancer. Method: The study will consist of three...

  5. Associations of prognostic awareness/acceptance with psychological distress, existential suffering, and quality of life in terminally ill cancer patients' last year of life.

    Science.gov (United States)

    Tang, Siew Tzuh; Chang, Wen-Cheng; Chen, Jen-Shi; Chou, Wen-Chi; Hsieh, Chia-Hsun; Chen, Chen H

    2016-04-01

    Whether prognostic awareness benefits terminally ill cancer patients' psychological-existential well-being and quality of life (QOL) is unclear because of lack of well-controlled longitudinal studies. This study longitudinally evaluated the associations of accurate prognostic awareness and prognostic acceptance with psychological distress, existential suffering, and QOL while comprehensively controlling for confounders in Taiwanese terminally ill cancer patients' last year of life. A convenience sample of 325 cancer patients was followed until death. Psychological distress and existential suffering were assessed by severe anxiety and depressive symptoms and high self-perceived sense of burden to others, respectively. Dichotomized and continuous (QOL) outcome variables were evaluated by multivariate logistic and linear regression modeling with the generalized estimating equation, respectively. Accurate prognostic awareness was not associated with the likelihood of severe anxiety or depressive symptoms but significantly increased the likelihood of high self-perceived sense of burden to others and was associated with poorer QOL in participants' last year of life. Participants who knew and highly accepted their prognosis were significantly less likely to experience severe anxiety symptoms than those who were unaware of or knew their prognosis but had difficulty accepting it. Knowing one's poor prognosis and confronting one's impending death without full acceptance and adequate professional psycho-spiritual support may harm more than benefit terminally ill cancer patients' psychological state, existential well-being, and QOL. These findings highlight the importance of tailoring psycho-spiritual support to cancer patients' psychological and existential needs when prognostic information is disclosed. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Quantification of surfactant proteins in tears of patients suffering from dry eye disease compared to healthy subjects.

    Science.gov (United States)

    Posa, Andreas; Paulsen, Friedrich; Dietz, Richard; Garreis, Fabian; Sander, Ralph; Schicht, Martin; Sel, Saadettin; Scholz, Michael; Hammer, Christian M; Bräuer, Lars

    2018-03-01

    To quantify and compare the amounts of surfactant proteins SP-A, SP-B, SP-C and SP-D in the tear fluid collected from patients with dry eye syndrome and from individuals with a healthy ocular surface. Schirmer strips were used to collect tear fluid from both eyes of 241 volunteers (99 men, 142 women; age range: 18-87 years). Dry eye syndrome was diagnosed by ophthalmologists in 125 patients, whereas the healthy control group comprised 116 individuals. The total protein concentration was determined via Bradford assay. The relative concentration of surfactant proteins SP-A through -D was measured by enzyme-linked immuno-sorbent assay (ELISA). The mean relative concentrations of SP-A, SP-C and SP-D were significantly higher in the dry eye group as compared to the healthy controls (pdry eye group, but the difference to the control group was not statistically significant. The upregulation of SP-A and SP-D in the dry eye group is probably related to these proteins' known antimicrobial and immunomodulatory effects at the ocular surface. It may represent a pathophysiological response to the inflammatory condition of the ocular surface in dry eye. The upregulation of SP-B and SP-C may represent an effort of the lacrimal system to reduce surface tension and thus to counteract the increased tendency of the tear film to tear in dry eye. Copyright © 2017 Elsevier GmbH. All rights reserved.

  7. Switching to Aripiprazole as a Strategy for Weight Reduction: A Meta-Analysis in Patients Suffering from Schizophrenia

    Directory of Open Access Journals (Sweden)

    Yoram Barak

    2011-01-01

    Full Text Available Weight gain is one of the major drawbacks associated with the pharmacological treatment of schizophrenia. Existing strategies for the prevention and treatment of obesity amongst these patients are disappointing. Switching the current antipsychotic to another that may favorably affect weight is not yet fully established in the psychiatric literature. This meta-analysis focused on switching to aripiprazole as it has a pharmacological and clinical profile that may result in an improved weight control. Nine publications from seven countries worldwide were analyzed. These encompassed 784 schizophrenia and schizoaffective patients, 473 (60% men and 311 (40% women, mean age 39.4±7.0 years. The major significant finding was a mean weight reduction by −2.55±1.5 kgs following the switch to aripiprazole (<.001. Switching to an antipsychotic with a lower propensity to induce weight gain needs be explored as a strategy. Our analysis suggests aripiprazole as a candidate for such a treatment strategy.

  8. Beneficial Effects of the RESMENA Dietary Pattern on Oxidative Stress in Patients Suffering from Metabolic Syndrome with Hyperglycemia Are Associated to Dietary TAC and Fruit Consumption

    Directory of Open Access Journals (Sweden)

    J. Alfredo Martinez

    2013-03-01

    Full Text Available Hyperglycemia and oxidative stress are conditions directly related to the metabolic syndrome (MetS, whose prevalence is increasing worldwide. This study aimed to evaluate the effectiveness of a new weight-loss dietary pattern on improving the oxidative stress status on patients suffering MetS with hyperglycemia. Seventy-nine volunteers were randomly assigned to two low-calorie diets (−30% Energy: the control diet based on the American Health Association criteria and the RESMENA diet based on a different macronutrient distribution (30% proteins, 30% lipids, 40% carbohydrates, which was characterized by an increase of the meal frequency (seven-times/day, low glycemic load, high antioxidant capacity (TAC and high n-3 fatty acids content. Dietary records, anthropometrical measurements, biochemical parameters and oxidative stress biomarkers were analyzed before and after the six-month-long study. The RESMENA (Metabolic Syndrome Reduction in Navarra diet specifically reduced the android fat mass and demonstrated more effectiveness on improving general oxidative stress through a greater decrease of oxidized LDL (oxLDL values and protection against arylesterase depletion. Interestingly, oxLDL values were associated with dietary TAC and fruit consumption and with changes on body mass index (BMI, waist circumference, fat mass and triacilglyceride (TG levels. In conclusion, the antioxidant properties of the RESMENA diet provide further benefits to those attributable to weight loss on patients suffering Mets with hyperglycemia.

  9. Beneficial effects of the RESMENA dietary pattern on oxidative stress in patients suffering from metabolic syndrome with hyperglycemia are associated to dietary TAC and fruit consumption.

    Science.gov (United States)

    de la Iglesia, Rocio; Lopez-Legarrea, Patricia; Celada, Paloma; Sánchez-Muniz, Francisco J; Martinez, J Alfredo; Zulet, M Angeles

    2013-03-27

    Hyperglycemia and oxidative stress are conditions directly related to the metabolic syndrome (MetS), whose prevalence is increasing worldwide. This study aimed to evaluate the effectiveness of a new weight-loss dietary pattern on improving the oxidative stress status on patients suffering MetS with hyperglycemia. Seventy-nine volunteers were randomly assigned to two low-calorie diets (-30% Energy): the control diet based on the American Health Association criteria and the RESMENA diet based on a different macronutrient distribution (30% proteins, 30% lipids, 40% carbohydrates), which was characterized by an increase of the meal frequency (seven-times/day), low glycemic load, high antioxidant capacity (TAC) and high n-3 fatty acids content. Dietary records, anthropometrical measurements, biochemical parameters and oxidative stress biomarkers were analyzed before and after the six-month-long study. The RESMENA (Metabolic Syndrome Reduction in Navarra) diet specifically reduced the android fat mass and demonstrated more effectiveness on improving general oxidative stress through a greater decrease of oxidized LDL (oxLDL) values and protection against arylesterase depletion. Interestingly, oxLDL values were associated with dietary TAC and fruit consumption and with changes on body mass index (BMI), waist circumference, fat mass and triacilglyceride (TG) levels. In conclusion, the antioxidant properties of the RESMENA diet provide further benefits to those attributable to weight loss on patients suffering Mets with hyperglycemia.

  10. Exploring the potential role of the advanced nurse practitioner within a care path for patients with chronic fatigue syndrome.

    Science.gov (United States)

    Ryckeghem, Hannah; Delesie, Liesbeth; Tobback, Els; Lievens, Stefaan; Vogelaers, Dirk; Mariman, An

    2017-07-01

    To explore the experiences and expectations of patients with chronic fatigue syndrome and general practitioners to develop the potential role of an advanced nurse practitioner at the diagnostic care path of abnormal fatigue developed for regional transmural implementation in the Belgian provinces of East and West Flanders. Patients with chronic fatigue syndrome experience an incapacitating chronic fatigue that is present for at least 6 months. Since many uncertainties exist about the causes and progression of the disease, patients have to cope with disbelief and scepticism. Access to health care may be hampered, which could lead to inappropriate treatments and guidance. Qualitative design. Individual semi-structured interviews were conducted with patients with chronic fatigue syndrome and general practitioners in Belgium. Data were collected over 9 months in 2014-2015. All interviews were audio recorded and transcribed for qualitative analysis using open explorative thematic coding. Fifteen patients and 15 general practitioners were interviewed. Three themes were identified: mixed feelings with the diagnosis, lack of one central intermediator and insufficient coordination. Participants stressed the need for education, knowledge and an intermediator to provide relevant information at the right time and to build up a trust relationship. This qualitative exploration underscores some clear deficiencies in the guidance of patients suffering from chronic fatigue syndrome and abnormal fatigue. An advanced nurse practitioner as a central intermediator in the transmural care of these patients could promote interdisciplinary/multidisciplinary collaboration and effective communication, provide education and ensure a structured and coordinated approach. © 2016 John Wiley & Sons Ltd.

  11. Levamisole as an adjuvant to hepatitis B vaccination in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Mohammad-Hossein Somi

    2015-06-01

    Full Text Available Introduction: High risk of blood-borne infections is one of the problems of patients with chronic kidney disease (CKD, above which, there is hepatitis B. One of the ways to prevent this disease is vaccination against hepatitis B besides observing standard precautions. Lack of response to vaccine in uremic patients has been reported up to 33.0%. The aim of this study was to investigate the effect of levamisole as an adjuvant in improving vaccination response in patients suffering from CKD. Methods: In this cohort study, 30 patients suffering from the chronic renal disease who had undergone levamisole plus hepatitis B vaccine were included in the study as exposed group (Group A. Then 30 equivalent patients who had just underwent hepatitis B vaccination were in the study as a unexposed group (Group B. Antibody titer against hepatitis B virus (HBV was compared between two groups monthly, then data was analyzed. Results: Mean age of all investigated patients was 58.1 ± 14.9 years old, and it ranged from 26 to 82. 23 patients (38.3% were female, and 37 patients (61.7% were male. None of the patients in both groups had a history of previous hepatitis B vaccination. Mean antibody titer was higher in group A than that of the group B after the first and second stages of hepatitis B vaccination. However, the difference between two groups was not statistically significant (P = 0.14 and P = 0.46 respectively. Also, the mean antibody titer after the third stage was 98.8 ± 61 u/l in group A and 86.2 ± 49 u/l in group B where the difference between two groups was not statistically significant (P = 0.38. Side effects resulted from levamisole was not observed in any of patients in group A. Conclusion: According to the results it is possible to express that levamisole pill could be used as a proper adjuvant in improving the response of hepatitis B vaccination in patients suffering from CKD. However, further studies in this field are recommended according to the

  12. True microbiota involved in chronic lung infection of cystic fibrosis patients found by culturing and 16S rRNA gene analysis

    DEFF Research Database (Denmark)

    Rudkjøbing, Vibeke Børsholt; Thomsen, Trine R; Alhede, Morten

    2011-01-01

    Patients suffering from cystic fibrosis (CF) develop chronic lung infection. In this study, we investigated the microorganisms present in transplanted CF lungs (n = 5) by standard culturing and 16S rRNA gene analysis. A correspondence between culturing and the molecular methods was observed. In c...

  13. Evaluation of set-up deviations during the irradiation of patients suffering from breast cancer treated with two different techniques

    International Nuclear Information System (INIS)

    KukoIowicz, Pawel Franciszek; Debrowski, Andrzej; Gut, Piotr; Chmielewski, Leszek; Wieczorek, Andrzej; Kedzierawski, Piotr

    2005-01-01

    Purpose: To compare reproducibility of set-up for two different treatment techniques for external irradiation of the breast. Methods and materials: In total, the analysis comprised 56 pairs of portal and simulator films for 14 consecutive patients treated following breast conserving therapy and 98 pairs of portal and simulator films for 20 consecutive patients treated after mastectomy. For the first group the tangential field technique (TF technique) was used, for the second the inverse hockey stick technique (IHS technique). Evaluation of the treatment reproducibility was performed in terms of systematic and random error calculated for the whole groups, comparison of set-up accuracy by means of comparison of cumulative distribution of the length of the displacement vector. Results: In the IHS and TF techniques for medial and lateral fields, displacement larger than 5 mm occurred in 28.3, 15.8 and 25.4%, respectively. For the IHS technique, the systematic errors for lateral and cranial-caudal direction were 1.9 and 1.7 mm, respectively (1 SD), the random errors for lateral and cranial-caudal direction were 2.0 and 2.5 mm. For the TF technique, the systematic errors for ventral-dorsal and cranial-caudal direction were 2.6 and 1.3 mm for medial field and 3.7 and 0.7 mm for lateral fields, respectively, the random errors for lateral and cranial-caudal direction were 2.2 and 1.0 mm for medial field and 2.9 and 1.1 for lateral field, respectively. Rotations were negligible in the IHS technique. For the TF technique the systematic and random components amounted to about 2.0 degrees (1 SD). Conclusions: Both the inverse hockey stick and standard tangential techniques showed good reproducibility of patients' set-up with respect to cranial-caudal direction. For the TF technique, the accuracy should be improved for the medial field with respect to the ventral-dorsal direction

  14. {sup 18}F-FDG PET/MRI in patients suffering from lymphoma: how much MRI information is really needed?

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, Julian; Heusch, Philipp; Antoch, Gerald [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Deuschl, Cornelius; Grueneisen, Johannes; Forsting, Michael; Umutlu, Lale [University of Duisburg-Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen (Germany); Herrmann, Ken [University of Duisburg-Essen, Department of Nuclear Medicine, University Hospital Essen, Essen (Germany)

    2017-06-15

    To evaluate and compare the diagnostic potential of different reading protocols, entailing non-enhanced/contrast-enhanced and diffusion-weighted {sup 18}F-FDG PET/MR imaging for lesion detection and determination of the tumor stage in lymphoma patients. A total of 101 {sup 18}F-FDG PET/MRI datasets including a (1) transverse T2-w HASTE and {sup 18}F-FDG PET (PET/MRI{sub 1}), (2) with an additional contrast enhanced VIBE (PET/MRI{sub 2}), and (3) with additional diffusion-weighted imaging (PET/MRI{sub 3}) were evaluated. Scans were performed for initial staging, restaging during treatment, or at the end of treatment and under surveillance with suspicion for tumor relapse. In all datasets lymphoma manifestations as well as tumor stage in analogy to the revised criteria of the Ann Arbor staging system were determined. Furthermore, potential changes in therapy compared to the reference standard were evaluated. Hitherto performed PET/CT and all available follow-up and prior examinations as well as histopathology served as reference standard. PET/MRI{sub 1} correctly identified 53/55 patients with active lymphoma and 190/205 lesions. Respective values were 55/55, 202/205 for PET/MRI{sub 2} and 55/55, 205/205 for PET/MRI{sub 3}. PET/MRI{sub 1} determined correct tumor stage in 88 out of 101 examinations, and corresponding results for PET/MRI{sub 2} were 95 out of 101 and 96 out of 101 in PET/MRI{sub 3}. Relating to the reference standard changes in treatment would occur in 11% based on PET/MRI{sub 1}, in 6% based on PET/MRI{sub 2}, and in 3% based on PET/MRI{sub 3}. The additional application of contrast-enhanced and diffusion-weighted imaging to {sup 18}F-FDG PET/MRI resulted in higher diagnostic competence, particularly for initial staging and correct classification of the disease extent with potential impact on patient and therapy management. (orig.)

  15. Activity of Bacteriophages in Removing Biofilms of Pseudomonas aeruginosa Isolates from Chronic Rhinosinusitis Patients

    NARCIS (Netherlands)

    Fong, Stephanie A.; Drilling, Amanda; Morales, Sandra; Cornet, Marjolein E.; Woodworth, Bradford A.; Fokkens, Wytske J.; Psaltis, Alkis J.; Vreugde, Sarah; Wormald, Peter-John

    2017-01-01

    Introduction:Pseudomonas aeruginosa infections are prevalent amongst chronic rhinosinusitis (CRS) sufferers. Many P. aeruginosa strains form biofilms, leading to treatment failure. Lytic bacteriophages (phages) are viruses that infect, replicate within, and lyse bacteria, causing bacterial death.

  16. Dramatic course of osteomyelitis in a patient treated with immediately placed dental implants suffering from uncontrolled diabetes: A case report.

    Science.gov (United States)

    Doll, Christian; Hartwig, Stefan; Nack, Claudia; Nahles, Susanne; Nelson, Katja; Raguse, Jan-Dirk

    2015-01-01

    To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes. In this case report we present the dramatic course of a 64-year old female patient treated with five immediate post-extractive dental implants in the mandible, who developed osteomyelitis, which manifested initially as local peri-implant inflammation and progressed into a spontaneous jaw fracture, despite repeated surgical interventions and antibiotic courses over a 3-year period, until diabetes was diagnosed. A symptom-free status could be achieved only after partial mandibulectomy, treatment of diabetes and reconstruction with a microvascular fibula free flap. In the presence of mandibular osteomyelitis refractory to therapy, yet undiagnosed underlying pathologies, such as diabetes, should be investigated and treated urgently.

  17. Results of radioiodine therapy using different radiation doses in patients suffering from immunogenic and non-immunogenic hyperthyroidism

    International Nuclear Information System (INIS)

    Moser, E.

    1992-01-01

    During the past few years high rates of recidivation have increasingly been reported following drug treatment for hyperthyroidism. In view of these unsatisfactory results it is only natural that the use of surgery and ratioiodine treatment is now more often considered in order to achieve complete elimination of the metabolic disorders caused by hyperactivity of the thyroid gland. The aim of this study was to investigate into the effectiveness of radioiodine therapy in a large cohort of patients (n = 925). Particular attention was given to the influence of the dose applied to the thyroid tissue on the rates of success achieved in immunogenic hyperthyroidism (IH) and autonomous disorders (non-immunogenic hyperthyroidism = NIH). (orig./GDG) [de

  18. Patient-Centered Medical Home in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ortiz G

    2011-10-01

    Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

  19. An observation on positive rate of HBsAg in the urine of patients suffering from positive serum HBsAg

    Energy Technology Data Exchange (ETDEWEB)

    Peixun, Lin; Mingzheng, Zeng; Xiaoling, Chai [Wuhan Eighth Municipal Hospital, HB (China). Dept. of Laboratory

    1989-08-01

    In 1983, the Virus Research Office of the Shanxi Research Insitute of Preventive Medicine found out the granules of hepatitis B virus from the urine of patients and proved that this kind of virus can be spread through the urine. With the help of self-developed method of radio immunoelectrophoresis, our research office has purified and concentrated the urine of the patients suffering from positive serum HBsAg (hepatitis B surface antigen). Among them 25 are male, and another 25 are female. The result shows that the positive rate of HBsAg accounts for 80%. This is of important significance to the care of urine specimens, the protection of experimentalists and the development of clinical medicine.

  20. Energy expenditure in patients with chronic renal failure.

    Science.gov (United States)

    Monteon, F J; Laidlaw, S A; Shaib, J K; Kopple, J D

    1986-11-01

    Although nondialyzed, chronically uremic patients and patients undergoing maintenance hemodialysis often show evidence for wasting and calorie malnutrition and have low dietary energy intakes, their energy expenditure has never been systematically evaluated. It is possible that low energy intakes are an adaptive response to reduced energy needs; alternatively, energy expenditure could be normal or high and the low energy intakes would be inappropriate. Energy expenditure was therefore measured by indirect calorimetry in 12 normal individuals, 10 nondialyzed patients with chronic renal failure, and 16 patients undergoing maintenance hemodialysis. Energy expenditure was measured in the resting state, during quiet sitting, during controlled exercise on an exercise bicycle, and for four hours after ingestion of a test meal. Resting energy expenditure (kcal/min/1.73 m2) in the normal subjects, chronically uremic patients and hemodialysis patients was, respectively, 0.94 +/- 0.24 (SD), 0.91 +/- 0.20, and 0.97 +/- 0.10. There was also no difference among the three groups in energy expenditure during sitting, exercise, or the postprandial state. Within each group, energy expenditure during resting and sitting was directly correlated. During bicycling, energy expenditure was directly correlated with work performed, and the regression equation for this relationship was similar in each of the three groups. These findings suggest that for a given physical activity, energy expenditure in nondialyzed, chronically uremic patients and maintenance hemodialysis patients is not different from normal. The low energy intakes of many of these patients may be inadequate for their needs.

  1. Pancreatic duct stones in patients with chronic pancreatitis: surgical outcomes.

    Science.gov (United States)

    Liu, Bo-Nan; Zhang, Tai-Ping; Zhao, Yu-Pei; Liao, Quan; Dai, Meng-Hua; Zhan, Han-Xiang

    2010-08-01

    Pancreatic duct stone (PDS) is a common complication of chronic pancreatitis. Surgery is a common therapeutic option for PDS. In this study we assessed the surgical procedures for PDS in patients with chronic pancreatitis at our hospital. Between January 2004 and September 2009, medical records from 35 patients diagnosed with PDS associated with chronic pancreatitis were retrospectively reviewed and the patients were followed up for up to 67 months. The 35 patients underwent ultrasonography, computed tomography, or both, with an overall accuracy rate of 85.7%. Of these patients, 31 underwent the modified Puestow procedure, 2 underwent the Whipple procedure, 1 underwent simple stone removal by duct incision, and 1 underwent pancreatic abscess drainage. Of the 35 patients, 28 were followed up for 4-67 months. There was no postoperative death before discharge or during follow-up. After the modified Puestow procedure, abdominal pain was reduced in patients with complete or incomplete stone clearance (P>0.05). Steatorrhea and diabetes mellitus developed in several patients during a long-term follow-up. Surgery, especially the modified Puestow procedure, is effective and safe for patients with PDS associated with chronic pancreatitis. Decompression of intraductal pressure rather than complete clearance of all stones predicts postoperative outcome.

  2. Bone marrow transplantation for patients with chronic myeloid leukemia

    International Nuclear Information System (INIS)

    Goldman, J.M.; Apperley, J.F.; Jones, L.

    1986-01-01

    Between February 1981 and December 1984 we treated 52 patients with chronic myeloid leukemia in the chronic phase and 18 patients with more advanced disease by high-dose chemoradiotherapy followed by allogeneic bone marrow transplantation using marrow cells from HLA-identical sibling donors. In addition, the 40 patients who had not previously undergone splenectomy received radiotherapy to the spleen. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with donor marrow depleted of T cells. Of the 52 patients treated in the chronic phase, 38 are alive after a median follow-up of 25 months (range, 7 to 50); the actuarial survival at two years was 72%, and the actuarial risk of relapse was 7%. Of the 18 patients with more advanced disease, 4 have survived; the actuarial two-year survival was 18%, and the actuarial risk of relapse was 42%. We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase of chronic myeloid leukemia. T-cell depletion may have reduced the incidence and severity of graft versus host disease. The value of irradiation to the spleen before transplantation has not been established

  3. The prevalence and risk factors of stroke in patients with chronic schizophrenia

    Directory of Open Access Journals (Sweden)

    Liang Y

    2016-05-01

    Full Text Available Ying Liang,1 Jian Huang,1 Jingbin Tian,2 Yuanyuan Cao,2 Guoling Zhang,2 Chungang Wang,2 Ying Cao,2 Jianrong Li2 1National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health, Peking University, 2Changping Traditional Chinese Medicine Hospital, Beijing, People’s Republic of China Objective: To investigate the stroke risk and risk factors in patients with chronic schizophrenia.Patients and methods: This study was a large-sample, cross-sectional survey. A total of 363 patients with