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Sample records for subjects including patients

  1. Comorbid subjective health complaints in patients with sciatica: a prospective study including comparison with the general population.

    Science.gov (United States)

    Grøvle, Lars; Haugen, Anne J; Ihlebaek, Camilla M; Keller, Anne; Natvig, Bård; Brox, Jens I; Grotle, Margreth

    2011-06-01

    Chronic nonspecific low back pain is accompanied by high rates of comorbid mental and physical conditions. The aims of this study were to investigate if patients with specific back pain, that is, sciatica caused by lumbar herniation, report higher rates of subjective health complaints (SHCs) than the general population and if there is an association between change in sciatica symptoms and change in SHCs over a 12-month period. A multicenter cohort study of 466 sciatica patients was conducted with follow-up at 3 months and 1 year. Comorbid SHCs were measured by 27 items of the SHC inventory. Odds ratios (ORs) for each SHC were calculated with comparison to a general population sample (n=928) by logistic regression. The SHC number was calculated by summing all complaints present. At baseline, the ORs for reporting SHCs for the sciatica patients were significantly elevated in 15 of the 27 items with a mean (S.D.) SHC number of 7.5 (4.4), compared to 5.2 (4.4) in the general population (Psciatica, the SHC number was reduced to normal levels. Among those with persisting or worsening sciatica, the number increased to a level almost double that of the general population. Compared to the general population, the prevalence of subjective health complaints in sciatica is increased. During follow-up, the number of health complaints increased in patients with persisting or worsening sciatica. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. Including subjectivity in the teaching of Psychopathology

    Directory of Open Access Journals (Sweden)

    Octavio Domont de Serpa Junior

    2007-01-01

    Full Text Available Current psychopathology studies have often been presented in their descriptive dimension. This perspective is important for teaching because it helps the students to recognize and identify the symptomatology of each psychopathology case. However, subjectivity, the experience of suffering and interpersonal aspects are all lost in this perspective. Coming from another psychopathology tradition - existential anthropology - this paper presents practical psychopathology teaching experience which considers such dimensions as being relevant to the understanding of mental suffering. The features and limitations of such traditions are briefly reviewed to support this teaching experience. Two new modalities of practical teaching, used in the discipline of "Special Psychopathology I" offered by the Department of Psychiatry and Forensic Medicine at the medical school of the Federal University of Rio de Janeiro for students of psychology, will be presented according to descriptive case study methodology. With these activities we also expect to change the practice of teaching. Traditionally, interviewing of in-patients by a large group of students who observe passively what is happening is the center of this kind of education. We intend to develop a model of teaching which is closer to the proposal of the Brazilian Psychiatric Reform which views mental illness as a complex phenomenon, always involving the relationship that the subject establishes with the world.

  3. Student Motivation in Science Subjects in Tanzania, Including Students' Voices

    Science.gov (United States)

    Mkimbili, Selina Thomas; Ødegaard, Marianne

    2017-12-01

    Fostering and maintaining students' interest in science is an important aspect of improving science learning. The focus of this paper is to listen to and reflect on students' voices regarding the sources of motivation for science subjects among students in community secondary schools with contextual challenges in Tanzania. We conducted a group-interview study of 46 Form 3 and Form 4 Tanzanian secondary school students. The study findings reveal that the major contextual challenges to student motivation for science in the studied schools are limited resources and students' insufficient competence in the language of instruction. Our results also reveal ways to enhance student motivation for science in schools with contextual challenges; these techniques include the use of questioning techniques and discourse, students' investigations and practical work using locally available materials, study tours, more integration of classroom science into students' daily lives and the use of real-life examples in science teaching. Also we noted that students' contemporary life, culture and familiar language can be utilised as a useful resource in facilitating meaningful learning in science in the school. Students suggested that, to make science interesting to a majority of students in a Tanzanian context, science education needs to be inclusive of students' experiences, culture and contemporary daily lives. Also, science teaching and learning in the classroom need to involve learners' voices.

  4. Patient-generated subjective global assessment

    NARCIS (Netherlands)

    Dr Harriët Jager-Wittenaar; Martine J. Sealy; Suzanne Kasenic; Elizabeth Isenring; Faith D. Ottery; Susan P. DeBolt

    2015-01-01

    Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening,

  5. Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort

    DEFF Research Database (Denmark)

    Salem, L C; Vogel, Asmus Mejling; Ebstrup, J

    2015-01-01

    functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score. RESULTS: We found that young patients......OBJECTIVE: Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic. METHODS: Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet....... In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive...

  6. Subjective burden on spouses of schizophrenia patients

    Directory of Open Access Journals (Sweden)

    Surekha Kumari

    2009-01-01

    Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

  7. Subjective Response to Foot-Fall Noise, Including Localization of the Source Position

    DEFF Research Database (Denmark)

    Brunskog, Jonas; Hwang, Ha Dong; Jeong, Cheol-Ho

    2011-01-01

    Although an impact noise level is objectively evaluated the same according to current standards, a lightweight floor structure is often subjectively judged more annoying than a heavy homogeneous structure. The hypothesis of the present investigation is that the subjective judgment of impact noise...

  8. Is dietary pattern of schizophrenia patients different from healthy subjects?

    Directory of Open Access Journals (Sweden)

    Amani Reza

    2007-05-01

    Full Text Available Abstract Background There are limited findings about dietary patterns and food preferences among patients suffering from schizophrenia. The main objective of this study was therefore to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects. Methods The dietary pattern of 30 hospitalized 16–67 years old schizophrenic patients (11 female was compared with that of 30 healthy age and sex matched individuals as control group. Subjects' anthropometric measurements including weight, height and body mass index (BMI, semi-quantitative food frequency (FFQ, medical and food history questionnaires were also collected and FFQs were then scored using Food Guide Pyramid to obtain the dietary scores. Percent body fat (%BF was measured using bioelectrical impedance analysis (BIA method. Results Female patients had more %BF and lower dietary pattern scores than that of their controls (32 ± 3.6 vs 27.7 ± 4.6 percent and 43.2 ± 11.9 vs 54.5 ± 10.7 points; respectively, p Conclusion Schizophrenia patients have poor nutritional patterns. In particular, female patients have more percent body fat and lower dietary pattern scores compared with their healthy controls. All patients used to consume more fats and sweet drinks frequently. The findings of this study suggest that schizophrenia patients need specific medical nutrition therapies through limiting dietary fats and sugars intakes and weight control. Whether obesity is the consequence of disease, dietary preference or medications used remains to be cleared.

  9. Late psychological symptoms after awareness among consecutively included surgical patients.

    Science.gov (United States)

    Samuelsson, Peter; Brudin, Lars; Sandin, Rolf H

    2007-01-01

    Awareness during general anesthesia can cause late psychological symptoms. Selection bias may have affected the results in previous retrospective studies. The authors used prospective consecutive collection to recruit patients with previous awareness. In a cohort of 2,681 consecutive patients scheduled to undergo general anesthesia, 98 considered themselves to have been aware during previous surgery. Six patients died before inclusion, and another 13 were excluded (4 cases of stroke or dementia, 7 declined to participate, and 2 could not be located). Seventy-nine patients were interviewed by telephone, and medical records were checked in uncertain cases. The interview followed a structured protocol, including seven late symptoms (anxiety, chronic fear, nightmares, flashbacks, indifference, loneliness, and lack of confidence in future life). Three persons independently assessed the interviews for classification, to determine whether awareness had occurred. Four cases were performed using regional anesthesia, and another 29 were not considered as awareness by the assessors. Therefore, the final analyses included 46 patients. Twenty (43%) had experienced pain, and 30 (65%) described acute emotional reactions during the awareness episode. Fifteen (33%) patients had experienced late psychological symptoms afterward. In 6 of those cases, the symptoms lasted for more than 2 months, and 1 patient had a diagnosis of post-traumatic stress disorder. Acute emotional reactions were significantly related to late psychological symptoms (Paffect the result. The authors found fewer and milder problems, despite a similar degree of initial problems as in previous studies.

  10. Validity of subjective smoking status in orthopedic patients

    Directory of Open Access Journals (Sweden)

    Bender D

    2015-08-01

    Full Text Available Daniel Bender,* Patrick Haubruck,* Sonja Boxriker, Sebastian Korff, Gerhard Schmidmaier, Arash Moghaddam Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany *These authors contributed equally to this work Purpose: In this level 1 diagnostic study, we analyzed the validity of subjective smoking status and, as secondary research question, the smoking cessation adherence in orthopedic patients during a routine hospital stay of nonunion patients by measuring serum cotinine.  Methods: We included patients undergoing revision surgery due to nonunion of long bones. Patients were interviewed about their smoking status. Blood samples were taken from all the patients prior to surgery and for an additional 6 weeks following surgery. Serum levels of cotinine were measured, and coherence between subjective smoking status and objective cotinine analysis was evaluated.  Results: Between March 2012 and August 2014, we enrolled 136 patients. Six of the 26 “previous smokers” (23% and four of the 65 “nonsmokers” (6% had serum cotinine above cutoff levels. In self-labeled smokers, serum cotinine levels averaged at 2,367.4±14,885.9 ng/mL (with a median of 100 ng/mL, whereas in previous smokers the levels averaged at 4,270±19,619.4 ng/mL (with a median of 0 ng/mL and in the nonsmokers group the levels averaged at 12±53.9 ng/mL (with a median of 0.03 ng/mL. Overall, the subjective smoking status matched serum cotinine testing in 88% of the cases. Sensitivity was 79.6% and specificity was 93.1%. Ninety-one percent of the patients with preoperative positive serum values were still positive at follow-up.  Conclusion: In this study, we could show that subjective smoking status in orthopedic patients is predominantly reliable as validated by objective cotinine measurements; however, patients who declare themselves as “previous smokers” are at elevated risk

  11. Including patients’ perspectives in patient information leaflets: A polyocular approach

    DEFF Research Database (Denmark)

    Fage-Butler, Antoinette Mary

    2013-01-01

    Existing research reveals that patients’ perspectives are missing from mandatory patient information leaflets (PILs). At the same time, there is overwhelming consensus that they should be included in this genre, and a corresponding need for potential approaches to tackle this problem. This paper...... examines the appropriateness of perspectivist theory as a means of conceptualising the underrepresentation of patients’ perspectives in PILs. It also offers a framework for a possible solution that draws on polyocular theory, as polyocular approaches can support communication across perspectival......’ perspectives. Apart from its theoretical contributions, the paper includes guidelines to support the production of PILs where patients’ perspectives are included. The guidelines are informed by practices that have characterised previous polyocular communication events, as well as research into how to maximize...

  12. A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis.

    Science.gov (United States)

    Rizza, Stefano; Copetti, Massimiliano; Cardellini, Marina; Menghini, Rossella; Pecchioli, Chiara; Luzi, Alessio; Di Cola, Giovanni; Porzio, Ottavia; Ippoliti, Arnaldo; Romeo, Franco; Pellegrini, Fabio; Federici, Massimo

    2015-04-01

    Atherosclerosis disease is a leading cause for mortality and morbidity. The narrowing/rupture of a vulnerable atherosclerotic plaque is accountable for acute cardiovascular events. However, despite of an intensive research, a reliable clinical method which may disclose a vulnerable patient is still unavailable. We tested the association of ADAM17 (A Disintegrin and Metallo Protease Domain 17) circulating substrates (sICAM-1, sVCAM-1, sIL6R and sTNFR1) with a second major cardiovascular events [MACEs] (cardiovascular death, peripheral artery surgeries, non-fatal myocardial infarction and non-fatal stroke) in 298 patients belonging to the Vascular Diabetes (AVD) study. To evaluate ADAM17 activity we create ADAM17 score through a RECPAM model. Finally we tested the discrimination ability and the reclassification of clinical models. At follow-up (mean 47 months, range 1-118 months), 55 MACEs occurred (14 nonfatal MI, 14 nonfatal strokes, 17 peripheral artery procedures and 10 cardiovascular deaths) (incidence = 7.8% person-years). An increased risk for incident events was observed among the high ADAM17 score individuals both in univariable (HR 19.20, 95% CI 15.82-63.36, p atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Compliance and Subjective Patient Responses to Eyelid Hygiene.

    Science.gov (United States)

    Alghamdi, Yousef A; Camp, Andrew; Feuer, William; Karp, Carol L; Wellik, Sarah; Galor, Anat

    2017-07-01

    Lid hygiene is a commonly prescribed first-line therapy in patients with lid margin disease, yet compliance with therapy is not well characterized. The goals of this study were to assess patient compliance with lid hygiene and evaluate which factors predict a favorable symptomatic response to treatment. This was a cross-sectional study of patients seen in the Miami Veterans Affairs eye clinic between August and December 2014. An evaluation was performed to assess dry eye symptoms and lid margin signs. All patients were then instructed to perform warm compresses and lid scrubs. A follow-up phone survey assessed compliance and subjective therapeutic response 6 weeks later. Two hundred seven of 211 (98%) patients (94% male, 60% white) completed the survey. Of the 207 patients, 188 (91%) completed the follow-up survey. Compliance with therapy was reported in 104 patients (55%); 66 reported complete improvement, 30 partial improvement, and 8 no improvement in symptoms. Patients who self-reported dry eye symptoms at first visit (n=86, 74%) were more likely to be compliant with lid hygiene than those who did not report symptoms (n=18, 25%) (P<0.0005). The only factor associated with poorer response to lid hygiene was longer time of self-reported dry eye symptoms. None of the other signs studied, including the presence of skin rosacea and lid margin telangiectasia, were associated with a differential response to lid hygiene. Patients with dry eye symptoms were moderately compliant with lid hygiene, and patients who performed the routine noted improvement in symptoms.

  14. [Can men be included in the population subjected to puerperal psychosis? A case report].

    Science.gov (United States)

    Colombel, M; Rebillard, C; Nathou, C; Dollfus, S

    2016-08-01

    Puerperal psychosis (PP) is a psychiatric disorder that occurs in 1 out of 1000 pregnancies. Well known since antiquity, its symptoms have often been described in mothers, but few studies have successfully investigated a related disorder in fathers. The characteristic of this pathology is more related to its appearance than to its semiological description which is why its nosographic place is always discussed. The objective here is to focus on the definition of PP and to suggest an entity for both genders. Our case report focused on the clinical description of an eighteen-year-old man suffering from an acute psychosis episode that occurred around the birth of his first child. Delusion followed a sudden decline in mood that lasted for a short period of time during the course of the third trimester of his wife's pregnancy. The delirium was rich with auditory and cenesthesic hallucinations, pregnancy and birth denial, feeling movements and hearing voices in his stomach. The symptoms disappeared after one month of treatment via an antipsychotic drug, risperidone. We can confirm that the symptomatic description of the disorder in this patient fits the classical descriptions of PP. Two elements make the PP different from other acute psychoses: the context of pregnancy and delirium focused on the child which can lead to a child murder. The absence of a framework precisely defining the PP does not improve its prevention and can lead to legal attitudes rather than medical care. Men suffering from acute psychosis in a context of pregnancy are submitted to the same risks as women. It is necessary to emphasize descriptions of PP in men to redefine the disease and consider that this entity involves both men and women. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  15. Verifying the attenuation of earplugs in situ: method validation on human subjects including individualized numerical simulations.

    Science.gov (United States)

    Bockstael, Annelies; Van Renterghem, Timothy; Botteldooren, Dick; D'Haenens, Wendy; Keppler, Hannah; Maes, Leen; Philips, Birgit; Swinnen, Freya; Vinck, Bart

    2009-03-01

    The microphone in real ear (MIRE) protocol allows the assessment of hearing protector's (HPD) attenuation in situ by measuring the difference between the sound pressure outside and inside the ear canal behind the HPD. Custom-made earplugs have been designed with an inner bore to insert the MIRE probe containing two microphones, the reference microphone measuring the sound pressure outside and the measurement microphone registering the sound pressure behind the HPD. Previous research on a head and torso simulator reveals a distinct difference, henceforth called transfer function, between the sound pressure at the MIRE measurement microphone and the sound pressure of interest at the eardrum. In the current study, similar measurements are carried out on humans with an extra microphone to measure the sound pressure at the eardrum. The resulting transfer functions confirm the global frequency dependency found earlier, but also show substantial variability between the ears with respect to the exact frequency and amplitude of the transfer functions' extrema. In addition, finite-difference time-domain numerical models of an ear canal with earplug are developed for each individual ear by including its specific geometrical parameters. This approach leads to a good resemblance between the simulations and their corresponding measurements.

  16. Minnesota Multiphasic Personality Inventory profile of patients with subjective tinnitus.

    Science.gov (United States)

    Bayar, Nuray; Oğuztürk, Omer; Koç, Can

    2002-10-01

    Subjective tinnitus is frequently seen in the general population. We investigated the personality traits in tinnitus and nontinnitus groups, both of which were nonpsychiatric. In this study, we evaluated 28 patients with subjective tinnitus and 28 subjects for a control group. In the analysis of psychiatric status, Minnesota Multiphasic Personality Inventory (MMPI) profiles were used. Psychasthenia was found to be higher in tinnitus patients of both sexes, whereas Hypochondriasis, Hysteria, Masculinity/Feminity, Psychasthenia, Schizophrenia, and Social Introversion scores were higher in females with tinnitus. In our research, it is thought that the experience of tinnitus may cause the psychological disturbance.

  17. [Combined treatment including ozonotherapy of patients with viral hepatitis ].

    Science.gov (United States)

    Chernyshev, A L; Filimonov, R M; Karasev, A V; Neronov, V A; Maksimov, V A

    2008-01-01

    Patients with viral hepatitis have disturbances of biliary tract motor function with the tendency to hypertonus of Oddi's sphincter, changes of physic-colloid properties of bile with increase in density of gall and hepatic bile, pH shift to acid side, microlites formation, disorders in biochemical composition of bile. More than 80% patients have biliar insufficiency. According to our data, with the purpose to correct of disturbances of hepatic exocrine function in patients with viral hepatitis and to prevent stone formation, it is reasonable to use together with antiviral therapy also intravenous injection of ozonated physiological solution and preparations of ursodeoxycholic acid.

  18. Canine cancer patients are included in translational research

    DEFF Research Database (Denmark)

    Børresen, Betina; Clausen, Malene Martini; Hansen, Anders Elias

    2014-01-01

    Cancer bearing dogs represent a unique clinical cancer model with a direct potential for accelerating translation into human patients. A research collaboration between the veterinary and human medical facilities at Copenhagen University and Rigshospitalet has taken offset in this. Canine cancer...... patients are implemented for development of new strategies in molecular imaging and radiotherapy. The obtained results will be used to guide human clinical trials....

  19. Comparison of Subjective and Objective Sleep Estimations in Patients with Bipolar Disorder and Healthy Control Subjects

    Directory of Open Access Journals (Sweden)

    Philipp S. Ritter

    2016-01-01

    Full Text Available Background. Several studies have described but not formally tested discrepancies between subjective and objective measures of sleep. Study Objectives. To test the hypothesis that patients with bipolar disorder display a systematic bias to underestimate sleep duration and overestimate sleep latency. Methods. Actimetry was used to assess sleep latency and duration in 49 euthymic participants (bipolar = 21; healthy controls = 28 for 5–7 days. Participants simultaneously recorded estimated sleep duration and sleep latency on a daily basis via an online sleep diary. Group differences in the discrepancy between subjective and objective parameters were calculated using t-tests and corrected for multiple comparisons. Results. Patients with bipolar disorder significantly underestimated their sleep duration but did not overestimate their sleep latency compared to healthy controls. Conclusions. Studies utilizing diaries or questionnaires alone in patients with bipolar disorders may systematically underestimate sleep duration compared to healthy controls. The additional use of objective assessment methods such as actimetry is advisable.

  20. Subjectivity

    Directory of Open Access Journals (Sweden)

    Jesús Vega Encabo

    2015-11-01

    Full Text Available In this paper, I claim that subjectivity is a way of being that is constituted through a set of practices in which the self is subject to the dangers of fictionalizing and plotting her life and self-image. I examine some ways of becoming subject through narratives and through theatrical performance before others. Through these practices, a real and active subjectivity is revealed, capable of self-knowledge and self-transformation. 

  1. [Why cardiovascular rehabilitation services should include patients with intermittent claudication?].

    Science.gov (United States)

    Carlon, Roberto; Zanchetta, Mario

    2006-12-01

    Chronic peripheral arterial disease represents a frequent and underestimated localization of atherosclerosis and its management often appears to be inadequate. The association with ischemic heart disease, the weighty prevalence of coronary disease risk factors, the high cardiovascular rate of morbidity and mortality, the sharp reduction in the tenor of life and the well-being supervised physical training efficacy constitute the main reasons that transform Cardiac Rehabilitation into an ideal setting for the treatment of patients suffering from intermittent claudication. Thanks to the cultural patrimony of cardiologists, together with other professionals, such as psychologists, dietitians, physiotherapists and nurses, it is possible to initiate an multi-comprehensive treatment program. Besides, this type of management may decrease both morbidity and mortality as well as reduce symptoms and improve the patients' quality of life.

  2. Humanized care; the case of patients subjected to chemotherapy

    OpenAIRE

    Luz Viviana Grisales-Naranjo; María Mercedes Arias-Valencia

    2013-01-01

    Objective. Herein, we seek to know the necessities of humanized care of patients subjected to chemotherapy. Methodology. The study was carried out with patients, of both sexes, diagnosed with different types of cancer who received chemotherapy treatment in an oncology unit of the city of Medellín, Colombia during 2011. A qualitative approach was used with tools from grounded theory; 23 interviews were conducted and a field diary was kept. During the analysis, codes were extracted that were su...

  3. Reliability of scored patient generated subjective global assessment ...

    African Journals Online (AJOL)

    Objective: Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults. Methods: A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization ...

  4. Stretch reflex regulation in healthy subjects and patients with spasticity

    DEFF Research Database (Denmark)

    Nielsen, Jens Bo; Petersen, Nicolas; Crone, Clarissa

    2005-01-01

    during voluntary muscle contraction in part because of depression of the inhibitory mechanisms that are affected in spasticity. In spastic patients, these inhibitory mechanisms are already depressed at rest and cannot be depressed further in connection with a contraction. In relation to most normal......In recent years, part of the muscle resistance in spastic patients has been explained by changes in the elastic properties of muscles. However, the adaptive spinal mechanisms responsible for the exaggeration of stretch reflex activity also contribute to muscle stiffness. The available data suggest...... of the spastic symptoms. A recent finding also shows no sign of exaggerated stretch reflexes in muscles voluntarily activated by the spastic patient in general. This is easily explained by the control of stretch reflex activity in healthy subjects. In healthy subjects, the stretch reflex activity is increased...

  5. Humanized care; the case of patients subjected to chemotherapy

    Directory of Open Access Journals (Sweden)

    Luz Viviana Grisales-Naranjo

    2013-12-01

    Full Text Available Objective. Herein, we seek to know the necessities of humanized care of patients subjected to chemotherapy. Methodology. The study was carried out with patients, of both sexes, diagnosed with different types of cancer who received chemotherapy treatment in an oncology unit of the city of Medellín, Colombia during 2011. A qualitative approach was used with tools from grounded theory; 23 interviews were conducted and a field diary was kept. During the analysis, codes were extracted that were subsequently grouped into categories that best represented the phenomenon studied. Results. Cancer patients subjected to chemotherapy have needs for humanized care. The emotional, spiritual, social, and affective necessities were highlighted as a consequence of the impact of the news of the diagnosis and the notorious physical changes confronted by these patients. The category of dehumanization of care emerged related to the information of the diagnosis and in the communication the personnel maintained with these patients. Conclusion. The cancer patient receiving chemotherapy is a seriously ill person, with necessities, who requires humanized care by the healthcare provider personnel.

  6. Patient-generated subjective global assessment : Innovation from paper to digital app

    NARCIS (Netherlands)

    Faith D. Ottery; Suzanne Kasenic; Martine J. Sealy; Susan P. DeBolt; Elizabeth Isenring; Dr Harriët Jager-Wittenaar

    2015-01-01

    Purpose: The Patient-Generated Subjective Global Assessment (PG-SGA), including the PG-SGA Short Form (SF, aka ‘abridged’), was originally developed in the mid 1990’s as a scored, patient self-report, paperbased instrument and has been widely validated. The PG-SGA (SF) has been used for screening,

  7. Differences in walking pattern during 6-min walk test between patients with COPD and healthy subjects.

    Science.gov (United States)

    Annegarn, Janneke; Spruit, Martijn A; Savelberg, Hans H C M; Willems, Paul J B; van de Bool, Coby; Schols, Annemie M W J; Wouters, Emiel F M; Meijer, Kenneth

    2012-01-01

    To date, detailed analyses of walking patterns using accelerometers during the 6-min walk test (6MWT) have not been performed in patients with chronic obstructive pulmonary disease (COPD). Therefore, it remains unclear whether and to what extent COPD patients have an altered walking pattern during the 6MWT compared to healthy elderly subjects. 79 COPD patients and 24 healthy elderly subjects performed the 6MWT wearing an accelerometer attached to the trunk. The accelerometer features (walking intensity, cadence, and walking variability) and subject characteristics were assessed and compared between groups. Moreover, associations were sought with 6-min walk distance (6MWD) using multiple ordinary least squares (OLS) regression models. COPD patients walked with a significantly lower walking intensity, lower cadence and increased walking variability compared to healthy subjects. Walking intensity and height were the only two significant determinants of 6MWD in healthy subjects, explaining 85% of the variance in 6MWD. In COPD patients also age, cadence, walking variability measures and their interactions were included were significant determinants of 6MWD (total variance in 6MWD explained: 88%). COPD patients have an altered walking pattern during 6MWT compared to healthy subjects. These differences in walking pattern partially explain the lower 6MWD in patients with COPD.

  8. Anxious, introverted personality traits in patients with chronic subjective dizziness.

    Science.gov (United States)

    Staab, Jeffrey P; Rohe, Daniel E; Eggers, Scott D Z; Shepard, Neil T

    2014-01-01

    Chronic subjective dizziness (CSD) is a neurotologic disorder of persistent non-vertiginous dizziness, unsteadiness, and hypersensitivity to one's own motion or exposure to complex visual stimuli. CSD usually follows acute attacks of vertigo or dizziness and is thought to arise from patients' failure to re-establish normal locomotor control strategies after resolution of acute vestibular symptoms. Pre-existing anxiety or anxiety diathesis may be risk factors for CSD. This study tested the hypothesis that patients with CSD are more likely than individuals with other chronic neurotologic illnesses to possess anxious, introverted personality traits. Data were abstracted retrospectively from medical records of 40 patients who underwent multidisciplinary neurotology evaluations for chronic dizziness. Twenty-four subjects had CSD. Sixteen had chronic medical conditions other than CSD plus co-existing anxiety disorders. Group differences in demographics, Dizziness Handicap Inventory (DHI) scores, Hospital Anxiety and Depression Scale (HADS) scores, DSM-IV diagnoses, personality traits measured with the NEO Personality Inventory - Revised (NEO-PI-R), and temperaments composed of NEO-PI-R facets were examined. There were no differences between groups in demographics, mean DHI or HADS-anxiety scores, or DSM-IV diagnoses. The CSD group had higher mean HADS-depression and NEO-PI-R trait anxiety, but lower NEO-PI-R extraversion, warmth, positive emotions, openness to feelings, and trust (all p<0.05). CSD subjects were significantly more likely than comparison subjects to have a composite temperament of high trait anxiety plus low warmth or excitement seeking. An anxious, introverted temperament is strongly associated with CSD and may be a risk factor for developing this syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Behavior disorders and subjective burden among caregivers of demented patients

    Directory of Open Access Journals (Sweden)

    Ceres Eloah de Lucena Ferretti

    Full Text Available Abstract Many patients with dementia live within the community supported by their family and friends. Majority of patient caregivers suffer from high levels of stress. Methods: A quasi-experimental study, which compared the effects of nursing interventions on behavior disorders in both patients with moderate to severe dementia and their caregivers, followed over 18 months. The assessments were performed at the outpatient clinic of the Federal University of São Paulo and again at patients' homes with their primary caregiver, after informed consent form. Measurements were performed at baseline and after 18 months (pre and post-test. The instruments used were: The CDR, NPI and NPI-D; Katz Index and FAQ. Simultaneously, caregivers were enrolled onto the Dementia Education Program. Results: The final sample was composed of 31 subjects, having a mean age of 77.4 y.o. (±8 SD. Nursing interventions were effective in reducing some of the behavioral disturbances (Z= -3.1; p=0.002, such as Aggression (Z= -3.7; p<0.001 and anxiety (Z= -2.3; p=0.023. Caregiver distress also reduced upon interventions (Z= -2.2; p=0.030. Conclusion: Our results indicate nursing interventions may be effective in reducing the frequency and severity of behavioral disorders and subjective burden among caregivers. Education Programs can improve caregiver burden through conveying information on difficulties related to the disease and how to deal with them.

  10. Sensenbrenner syndrome (Cranioectodermal dysplasia): clinical and molecular analyses of 39 patients including two new patients.

    Science.gov (United States)

    Lin, Angela E; Traum, Avram Z; Sahai, Inderneel; Keppler-Noreuil, Kim; Kukolich, Mary K; Adam, Margaret P; Westra, Sjirk J; Arts, Heleen H

    2013-11-01

    Sensenbrenner syndrome, also known as cranioectodermal dysplasia, is a rare multiple anomaly syndrome with distinctive craniofacial appearance, skeletal, ectodermal, connective tissue, renal, and liver anomalies. Dramatic advances with next-generation sequencing have expanded its phenotypic variability and molecular heterogeneity. We review 39 patients including two new patients, one with compound heterozygous novel mutations in WDR35 and a previously unreported multisutural craniosynostosis that may be a part of Sensenbrenner syndrome. In 14 of 25 (56.0%) patients pathogenic mutations have been identified in 4 different genes that regulate (intraflagellar) cilia transport. We compared Sensenbrenner syndrome to asphyxiating thoracic dystrophy-Jeune syndrome (ATD-JS) and other ciliopathies. Our analyses showed that the high anterior hairline, forehead bossing and dolichocephaly (accompanied by sagittal craniosynostosis in more than half of the patients) occur in almost all patients with Sensenbrenner syndrome. Metaphyseal dysplasia with narrow thorax, proximal limb shortness, and short fingers are typical of Sensenbrenner syndrome and ATD-JS. Respiratory complications have been reported in both syndromes, usually less severe with Sensenbrenner syndrome. Proposed diagnostic criteria for Sensenbrenner syndrome include the distinctive craniofacial appearance, ubiquitous brachydactyly and ectodermal anomalies, and sagittal craniosynostosis. Mild heart defects have been noted, but there have been no atrioventricular canal or heterotaxy defects that are common in Ellis-Van Creveld syndrome. We anticipate that the steady identification of molecularly defined patients may allow correlation of phenotype and genotype. Additional natural history data will improve genetic counseling and current guidelines. © 2013 Wiley Periodicals, Inc.

  11. [Baseline clinical characteristics and management of patients included in IBERICAN study].

    Science.gov (United States)

    Barrios, V; Escobar, C; Llisterri, J L; Rodríguez Roca, G; Badimón, J J; Vergara, J; Prieto, M Á; Serrano, A; Cinza, S; Murillo, C

    2015-01-01

    To determine the prevalence and incidence of cardiovascular risk factors and cardiovascular events in Spain, as well as the quality of the follow-up in clinical practice. In this study the baseline data of the first interim analysis of IBERICAN are shown (n=830). IBERICAN is a multicenter, longitudinal and observational population-based study of patients daily attended in primary care setting according to clinical practice in Spain. Subjects between 18 and 85 years daily attended in primary care setting are being included consecutively. Treatment of patients will be performed according only to clinical criteria of investigators. Blood pressure control was defined according to 2013 European guidelines of hypertension; LDL-cholesterol control was defined according to 2012 European guidelines of cardiovascular prevention; diabetes control was defined as HbA1c<7%. Mean age was 57.9±14.1 years. 54.1% of patients had dyslipidemia, 47.5% hypertension, 17.7% diabetes, and 10.8% history of ischemic heart disease. Regarding drugs, despite 55% of hypertensive patients were taking≥2 antihypertensive agents, only 59.9% achieved blood pressure targets; 65.7% of patients with dyslipidemia were taking statins, but only 35.6% attained LDL-cholesterol goals. Only 51.4% of diabetics achieved HbA1c goals. Subjects attended in primary care showed a high prevalence of cardiovascular risk factors with a poor control. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  12. [Clinical analysis of normal subjects and dizzy patients with postural sway test].

    Science.gov (United States)

    Wen, Yan-hua; Jiang, Zi-Dong; Zhang, Yan; Zhang, Lian-Shan; Gao, Zhi-Qiang

    2008-12-01

    To study the characteristics of the normal subjects with postural sway test and discuss the value of postural sway test in the diagnosis of dizzy patients. Totally 112 normal subjects, 72 patients with peripheral vertigo, and 30 patients with central vertigo were examined using a stabilometer (EAB-100, Anima Co., Japan). Items include patterns, length of locus, envelope area, deflection average center displacement, and romberg rate were recorded and compared. The postural sway was classified into the following five patterns: centripetal, forward and backward, right and left, diffuse, and multicentric. Centripetal pattern was the most prominent figure pattern in the normal subjects, while diffuse pattern was the most prominent figure pattern in the patients with central vertigo. When the normal subjects closed their eyes, age was linearly correlated with the length of locus, envelope area, rectangel area, and unit area path length (P < 0.05). Sex was not correlated to all of these parameters. The length of locus and envelope area in the patient groups were significantly increased when compared with the normal subjects (P < 0.0167). Romberg rate was not significantly different between the patients and the normal subjects. The pattern of postural sway is useful for the diagnosis of vertigo. Age is an important factor that affects the balance function. Sex seems has no influence. Visual input plays an important role in maintaining postural balance. Stabilometer is a useful tool for evaluating balance function, and postural sway test may be a valuable assistant examination.

  13. [Readaptation time after photo-stress in normal subjects and glaucoma patients].

    Science.gov (United States)

    Kamppeter, B; Degenring, R F; Jonas, J B

    2003-12-01

    A photo-stress test was conducted at the subjective contrast threshold to evaluate whether psychophysical differences could be detected between chronic open-angle glaucoma patients and normal subjects. The prospective, comparative, clinical observational study included 20 patients (29 eyes) with chronic open-angle glaucoma and 20 control subjects (29 eyes). The study groups did not vary significantly in age and refractive error, but visual acuity showed a difference of 0.16. All participants underwent photo-stress using the Kontrastometer BA4. In the glaucoma group compared with the control group, the mean contrast threshold was significantly higher and the readaptation time significantly longer. The latter correlated significantly with the papillo-morphological glaucoma stage. In patients with chronic open-angle glaucoma, the foveal recovery time after a photo-stress test is significantly prolonged compared with normal subjects. It may suggest involvement of the fovea in glaucoma even if the visual acuity is 20/20.

  14. Differentiation chronic post traumatic stress disorder patients from healthy subjects using objective and subjective sleep-related parameters.

    Science.gov (United States)

    Tahmasian, Masoud; Jamalabadi, Hamidreza; Abedini, Mina; Ghadami, Mohammad R; Sepehry, Amir A; Knight, David C; Khazaie, Habibolah

    2017-05-22

    Sleep disturbance is common in chronic post-traumatic stress disorder (PTSD). However, prior work has demonstrated that there are inconsistencies between subjective and objective assessments of sleep disturbance in PTSD. Therefore, we investigated whether subjective or objective sleep assessment has greater clinical utility to differentiate PTSD patients from healthy subjects. Further, we evaluated whether the combination of subjective and objective methods improves the accuracy of classification into patient versus healthy groups, which has important diagnostic implications. We recruited 32 chronic war-induced PTSD patients and 32 age- and gender-matched healthy subjects to participate in this study. Subjective (i.e. from three self-reported sleep questionnaires) and objective sleep-related data (i.e. from actigraphy scores) were collected from each participant. Subjective, objective, and combined (subjective and objective) sleep data were then analyzed using support vector machine classification. The classification accuracy, sensitivity, and specificity for subjective variables were 89.2%, 89.3%, and 89%, respectively. The classification accuracy, sensitivity, and specificity for objective variables were 65%, 62.3%, and 67.8%, respectively. The classification accuracy, sensitivity, and specificity for the aggregate variables (combination of subjective and objective variables) were 91.6%, 93.0%, and 90.3%, respectively. Our findings indicate that classification accuracy using subjective measurements is superior to objective measurements and the combination of both assessments appears to improve the classification accuracy for differentiating PTSD patients from healthy individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Nightmare disorder, dream anxiety, and subjective sleep quality in patients with borderline personality disorder.

    Science.gov (United States)

    Semiz, Umit B; Basoglu, Cengiz; Ebrinc, Servet; Cetin, Mesut

    2008-02-01

    The aims of the present study were to examine the rate of nightmare disorder (ND) and to determine the levels of dream anxiety and subjective sleep quality in patients with borderline personality disorder (BPD). Another aim was to determine whether dream anxiety was associated with childhood trauma, dissociative experiences, and subjective sleep disturbance in BPD patients. Finally, the hypothesis as to whether BPD patients with ND exhibited a more severe clinical profile than those without ND, was also tested. A total of 88 borderline patients and 100 age- and sex-matched healthy control subjects were assessed using the Structured Clinical Interview for DSM-III-R Personality Disorders, Structured Clinical Interview for DSM-IV Axis I Disorders, Van Dream Anxiety Scale, Pittsburgh Sleep Quality Index, Dissociative Experiences Scale, and Traumatic Experiences Checklist. Subjects with codiagnoses that could affect sleep were not included. BPD patients suffered a significantly greater rate of nightmares, elevated levels of dream anxiety, and disturbed sleep quality than did controls. In the borderline group, heightened dream anxiety was correlated with higher rates of early traumatic experiences and dissociative symptoms, and impaired sleep quality. Furthermore, borderline patients with ND exhibited greater psychopathology as compared to those without ND in terms of several clinical characteristics. The present study provides support for a strong association between BPD, distressing nightmares, and subjective sleep quality. Recognition and management of dream and sleep disturbances in BPD patients might lead to improvements in their global clinical picture.

  16. Survey of Saccadic Parameters Using Videonystagmography in Patients with Idiopathic Parkinson's Disease and Normal Subjects

    Directory of Open Access Journals (Sweden)

    Reza Hosseinabadi

    2008-06-01

    Full Text Available Background and Aim: Patients with Parkinson’s disease manifest oculomotor abnormalities. This is the consequence of basal ganglia impairment. The most common abnormalities include increased saccade latency, hypometric saccades and decreased saccade velocity. The purpose of this study was comparison of saccadic parameters using videonystagmography in patients with idiopathic Parkinson’s disease and normal subjects.Materials and Methods: In this cross sectional study, saccadic movements were investigated in thirty patients with idiopathic Parkinson’s disease and thirty age matched subjects were 35-70 years old. Saccade latency, velocity and accuracy were quantitatively analyzed. Results: Results of this study indicated increased saccade latency, reduction of saccade velocity and accuracy in patients with Parkinson’s disease(P<0.001.Conclusion: This study showed that patients with Parkinson’s disease manifest saccadic deficits. This suggests dopaminergic control of these ocular movements.

  17. BAHA in single-sided deafness: patient compliance and subjective benefit.

    Science.gov (United States)

    Schrøder, Stine Attrup; Ravn, Tomaas; Bonding, Per

    2010-04-01

    Despite most patients with single-sided deafness (SSD) after operation for acoustic neuroma (AN) perceiving a significant hearing handicap, less than 25% are interested in bone-anchored hearing aid (BAHA) implantation. We evaluated the treatment compliance of BAHA in SSD and the effect of BAHA on the subjective handicap. Part 1: It was determined, from our first study, how many of the SDD patients after operation for AN (n = 59) and interested in BAHA (n = 14) had been implanted. Part 2: Of 23 BAHA-implanted patients with SSD due to various causes, including the implanted patients from the previous study, 21 answered a questionnaire on the BAHA treatment compliance and the subjective handicap with and without BAHA. Part 1: Of the 14 patients from our first study who were interested in implantation for BAHA, 11 had been implanted (18.6% of all 59 patients). Part 2: Of the 21 patients with SSD, 95% still used BAHA, and of these, 81% used it more than 8 hours a day. Of the patients, 90% considered BAHA a moderate to significant aid; it reduced the subjective hearing handicap from 7.4 to 2.3 arbitrary units on a visual analog scale. Despite the subjective handicap perception among most patients with SSD after AN surgery, less than 20% chose treatment with BAHA. Conversely, patients with SSD choosing implantation had high treatment compliance and felt that BAHA reduced their handicap. Thus, when selected by the patients after testing, BAHA is effective in SSD and results in a high patient compliance.

  18. Students' Learning Experiences from Didactic Teaching Sessions Including Patient Case Examples as Either Text or Video

    DEFF Research Database (Denmark)

    Pedersen, Kamilla; Moeller, Martin Holdgaard; Paltved, Charlotte

    2017-01-01

    OBJECTIVES: The aim of this study was to explore medical students' learning experiences from the didactic teaching formats using either text-based patient cases or video-based patient cases with similar content. The authors explored how the two different patient case formats influenced students....... Students taught with video-based patient cases, in contrast, often referred to the patient cases when highlighting new insights, including the importance of patient perspectives when communicating with patients. CONCLUSION: The format of patient cases included in teaching may have a substantial impact...

  19. Is there an association between subjective and objective measures of cognitive function in patients with affective disorders?

    DEFF Research Database (Denmark)

    Svendsen, Anne M; Kessing, Lars V; Munkholm, Klaus

    2012-01-01

    Background: Patients with affective disorders experience cognitive dysfunction in addition to their affective symptoms. The relationship between subjectively experienced and objectively measured cognitive function is controversial with several studies reporting no correlation between subjective...... and objective deficits. Aims: To investigate whether there is a correlation between subjectively reported and objectively measured cognitive function in patients with affective disorders, and whether subjective complaints predict objectively measured dysfunction. Methods: The study included 45 participants; 15...... with bipolar disorder (BD), 15 with unipolar disorder (UD) and 15 healthy individuals. Participants' subjectively experienced cognitive function and objective cognitive function were assessed with the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) and the Screen...

  20. Periictal and interictal headache including migraine in Dutch patients with epilepsy: a cross-sectional study.

    Science.gov (United States)

    Hofstra, W A; Hageman, G; de Weerd, A W

    2015-03-01

    As early as in 1898, it was noted that there was a need to find "a plausible explanation of the long recognized affinities of migraine and epilepsy". However, results of recent studies are clearly conflicting on this matter. In this cross-sectional study, we aimed to define the prevalence and characteristics of both seizure-related and interictal headaches in patients with epilepsy (5-75years) seeking help in the tertiary epilepsy clinic SEIN in Zwolle. Using a questionnaire, subjects were surveyed on the existence of headaches including characteristics, duration, severity, and accompanying symptoms. Furthermore, details on epilepsy were retrieved from medical records (e.g., syndrome, seizure frequency, and use of drugs). Diagnoses of migraine, tension-type headache, or unclassifiable headache were made based on criteria of the International Classification of Headache Disorders. Between March and December 2013, 29 children and 226 adults were evaluated, 73% of whom indicated having current headaches, which is significantly more often when compared with the general population (pepilepsy in comparison with the general population (ptype headaches conforms to results in the general population. These results show that current headaches are a significantly more frequent problem amongst people with epilepsy than in people without epilepsy. When comparing migraine prevalence, this is significantly higher in the population of patients with epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Patients with gout differ from healthy subjects in renal response to changes in serum uric acid.

    Science.gov (United States)

    Liu, Sha; Perez-Ruiz, Fernando; Miner, Jeffrey N

    2017-03-01

    Our objectives were to determine whether a change in serum uric acid (sUA) resulted in a corresponding change in the fractional excretion of uric acid (FEUA) and whether the renal response was different in patients with gout versus healthy subjects. FEUA was calculated from previously published studies and four new phase I studies in healthy subjects and/or patients with gout before and after treatment to lower or raise sUA. Treatments included xanthine oxidase inhibitors to lower sUA as well as infusion of uric acid and provision of a high-purine diet to raise sUA. Plots were created of FEUA versus sUA before and after treatment. For the phase I studies, percent change in FEUA per mg/dL change in sUA was calculated separately for healthy subjects and patients with gout, and compared using Student's t test. Analysis of previously published data and the new phase I clinical data indicates that changing sUA by a non-renal mechanism leads to a change in FEUA. The magnitude of change is greater in subjects with higher baseline FEUA versus patients with gout. Healthy subjects excrete more urate than do patients with gout at physiological urate-filtered load; this difference disappears when the urate-filtered load is decreased to ∼5000mg/24hours. These observations are consistent with a less saturated urate reabsorption system in patients with gout versus healthy subjects, resulting in elevated retention of uric acid. Further investigation could lead to the discovery of mechanisms responsible for the etiology of hyperuricemia/gout. Copyright © 2016 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  2. Periodontitis progession in patients subjected to supportive maintenance care.

    Science.gov (United States)

    Jansson, Leif; Lagervall, Maria

    2008-01-01

    The maintenance care following the initial active therapy phase plays an essential part in periodontal treatment to prevent disease progression and includes supportive periodontal therapy based on the patient's individual needs. The purpose of this study was to investigate the longitudinal proximal alveolar bone loss and tooth loss in periodontitis-prone patients during the active treatment and maintenance phase. In addition, the effect on disease progression of potential predictors was investigated. The investigation was conducted as a retrospective longitudinal study over a period of at least 10 years on a randomly selected population of patients referred for periodontal treatment in a specialist periodontal clinic. The mean number of teeth lost between baseline and the first re-evaluation was 2.4 and another 2.3 teeth were lost between the first and last re-evaluation. More than 50% of the periodontal pockets > or = 6 mm were reduced to periodontal pockets > or = 6 mm at baseline was significantly correlated to an increased longitudinal bone loss. The magnitudes of marginal bone loss and tooth loss during a maintenance phase of 10-26 years were in accordance with the results from longitudinal studies performed on normal populations in Sweden.

  3. [Comparison of Inflammatory Biomarkers Between Bipolar Disorder I Patients and Control Subjects].

    Science.gov (United States)

    Palacio, Juan David; Guzman, Sandra; Vargas, Cristian; Díaz-Zuluaga, Ana María; López-Jaramillo, Carlos

    2016-01-01

    Inflammatory changes have been described in different affective episodes, as well as in the euthymic phase of Bipolar I Disease. These changes have been proposed as possible peripheral markers of the disease. For this reason well-designed studies are needed to explore this hypothesis. Quantify and compare the serum levels of interleukins (IL) and tumour necrosis factor (TNF) in bipolar I patients and healthy subjects, including the comparison between the affective episodes of the disease. Cross-sectional study including 41 bipolar I patients and 11 healthy control subjects. Serum levels of IL-1B, IL-RA, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, and TNF were measured during the euthymic, depressive, and manic phases and were compared with the serum levels of the healthy subjects. Manic phase patients had low education and high number of hospitalisations. Depressive phase patients showed high number of depressive episodes throughout life. No statistically significant differences were found in IL and TNF levels between bipolar I patients and healthy controls, or between the bipolar I subgroups (euthymic, manic and depressive states). An increase in the size of the sample is necessary in future studies, in order to enhance the statistical value of the results, and explore the inflammatory hypothesis of the bipolar disease. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  4. Effects of sleep deprivation on nocturnal cytokine concentrations in depressed patients and healthy control subjects.

    Science.gov (United States)

    Voderholzer, Ulrich; Fiebich, Bernd L; Dersch, Rick; Feige, Bernd; Piosczyk, Hannah; Kopasz, Marta; Riemann, Dieter; Lieb, Klaus

    2012-01-01

    Previous studies have reported alterations of cytokine and cytokine-receptor concentrations in psychiatric patient populations, including patients with major depressive disorder (MDD). However, study results are conflicting, and possible causes for these abnormalities are unknown. Since sleep deprivation may induce a rapid improvement of mood in depressed patients, the authors investigated the impact of total sleep deprivation (TSD) for one night, and subsequent recovery sleep, on nocturnal concentrations of interleukin-6 (IL-6), interleukin-1-receptor antagonist (IL-1RA), and soluble IL-2 receptor (sIL-2R) in 15 unmedicated patients with MDD and 16 healthy volunteers. Whereas IL-6 levels normalized again during the recovery night in depressed patients, they were still elevated in control subjects. Serum levels of IL-1RA were higher in depressed patients than in controls, but were not affected by TSD. During recovery sleep, IL-1RA levels increased as compared with the preceding TSD night only in controls. Responders (N=8) differed from nonresponders (N=7) to TSD with regard to IL-1RA, which increased significantly during TSD in responders only. Sleep deprivation therefore seems to significantly affect cytokine levels in both depressed patients and healthy subjects, but does so in different ways. Sleep disturbances in depressed patients could account for the increased levels of cytokines found in these patients in several previous studies. The interaction between antidepressant effects of TSD and alterations of cytokines warrants further investigation.

  5. Importance to include the term superficial musculoaponeurotic system in medical subject headings and in the international anatomical nomenclature.

    Science.gov (United States)

    Ferreira, Lydia Massako; Locali, Rafael Fagionato; Lapin, Guilherme Abbud Franco; Hochman, Bernardo

    2011-06-01

    To investigate the relevance of the term superficial musculoaponeurotic system (SMAS) and demonstrate that this term is important enough to be added to the MeSH database and listed in International Anatomical Nomenclature. Terms related to SMAS were selected from original articles retrieved from the ISI Web of Science and MEDLINE (PubMed) databases. Groups of terms were created to define a search strategy with high-sensitivity and restricted to scientific periodicals devoted to plastic surgery. This study included articles between January 1996 and May 2009, whose titles, abstracts, and keywords were searched for SMAS-related terms and all occurrences were recorded. A total of 126 original articles were retrieved from the main periodicals related to plastic surgery in the referred databases. Of these articles, 51.6% had SMAS-related terms in the abstract only, and 25.4% had SMAS-related terms in both the title and abstract. The term 'superficial musculoaponeurotic system' was present as a keyword in 19.8% of the articles. The most frequent terms were 'SMAS' (71.4%) and superficial musculoaponeurotic system (62.7%). The term SMAS refers to a structure relevant enough to start a discussion about indexing it as a keyword and as an official term in Terminologia Anatomica: International Anatomical Terminology.

  6. Subjective evaluation of the effectiveness of whole-body cryotherapy in patients with osteoarthritis

    Directory of Open Access Journals (Sweden)

    Tomasz Chruściak

    2016-12-01

    Full Text Available Objectives: One of the treatments for osteoarthritis (OA is whole-body cryotherapy (WBC. The aim of this study is to assess the effect of whole-body cryotherapy on the clinical status of patients with osteoarthritis (OA, according to their subjective feelings before and after the application of a 10-day cold treatment cycle. The aim is also to assess the reduction of intensity and frequency of pain, the reduction of the painkiller medication used, and to assess the possible impact on physical activity. Material and methods : The study involved 50 people, including 30 women (60% and 20 men (40%. Thirty-one patients had spondyloarthritis (62% of respondents, 10 had knee osteoarthritis (20%, and 9 hip osteoarthritis (18%. The overall average age was 50.1 ±10.9 years; the youngest patient was 29 years old and the oldest 73 years old. The average age of the women was 6 years higher. The study used a questionnaire completed by patients, and consisted of three basic parts. The modified Laitinen pain questionnaire contained questions concerning the intensity and frequency of pain, frequency of painkiller use and the degree of limited mobility. The visual analogue scale (VAS was used in order to subjectively evaluate the therapy after applying the ten-day treatment cycle. Results: According to the subjective assessment of respondents, after the whole-body cryotherapy treatments, a significant improvement occurred in 39 patients (78%, an improvement in 9 patients (18%, and no improvement was only declared by 2 patients (4%. Conclusions : Whole-body cryotherapy resulted in a reduction in the frequency and degree of pain perception in patients with osteoarthritis. WBC reduced the number of analgesic medications in these patients. It improved the range of physical activity and had a positive effect on the well-being of patients.

  7. Subjective evaluation of the effectiveness of whole-body cryotherapy in patients with osteoarthritis.

    Science.gov (United States)

    Chruściak, Tomasz

    2016-01-01

    One of the treatments for osteoarthritis (OA) is whole-body cryotherapy (WBC). The aim of this study is to assess the effect of whole-body cryotherapy on the clinical status of patients with osteoarthritis (OA), according to their subjective feelings before and after the application of a 10-day cold treatment cycle. The aim is also to assess the reduction of intensity and frequency of pain, the reduction of the painkiller medication used, and to assess the possible impact on physical activity. The study involved 50 people, including 30 women (60%) and 20 men (40%). Thirty-one patients had spondyloarthritis (62% of respondents), 10 had knee osteoarthritis (20%), and 9 hip osteoarthritis (18%). The overall average age was 50.1 ±10.9 years; the youngest patient was 29 years old and the oldest 73 years old. The average age of the women was 6 years higher. The study used a questionnaire completed by patients, and consisted of three basic parts. The modified Laitinen pain questionnaire contained questions concerning the intensity and frequency of pain, frequency of painkiller use and the degree of limited mobility. The visual analogue scale (VAS) was used in order to subjectively evaluate the therapy after applying the ten-day treatment cycle. According to the subjective assessment of respondents, after the whole-body cryotherapy treatments, a significant improvement occurred in 39 patients (78%), an improvement in 9 patients (18%), and no improvement was only declared by 2 patients (4%). Whole-body cryotherapy resulted in a reduction in the frequency and degree of pain perception in patients with osteoarthritis. WBC reduced the number of analgesic medications in these patients. It improved the range of physical activity and had a positive effect on the well-being of patients.

  8. Correlation of Anxiety Levels between Temporomandibular Disorder Patients and Normal Subjects

    OpenAIRE

    Subhash Vasudeva; Asha Iyengar; Nagesh Seetaramaiah

    2014-01-01

    Background. Temporomandibular disorders (TMDs) are among the common musculoskeletal conditions affecting the individual. Anxiety plays an important role in the pathogenesis of TMD. Modern lifestyle and work environment bring to focus the role of anxiety in everyday life which is changing the demographics of diseases like TMD. This study compared the anxiety scores between TMD patients and normal subjects. Material and Methods. 505 individuals were included in the study who were divided into g...

  9. Circulating Total Glutathione in Normal Tension Glaucoma Patients: Comparison with Normal Control Subjects

    OpenAIRE

    Park, Myoung Hee; Moon, Jungil

    2012-01-01

    Purpose Oxidative stress plays a critical role in the pathogenesis of glaucoma. Glutathione is a major antioxidant molecule present in intracellular or extracellular space. Herein, we aimed to examine circulating glutathione level in normal tension glaucoma (NTG), which comprises the largest proportion of glaucoma disease in the Korean population. Methods Nineteen NTG patients (NTG group) and 30 age- and gender-matched normal control subjects (control group) were included. Antecubital venous ...

  10. The effect of Group Hope Therapy on subjective wellbeing, acceptance and rumination in HIV+ patients

    OpenAIRE

    Roghayeh Ataie Moghanloo; Vahid Ataie Moghanloo; Jalil Babapour -Kheiroddin; Hamid Poursharifi; Maliheh Pishvaei

    2014-01-01

    Background: Women and men afflicted with HIV bear specific physical, mental and social problems. The aim of this research was to determine the effects of group hope therapy on subjective wellbeing, acceptance and rumination in HIV+ patients. Methods: The present study was a randomized clinical trial research with a pretest-posttest and control group. The study population included all the people infected with AIDS virus (HIV+) who referred to counseling and treatment center of behavioral di...

  11. CMR in patients with severe myocarditis: diagnostic value of quantitative tissue markers including extracellular volume imaging.

    Science.gov (United States)

    Radunski, Ulf K; Lund, Gunnar K; Stehning, Christian; Schnackenburg, Bernhard; Bohnen, Sebastian; Adam, Gerhard; Blankenberg, Stefan; Muellerleile, Kai

    2014-07-01

    This study evaluated the accuracy of T2, T1, and extracellular volume (ECV) quantification as novel quantitative tissue markers in comparison with standard "Lake-Louise" cardiac magnetic resonance (CMR) criteria to diagnose myocarditis. Novel approaches using T2 and T1 mapping may overcome the limitations of signal intensity-based parameters, which would potentially result in a better diagnostic accuracy compared with standard CMR techniques in suspected myocarditis. CMR was performed in 104 patients with myocarditis and 21 control subjects at 1.5-T. Patients with myocarditis underwent CMR 2 weeks (interquartile range: 1 to 7 weeks) after presentation with new-onset heart failure (n = 66) or acute chest pain (n = 38). T2 and T1 mapping were implemented into a standard protocol including T2-weighted (T2w), early gadolinium enhancement (EGE) CMR, and late gadolinium enhancement (LGE) CMR. T2 quantification was performed using a free-breathing, navigator-gated multiecho sequence. T1 quantification was performed using the modified Look-Locker inversion recovery sequence before and after administration of 0.075 mmol/kg gadobenate dimeglumine. T2, T1, and ECV maps were generated using a plug-in for the OsiriX software (Pixmeo, Bernex, Switzerland) to calculate mean global myocardial T2, T1, and ECV values. The diagnostic accuracies of conventional CMR were 70% (95% confidence interval [CI]: 61% to 77%) for T2w CMR, 59% (95% CI: 56% to 73%) for EGE, and 67% (95% CI: 59% to 75%) for LGE. The diagnostic accuracies of mapping techniques were 63% (95% CI: 53% to 73%) for myocardial T2, 69% (95% CI: 60% to 76%) for native myocardial T1, and 76% (95% CI: 68% to 82%) for global myocardial ECV. The diagnostic accuracy of CMR was significantly improved to 90% (95% CI: 84% to 95%) by a stepwise approach, using the presence of LGE and myocardial ECV ≥27% as diagnostic criteria, compared with 79% (95% CI: 71% to 85%; p = 0.0043) for the Lake-Louise criteria. In patients

  12. Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome

    DEFF Research Database (Denmark)

    Reiman, M P; Thorborg, K; Covington, K

    2017-01-01

    PURPOSE: Determine which examination findings are key clinical descriptors of femoroacetabular impingement syndrome (FAIS) through use of an international, multi-disciplinary expert panel. METHODS: A three-round Delphi survey utilizing an international, multi-disciplinary expert panel operationally...... defined from international publications and presentations was utilized. RESULTS: All six domains (subjective examination, patient-reported outcome measures, physical examination, special tests, physical performance measures, and diagnostic imaging) had at least one descriptor with 75% consensus agreement...

  13. Patients' subjective visual experiences during vitreous surgery under local anesthesia.

    Science.gov (United States)

    Yu, Ji-Feng; Liang, Li; Wen, Yu-Qin; Liu, Li; Huang, Yi-Fei

    2011-01-01

    To investigate patient's visual experience during vitreous surgery under local anesthesia. A prospective and randomized study of 76 patients that underwent vitreous surgeries in our hospital between July 2010 and December 2010 was designed. All patients were interviewed half an hour before and within 1 hour after the surgery using a standardized questionnaire. Basic characteristics of patients and their intraoperative visual experiences like light, color, moving object, pain, fear, and the desire for general anesthesia before and after the surgery were recorded. Sixty patients (78.9%) perceived at least light perception, and 16 patients (21.1%) got no light perception throughout the entire duration of the operation. Forty one patients (53.9%) perceived only light, while 19 patients (25%) experienced moving objects. Thirty nine patients (51.3%) were frightened during their intraoperative visual experiences. Patients with better preoperative best-corrected visual acuity (BCVA) were more likely to be frightened (p=0.002). The frightened experience was affected notably by the different perceptions during operation, moving object (p=0.024), light (p=0.071), and color (p=0.071). Patients below 50 years old, especially from 20 to 30, were more likely to choose general anesthesia after the vitreous surgery. Most patients (78.9%) experienced at least light perception during the vitreous surgery under local anesthesia. There were no significant differences between the various visual experiences and their basic characteristics. Patients with better preoperative BCVA, perceived moving objects in their visual sensations seemed more likely to be frightened.

  14. Subjective wellbeing of primary healthcare patients in the Western ...

    African Journals Online (AJOL)

    Department of Psychology, Stellenbosch University. Correspondence to: Marieanna le .... In Putter's24 study, coping strategies were not good predictors of psychological wellbeing, while in other ..... (Accessed 14/11/2005). 33. Diener E. Subjective well-being: the science of happiness and a proposal for a national index.

  15. Relationship between patient-generated subjective global assessment and survival in patients in palliative care.

    Science.gov (United States)

    Carvalho, Celina Soares; Souza, Daiane Spitz; Lopes, Jessica Rodrigues; Castanho, Ivany Alves; Lopes, Agnaldo José

    2017-08-01

    A significant number of cancer deaths is partly due to late diagnosis of the disease at an advanced stage beyond cure. In this context, by applying the adequate tools, palliative care provides terminal cancer patients with the proper support for survival with a higher quality of life. The objective of this study was to describe the nutritional profile of terminal cancer patients and to evaluate the relationship among Patient-Generated Subjective Global Assessment (PG-SGA) score, clinical-functional characteristics and survival. The present work is a retrospective cohort study with 104 terminal cancer patients. The Karnofsky Performance Status (KPS) was used to obtain socio-demographic data and clinical history and assess functional capacity. Furthermore, patients were classified by groups and PG-SGA score ranges. In the first medical consultation, the PG-SGA revealed that most patients were moderately or severely malnourished and in critical need of immediate symptom management. Functional capacity of almost half of all patients lay within a KPS score of 40 to 70. Survival analysis revealed that the median time of mortality by cancer was 5 (3.3-6.7) months. Furthermore, patients with an SGA-C, i.e., severely malnourished (Ppatients. The use of this tool in the studied population is of paramount importance to provide individualised and adequate support for these patients.

  16. Investigation of Tinnitus Characteristics in 36 Patients with Subjective Tinnitus with Unknown Etiology

    Directory of Open Access Journals (Sweden)

    Mahdi Bakhshaee

    2006-06-01

    Full Text Available Background and Aim: Tinnitus represents the perception of sound without an external stimulus. The prevalence of tinnitus ranges from 3% to 30%. In most cases its etiology is unknown. Tinnitus can be classified as pulsatile or nonpulsatile. Nonpulsatile form is the most common form and almost exclusively subjective in nature. There is a range of condition attributed to nonpulsatile high frequency tinnitus (acoustic neuroma, Meniere’s disease, ototoxic agents, and noise exposure, etc. There are many studies about form, site, loudness, and frequency of tinnitus and how it can affect the quality of patient life. Materials and methods: This was a descriptive and analytic study. Thirty-six patients (23 men and 13 women with mean age 53.1 year old with subjective tinnitus evaluated in Pezhvak audiometric clinic in Mashhad.The data consisting of age sex, loudness, frequency form and site of tinnitus. Evaluation of effects of tinnitus on the quality of life and habits was performed with a tinnitus questionnaire (TQ. Results: Tinnitus was unilateral in 64% of cases. The right site was more common. Mean pitch was 7.03 kHz and average loudness was 3.8 dB SPL. SDS was in normal range in all of patients. There was a high frequency sensory neural hearing loss (above the 4 kHz in most of the patients. The greatest score (60.3% of TQ related to intrusiveness aspect. Sleep disorder has the lowest score (39/3%. Global score was 52.4%. Conclusion: Nonpulsatile subjective tinnitus has a broad range of etiology with unknown mechanism in most cases and without any history of underlying disease in a large group of patients. This symptom mostly involves the patients` lifestyle that is intrusiveness aspect in comparison with the other aspects including sleep, hearing and somatic complaints. There is no cure for most patient and more studies are needed in the future.

  17. Subjective experience and dopamine D2 receptor occupancy in patients treated with antipsychotics: clinical implications

    NARCIS (Netherlands)

    de Haan, Lieuwe; Lavalaye, Jules; van Bruggen, Marion; van Nimwegen, Lonneke; Booij, Jan; van Amelsvoort, Therese; Linszen, Don

    2004-01-01

    OBJECTIVES: This paper gives an overview of studies on the association between dopaminergic neurotransmission and the subjective experience of patients with schizophrenia. METHODS: We undertook a review of the literature. RESULTS: Dopaminergic neurotransmission may be relevant for subjective

  18. Discrepancy between subjective autobiographical reliving and objective recall: The past as seen by Alzheimer's disease patients.

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    El Haj, Mohamad; Antoine, Pascal

    2017-03-01

    This paper investigated whether Alzheimer's disease (AD) patients may demonstrate a discrepancy between subjective autobiographical reliving and objective recall. To this end, 31 AD patients and 35 controls were asked to retrieve three autobiographical memories. For each memory, participants were asked to rate its subjective characteristics (e.g., reliving, travel in time, visual imagery…). Besides this subjective assessment, we analyzed recall objectively with regard to specificity. Results showed poorer subjective autobiographical reliving and objective recall in AD patients than in controls. A discrepancy (i.e., higher level of subjective reliving than of objective recall) was observed in AD but not in control participants. Despite a compromise in their objective recall, AD patients seemed to attribute a high value to their subjective autobiographical experience. This discrepancy can be attributed to a potential genuine consciousness experience in which mild AD patients can, to some extent, experience some subjective features of the past. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Links between life events, traumatism and dementia; an open study including 565 patients with dementia].

    Science.gov (United States)

    Charles, E; Bouby-Serieys, V; Thomas, P; Clément, J-P

    2006-10-01

    Ageing is due to a progressive loss of the person's adaptation capability, whereas during this period environmental aggression increases. In the elderly, life events re-present a psychological traumatism that overwhelms the old person and related family, disrupting and fragilising homeostatic balance. A number of authors have suggested a possible link between life traumatisms and the dementia processes. The aim of this study is to reveal the presence of life traumatisms preceding the apparition of the dementia syndrome. This is a retrospective and comparative work based on the PIXEL study on complaints and demands from the principle informal caregivers of Alzheimer patients. It includes 565 patients presenting the criterion of dementia as defined by the DSM IV, and questionnaires filled out by the principle caregivers. One item of the questionnaire referred to life events which could have played a part in the development of the disorder. In a second stage, the reported events were classified into 4 distinct categories: loss, repeated or prolonged stress, psychotraumatism and depression-inducing events. The statistics were produced using SAS and Stat 10 software. Student's test, ANOVA and chi2-test were used. 372 caregivers answered the first item (65%); 76 of them believed there was no event while 296 related the disorder to one or several life events (79% of responders, 52% of the sample). These results confirm Persson and Clement's study which evidenced a higher frequency of stressing life events for subjects afflicted with dementia as compared with older people without any psychic disorder. Reported events and their respective frequency: spouse death (15.39%), parents' death (15%), familial difficulty (10.08%), anaesthesia (8.49%), child's death (4.42%), somatic disturbance (4%), depression (3.89%), retirement (3.89%), financial problems (2.65%), loneliness (2.65%), removal (1.76%), fall (1%), alcohol (0.8%), traumatism (0.53%), spouse care (0.35%), leaving for

  20. Structural differences in hippocampal subfields among schizophrenia patients, major depressive disorder patients, and healthy subjects.

    Science.gov (United States)

    Ota, Miho; Sato, Noriko; Hidese, Shinsuke; Teraishi, Toshiya; Maikusa, Norihide; Matsuda, Hiroshi; Hattori, Kotaro; Kunugi, Hiroshi

    2017-01-30

    Many MRI studies have reported a volume reduction of the hippocampus in psychiatric diseases. However, disease-related volume differences in hippocampus subfields remain unclear. Here we compared the volumes of hippocampus subfields in patients with schizophrenia, patients with major depressive disorder (MDD), and healthy subjects as controls. T2-weighted images were acquired in 20 patients with schizophrenia, 36 with MDD, and 35 healthy volunteers by 3-Tesla MRI. Hippocampal subfields were segmented using an automatic algorithm, Automatic Segmentation of Hippocampal Subfields (ASHS). Schizophrenia patients exhibited significant volume reductions in the cornu ammonis (CA)1 compared to the controls, and in the dentate gyrus compared to the controls and MDD patients without medication, whereas there was no significant difference between the MDD patients and controls. There was a nominal negative correlation between the perirhinal cortex volume and depression severity in the MDD patients without medication, whereas there were negative correlations between CA2 volume and both negative symptoms and the duration of illness in the schizophrenia patients. We identified differing volume reductions in hippocampal subfields and varying correlations between disease severity and subfield volumes depending on diagnosis, suggesting that volume differences in hippocampus subfields may provide important information regarding the pathophysiology of schizophrenia and MDD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Personality Traits in Patients with Subjective Idiopathic Tinnitus

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    Mahboobeh Adami Dehkordi

    2015-09-01

    Full Text Available Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group.   Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex. A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software.   Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001 and extraversion (P=0.001 between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism.   Conclusion:  Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.

  2. Increased Subjective Distaste and Altered Insula Activity to Umami Tastant in Patients with Bulimia Nervosa.

    Science.gov (United States)

    Setsu, Rikukage; Hirano, Yoshiyuki; Tokunaga, Miki; Takahashi, Toru; Numata, Noriko; Matsumoto, Koji; Masuda, Yoshitada; Matsuzawa, Daisuke; Iyo, Masaomi; Shimizu, Eiji; Nakazato, Michiko

    2017-01-01

    The aim of this study was to examine differences in brain neural activation in response to monosodium glutamate (MSG), the representative component of umami, between patients with bulimia nervosa (BN) and healthy women (HW) controls. We analyzed brain activity after ingestion of an MSG solution using functional magnetic resonance imaging (fMRI) in a group of women with BN ( n  = 18) and a group of HW participants ( n  = 18). Both groups also provided a subjective assessment of the MSG solution via a numerical rating scale. The BN group subjectively rated the MSG solution lower in pleasantness and liking than the control group, although no difference in subjective intensity was noted. The fMRI results demonstrated greater activation of the right insula in the BN group versus the control group. Compared with the HW controls, the BN patients demonstrated both altered taste perception-related brain activity and more negative hedonic scores in response to MSG stimuli. Different hedonic evaluation, expressed as the relative low pleasing taste of umami tastant and associated with altered insula function, may explain disturbed eating behaviors, including the imbalance in food choices, in BN patients.

  3. Increased Subjective Distaste and Altered Insula Activity to Umami Tastant in Patients with Bulimia Nervosa

    Directory of Open Access Journals (Sweden)

    Rikukage Setsu

    2017-09-01

    Full Text Available The aim of this study was to examine differences in brain neural activation in response to monosodium glutamate (MSG, the representative component of umami, between patients with bulimia nervosa (BN and healthy women (HW controls. We analyzed brain activity after ingestion of an MSG solution using functional magnetic resonance imaging (fMRI in a group of women with BN (n = 18 and a group of HW participants (n = 18. Both groups also provided a subjective assessment of the MSG solution via a numerical rating scale. The BN group subjectively rated the MSG solution lower in pleasantness and liking than the control group, although no difference in subjective intensity was noted. The fMRI results demonstrated greater activation of the right insula in the BN group versus the control group. Compared with the HW controls, the BN patients demonstrated both altered taste perception-related brain activity and more negative hedonic scores in response to MSG stimuli. Different hedonic evaluation, expressed as the relative low pleasing taste of umami tastant and associated with altered insula function, may explain disturbed eating behaviors, including the imbalance in food choices, in BN patients.

  4. Changes after voice therapy in objective and subjective voice measurements of pediatric patients with vocal nodules.

    Science.gov (United States)

    Tezcaner, Ciler Zahide; Karatayli Ozgursoy, Selmin; Ozgursoy, Selmin Karatayli; Sati, Isil; Dursun, Gursel

    2009-12-01

    The aim of this study was to analyze the efficiency of the voice therapy in children with vocal nodules by using the acoustic analysis and subjective assessment. Thirty-nine patients with vocal fold nodules, aged between 7 and 14, were included in the study. Each subject had voice therapy led by an experienced voice therapist once a week. All diagnostic and follow-up workouts were performed before the voice therapy and after the third or the sixth month. Transoral and/or transnasal videostroboscopic examination and acoustic analysis were achieved using multi-dimensional voice program (MDVP) and subjective analysis with GRBAS scale. As for the perceptual assessment, the difference was significant for four parameters out of five. A significant improvement was found in the acoustic analysis parameters of jitter, shimmer, and noise-to-harmonic ratio. The voice therapy which was planned according to patients' needs, age, compliance and response to therapy had positive effects on pediatric patients with vocal nodules. Acoustic analysis and GRBAS may be used successfully in the follow-up of pediatric vocal nodule treatment.

  5. A comparison of corneal biomechanical properties in patients with psoriasis and healthy subjects.

    Science.gov (United States)

    Celik, Ugur; Aykut, Veysel; Celik, Burcu; Tas, Mehmet; Yazgan, Serpil; Kaldrm, Havva; Erdur, Sevil Karaman

    2015-03-01

    To evaluate the differences in corneal biomechanical properties between healthy subjects and patients with psoriasis using the ocular response analyzer (ORA). Fifty-nine eyes of 59 psoriasis patients and 66 healthy individuals were included in the study. Corneal biomechanical parameters were obtained using ORA. Ultrasound pachymetry was used to measure central corneal thickness (CCT). The main parameters assessed were corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg) measurement and corneal-compensated IOP (IOPcc) through ORA. The dry eye evaluation was performed with tear break-up time (TBUT) and Shirmer test. The mean CH values in psoriasis and healthy subject eyes were 10.75±2.9 mm Hg, 11.97±3.6 mm Hg, respectively (P=0.047). The mean CRF values were 10.14±3.1 mm Hg and 11.61±3.3 mm Hg, respectively (P=0.012). The mean CCT were 539.1±36 μm and 536.3±28 μm, respectively (P=0.643). Mean TBUT values were 8.2±2.9 sec in psoriasis group and 10.4±3.6 sec in healthy subjects (Pcorneal biomechanical properties. Patients with psoriasis had lower CH and CRF, but higher IOPg and IOPcc values than healthy controls. These corneal biomechanical changes should be considered when determining IOP values.

  6. Understanding excess skin in postbariatric patients: objective measurements and subjective experiences.

    Science.gov (United States)

    Biörserud, Christina; Olbers, Torsten; Staalesen, Trude; Elander, Anna; Olsén, Monika Fagevik

    2016-08-01

    Excess skin is a well-known side effect of massive weight loss after bariatric surgery. However, there is a lack of longitudinal follow-ups. The primary aims of this study were to investigate the development and amount of excess skin after laparoscopic Roux-en-Y gastric bypass and to relate objective results to subjective experiences. University hospital. From 2009 to 2012, 200 patients were included and assessed with respect to excess skin before and 18 months after bariatric surgery. Patients were measured according to a standardized protocol and completed a questionnaire regarding their subjective experience of excess skin. A follow-up visit was completed in 149 patients (78%). All ptosis measurements decreased after weight reduction except for ptosis on the thighs. When comparing objective measurements with patients' subjective experience and discomfort from excess skin, we found little or low correlation in most body parts (rs .03-.67). The prediction analysis indicated that, for every centimeter of ptosis on the abdomen preoperatively, there was a 2-fold greater probability of having a postoperative ptosis on the abdomen of>3 cm (OR = 2.32, 1.76-3.07). The objective measurement of excess skin provides unique information in postbariatric patients' body habitus. Although the measured excess skin decreased compared with preoperative measurements, patients seem to become more aware of and disturbed and discomforted by it after the weight loss. Importantly, the objectively assessed measurements of excess skin correlated fairly with the perceived discomfort. Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  7. Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO).

    Science.gov (United States)

    López Sanchez, M

    2017-11-01

    Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Although numerous trials have investigated different ventilation strategies in patients with ARDS, consensus is lacking on the optimal MV settings during venovenous ECMO. Although the concept of "lung rest" was introduced years ago, there are no evidence-based guidelines on its use in application to MV in patients supported by ECMO. How MV in ECMO patients can promote lung recovery and weaning from ventilation is not clear. The purpose of this review is to describe the ventilation strategies used during venovenous ECMO in clinical practice. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  8. The lifetime prevalence, health services utilization and risk of suicide of bipolar spectrum subjects, including subthreshold categories in the São Paulo ECA study.

    Science.gov (United States)

    Moreno, Doris Hupfeld; Andrade, Laura Helena

    2005-08-01

    Identifying the bipolar (BP) spectrum, including the classic Bipolar I subtype (BP-I), Bipolar II (BP-II) and subthreshold bipolar disorders not meeting DSM-IV diagnostic criteria has raised growing interest, as these softer expressions of bipolar spectrum have been underdiagnosed in spite of clinical consequences. Data are from the Sao Paulo Epidemiological Catchment Area Study (N=1464). Non-affective controls were compared to BP spectrum groups, based on DSM-IIIR and on the "clinical significance" criteria: Subsyndromal Hypomania (SSH) and Manic Symptoms (MS). The lifetime prevalence of BP subgroups was 8.3% (N=122). All BP-I and -II and around 75% of SSH and MS subjects had a lifetime depressive syndrome. Compared to controls and MS subjects, BP-I, BP-II and SSH groups searched more medical help and mental health services. SSH group displayed higher rates of clinical significance than BP-I subjects, and suicidality was higher in BP groups compared to controls. Even the softer MS group had higher rate of suicide attempts than SSH subjects. This is a cross-sectional study and interviews were conducted by lay personnel. Replication in bigger community samples using a mood spectrum approach is necessary to confirm these findings. However, our findings were very similar to those obtained by other authors. Softer expressions of BP disorders appear in 6.6% of this community sample and have serious clinical consequences, which supports the importance of including these categories in the BP spectrum.

  9. Analyses of aerodynamic characteristics of the oropharynx applying CBCT: obstructive sleep apnea patients versus control subjects.

    Science.gov (United States)

    Chen, Hui; Li, Yingguang; Reiber, Johan Hc; de Lange, Jan; Tu, Shengxian; van der Stelt, Paul; Lobbezoo, Frank; Aarab, Ghizlane

    2018-02-01

    To determine the most relevant aerodynamic characteristic of the oropharynx related to the collapse of the upper airway in obstructive sleep apnea (OSA) patients; and to determine the correlation between the most relevant aerodynamic characteristic(s) of the oropharynx and anatomical characteristics of the oropharynx in OSA patients. 31 mild to moderate OSA patients (mean ± SD age = 43.5 ± 9.7 years) and 13 control subjects (mean ± SD age = 48.5 ± 16.2 years) were included in this prospective study. The diagnosis of OSA patients was based on an overnight polysomnographic recording. To exclude the presence of OSA in the control subjects, they were asked to fill out a validated questionnaire to determine the risk of OSA. NewTom5G cone beam CT (CBCT) scans were obtained from both OSA patients and control subjects. Computational models of the oropharynx were reconstructed based on CBCT images. The aerodynamic characteristics of the oropharynx were calculated based on these computational models. Pearson correlation analysis was used to analyse the correlation between the most relevant aerodynamic characteristic(s) and anatomical characteristics of the oropharynx in OSA patients. Compared with controls, the airway resistance during expiration (R ex ) of the OSA patients was significantly higher (p = 0.04). There was a significant negative correlation between R ex and the minimum cross-sectional area (CSA min ) of the oropharynx (r = -0.41, p = 0.02), and between R ex and the volume of the oropharynx (r = -0.48, p = 0.01) in OSA patients. After excluding an outlier, there is only significant correlation between R ex and the CSA min of the oropharynx (r = -0.45, p = 0.01). Within the limitations of this study, we concluded that the most relevant aerodynamic characteristic of the oropharynx in the collapse of the upper airway in OSA patients is R ex . Therefore, the repetitive collapse of the upper airway in OSA patients may be explained by a high R ex , which is

  10. Subjective benefit after BAHA system application in patients with congenital unilateral conductive hearing impairment.

    Science.gov (United States)

    Kunst, Sylvia J W; Hol, Myrthe K S; Mylanus, Emmanuel A M; Leijendeckers, Joop M; Snik, Ad F M; Cremers, Cor W R J

    2008-04-01

    To study whether unilateral Bone-anchored Hearing Aid (BAHA) fitting led to subjective hearing benefit in patients with congenital unilateral conductive hearing impairment. Prospective evaluation on 20 patients. Tertiary referral center. Ten adults and 10 children with congenital unilateral conductive hearing impairment, with a mean air-bone gap of 50 dB, were included. Subjective bilateral hearing benefit after BAHA fitting was measured using 2 disability-specific questionnaires: Chung and Stephens and the Speech, Spatial and Qualities of hearing profile (children's version in the patients aged BAHA fitting. Chung and Stephens' questionnaire showed an overall preference for the BAHA in several specific hearing situations. The Glasgow children's benefit inventory demonstrated an overall mean improvement of +34, which was the most prominent in the learning domain. The 10 adults showed an already good score on the Speech, Spatial and Qualities of hearing scale in the unaided situation. The BAHA was well accepted by most of the patients with congenital unilateral conductive hearing impairment. A preoperative trial of the BAHA system with the BAHA on a headband is part of the preoperative procedure. In children with unilateral conductive hearing loss, with regard to possible childs' development and communication difficulties, intervention with BAHA can be considered as an option.

  11. Self care in patients with chronic heart failure. Pilot study - self care includes problems.

    Science.gov (United States)

    Halmo, Renata; Galuszka, Jan; Langova, Katerina; Galuszkova, Dana

    2015-03-01

    The goal of this pilot study was to define the scope of therapeutic self-care demand in heart failure (HF) patients according to the concepts of self-care postulated by D.E. Orem and to determine the level of problems experienced and self-care in these patients. A questionnaire consisting of 7 areas with closed format questions was developed according to the definition. The level of patient problems and level of self-care actions were mapped in each area. The questionnaire was distributed at the hospital outpatient clinic. The study group consisted of 47 heart failure patients (14 women) with following characteristics: average age 68 years, average BMI 29.4, resynchronization therapy 21%, hypertension 69.8%, diabetes mellitus 25.6%, coronary artery disease 46.5%, dilated cardiomyopathy 46.5%, obesity 46.5%, smoking history 39.5% (present and past smoking together), other cardiac disease 16.28%, condition after myocardial infarction 27.8% (NYHA II 41%, NYHA III 56.8%, NYHA IV 2.2%). The greatest problems were in the area of physical activity, sleep and fatigue, the least were in the area of chest pain and blood circulation. The greatest self-care agency was shown in the area of managing problems with physical activities and sleep, the lowest in the area of liquid intake and output. In the patients' subjective opinion, fatigue and sleep problems had the greatest impact on the quality of life. There were no substantial differences in either area based on gender. The data can serve as a foundation for modifying the extent and structure of patient education for more comprehensive and more effective out‑patient treatment of HF.

  12. Evaluation of perioperative nutritional status with subjective global assessment method in patients undergoing gastrointestinal cancer surgery.

    Science.gov (United States)

    Erdim, Aylin; Aktan, Ahmet Özdemir

    2017-01-01

    This study was designed to evaluate the perioperative nutritional status of patients undergoing surgery for gastrointestinal cancer using Subjective Global Assessment and surgeon behavior on nutritional support. We recruited 100 patients undergoing surgery for gastrointestinal cancer in one university and two state teaching hospitals. Subjective Global Assessment was administered to evaluate preoperative and postoperative nutritional status. Fifty-two patients in the state hospitals (Group 1) and 48 in the university hospital were assessed. Anthropometric and biochemical measurements were performed. Changes in preoperative Subjective Global Assessment scores and scores at the time of discharge and types of nutritional support were compared. Subjective Global Assessment-B was regarded as moderate and Subjective Global Assessment-C as heavy malnutrition. Ten patients had Subjective Global Assessment-B and 29 had Subjective Global Assessment-C malnutrition in Group 1 and nine had Subjective Global Assessment-B and 31 had Subjective Global Assessment-C malnutrition in Group 2 during preoperative assessment. Respective numbers in postoperative assessment were 12 for Subjective Global Assessment-B and 30 for Subjective Global Assessment-C in Group 1 and 14 for Subjective Global Assessment-B and 26 for Subjective Global Assessment-C in Group 2. There was no difference between two groups. Nutritional methods according to Subjective Global Assessment evaluation in pre- and postoperative periods were not different between the groups. This study demonstrated that the malnutrition rate is high among patients scheduled for gastrointestinal cancer surgery and the number of surgeons were inadequate to provide perioperative nutritional support. Both university and state hospitals had similar shortcomings. Subjective Global Assessment is an easy and reliable test and if utilized will be helpful to detect patients requiring nutritional support.

  13. The impact of different 18FDG PET healthy subject scans for comparison with single patient in SPM analysis.

    Science.gov (United States)

    Gallivanone, Francesca; Della Rosa, Pasquale A; Perani, Daniela; Gilardi, Maria C; Castiglioni, Isabella

    2017-03-01

    Statistical Parametric Mapping (SPM) has been applied for single-subject evaluation of [18F]FDG uptake in Alzheimer Disease (AD). In a single-subject framework, the patient is compared to a dataset of [18F]FDG PET images from healthy subjects (HS) evaluating brain metabolic abnormalities. No studies exist that assess the effects on SPM analysis of HS [18F]FDG PET datasets acquired from different subjects and using different PET scanners including the same or different PET scanners than those used for patients. This work aims to elucidate this issue from a methodological perspective. We considered six different [18F]FDG PET datasets, from different HS populations, acquired by different PET scanners. We applied SPM5 procedures for single-subject comparison with each of the six HS datasets in 10 probable AD patients showing the typical [18F]FDG pattern. We also implemented the same comparison in 3 probable AD patients and in 7 patients with a clinical diagnosis of Mild Cognitive Impariment (MCI), showing subtle changes on visual inspection of [18F]FDG distribution. Considering the 10 patients with the typical [18F]FDG pattern, the results were comparable for all the SPM maps. In the 3 probable AD patients with subtle changes in [18F]FDG distribution, no significant AD pattern emerged when a small number (50) HS image set was used. In the 7 considered MCI patients the use of a large (>50) HS image set allowed to assess significant hypometabolic patterns related to a probable neurodegenerative pathology. The use of large HS datasets of PET scans (>50) is recommended for single-subject SPM analysis. On condition that appropriate preprocessing steps are provided, large HS datasets can include HS images acquired with different PET systems, not including images from the same scanner of that used for patients.

  14. Evaluation of P300 components for emotion-loaded visual event-related potential in elderly subjects, including those with dementia.

    Science.gov (United States)

    Asaumi, Yasue; Morita, Kiichiro; Nakashima, Youko; Muraoka, Akemi; Uchimura, Naohisa

    2014-07-01

    In the present study, the P300 component of the emotion-loaded visual event-related potential in response to photographs of babies crying or smiling was measured to evaluate cognitive function in elderly subjects, including those with dementia. The subjects were 48 elderly people who consulted a memory disorder clinic. The visual event-related potential was measured using oddball tasks. Brain waves were recorded from four sites. We analyzed the P300 amplitude and latency. Subjects were divided into three groups (the dementia with Alzheimer's disease group [ADG]; the intermediate group [MG], and the healthy group [HG]) based on the Revised Hasegawa Dementia Scale, Mini-mental State Examination scores and the Clinical Dementia Rating. For all subjects, there was a significant positive correlation between P300 latency and Z-score of voxel-based specific regional analysis for Alzheimer's disease for crying or smiling faces. There was a negative correlation between P300 amplitude and Z-score for the crying face. MG subjects were divided into two groups (high risk: HRMG, low risk: LRMG) based on Z-scores (HRMG ≥ 2.0). The P300 amplitude of ADG was significantly smaller than that of HG, and the P300 latency of ADG was significantly longer than those of other groups for crying or smiling faces. The P300 latency of HRMG was significantly longer than that of LRMG for the smiling face. Furthermore, the P300 latency for the crying face was significantly shorter than that for the smiling face in HG and ADG. These findings suggest that analysis of P300 components of the emotion-loaded visual event-related potential may be a useful neuropsychological index for the diagnosis of Alzheimer's disease and high-risk subjects. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  15. Subjective and objective knowledge and decisional role preferences in cerebrovascular patients compared to controls

    Directory of Open Access Journals (Sweden)

    Riechel C

    2016-08-01

    Full Text Available Christina Riechel,1,* Anna Christina Alegiani,1,* Sascha Köpke,2 Jürgen Kasper,3,4 Michael Rosenkranz,1,5 Götz Thomalla,1 Christoph Heesen1,4 1Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 2Nursing Research Unit, Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany; 3Department of Health and Caring Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; 4Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 5Department of Neurology, Albertinen-Krankenhaus, Hamburg, Germany *These authors contributed equally to this work Background: Risk knowledge and active role preferences are important for patient involvement in treatment decision-making and adherence. Although knowledge about stroke warning signs and risk factors has received considerable attention, objective knowledge on secondary prevention and further self-esteem subjective knowledge have rarely been studied. The aim of our study was to investigate knowledge and treatment decisional role preferences in cerebrovascular patients compared to controls. Methods: We performed a survey on subjective and objective stroke risk knowledge and autonomy preferences in cerebrovascular patients from our stroke outpatient clinic (n=262 and from pedestrians on the street taken as controls during a “World Stroke Day” (n=274. The questionnaire includes measures for knowledge and decisional role preferences from previously published questionnaires and newly developed measures, for example, subjective knowledge, revealed on a visual analog scale. Results: The overall stroke knowledge was low to moderate, with no differences between patients and controls. Knowledge about secondary prevention was particularly low. Only 10%–15% of participants correctly estimated the stroke absolute risk reduction potential of aspirin. The medical data

  16. Somatoform disorders in patients with chronic subjective tinnitus.

    Science.gov (United States)

    Sahin, Caner; Aras, Hatice İmer; Yilmaz, Mahmut Sinan

    2016-11-01

    This study aimed to investigate the correlation of psychiatric disorders with tinnitus and tinnitus handicap scores. A total of 30 patients and 30 otherwise healthy people were enrolled for the study. Somatoform disorder questionnaire SDQ-20 was filled in by both the study and the control group. Tinnitus handicap scores were filled in study group. Tinnitus handicap scores were 28.1 ± 19.8, and somatoform disorder questionnaire scores were 30.5 ± 7.3 in the tinnitus group. In the control group the somatoform disorder questionnaire scores were 25.4 ± 4.6. (1) We found a statistically significant difference between somatoform disorder questionnaire scores between groups (p tinnitus handicap scores and somatoform disorder questionnaire scores in study group (p = 0.0). The correlation between these tests was positively strong (R = 0.782). (3) There was no statistical difference between genders. We recommend investigating patients with long-lasting tinnitus for psychiatric comorbidity in relation to somatoform disorders in cooperation with psychiatric clinics.

  17. The Comparison of Ginkgo biloba and Cinnarizine effectiveness in tinnitus intensity of patients with subjective tinnitus

    OpenAIRE

    Hamidreza Khazraei; Nasim khodami; Soroush Amani; Mina Shahtoosi; Alireza Khodami

    2015-01-01

    Background and Aim: Subjective Tinnitus is one of the common problems in the world whose prevalence is estimated to be 7-20 percent in the community. In the present study, effectiveness of Ginkgo biloba with that of cinnarizine on subjective tinnitus were compared and assessed in order to determine the effective dose of Ginko on .patients. Materials and Methods: This clinical trial study conducted on 61 patients with subjective tinnitus who had been referred or had come to Shahrekord ENT c...

  18. Urticaria and Prodromal Symptoms Including Erythema Marginatum in Danish Patients with Hereditary Angioedema

    DEFF Research Database (Denmark)

    Rasmussen, Eva R; Valente de Freitas, Priscila; Bygum, Anette

    2016-01-01

    Erythema marginatum is a characteristic skin rash seen in patients with hereditary angioedema (HAE); however, it can be confused with urticaria, leading to delay in correct diagnosis. The aim of this study was to clarify how often erythema marginatum is misinterpreted as urticaria, potentially...... leading physicians to refrain from testing for HAE. Few studies have been published on urticaria and prodromal symptoms in HAE, thus the incidence of these parameters were also investigated. A total of 87 patients affiliated to the national HAE Centre were included. Retrospective and prospective data...... on skin eruptions and prodromal symptoms were collected. Fifty-six percent of 87 patients had a positive history of erythema marginatum. Half of the patients had experienced erythema marginatum being misinterpreted as urticaria. The most prevalent other prodromal symptoms were other skin symptoms, malaise...

  19. Basal and exercise-induced neuroendocrine activation in patients with heart failure and in normal subjects

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Appel, Jon; Hildebrandt, Per

    2004-01-01

    : Twenty-three newly-diagnosed CHF patients and 18 age- and gender-matched healthy subjects were exercised at two workloads, which were calculated to correspond to 50 and 75% of each individual's heart rate response. RESULTS: In CHF patients, baseline levels of ANP, BNP, AVP, PRA and ET-1 were elevated...... compared to healthy subjects. Exercise induced an increase in ANP, A and NA in both CHF patients and in normal subjects, however BNP was only increased in CHF patients and not in normal subjects. CONCLUSION: When CHF patients exercise at the same relative and submaximal level as age-matched healthy...... subjects, the relative increases in ANP, A and NA were similar, however, BNP levels only increased in the CHF group....

  20. OUTCOME AND NUTRITIONAL ASSESSMENT OF CHRONIC LIVER DISEASE PATIENTS USING ANTHROPOMETRY AND SUBJECTIVE GLOBAL ASSESSMENT.

    Science.gov (United States)

    Nunes, Gonçalo; Santos, Carla Adriana; Barosa, Rita; Fonseca, Cristina; Barata, Ana Teresa; Fonseca, Jorge

    2017-01-01

    Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined. In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition/CLD severity and malnutrition/outcome. Observational, prospective study. Consecutive CLD ambulatory/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded. A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease ( P nutritional status defined by BMI ( P =0.002), mid upper arm circumference ( P assessment ( P assessment ( P Nutritional assessment should be considered mandatory in the routine care of CLD patients.

  1. [The Helsinki Declaration for Patient Safety in Anaesthesiology - Post operative care including pain management].

    Science.gov (United States)

    Pfau, Giselher; Brinkers, Michael; Hachenberg, Thomas

    2013-07-01

    Primary aspects of post operative care should include decisive and adequate treatment of pain. Accordingly, schemes based on international guidelines and in consensus with other departments of the university hospital were developed. Successful therapy includes resolute action on three levels: Instruction of physicians, including supervision. standardized approach based on a readily available algorithm. adherence to fundamental implications of pain therapy such as pain assessment, repeated consultations and observation of complications. Based on this concept, patient safety in anesthesia can be increased. © Georg Thieme Verlag Stuttgart · New York.

  2. The effect of Group Hope Therapy on subjective wellbeing, acceptance and rumination in HIV+ patients

    Directory of Open Access Journals (Sweden)

    Roghayeh Ataie Moghanloo

    2014-08-01

    Full Text Available Background: Women and men afflicted with HIV bear specific physical, mental and social problems. The aim of this research was to determine the effects of group hope therapy on subjective wellbeing, acceptance and rumination in HIV+ patients. Methods: The present study was a randomized clinical trial research with a pretest-posttest and control group. The study population included all the people infected with AIDS virus (HIV+ who referred to counseling and treatment center of behavioral disorders in Tabriz. The samples were selected through convenience sampling method. Total of 30 participants with the criteria for inclusion in the study were selected and randomly placed in one of the two groups (control and experimental groups. The research tools consisted of Reef Psychological Wellbeing Scale and acceptance and focus on thinking subscales of Emotion Regulation Strategies Questionnaire. The experimental group received 8 sessions of group hope therapy (independent variable. Data were analyzed by SPSS-19 software using multivariable covariance analysis (MANCOVA. Results: Results of multivariate covariance analysis (MANCOVA showed that group hope therapy positively affected the subjective wellbeing, acceptance and rumination in HIV+ patients (P<0.001. Conclusion: It seems hope therapy could be useful as a new treatment in domains of supportive psychological therapies in patients infected with HIV.

  3. A pilot study to evaluate simulated driving performance and cognitive function in healthy subjects and patients with restless legs syndrome

    Directory of Open Access Journals (Sweden)

    Chen D

    2013-10-01

    Full Text Available Dan Chen,1 Paula Shaw,2 Daniel M Canafax,1,3 James Catesby Ware4 1XenoPort, Inc., Santa Clara, CA, USA; 2Charles River Northwest, Tacoma, WA, USA; 3Theravance Inc., South San Francisco, CA, USA; 4Division of Sleep Medicine, Eastern Virginia Medical School, Norfolk, VA, USA Objective: Symptoms of restless legs syndrome (RLS usually occur during the evening and night time, resulting in disrupted sleep and subsequent daytime fatigue. This study compared simulated driving performance, alertness, and cognitive function between healthy subjects and patients with a diagnosis of RLS. Methods: Fifteen healthy subjects and 15 untreated RLS subjects were enrolled and completed two driving tests. The first test occurred at 4 PM followed by the second test at 8 AM the next morning. Outcome measures included lane position variability (LPV, speed variability, frequency of simulated crashes (off-road events or collision, and brake reaction time. Other assessments included visual analog scale (VAS of alertness and the Brief Assessment of Cognition (BAC. Results: Overall, RLS patients and healthy subjects performed similarly on driving assessments. Two subjects within each group experienced off-road events. RLS patients had less alertness on the VAS than healthy subjects before and after driving assessments. Both groups scored similarly on the cognitive function assessments. Conclusion: Despite reported diminished alertness, RLS patients did not demonstrate impairment in driving or cognitive performance. Keywords: restless legs syndrome, simulated driving performance, cognitive function

  4. Subjective global assessment for nutritional assessment of hospitalized patients requiring haemodialysis: A prospective cohort study.

    Science.gov (United States)

    Tan, Sheau Kang; Loh, Yet Hua; Choong, Hui Lin; Suhail, Sufi M

    2016-11-01

    Evidence has validated that the nutritional status of hospitalized patients on haemodialysis could be compromised because of admission-related and hospital-associated morbidities on the background of their kidney disease. However, nutritional status is not assessed and monitored routinely during the hospitalization period. The aim of the present study was to assess the nutritional status of hospitalized patients requiring haemodialysis with the subjective global assessment (SGA) tool during the hospitalization period. This is a prospective cohort study conducted in an acute tertiary general hospital. Patients aged 21-75 years old, admitted for various illnesses and requiring haemodialysis between November 2011 and May 2012 were enrolled into this study. A trained dietician assessed patients' nutritional status with the SGA tool, which included historical data on weight change, dietary intake, gastrointestinal symptoms, functional capacity, comorbidities and physical examination on subcutaneous fat loss, muscle wasting and presence of oedema and/or ascites. Patients were categorized under three groups: SGA-A (well-nourished), SGA-B (moderately malnourished) and SGA-C (severely malnourished). Eighty patients (mean ± SD age = 59 ± 10 years; 76% Chinese ethnicity) were assessed. Mean ± SD body mass index (BMI) was 25.1 ± 6.1 kg/m(2) . SGA categories were 48% SGA-A, 46% SGA-B, and 6% SGA-C. Mean energy and protein intake (P nutritional status. More than half of the hospitalized patients requiring haemodialysis were malnourished. It is important to incorporate SGA in the care of hospitalized haemodialysis patients for early detection of malnutrition and for medical nutrition therapy to optimise patients' nutritional status for better outcomes. © 2015 Asian Pacific Society of Nephrology.

  5. Attitudes, subjective norms, and behavioral intentions of nurses toward dying patients and their families.

    Science.gov (United States)

    Waltman, N L

    1990-01-01

    This investigation aimed to develop and validate an instrument, "Attitudes, Subjective Norms, and Behavioral Intentions of Nurses Toward the Care of Dying Patients and Their Families" (ASBID), and to examine the relationship among selected demographic variables, death anxiety, and social desirability response tendency on the behavioral intentions of nurses toward the dying. The Ajzen-Fishbein theory of reasoned action was used as the conceptual framework. Nursing behaviors toward the dying included in the ASBID were developed from interviews with bereaved family members. Three hundred seventy-two registered nurses caring for dying patients were used as the sample population for testing the ASBID. Internal consistency reliability coefficients for the ASBID achieved satisfactory standards. Factor analysis suggested three factors were being measured: general acute care measures for the dying, open communication with the dying, and continuing care for bereaved family members. Results supported the Ajzen-Fishbein theory that attitudes and subjective norms were major determinants of intentions. Findings indicate that educational programs planned to influence nursing care of the dying should focus on the consequences of specific behaviors of nurses rather than on death anxiety in nurses, and they should include nursing supervisors as well as nurses providing direct care for the dying.

  6. Subjective sleep quality and sleep duration of patients in a psychiatric hospital

    OpenAIRE

    Müller, Matthias J; Olschinski, Christiane; Kundermann, Bernd; Cabanel, Nicole

    2016-01-01

    Sleep complaints and sleep disturbances are highly prevalent in patients with psychiatric disorders. During hospitalization the patients? condition may be even worse but little is known about the subjective sleep quality in psychiatric hospitals. Thus, we have investigated subjective sleep quality and mean sleep duration in patients with different psychiatric disorders at the end of hospitalization. For a period of one year, inpatients of a psychiatric hospital with diagnosis of substance use...

  7. Depressive Symptoms are the Main Predictor for Subjective Sleep Quality in Patients with Mild Cognitive Impairment--A Controlled Study.

    Directory of Open Access Journals (Sweden)

    Stefan Seidel

    Full Text Available Controlled data on predictors of subjective sleep quality in patients with memory complaints are sparse. To improve the amount of comprehensive data on this topic, we assessed factors associated with subjective sleep quality in patients from our memory clinic and healthy individuals.Between February 2012 and August 2014 patients with mild cognitive impairment (MCI and subjective cognitive decline (SCD from our memory clinic and healthy controls were recruited. Apart from a detailed neuropsychological assessment, the subjective sleep quality, daytime sleepiness and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI, the Epworth Sleepiness Scale (ESS and the Beck Depression Inventory (BDI-II.One hundred fifty eight consecutive patients (132 (84% MCI patients and 26 (16% SCD patients and 75 healthy controls were included in the study. Pairwise comparison of PSQI scores showed that non-amnestic MCI (naMCI patients (5.4 ± 3.5 had significantly higher PSQI scores than controls (4.3 ± 2.8, p = .003 Pairwise comparison of PSQI subscores showed that naMCI patients (1.1 ± 0.4 had significantly more "sleep disturbances" than controls (0.9 ± 0.5, p = .003. Amnestic MCI (aMCI (0.8 ± 1.2, p = .006 and naMCI patients (0.7 ± 1.2, p = .002 used "sleep medication" significantly more often than controls (0.1 ± 0.6 Both, aMCI (11.5 ± 8.6, p < .001 and naMCI (11.5 ± 8.6, p < .001 patients showed significantly higher BDI-II scores than healthy controls (6.1 ± 5.3. Linear regression analysis showed that the subjective sleep quality was predicted by depressive symptoms in aMCI (p < .0001 and naMCI (p < .0001 patients as well as controls (p < .0001. This means, that more depressive symptoms worsened subjective sleep quality. In aMCI patients we also found a significant interaction between depressive symptoms and global cognitive function (p = .002.Depressive symptoms were the main predictor of subjective sleep quality in MCI

  8. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients.

    Science.gov (United States)

    De Ciuceis, Carolina; Cornali, Claudio; Porteri, Enzo; Mardighian, Dikran; Pinardi, Chiara; Fontanella, Marco M; Rodella, Luigi F; Rezzani, Rita; Rizzoni, Damiano; Boari, Gianluca E M; Rosei, Enrico Agabiti; Gasparotti, Roberto

    2014-12-01

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p cerebral arteries and CBF in the cortical grey matter (r = -0.516, p microvascular structure might play a role in controlling CBF, with possible clinical consequences.

  9. Assessing blood brain barrier dynamics or identifying or measuring selected substances, including ethanol or toxins, in a subject by analyzing Raman spectrum signals

    Science.gov (United States)

    Lambert, James L. (Inventor); Borchert, Mark S. (Inventor)

    2008-01-01

    A non-invasive method for analyzing the blood-brain barrier includes obtaining a Raman spectrum of a selected portion of the eye and monitoring the Raman spectrum to ascertain a change to the dynamics of the blood brain barrier.Also, non-invasive methods for determining the brain or blood level of an analyte of interest, such as glucose, drugs, alcohol, poisons, and the like, comprises: generating an excitation laser beam at a selected wavelength (e.g., at a wavelength of about 400 to 900 nanometers); focusing the excitation laser beam into the anterior chamber of an eye of the subject so that aqueous humor, vitreous humor, or one or more conjunctiva vessels in the eye is illuminated; detecting (preferably confocally detecting) a Raman spectrum from the illuminated portion of the eye; and then determining the blood level or brain level (intracranial or cerebral spinal fluid level) of an analyte of interest for the subject from the Raman spectrum. In certain embodiments, the detecting step may be followed by the step of subtracting a confounding fluorescence spectrum from the Raman spectrum to produce a difference spectrum; and determining the blood level and/or brain level of the analyte of interest for the subject from that difference spectrum, preferably using linear or nonlinear multivariate analysis such as partial least squares analysis. Apparatus for carrying out the foregoing methods are also disclosed.

  10. Including the online feedback site, Patient Opinion, in the nursing curriculum: Exploratory study.

    Science.gov (United States)

    Jones, Ray; Young, Kim; Munro, James; Miller, Heather; Brelsford, Stephanie; Aronsson, Jennie; Goodman, Benny; Peters, Jane

    2017-10-01

    Globally, universities aim to involve people who use health services to enrich the nursing curriculum for students, but there can be barriers to this involvement. Many also want students to contribute to local communities. Online communication can help connect students to service users to achieve these aims. The online British patient feedback site, Patient Opinion, gathers comments from service users about services and encourages service responses to the comments. To explore the feasibility and acceptability of five ways of including Patient Opinion in the undergraduate nursing curriculum. Five case studies using mixed data collection methods. British University with nursing students across two campuses, accustomed to using webinars, video presentations and social media. Students from different years participated in the five approaches of making use of Patient Opinion in the curriculum; 18 students took part in an online forum to discuss Patient Opinion in the curriculum. We trialled timetabled webinars, video-linked lectures, optional enhanced access for self-study, optional audit of service user comments for two local hospitals, and optional Twitter and Tweetchat. Students discussed the aims and approaches in an online forum. Of the five approaches trialled, webinars seemed effective in ensuring that all nursing students engaged with the topic. Video-linked lectures provided an alternative when timetabling did not allow webinars, but were less interactive. The three optional approaches (Tweetchats, audit exercise, self-directed study) provided opportunities for some students to enhance their learning but students needed guidance. Sending a summary of student reviews of patients' feedback to local hospitals illustrated how students might be agents of change in local health services. Experience from these case studies suggests that webinars followed by use of Patient Opinion preparing for placements may be a sustainable way of embedding feedback sites in the

  11. ANALYTICAL JUSTIFICATION OF INCLUDING THE ANTIVIRAL DRUG INTO TREATMENT SCHEME FOR PATIENTS WITH SUSPECTED VIRAL DISEASE

    Directory of Open Access Journals (Sweden)

    Soloviov S. O

    2016-12-01

    Full Text Available Background: Viruses play a leading role in human pathology development, causing a large number of infectious diseases in acute, persistent or chronic forms. Although the number of deaths caused by viral infections have decreased significantly today, they continue to be a significant factor in reducing of the population overall productivity. Viral diseases cause additional losses in community related to the duration of the course or disease or its chronization, increased use of health care, loss of working hours, premature death etc. Introduction of the new antiviral drugs into medical practice is accompanied by the emergence of questions to assess its effectiveness and including into existing clinical protocols. So the aim of this work is the development of methodology of choosing and justification of optimal treatment strategy for viral diseases that could be included into certain clinical protocols for managing patients with certain viral diseases. Methodology justification: The methodology based on the method of pharmacoeconomic analysis "cost of illness", takes into account the economic burden of viral diseases: direct costs for treating of disease, indirect costs related to the disease and intangible costs. Algorithm of treatment scheme choice depends on the cost of treatment for the patient without viral disease also as for patient with viral disease. It was proposed to use lower limit priori probability (critical prevalence of viral disease as decision rule in the choice of treatment scheme. Results: Examples of the proposed methodology use show that the choice of the optimal therapeutic scheme for patients with suspected viral disease depends on the current prevalence of this disease among patients with similar clinical symptoms of the disease and its cost, depending on the chosen strategy of therapy. The proposed methodology determines the critical level of viral infection prevalence, which comparing to the current prevalence level is

  12. Subjective benefit after BAHA system application in patients with congenital unilateral conductive hearing impairment.

    NARCIS (Netherlands)

    Kunst, S.J.W.; Hol, M.K.S.; Mylanus, E.A.M.; Leijendeckers, J.M.; Snik, A.F.M.; Cremers, C.W.R.J.

    2008-01-01

    OBJECTIVE: To study whether unilateral Bone-anchored Hearing Aid (BAHA) fitting led to subjective hearing benefit in patients with congenital unilateral conductive hearing impairment. STUDY DESIGN: Prospective evaluation on 20 patients. SETTING: Tertiary referral center. PATIENTS: Ten adults and 10

  13. Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation.

    Science.gov (United States)

    García-Rodríguez, María Teresa; López-Calviño, Beatriz; Piñón-Villar, María Del Carmen; Otero-Ferreiro, Alejandra; Suárez-López, Francisco; Gómez-Gutiérrez, Manuel; Pértega-Díaz, Sonia; Seoane-Pillado, María Teresa; Pita-Fernández, Salvador

    2017-10-01

    The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. Patients on the waiting list for liver transplantation (n = 110) were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child-Pugh Scale. Nutritional state was studied using the Controlling Nutritional Status (CONUT), the Spanish Society of Parenteral and Enteral Nutrition (SENPE) criteria, the Nutritional Risk Index (NRI), the Prognostic Nutritional Index (PNI-O), and the Subjective Global Assessment (SGA). Agreement was determined using the Kappa index. Area under receiver operator characteristic curves (AUCs), the Youden index (J), and likelihood ratios were computed. Malnutrition varied depending on the method of evaluation. The highest value was detected using the CONUT (90.9%) and the lowest using the SGA (50.9%). The pairwise agreement among the methods ranged from K = 0.041 to K = 0.826, with an overall agreement of each criteria with the remaining methods between K = 0.093 and K = 0.364. PNI-O was the method with the highest overall agreement. Taking this level of agreement into account, we chose the PNI-O as a benchmark method of comparison. The highest positive likelihood ratio for the diagnosis of malnutrition was obtained from the Nutritional Risk Index (13.56). Malnutrition prevalence is high and prevalence estimates vary according the method used, with low concordance among methods. PNI-O and NRI are the most consistent methods to identify malnutrition in these patients. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  14. Concordance among methods of nutritional assessment in patients included on the waiting list for liver transplantation

    Directory of Open Access Journals (Sweden)

    María Teresa García-Rodríguez

    2017-09-01

    Full Text Available Background: The aim of the present study was to determine the extent of malnutrition in patients waiting for a liver transplant. The agreement among the methods of nutritional assessment and their diagnostic validity were evaluated. Methods: Patients on the waiting list for liver transplantation (n = 110 were studied. The variables were: body mass index, analytical parameters, liver disease etiology, and complications. Liver dysfunction was evaluated using the Child–Pugh Scale. Nutritional state was studied using the Controlling Nutritional Status (CONUT, the Spanish Society of Parenteral and Enteral Nutrition (SENPE criteria, the Nutritional Risk Index (NRI, the Prognostic Nutritional Index (PNI-O, and the Subjective Global Assessment (SGA. Agreement was determined using the Kappa index. Area under receiver operator characteristic curves (AUCs, the Youden index (J, and likelihood ratios were computed. Results: Malnutrition varied depending on the method of evaluation. The highest value was detected using the CONUT (90.9% and the lowest using the SGA (50.9%. The pairwise agreement among the methods ranged from K = 0.041 to K = 0.826, with an overall agreement of each criteria with the remaining methods between K = 0.093 and K = 0.364. PNI-O was the method with the highest overall agreement. Taking this level of agreement into account, we chose the PNI-O as a benchmark method of comparison. The highest positive likelihood ratio for the diagnosis of malnutrition was obtained from the Nutritional Risk Index (13.56. Conclusions: Malnutrition prevalence is high and prevalence estimates vary according the method used, with low concordance among methods. PNI-O and NRI are the most consistent methods to identify malnutrition in these patients.

  15. Evaluation of the pharmacokinetics and safety of bosutinib in patients with chronic hepatic impairment and matched healthy subjects.

    Science.gov (United States)

    Abbas, Richat; Chalon, Stephan; Leister, Cathie; El Gaaloul, Myriam; Sonnichsen, Daryl

    2013-01-01

    Bosutinib, a dual Src/Abl kinase inhibitor in development for treatment of chronic myeloid leukemia, is primarily metabolized by the CYP3A4 hepatic enzyme. This study evaluated the pharmacokinetics and safety of bosutinib in patients with chronic hepatic impairment and matched healthy subjects. Hepatically impaired patients were aged 18-65 years and of Child-Pugh classes A, B, or C; healthy subjects were matched by age, sex, body mass index, and smoking habits. A single oral dose of bosutinib 200 mg was administered on day 1 within 5 min after completion of breakfast. Compared with healthy subjects (n = 9), maximal plasma concentration (C(max)) and area under the curve increased 2.42-fold and 2.25-fold in Child-Pugh A (n = 6), 1.99-fold and 2.0-fold in Child-Pugh B (n = 6), and 1.52-fold and 1.91-fold in Child-Pugh C patients (n = 6). Time to C(max) decreased from 4 h in healthy subjects to 2.5, 2.0, and 1.5 h in Child-Pugh A, B, and C patients, respectively; the elimination half-life increased from 55 h in healthy subjects to 86, 113, and 111 h in Child-Pugh A, B, and C patients. Bosutinib oral clearance was lower in hepatically impaired patients compared with healthy subjects. Frequently reported adverse events included prolonged QTc interval (37.0%, n = 10), nausea (11.1%, n = 3), and vomiting (7.4%, n = 2). A single oral dose of bosutinib 200 mg showed acceptable tolerability in healthy subjects and in patients with mild, moderate, or severe chronic hepatic impairment.

  16. P600 alteration of syntactic language processing in patients with bipolar mania: Comparison to schizophrenic patients and healthy subjects.

    Science.gov (United States)

    Lee, Chang Woo; Kim, Sung Hwa; Shim, Miseon; Ryu, Vin; Ha, Ra Yeon; Lee, Su Jin; Cho, Hyun-Sang

    2016-09-01

    Disturbances in thought, speech, and linguistic processing are frequently observed in bipolar manic patients, but the underlying neurophysiological mechanisms are not well understood. P600 is a distinct, positive event-related potential component elicited by syntactic violations. Using the P600 ERP, we examined neural processing of syntactic language comprehension in patients with bipolar mania compared to patients with schizophrenia and healthy people. P600s were recorded from 21 manic patients with bipolar disorder, 26 patients with schizophrenia, and 29 healthy subjects during the presentation of 120 auditory sentences with syntactic violations or non-violations. Subjects were asked to judge whether each sentence was correct or incorrect. Patients with mania and schizophrenia had significantly smaller P600 amplitudes associated with syntactic violations compared with healthy subjects. There was no difference in P600 amplitude between patient groups. For behavioral performance, patients with schizophrenia had significantly less accurate rates and longer reaction times compared with healthy subjects, whereas manic patients exhibited no significant differences in accuracy and only showed increased reaction times in comparison with healthy subjects. Psychotropic drug usage and small sample size. Patients with bipolar mania have reduced P600 amplitude, comparable to patients with schizophrenia. Our findings may represent the first neurophysiological evidence of abnormal syntactic linguistic processing in bipolar mania. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Subjective sleep quality in relation to inhibition and heart rate variability in patients with panic disorder.

    Science.gov (United States)

    Hovland, Anders; Pallesen, Ståle; Hammar, Asa; Hansen, Anita Lill; Thayer, Julian F; Sivertsen, Børge; Tarvainen, Mika P; Nordhus, Inger Hilde

    2013-08-15

    Patients with panic disorder (PD) are known to report impaired sleep quality and symptoms of insomnia. PD is an anxiety disorder characterised by deficient physiological regulation as measured by heart rate variability (HRV), and reduced HRV, PD and insomnia have all been related to impaired inhibitory ability. The present study aimed to investigate the interrelationships between subjectively reported sleep impairment, cognitive inhibition and vagally mediated HRV in a sample characterised by variability on measures of all these constructs. Thirty-six patients with PD with or without agoraphobia were included. Cognitive inhibition was assessed with the Color-Word Interference Test from the Delis-Kaplan Executive Function System (D-KEFS), HRV was measured using high frequency (HF) power (ms(2)), and subjectively reported sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Cognitive inhibition was related to both Sleep latency and Sleep disturbances, whereas HRV was only related to Sleep disturbances. These relationships were significant also after controlling for depression. Correlational design. Cognitive inhibition is related to key insomnia symptoms: sleep initiation and sleep maintenance. The data supports the psychobiological inhibition model of insomnia, and extends previous findings. Possible clinical implications of these findings are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Age influence on renalase and catecholamines concentration in hypertensive patients, including maintained dialysis.

    Science.gov (United States)

    Zbroch, Edyta; Musialowska, Dominika; Koc-Zorawska, Ewa; Malyszko, Jolanta

    2016-01-01

    Hypertension in elderly patients is one of the main problems in cardiovascular diseases. The sympathetic nervous system hyperactivity seen in older patients is a known risk factor for hypertension and other cardiovascular events as well as chronic kidney disease. Renalase, secreted by the kidney and circulated in blood, may regulate the sympathetic tone by catecholamine degradation and in this way has an impact on cardiovascular and renal complications. To assess the impact of age on renalase and catecholamine concentration in hypertensive patients, including those on dialyses and its possible relation to blood pressure control and cardiovascular disease. The study cohort of 211 patients was divided into two groups according to age below 65 years (range 19-64) and above 65 years (range 65-86). The older group represented 38% of the whole studied population and 75% of them were dialyzed. The two groups of different ages were also divided into dialysis and nondialysis subgroups. The serum renalase, dopamine, and norepinephrine concentration together with blood pressure value and echocardiography were assessed. Patients aged 65 years and more had higher renalase (20.59 vs 13.14 µg/mL, P =0.02) and dopamine (41.71 vs 15.46 pg/mL, P catecholamine level but older participants had lower diastolic blood pressure (69 vs 78 mmHg, P =0.001) and ejection fraction (51% vs 56.8%, P =0.03). The elevated renalase level in older hypertensive patients is related rather to kidney function and cardiovascular diseases than to age itself. Thus, renalase appears to be the possible new marker of these indications in this special population.

  19. [Efficacy of modified auriculotherapy for post-operative pain control in patients subjected to laparoscopic cholecystectomy].

    Science.gov (United States)

    Toca-Villegas, Jiovanni; Esmer-Sánchez, David; García-Narváez, Jesús; Sánchez-Aguilar, Martín; Hernández-Sierra, Juan Francisco

    The high frequency of post-operative pain in the patients after laparoscopic cholecystectomy has led to the need to use multiple analgesic therapies. These include auriculotherapy, although not very good results have been obtained with the traditional techniques. To evaluate the effectiveness of modified auriculotherapy for post-operative pain control in laparoscopic cholecystectomy patients. Double-blind controlled clinical trial. Experimental group: Different points ear puncture with xylocaine without needles vs. placebo group. Post-operative visual analogue scale (VAS) at 6, 12, 18, 24, 36, and 48h and rescue doses of analgesics, were measured in both groups. At 6h post-operative, 87% of the auriculotherapy group had a VAS of<4 vs. 48% of placebo group (p = 0.004), and 96 vs. 74% (p = 0.008) at 18hours. At 24, 36 and 48h after surgery there were no differences, and as all of the patients in both groups had a VAS<4, they were discharged to the hospital. Modified auriculotherapy was better to the conventional analgesics for post-operative pain control in patients subjected to laparoscopic cholecystectomy. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  20. Comparison of Lumbo-Pelvic Stability between Patients with Chronic Low Back Pain and Healthy Subjects

    OpenAIRE

    Mohammad Hosseinifar

    2016-01-01

    Because of the importance of lumbo-pelvic stability as one of the suggested factors to prevent low back pain and since to date no study accomplished to compare lumbo-pelvic stability between chronic low back pain (CLBP) and healthy subjects, the aim of this study was to determine and to compare lumbo-pelvic stability, lumbar lordosis, and lumbar mobility between CLBP and healthy subjects. Thirty CLBP patients and thirty healthy subjects through simple non-probability sampling participated in ...

  1. Endoscopy findings affect subjective smell rehabilitation in post-laryngectomy patients using the nasal airflow-inducing manoeuvre.

    Science.gov (United States)

    Saedi, B; Razmpa, E; Nikjo, A; Ghalandarabadi, M; Ghadimi, H; Saidabadi, G

    2014-09-01

    To evaluate the characteristics of post-laryngectomy patients, including nasal endoscopy findings, that affect subjective smell improvement in the post-surgical period. Thirty patients who had undergone total laryngectomy participated in at least three sessions of a smell rehabilitation programme involving the nasal airflow-inducing manoeuvre, under the supervision of a speech-language pathologist. Patient characteristics and nasal endoscopy findings were evaluated. Participants experienced a mean improvement in sense of smell of 61 per cent (p smell perception and appetite in laryngectomy patients. There was no relationship between nasal endoscopy findings and outcome of the nasal airflow-inducing manoeuvre rehabilitation programme in our case series.

  2. Two tracheal BALT lymphoma patients successfully treated with chemotherapy including rituximab.

    Science.gov (United States)

    Hiraishi, Yoshihisa; Iikura, Motoyasu; Kogure, Yoshihito; Hirashima, Junko; Izumi, Shinyu; Sugiyama, Haruhito

    2014-03-01

    Bronchus-associated lymphoid tissue (BALT) lymphoma of the trachea, an important differential diagnosis for tracheal tumors, is a rare disease with characteristic bronchoscopic findings. In this study, we reviewed 2 cases of patients who were symptomatic at the time of diagnosis, with tumors in the trachea and left main bronchus, putting them at high risk for asphyxia. Chemotherapies including rituximab were administered, and complete remission was confirmed in both cases. Because tracheal tumors often have a pernicious course, it might be beneficial to initiate a chemotherapeutic treatment regimen instead of adopting the "wait-and-see" approach in patients with symptomatic tracheal BALT lymphoma. © 2013 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  3. Effects of kinesthetic haptic feedback on standing stability of young healthy subjects and stroke patients

    National Research Council Canada - National Science Library

    Afzal, Muhammad Raheel; Byun, Ha-Young; Oh, Min-Kyun; Yoon, Jungwon

    2015-01-01

    .... Kinesthetic haptic feedback in terms of body sway can be delivered via a commercially available haptic device and can enhance the balance stability of both young healthy subjects and stroke patients...

  4. Investigation of patients with atypical or severe hyperandrogenaemia including androgen-secreting ovarian teratoma.

    LENUS (Irish Health Repository)

    Dennedy, Michael Conall

    2012-02-01

    Approximately 7% of women of reproductive age manifest polycystic ovary syndrome (PCOS) and <0.5% have other causes of hyperandrogenism including congenital adrenal hyperplasia (CAH), androgen-secreting tumour of an ovary or an adrenal gland, Cushing\\'s syndrome or hyperthecosis. The presence of features atypical of PCOS should prompt more extensive evaluation than that usually undertaken. Features atypical of PCOS include the onset of symptoms outside the decade of 15-25 years, rapid progression of symptoms, the development of virilization and a serum testosterone concentration in excess of twice the upper limit of the reference range. Ethnic background, family history and specific clinical findings, e.g. Cushingoid appearance, may inform a focused investigation. Otherwise, patients should have measurement of 17-hydroxyprogesterone (17-OHP) under basal conditions ideally in the early morning, and if abnormal, they should have measurement of 17-OHP one hour after the administration of synthetic ACTH, 250 microg i.v., to screen for CAH, which is present in approximately 2% of hyperandrogenic patients. The overnight cortisol suppression test employing 1 mg dexamethasone at midnight is a sensitive test for Cushing\\'s syndrome. Coronal tomographic (CT) scanning of the adrenals and transvaginal ultrasonography of the ovaries are the investigations of choice when screening for tumours in these organs. Less frequently required is catheterization and sampling from both adrenal and ovarian veins, which is a technically demanding procedure with potential complications which may provide definitive diagnostic information not available from other investigations. Illustrative case reports highlight some complexities in the investigation of hyperandrogenic patients presenting with features atypical of PCOS and include only the ninth case report of an androgen-secreting ovarian teratoma.

  5. Subjective deficits of attention, cognition and depression in patients with narcolepsy.

    Science.gov (United States)

    Zamarian, Laura; Högl, Birgit; Delazer, Margarete; Hingerl, Katharina; Gabelia, David; Mitterling, Thomas; Brandauer, Elisabeth; Frauscher, Birgit

    2015-01-01

    Patients with narcolepsy often complain about attention deficits in everyday situations. In comparison with these subjective complaints, deficits in objective testing are subtler. The present study assessed the relationships between subjective complaints, objectively measured cognitive performance, disease-related variables, and mood. A total of 51 patients with narcolepsy and 35 healthy controls responded to questionnaires regarding subjectively perceived attention deficits, sleepiness, anxiety and depression. Moreover, they performed an extensive neuropsychological assessment tapping into attention, executive functions, and memory. Patients rated their level of attention in everyday situations to be relatively poor. In an objective assessment of cognitive functioning, they showed only slight attention and executive function deficits. The subjective ratings of attention deficits significantly correlated with ratings of momentary sleepiness, anxiety, and depression, but not with objectively measured cognitive performance. Momentary sleepiness and depression predicted almost 39% of the variance in the ratings of subjectively perceived attention deficits. The present study showed that sleepiness and depression, more than objective cognitive deficits, might play a role in the subjectively perceived attention deficits of patients with narcolepsy. The results suggested that when counselling and treating patients with narcolepsy, clinicians should pay attention to potential depression because subjective cognitive complaints may not relate to objective cognitive impairments. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. [Clinical and psychosocial characteristics of subjects with fibromyalgia. Impact of the diagnosis on patients' activities].

    Science.gov (United States)

    Ubago Linares, Maria del Carmen; Ruiz Pérez, Isabel; Bermejo Pérez, Maria José; Olry de Labry Lima, Antonio; Plazaola Castaño, Juncal

    2005-01-01

    Little is known today about the characteristics of individuals diagnosed with fibromyalgia, their degree of disability and the health system response system response to this condition. The objectives of this work include: to establish the sociodemographic, clinical and psychosocial profile of male and female patients with fibromyalgia. To describe the response they receive from the health service, and to study the repercussions of this syndrome on the daily activities of subjects who suffer it, including its effects on their work environment. Descriptive cross-sectional study. The information was received from telephone interviews of individuals diagnosed with fibromyalgia in the Hospital Universitario Virgen de las Nieves in Granada during 2003. 92.1% of those interviewed were women. Fibromyalgia caused work absenteeism in 31.4% of cases; and 64% regarded their health as poor or very poor. Fibromyalgia was associated with other diseases in 52.3% of cases. The family doctor is the specialist consulted before diagnosis in 92.1% of cases. A total of 50.5% had a history of psychiatric disorders, these were still present at the time of interview in 36.4%. Around 71% of the sample received family support, and 70.1% of cases considered the disease to seriously affect their environment. Fibromyalgia was mainly diagnosed in women. Subjects with this syndrome have a poor perception of their own health and work situation, and it negatively affects their family environment.

  7. MUNIX and incremental stimulation MUNE in ALS patients and control subjects

    DEFF Research Database (Denmark)

    Furtula, Jasna; Johnsen, Birger; Christensen, Peter Broegger

    2013-01-01

    This study compares the new Motor Unit Number Estimation (MUNE) technique, MUNIX, with the more common incremental stimulation MUNE (IS-MUNE) with respect to reproducibility in healthy subjects and as potential biomarker of disease progression in patients with ALS.......This study compares the new Motor Unit Number Estimation (MUNE) technique, MUNIX, with the more common incremental stimulation MUNE (IS-MUNE) with respect to reproducibility in healthy subjects and as potential biomarker of disease progression in patients with ALS....

  8. Favored subjects and psychosocial needs in music therapy in terminally ill cancer patients: a content analysis

    OpenAIRE

    Preissler, Pia; Kordovan, Sarah; Ullrich, Anneke; Bokemeyer, Carsten; Oechsle, Karin

    2016-01-01

    Background Research has shown positive effects of music therapy on the physical and mental well-being of terminally ill patients. This study aimed to identify favored subjects and psychosocial needs of terminally ill cancer patients during music therapy and associated factors. Methods Forty-one Patients receiving specialized inpatient palliative care prospectively performed a music therapy intervention consisting of at least two sessions (total number of sessions: 166; per patient average: 4,...

  9. Metacognitions are associated with subjective memory problems in patients with chronic fatigue

    Directory of Open Access Journals (Sweden)

    Henrik Børsting Jacobsen

    2016-05-01

    Full Text Available Background: Subjective cognitive impairments are frequent, but poorly understood in patients with chronic fatigue. We hypothesized that maladaptive metacognitive beliefs at baseline were associated with baseline subjective cognitive impairments, that they predict subjective cognitive impairments at treatment termination, and that a reduction in maladaptive metacognitive beliefs was associated with less subjective cognitive impairments at treatment termination, independent of changes in fatigue, pain, insomnia, depression, and anxiety.Methods: In this non-controlled study, patients (n=137 on sick leave due to chronic fatigue received a 3.5-week inpatient RTW rehabilitation program. Of these patients 69 (50.4 % was referred with a ICPC-2 diagnosis of chronic fatigue. Patients completed questionnaires about metacognitive beliefs, somatic complaints, psychological complaints, and cognitive impairments before and after treatment. To test the hypotheses we performed paired t tests of change, as well as seven hierarchical linear regressions.Results: Results showed that baseline maladaptive metacognitive beliefs were significantly associated with subjective cognitive impairments at baseline, controlling for symptoms. Score on baseline metacognitive beliefs did not predict impairments post-treatment. Testing specific maladaptive beliefs, pre-treatment scores on cognitive confidence were associated with subjective cognitive impairments both pre and post-treatment, controlling for symptoms. Post-treatment metacognitive beliefs and post-treatment cognitive confidence were associated with post-treatment subjective cognitive impairments, controlling for pre-treatment impairments and pre-treatment metacognitive beliefs, as well as pre and post scores on symptom measures. Conclusion: This study reports associations between maladaptive metacognitive beliefs and subjective cognitive impairments in patients with chronic fatigue. Targeting metacognitive beliefs

  10. Clinical Outcomes in Patients with Severe Renal Dysfunction Including Dialysis Following Defibrillator Implantation.

    Science.gov (United States)

    Bogdan, Stefan; Nof, Eyal; Eisen, Alon; Sela, Ron; Rosenheck, Shimon; Freedberg, Nahum; Geist, Michael; Ben-Zvi, Shlomit; Haim, Moti; Glikson, Michael; Goldenberg, Ilan; Suleiman, Mahmoud

    2015-01-01

    Renal dysfunction is associated with increased mortality in heart failure (HF) patients. However, there are limited data regarding clinical and arrhythmic outcomes associated with implantable cardioverter defibrillator (ICD) therapy in this population. We evaluated outcomes associated with the severity of renal dysfunction with or without dialysis among 2,289 patients who were enrolled and prospectively followed up in the Israeli ICD Registry. The primary endpoint of the study was all-cause mortality. Secondary endpoints included cardiac mortality, HF hospitalization, non-cardiac hospitalization, and appropriate and inappropriate ICD therapy. Severe renal dysfunction patients (estimated glomerular filtration ratedialysis had a lower prevalence of wide QRS and complete left bundle branch morphology, resulting in lower cardiac resynchronization therapy defibrillator (CRTD) implantation rates. Dialysis was associated with an overall increased risk for all-cause mortality (hazard ratio (HR) 3.22; 95% CI 1.69-6.13; pdialysis was not an independent risk factor for all-cause mortality (HR 0.99; p=0.97) as compared to non-dialysis. The rate of appropriate ICD therapy for ventricular tachyarrhythmias increased with declining renal function, with the highest rate observed among those undergoing dialysis. The present findings suggest that dialysis does not significantly modify the adverse outcomes associated with severe renal dysfunction following ICD/CRTD implantation. © 2015 S. Karger AG, Basel.

  11. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects.

    Science.gov (United States)

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-07-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stability). The Mann-Whitney test was used to analyze differences in Functional Movement Screen scores between the two groups. [Results] Chronic lower back pain patients scored lower on the Functional Movement Screen total composite compared with healthy control subjects. Chronic lower back pain patients scored lower on Functional Movement Screen subtests including the deep squat, hurdle step, active straight leg raise, and rotary stability tests. [Conclusion] The deep squat, hurdle step, active straight leg raise, and rotary stability tasks of the Functional Movement Screen can be recommended as a functional assessment tools to identify functional deficits in chronic lower back pain patients.

  12. Incidence of missed inferior alveolar nerve blocks in vital asymptomatic subjects and in patients with symptomatic irreversible pulpitis.

    Science.gov (United States)

    Fowler, Sara; Reader, Al; Beck, Mike

    2015-05-01

    The purpose of this retrospective study was to determine the incidence of missed inferior alveolar nerve (IAN) blocks by using a 1- or 2-cartridge volume of 2% lidocaine with 1:100,000 epinephrine in vital asymptomatic teeth and in emergency patients with symptomatic irreversible pulpitis. As part of 37 studies, 3169 subjects/patients were evaluated for missed IAN blocks. The study included 2450 asymptomatic subjects and 719 emergency patients presenting with symptomatic irreversible pulpitis. Each subject or patient received either a 1- or 2-cartridge volume of 2% lidocaine with 1:100,000 epinephrine. A missed block was defined as no lip numbness at 15-20 minutes after the IAN block. The effect of anesthetic volume on the incidence of missed blocks was assessed by using mixed models logistic regression with individual studies as a random effect. The incidence of missed blocks for asymptomatic subjects was 6.3% for the 1-cartridge volume and 3.8% for the 2-cartridge volume. For patients presenting with irreversible pulpitis, the incidence of missed blocks was 7.7% for the 1-cartridge volume and 2.3% for the 2-cartridge volume. In both asymptomatic subjects and patients with irreversible pulpitis, the 2-cartridge volume was significantly (P = .0395) better than the 1-cartridge volume. There were no significant effects for pulpal diagnosis (P = .7523) or the pulpal diagnosis and anesthetic volume interaction (P = .3973). Concerning missed IAN blocks, we concluded that administration of a 2-cartridge volume was significantly better (P = .0395) than a 1-cartridge volume in both asymptomatic subjects and emergency patients presenting with irreversible pulpitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Favored subjects and psychosocial needs in music therapy in terminally ill cancer patients: a content analysis.

    Science.gov (United States)

    Preissler, Pia; Kordovan, Sarah; Ullrich, Anneke; Bokemeyer, Carsten; Oechsle, Karin

    2016-05-12

    Research has shown positive effects of music therapy on the physical and mental well-being of terminally ill patients. This study aimed to identify favored subjects and psychosocial needs of terminally ill cancer patients during music therapy and associated factors. Forty-one Patients receiving specialized inpatient palliative care prospectively performed a music therapy intervention consisting of at least two sessions (total number of sessions: 166; per patient average: 4, range, 2-10). Applied music therapy methods and content were not pre-determined. Therapeutic subjects and psychosocial needs addressed in music therapy sessions were identified from prospective semi-structured "field notes" using qualitative content analysis. Patient- and treatment-related characteristics as well as factors related to music and music therapy were assessed by questionnaire or retrieved from medical records. Seven main categories of subjects were identified: "condition, treatment, further care", "coping with palliative situation", "emotions and feelings", "music and music therapy", "biography", "social environment", and "death, dying, and spiritual topics". Patients addressed an average of 4.7 different subjects (range, 1-7). Some subjects were associated with gender (p = .022) and prior impact of music in patients' life (p = .012). The number of subjects per session was lower when receptive music therapy methods were used (p = .040). Psychosocial needs were categorized into nine main dimensions: "relaxing and finding comfort", "communication and dialogue", "coping and activation of internal resources", "activity and vitality", "finding expression", "sense of self and reflection", "finding emotional response", "defocusing and diversion", and "structure and hold". Patients expressed an average of 4.9 psychosocial needs (range, 1-8). Needs were associated with age, parallel art therapy (p = .010), role of music in patient's life (p = .021), and the applied music

  14. Subjective cognitive complaints and functional disability in patients with borderline personality disorder and their nonaffected first-degree relatives.

    Science.gov (United States)

    Ruocco, Anthony C; Lam, Jaeger; McMain, Shelley F

    2014-06-01

    To examine the contributions of subjective cognitive complaints to functional disability in patients with borderline personality disorder (BPD) and their nonaffected relatives. Patients with BPD (n = 26), their first-degree biological relatives (n = 17), and nonpsychiatric control subjects (n = 31) completed a self-report measure of cognitive difficulties and rated the severity of their functional disability on the World Health Organization Disability Assessment Schedule 2.0. After accounting for group differences in age and severity of depressive symptoms, patients and relatives endorsed more inattention and memory problems than control subjects. Whereas probands reported greater disability than relatives and control subjects across all functional domains, relatives described more difficulties than control subjects in managing multiple life activities, including domestic activities and occupational and academic functioning, and participating in society. For both probands and relatives, inattention and memory problems were linked primarily to difficulties with life activities, independent of depression and other comorbid psychiatric disorders. Problems with inattention and forgetfulness may lead to difficulties carrying out activities of daily living and occupational or academic problems in patients with BPD, as well as their nonaffected first-degree relatives.

  15. Subjective Cognitive Complaints and Functional Disability in Patients With Borderline Personality Disorder and Their Nonaffected First-Degree Relatives

    Science.gov (United States)

    Ruocco, Anthony C; Lam, Jaeger; McMain, Shelley F

    2014-01-01

    Objective: To examine the contributions of subjective cognitive complaints to functional disability in patients with borderline personality disorder (BPD) and their nonaffected relatives. Method: Patients with BPD (n = 26), their first-degree biological relatives (n = 17), and nonpsychiatric control subjects (n = 31) completed a self-report measure of cognitive difficulties and rated the severity of their functional disability on the World Health Organization Disability Assessment Schedule 2.0. Results: After accounting for group differences in age and severity of depressive symptoms, patients and relatives endorsed more inattention and memory problems than control subjects. Whereas probands reported greater disability than relatives and control subjects across all functional domains, relatives described more difficulties than control subjects in managing multiple life activities, including domestic activities and occupational and academic functioning, and participating in society. For both probands and relatives, inattention and memory problems were linked primarily to difficulties with life activities, independent of depression and other comorbid psychiatric disorders. Conclusions: Problems with inattention and forgetfulness may lead to difficulties carrying out activities of daily living and occupational or academic problems in patients with BPD, as well as their nonaffected first-degree relatives. PMID:25007408

  16. Translating data and measurements from stratus to cirrus OCT in glaucoma patients and healthy subjects.

    Science.gov (United States)

    Chiseliţă, Dorin; Pantalon, Anca Delia; Cantemir, Alina; Gălăţanu, Cătălina

    2016-01-01

    Aim: our study tried to find a mathematical conversion method of the measurements obtained in Time Domain (TD) OCT to Spectral Domain (SD) OCT. Material and method: A prospective randomized, double blind study that included 244 eyes, from 121 patients (normal subjects, glaucoma suspects, glaucoma), in whom we analyzed the retinal nerve fiber layer (RNFL) and the optic disc in the same session by using TD OCT (Stratus) and SD OCT (Cirrus), was performed. The means for RNFL thickness (overall value and per quadrants), neural area and cup/ disc (C/ D) ratio, were measured. Results: We found statistically significant differences between parameters measured in TD OCT and SD OCT (pOCT machines. Data dispersion showed a linear relation between measurements. One can use the following mathematical equations for conversion: Mean RNFL (Cirrus) = 15.77 + 0.748 x Mean RNFL (Stratus) Mean neural area (Cirrus) = 0.508 + 0.388 x Mean neural area (Stratus) Mean C/ D ratio (Cirrus) = 0.157 + 0.792 x Mean C/ D (Stratus) Conclusions: data based on our calculated mathematical conversion equations can be converted into SD OCT. Therefore, we offered a useful tool for the long term monitoring of our patients although the initial measurements in TD OCT made comparisons for patients later measured with SD OCT impossible. Abbreviations: RNFL = retinal nerve fiber layer, TD OCT = time domain optical coherence tomography, SD OCT = spectral domain optical coherence tomography, VF = visual field, CI = confidence interval, ISNT segments = inferior, superior, nasal, temporal segment.

  17. Interpersonal interaction and cardiovascular response in type A subjects and coronary patients.

    Science.gov (United States)

    Dembroski, T M; MacDougall, J M; Lushene, R

    1979-12-01

    The present study tested the hypothesis that Type A subjects respond with greater cardiovascular response than Type B subjects during the structured interview used to assess the Type A pattern. Coronary patients (n = 31) and patient controls (n = 33) were subjected to the interview and a history quiz while ECG and blood pressure were monitored. As predicted, Type A relative to Type B subjects evidenced significantly greater increases in both systolic and diastolic blood pressure, which were sustained over the course of the entire 12-15 minute interview. Type A subjects compared with B's also showed significantly greater blood pressure elevations during the quiz. Coronary patients displayed significantly greater Type A attributes than control subjects and tended to show greater blood pressure elevations than controls during the interview. In addition, the quiz induced significant elevations in the blood pressure of coronary patients, but not patient controls, over that displayed during the interview, despite the presence of beta-adrenergic blocking medication. Implications of the findings for coronary-prone behavior and coronary heart disease are discussed.

  18. Subjective sleep complaints indicate objective sleep problems in psychosomatic patients: a prospective polysomnographic study

    Directory of Open Access Journals (Sweden)

    Linden M

    2016-08-01

    Full Text Available Michael Linden,1,2 Marie Dietz,1 Christian Veauthier,3 Ingo Fietze3 1Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, 2Department of Psychosomatic Medicine, Rehabilitation Centre Seehof, Teltow, 3Interdisciplinary Center of Sleep Medicine, Charité University Medicine Berlin, Berlin, Germany Objective: To elucidate the relationship between subjective complaints and polysomnographical parameters in psychosomatic patients.Method: A convenience sample of patients from a psychosomatic inpatient unit were classified according to the Pittsburgh Sleep Quality Index (PSQI as very poor sleepers (PSQI >10, n=80 and good sleepers (PSQI <6, n=19. They then underwent a polysomnography and in the morning rated their previous night’s sleep using a published protocol (Deutschen Gesellschaft für Schlafforschung und Schlafmedizin morning protocol [MP].Results: In the polysomnography, significant differences were found between very poor and good sleepers according to the PSQI with respect to sleep efficiency and time awake after sleep onset. When comparing objective PSG and subjective MP, the polysomnographical sleep onset latency was significantly positively correlated with the corresponding parameters of the MP: the subjective sleep onset latency in minutes and the subjective evaluation of sleep onset latency (very short, short, normal, long, very long were positively correlated with the sleep latency measured by polysomnography. The polysomnographical time awake after sleep onset (in minutes was positively correlated with the subjective time awake after sleep onset (in minutes, evaluation of time awake after sleep onset (seldom, normal often, and subjective restfulness. The polysomnographical total sleep time (TST was positively correlated with the subjective TST. Conversely, the polysomnographical TST was negatively correlated with the evaluation of TST (high polysomnographical TST was correlated with the subjective

  19. Supportive and palliative care for patients with chronic mental illness including dementia.

    Science.gov (United States)

    Lloyd-Williams, Mari; Abba, Katharine; Crowther, Jacqueline

    2014-09-01

    People with preexisting mental illness are known to have difficulty accessing healthcare services including palliative care and people with dementia have similar issues accessing palliative care. The review addressed the time period from January 2013 to March 2014. There were few articles addressing issues for palliative and supportive care for patients with preexisting mental health issues. The main factor that would improve care is interdisciplinary working between mental healthcare teams and palliative care teams. In contrast, there were many published articles on the palliative and supportive care needs for people with dementia. These articles included consensus statements, models of care; studies of why models of care, for example Advanced Care Planning were not being implemented; and carer reports of care in the last year of life. Urgent research is required as to how support for people with preexisting mental illness who require palliative care can be improved--excellent liaison between mental health and palliative care teams is essential. There is much research on palliative care needs for people with dementia but an apparent lack of innovative approaches to care including care of people within their family home.

  20. Abnormal distribution of AQP5 in labial salivary glands is associated with poor saliva secretion in patients with Sjögren's syndrome including neuromyelitis optica complicated patients.

    Science.gov (United States)

    Yoshimura, Shunsuke; Nakamura, Hideki; Horai, Yoshiro; Nakajima, Hideki; Shiraishi, Hirokazu; Hayashi, Tomayoshi; Takahashi, Toshiyuki; Kawakami, Atsushi

    2016-01-01

    To investigate whether aquaporins (AQPs) are involved in salivary gland dysfunction in patients with neuromyelitis optica (NMO) complicated with Sjögren's syndrome (SS). Eight primary SS (pSS) patients, four NMO spectrum disorder (NMOsd) patients complicated with SS (NMOsd-SS), and three control subjects were enrolled. Immunohistochemistry of labial salivary glands (LSGs) was performed to determine the expressions of AQP4, AQP5, and tumor necrosis factor-alpha (TNF-α). In vitro expression of AQP5 was examined by Western blotting in cultured primary salivary gland epithelial cells (SGECs). No expression of AQP4 was shown in all LSGs. AQP5 was clearly expressed in the all acini, but the predominant localization of AQP5 in the apical side was diminished in the patients with pSS or NMOsd-SS compared with the controls and tended to be even lower in NMOsd-SS than pSS. The abnormal localization of AQP5 was associated with poor saliva secretion. No difference was found in TNF-α expression in the LSGs between patients with pSS and NMOsd-SS. AQP5 expression of SGECs in vitro was not changed by TNF-α or interleukin-10. Our results suggest that AQP5 but not AQP4 contributes to salivary secretion in patients with SS including those with NMO complicated with SS.

  1. Quality of life of healthy subjects and patients with arthritis and ...

    African Journals Online (AJOL)

    Purpose: There is paucity of information about quality of life (QOL) studies among patients with arthritis and diabetes mellitus in developing countries. The objective of this study was to evaluate quality of life of patients with arthritis (AR) and diabetes mellitus (DM). Methods: A total of 507 subjects comprising 364 healthy ...

  2. Assessment of five different guideline indication criteria for spirometry, including modified GOLD criteria, in order to detect COPD: data from 5,315 subjects in the PLATINO study.

    Science.gov (United States)

    Luize, Ana P; Menezes, Ana Maria B; Perez-Padilla, Rogelio; Muiño, Adriana; López, Maria Victorina; Valdivia, Gonzalo; Lisboa, Carmem; Montes de Oca, Maria; Tálamo, Carlos; Celli, Bartolomé; Nascimento, Oliver A; Gazzotti, Mariana R; Jardim, José R

    2014-10-30

    Spirometry is the gold standard for diagnosing chronic obstructive pulmonary disease (COPD). Although there are a number of different guideline criteria for deciding who should be selected for spirometric screening, to date it is not known which criteria are the best based on sensitivity and specificity. Firstly, to evaluate the proportion of subjects in the PLATINO Study that would be recommended for spirometry testing according to Global initiative for Obstructive Lung Disease (GOLD)-modified, American College of Chest Physicians (ACCP), National Lung Health Education Program (NLHEP), GOLD and American Thoracic Society/European Respiratory Society (ATS/ERS) criteria. Secondly, we aimed to compare the sensitivity, specificity, and positive predictive and negative predictive values, of these five different criteria. Data from the PLATINO study included information on respiratory symptoms, smoking and previous spirometry testing. The GOLD-modified spirometry indication criteria are based on three positive answers out of five questions: the presence of cough, phlegm in the morning, dyspnoea, age over 40 years and smoking status. Data from 5,315 subjects were reviewed. Fewer people had an indication for spirometry (41.3%) according to the GOLD-modified criteria, and more people had an indication for spirometry (80.4%) by the GOLD and ATS/ERS criteria. A low percentage had previously had spirometry performed: GOLD-modified (14.5%); ACCP (13.2%); NLHEP (12.6%); and GOLD and ATS/ERS (12.3%). The GOLD-modified criteria showed the least sensitivity (54.9) and the highest specificity (61.0) for detecting COPD, whereas GOLD and ATS/ERS criteria showed the highest sensitivity (87.9) and the least specificity (20.8). There is a considerable difference in the indication for spirometry according to the five different guideline criteria. The GOLD-modified criteria recruit less people with the greatest sum of sensitivity and specificity.

  3. Antibody isotypes, including IgG subclasses, in Ecuadorian patients with pulmonary Paragonimiasis

    Directory of Open Access Journals (Sweden)

    Angel Guevara E.

    1995-08-01

    Full Text Available An ELISA test was developed to detect Paragonimus-specific antibodies, including IgG subclasses, using P. mexicanus crude water-soluble antigens. The test was standardized to detect antibodies in sera of Ecuadorian patients with pulmonary paragonimiasis and negative controls from the endemic area. The detected mean levels of IgG (0.753, SEM: 0.074 and IgM (0.303, SEM: 0.033 were significantly elevated (P<0.05. Within the IgG subclasses, IgG4 showed the highest detected mean level (0.365, SEM: 0.116 and the other three subclasses showed considerably lower mean levels (IgG1, 0.186 SEM: 0.06; IgG2, 0.046 SEM: 0.01; IgG3, 0.123 SEM: 0.047. The number of P. mexicanus eggs found in sputum of infected individuals showed a positive correlation with the level of antibodies detected for IgM, IgG and its subclasses (P<0.001. The relevance of these findings in Ecuadorian patients suffering from pulmonary paragonimiasis is discussed.

  4. The Patient-Worker: A Model for Human Research Subjects and Gestational Surrogates.

    Science.gov (United States)

    Ryman, Emma; Fulfer, Katy

    2017-01-13

    We propose the 'patient-worker' as a theoretical construct that responds to moral problems that arise with the globalization of healthcare and medical research. The patient-worker model recognizes that some participants in global medical industries are workers and are owed worker's rights. Further, these participants are patient-like insofar as they are beneficiaries of fiduciary relationships with healthcare professionals. We apply the patient-worker model to human subjects research and commercial gestational surrogacy. In human subjects research, subjects are usually characterized as either patients or as workers. Through questioning this dichotomy, we argue that some subject populations fit into both categories. With respect to commercial surrogacy, we enrich feminist discussions of embodied labor by describing how surrogates are beneficiaries of fiduciary obligations. They are not just workers, but patient-workers. Through these applications, the patient-worker model offers a helpful normative framework for exploring what globalized medical industries owe to the individuals who bear the bodily burdens of medical innovation. © 2017 John Wiley & Sons Ltd.

  5. Use of Subjective Global Assessment, Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 to evaluate the nutritional status of non-critically ill patients on parenteral nutrition.

    Science.gov (United States)

    Badia-Tahull, M B; Cobo-Sacristán, S; Leiva-Badosa, E; Miquel-Zurita, M E; Méndez-Cabalerio, N; Jódar-Masanés, R; Llop-Talaverón, J

    2014-02-01

    To evaluate the nutritional status of non-critically ill digestive surgery patients at the moment of parenteral nutrition initiation using three different nutritional test tools and to study their correlation. To study the association between the tests and the clinical and laboratory parameters used in the follow-up of PN treatment. Prospective study over 4 months. Anthropometric and clinical variables were recorded. Results of Subjective Global Assessment; Patient-Generated Subjective Global Assessment; and Nutritional Risk Screening 2002 were compared applying kappa test. Relationship between the clinical and laboratory parameters with Subjective Global Assessment was studied by multinominal regression and with the other two tests by multiple linear regression models. Age and sex were included as adjustment variables. Malnutrition in 45 studied patients varied from 51% to 57%. Subjective Global Assessment correlated well with Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 (κ = 0531 p = 0.000). The test with the greatest correlation with the clinical and analytical variables was the Nutritional Risk Screening 2002. Worse nutritional state in this test was associated with worse results in albumin (B = -0.087; CI = -0.169/-0.005], prealbumin (B = -0.005; CI = [-0.011/-0.001]), C-reactive protein (B = 0.006;CI = [0.001/ 0.011]) and leukocytes (B = 0.134; CI = [0.031/0.237]) at the en of parenteral nutrition treatment. Half of the digestive surgery patients were at malnutritional risk at the moment of initiating parenteral nutrition. Nutritional Risk Screening 2002 was the test with best association with the parameters used in the clinical follow-up of parenteral nutrition treated patients. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Optimal timing in screening patients with congestive heart failure and healthy subjects during circadian observation.

    Science.gov (United States)

    Jong, Tai-Lang; Chang, Ben; Kuo, Cheng-Deng

    2011-02-01

    Congestive heart failure (CHF) is a major medical challenge in developed countries. In order to screen patients with CHF and healthy subjects during circadian observation, accurate judgment and fast response are imperative. In this study, optimal timing during circadian observation via the heart rate variability (HRV) was sought. We tested 29 CHF patients and 54 healthy subjects in the control group from the interbeat interval databases of PhysioBank. By invoking the α1 parameter in detrended fluctuation analysis of HRV, we found that it could be used as an indicator to screen the patients with CHF and subjects in normal sinus rhythm (NSR) under Kruskal-Wallis test. By invoking Fano factor, the optimal timing to screen CHF patients and healthy subjects was found to be from 7 PM to 9 PM during the circadian observation. In addition, this result is robust in a sense that the same result can be achieved by using different ECG recording lengths of 2, 5, 10, … , and 120 min, respectively. Furthermore, a support vector machine was employed to classify CHF and NSR with α1 parameter of a moving half-hour ECG recordings via leave-one-out cross validation. The results showed that the superlative screening performance was obtained in the 7 pm-9 pm period during circadian observation. It is believed that this result of optimal timing will be helpful in the non-invasive monitoring and screening of CHF patients and healthy subjects in the clinical practice.

  7. Circulating Total Glutathione in Normal Tension Glaucoma Patients: Comparison with Normal Control Subjects

    Science.gov (United States)

    Park, Myoung Hee

    2012-01-01

    Purpose Oxidative stress plays a critical role in the pathogenesis of glaucoma. Glutathione is a major antioxidant molecule present in intracellular or extracellular space. Herein, we aimed to examine circulating glutathione level in normal tension glaucoma (NTG), which comprises the largest proportion of glaucoma disease in the Korean population. Methods Nineteen NTG patients (NTG group) and 30 age- and gender-matched normal control subjects (control group) were included. Antecubital venous puncture was performed between 8 and 10 o'clock in the morning to obtain a 4 mL venous blood sample. Total glutathione level was measured by the spectrophotometric method at 412 nm. Correlation of total glutathione level with mean deviation and pattern standard deviation from the Humphrey visual field test was analyzed in the NTG group. Results Total glutathione level in circulating blood was 524.02 ± 231.09 nmol and 586.06 ± 156.08 nmol in the NTG group and the control group, respectively. The difference between these values was not statistically significant (p = 0.121, F = 2.212). Age had no significant effect on circulating total glutathione level in either the NTG group (p = 0.171, r = -0.328) or the control group (p = 0.380, r = -0.166). In the NTG group, circulating total glutathione level had no significant relationship with mean deviation (p = 0.226, F = 1.636) and pattern standard deviation (p = 0.200, F = 1.766) after correcting for age and gender. Conclusions In NTG patients, circulating total glutathione levels were not different compared to those of normal subjects. PMID:22511833

  8. Internal Lymphedema Correlates with Subjective and Objective Measures of Dysphagia in Head and Neck Cancer Patients.

    Science.gov (United States)

    Jackson, Leanne K; Ridner, Sheila H; Deng, Jie; Bartow, Carmin; Mannion, Kyle; Niermann, Ken; Gilbert, Jill; Dietrich, Mary S; Cmelak, Anthony J; Murphy, Barbara A

    2016-09-01

    Tumor/treatment-related internal lymphedema (IL) and/or external lymphedema (EL) are associated with functional deficits and increased symptom burden in head and neck cancer patients (HNCP). Previously, we noted association between EL/IL and patient-reported dysphagia using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0. To determine the relationship between IL/EL and subjective and objective measures of swallowing function. Eighty-one HNCP completed: (1) VHNSS version 2.0, including 13 swallowing/nutrition-related questions grouped into three clusters: swallow solids (ss), swallow liquids (sl), and nutrition(nt); (2) physical assessment of EL using Foldi scale; (3) endoscopic assessment of IL using Patterson scale (n = 56); and (4) modified barium swallow study rated by dysphagia outcome and severity scale (DOSS) and in conjunction with a swallow evaluation by National Outcomes Measurement System (NOMS). Examinations were performed at varied time points to assess lymphedema spectrum, from baseline (n = 15, 18.1%) to 18 months post-therapy (n = 20, 24.1%). VHNSS swallow/nutrition items scores correlated with NOMS/DOSS ratings (p nutrition scores correlated with maximum grade of swelling for any single structure on Patterson scale: ss (0.43; p = 0.001); sl (0.38; p = 0.004); nt (0.41; p = 0.002). IL of aryepiglottic/pharyngoepiglottic folds, epiglottis, and pyriform sinus were most strongly correlated with VHNSS and NOMS ratings. NOMS/DOSS ratings correlated with EL (> = -0.34; p nutrition items and EL ( 0.20). IL correlated with subjective and objective measures of swallow dysfunction. Longitudinal analysis of trajectory and impact of IL/EL on dysphagia is ongoing.

  9. [Baseline characteristics and changes in treatment after a period of optimization of the patients included in the study EFICAR].

    Science.gov (United States)

    Gómez-Marcos, Manuel A; Agudo-Conde, Cristina; Torcal, Jesús; Echevarria, Pilar; Domingo, Mar; Arietaleanizbeascoa, María; Sanz-Guinea, Aitor; de la Torre, Maria M; Ramírez, Jose I; García-Ortiz, Luis

    2016-03-01

    To describe the baseline date and drugs therapy changes during treatment optimization in patients with heart failure with depressed systolic function included in the EFICAR study. Multicenter randomized clinical trial. Seven Health Centers. 150 patients (ICFSD) age 68±10 years, 77% male. Sociodemographic variables, comorbidities (Charlson index), functional capacity and quality of life. Drug therapy optimization was performed. The main etiology was ischemic heart disease (45%), with 89% in functional class II. The Charlson index was 2.03±1.05. The ejection fraction mean was 37%±8, 19% with ejection fraction <30%. With the stress test 6.3±1.6 mean was reached, with the 6 minutes test 446±78 meters and the chair test 13.7±4.4 seconds. The overall quality of life with ejection fraction was 22.8±18.7 and with the Short Form-36 Health Survey, physical health 43.3±8.4 and mental health 50.1±10.6. After optimizing the treatment, the percentage of patients on drugs therapy and the dose of angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists and beta-blockers were not changed. The majority of the subjects are in functional class II, with functional capacity and quality of life decreased and comorbidity index high. A protocolized drug therapy adjustment did not increase the dose or number of patients with effective drugs for heart failure with depressed systolic function. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  10. A new yeast, Malassezia yamatoensis, isolated from a patient with seborrheic dermatitis, and its distribution in patients and healthy subjects.

    Science.gov (United States)

    Sugita, Takashi; Tajima, Mami; Takashima, Masako; Amaya, Misato; Saito, Masuyoshi; Tsuboi, Ryoji; Nishikawa, Akemi

    2004-01-01

    Over the last few years, new Malassezia species have been found regularly in Japanese subjects. We isolated another new Malassezia species from a Japanese patient with seborrheic dermatitis (SD), and named it M. yamatoensis. In its physiological characteristics and the utilization of Tween by M. yamatoensis is similar to that of M. furfur and M. dermatis. It is distinguished by its growth temperature. To examine the distribution of the microorganism in the skin of patients with SD and atopic dermatitis (AD), and healthy subjects, we applied transparent dressings to the skin, and detected M. yamatoensis DNA using a non-culture-based method that consisted of nested PCR with specific primers. M. yamatoensis DNA was detected from 3 of 31 SD patients (9.7%), 5 of 36 AD patients (13.9%), and 1 of 22 healthy subjects (4.6%). Therefore, M. yamatoensis is a rare member of the cutaneous microflora.

  11. AHRQ patient safety indicators: time to include hemorrhage and infection during childbirth.

    Science.gov (United States)

    Gregory, Kimberly D; Korst, Lisa M; Lu, Michael C; Fridman, Moshe

    2013-03-01

    Many Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) partially or completely exclude pregnant women. Both postoperative hemorrhage or hematoma (PSI 9; hemorrhage), and Postoperative Sepsis (PSI 13; infection) appear to be adaptable to pregnancy hospitalizations. Using the 2009 California Patient Discharge Dataset (N [total] = 508,842), the hemorrhage and infection PSIs were examined for their potential to include pregnant women in gynecological, antepartum, postpartum, and delivery subpopulations. The statewide and hospital-level indicator rates were calculated using hierarchical models adjusted for case mix. Only the delivery population had sufficient cases for hospital-level analysis. Both PSIs required major changes to the technical specifications because of pregnancy-specific codes and coding practices. Nevertheless, these revised indicators identified substantial morbidity that varied widely across hospitals. The hemorrhage indicator rate was 2.50% (95% confidence interval [CI], 2.45-2.54) for all deliveries, compared with 0.26% (95% CI, 0.25-0.27) in the AHRQ population and 0.18% (95% CI, 0.15-0.21) for nonpregnant women of reproductive age. Adjusted hospital rates averaged 2.52%, with a midquartile range of 1.16% to 3.09% Although infection rates were lower for all deliveries than for the AHRQ population (0.18% versus 1.20%), they were highly associated with cesarean versus vaginal birth (0.43% versus 0.05%) and ranged from 0% to 1.15% across hospitals. Although codes and coding practices for pregnancy hospitalizations differ from those used for nonpregnant adults, hospital-level measures of childbirth-associated hemorrhage and infection are feasible, vary widely, and demonstrate considerable opportunity for improvement.

  12. Age-related cutoffs for cervical movement behaviour to distinguish chronic idiopathic neck pain patients from unimpaired subjects.

    Science.gov (United States)

    Niederer, Daniel; Vogt, Lutz; Wilke, Jan; Rickert, Marcus; Banzer, Winfried

    2015-03-01

    The present study aims to develop age-dependent cutoff values in a quasi-experimental, cross-sectional diagnostic test study. One hundred and twenty (120) asymptomatic subjects (n = 100, 36♀, 18 75 years, for normative values; n = 20, 23-75 years, 15♀, for selectivity analyses) and 20 patients suffering from idiopathic neck pain (selectivity analyses, 22-71 years, 15♀) were included. Subjects performed five repetitive maximal cervical flexion/extension movements in an upright sitting position. Cervical kinematic characteristics (maximal range of motion (ROM), coefficient of variation (CV) and mean conjunct movements in rotation and flexion (CM)) were calculated from raw 3D ultrasonic data. Regression analyses were conducted to reveal associations between kinematic characteristics and age and gender and thus to determine normative values for healthy subjects. Age explains 53 % of the variance in ROM (decrease 10.2° per decade), 13 % in CV (increase 0.003 per decade) and 9 % in CM (increase 0.57° per decade). Receivers operating characteristic (ROC) analyses were conducted for differences between individual values of the kinematic characteristics and normative values to optimise cutoff values for distinguishing patients from unimpaired subjects (20 patients and 20 healthy). Cutoff values distinguished asymptomatic subjects' and chronic nonspecific neck patient's movement characteristics with sufficient quality (sensitivity 70-80 %, specificity 65-70 %). By including such classifications, the present findings expand actual research stating an age-related decrease in kinematic behaviour only using categorising span widths across decades. Future study is warranted to reveal our results' potential applicability for intervention onset decision making for idiopathic neck pain patients.

  13. Subjective changes in nasal patency after chewing a menthol-containing gum in patients with olfactory loss.

    Science.gov (United States)

    Schriever, Valentin A; Hummel, Thomas

    2015-03-01

    The subjective increase in nasal patency after oral menthol application depends on olfactory function. In patients with relatively low olfactory sensitivity, this effect is small or absent. It was hypothesized that this may also modulate the sensation of nasal blockage. Menthol stimulates the nasal trigeminal nerve, resulting in a subjectively increased nasal airflow and patency without objectively measurable changes. Patients suffering from olfactory impairment also express a reduced nasal trigeminal sensitivity. The aim of this investigation was to examine the effect of menthol on nasal patency ratings in a group of patients suffering from olfactory dysfunction. A group of 92 patients with olfactory impairment was included in this study. Olfactory function was assessed using the 'Sniffin' Sticks.' Patients were instructed to chew a menthol-containing gum for 30 s, after which they rated the change in nasal patency on a categorical scale. Patients who rated the change in nasal patency as pronounced scored higher on the Sniffin' Sticks olfactory test compared to patients who experienced little or no change in nasal patency after chewing the menthol-containing gum. On average, similar changes could be observed for all etiologies of olfactory impairment included in this study.

  14. Subjective memory ability and long-term forgetting in patients referred for neuropsychological assessment

    Directory of Open Access Journals (Sweden)

    Sieberen Pieter Van Der Werf

    2016-05-01

    Full Text Available It has been suggested that the memory complaints of patients who are not impaired on formal memory tests may reflect accelerated forgetting. We examined this hypothesis by comparing the one-week delayed recall and recognition test performance of outpatients who were referred for neuropsychological assessment and who had normal memory performance during standard memory assessment with that of a non-patient control group. Both groups performed equally in verbal learning and delayed recall. However, after one week, the patients performed worse than controls on both recall and recognition tests. Although subjective memory ability predicted short-term memory function in patients, it did not predict long-term delayed forgetting rates in either the patients or controls. Thus, long-term delayed recall and recognition intervals provided no additional value to explain poor subjective memory ability in the absence of objective memory deficits.

  15. Disruption of resting functional connectivity in Alzheimer's patients and at-risk subjects.

    Science.gov (United States)

    Krajcovicova, Lenka; Marecek, Radek; Mikl, Michal; Rektorova, Irena

    2014-10-01

    The resting brain exhibits continuous intrinsic activity, which is correlated between groups of regions forming resting state networks. Evaluating resting connectivity is a popular approach for studying brain diseases. Several hundred studies are now available that address integrity of resting connectivity in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI), as well as preclinical at-risk subjects. Most studies focus on the default mode network, a system of specific brain areas showing strong connected resting activity that attenuates during goal-directed behavior. The extent of intrinsic brain activity tends to be strongly correlated with cognitive processes and is specifically disrupted in AD and MCI patients and at-risk subjects, with changes seeming to evolve during the transition between the disease stages. In this study, we review the current findings in default mode network and other resting state network studies in AD and MCI patients and at-risk subjects as assessed by resting state functional magnetic resonance imaging.

  16. The concept of body image disturbance in anorexia nervosa: an empirical inquiry utilizing patients' subjective experiences.

    Science.gov (United States)

    Espeset, Ester M S; Nordbø, Ragnfrid H S; Gulliksen, Kjersti S; Skårderud, Finn; Geller, Josie; Holte, Arne

    2011-01-01

    We explored the concept body image disturbance (BID) by utilizing the subjective experience of 32 women (aged 20-39 years) diagnosed with AN (DSM-V). Using methods from Grounded Theory we identified four phenotypes of BID-"Integration," "Denial," "Dissociation," and "Delusion"-which differed according to whether the patients overestimated their own body size ("Subjective reality"), and whether they acknowledged the objective truth that they were underweight ("Objective reality"). The results suggest that BID should be conceptualized as a dynamic failure to integrate subjective experiences of one's own body appearance with an objective appraisal of the body. Conceptual, diagnostic and clinical implications are discussed.

  17. The relationship between serum 25-hydroxy vitamin D concentration and obesity in type 2 diabetic patients and healthy subjects

    Directory of Open Access Journals (Sweden)

    Taheri Ehsaneh

    2012-09-01

    Full Text Available Abstract Background Both obesity and type 2 diabetes are associated with hypovitaminosis D. The aims of this study were to investigate the association of serum 25-hydroxy vitamin D (25(OH D and parathyroid hormone (PTH concentration with body mass index (BMI in type 2 diabetic patients compared to control subjects and their predicting role in obesity. Methods This cross-sectional study was conducted on 200 subjects (100 type 2 diabetics and 100 healthy controls. Concentration of 25(OH D, calcium, phosphorous, parathyroid hormone (PTH, fasting blood glucose, HbA1c, serum insulin, homeostasis model assessment of insulin resistance (HOMA-IR was determined in the fasting samples. Anthropometric measurements including body mass index (BMI were also measured. Results Eighty-five percent of type 2 diabetics and 79% of healthy subjects were suffering from vitamin D deficiency or insufficiency. Serum concentration of 25(OH D (22.08 ± 15.20 ng/ml (r = −0.11, P = 0.04 and calcium (8.94 ± 0.59 mg/dl (r = −2.25, P = 0.04 has significant statistically with BMI in type 2 diabetic patients. Serum concentration of PTH has non-significantly associated with BMI in diabetic patients and healthy subjects. Conclusion Serum levels of vitamin D inversely and PTH positively are associated with BMI after adjusted for age, gender and serum calcium in both type 2 diabetic patients and healthy subjects. These associations were statistically significant for serum concentration of vitamin D and calcium only in diabetic patients. So the status of vitamin D is considered as an important factor in type 2 diabetic patients.

  18. Students’ Learning Experiences from Didactic Teaching Sessions Including Patient Case Examples as Either Text or Video: A Qualitative Study

    DEFF Research Database (Denmark)

    Pedersen, Kamilla; Holdgaard, Martin Møller; Paltved, Charlotte

    2017-01-01

    on students' patient-centeredness. Video-based patient cases are probably more effective than text-based patient cases in fostering patient-centered perspectives in medical students. Teachers sharing stories from their own clinical experiences stimulates both engagement and excitement, but may also provoke......' perceptions of psychiatric patients and students' reflections on meeting and communicating with psychiatric patients. METHODS: The authors conducted group interviews with 30 medical students who volunteered to participate in interviews and applied inductive thematic content analysis to the transcribed....... Students taught with video-based patient cases, in contrast, often referred to the patient cases when highlighting new insights, including the importance of patient perspectives when communicating with patients. CONCLUSION: The format of patient cases included in teaching may have a substantial impact...

  19. Relationship between the amount of rice oil ingested by patients with Yusho and their subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, T.; Hayabuchi, H.

    1985-02-01

    The goal of this study was to clarify the subjective symptoms closely related to Yusho by examining the relationship between the amount of PCB-contaminated rice oil ingested by patients and the subjective symptoms recorded on their questionnaires. The amount of PCB-contaminated rice oil consumed by the patients was obtained by interviewing the housewife in each Yusho family. Individual consumption of the oil was estimated by taking into account age, sex and the number of meals at home. In 1970, 46 patients were available for analysis, and in 1971, 33 patients were available. Among 12 subjective symptoms studied, numbness of the limbs, coughing, expectoration, and the sensation of elevated teeth were considered to show a dose-response relationship, which suggests that these subjective symptoms are closely related to Yusho. Consistent high rates of complaints of general fatigue and eye discharge were considered possibly to be connected with Yusho, although no dose-response relationships have been determined. Other subjective symptoms, such as fever, headache, dizziness, abdominal pain, swelling in the joints, changes in menstruation, and loss of hair failed to show consistent dose-response relationships. It should be noted, however, that for these symptoms which failed to show dose-response relationships, it is impossible to deny a causal relationship.

  20. Walking ability after stroke in patients from Argentina: predictive values of two tests in subjects with subacute hemiplegia

    Science.gov (United States)

    Gatti, Marcelo Andrés; Portela, Manuel; Gianella, Matias; Freixes, Orestes; Fernández, Sergio Anibal; Rivas, Maria Elisa; Tanga, Cristobal Osvaldo; Olmos, Lisandro Emilio; Rubel, Ivan Federico

    2015-01-01

    [Purpose] This study aimed to determine the predictive values of the trunk control test (TCT) and functional ambulation category (FAC) for independent walking up to 6 months post stroke. [Subjects] Twenty-seven subjects with hemiplegia secondary to a unilateral hemisphere stroke were included. [Methods] The protocol was started at 45 days post stroke, with the TCT and FAC as walking predictors. At 90, 120, and 180 days post stroke, the subjects’ independent walking ability was assessed by using the Wald test. [Results] The TCT was identified as an independent predictor of ambulation at 90, 120, and 180 days. Subjects who scored ≥ 49 in the initial test had 93.8% probability of achieving independent gait at 6 months. The FAC proved that 100% of the subjects who scored 2 at 45 days post stroke walked independently at 90 days, 100% of the subjects who scored 1 walked independently at 120 days, and only 33.3% of the subjects who scored 0 walked independently at 180 days. [Conclusion] The TCT and FAC can predict independent walking at 45 days post stroke. In subjects with FAC 0, the TCT should be used to predict patients who will be able to walk independently. PMID:26504338

  1. Subjective health expectations of patients with age-related macular degeneration treated with antiVEGF drugs.

    Science.gov (United States)

    Péntek, Márta; Brodszky, Valentin; Biró, Zsolt; Kölkedi, Zsófia; Dunai, Árpád; Németh, János; Baji, Petra; Rencz, Fanni; Gulácsi, László; Resch, Miklós D

    2017-10-10

    Subjective expectations regarding future health may influence patients' judgement of current health and treatment effects, as well as adherence to therapies in chronic diseases. We aimed to explore subjective expectations on longevity and future health-related quality of life (HRQOL) of patients with age-related macular degeneration (AMD) treated with antiVEGF injections and analyse the influencing factors. Consecutive AMD patients in two ophthalmology centres were included. Demographics, clinical characteristics and informal care utilisation were recorded. Current health was evaluated by the EQ-5D generic health status questionnaire and time trade-off (TTO) methods. Happiness was measured on a visual analogue scale (VAS). Subjective life-expectancy and expected EQ-5D status at ages 70, 80 and 90 were surveyed. T-test was applied to compare subgroups and Pearson correlations were performed to analyse relationships between variables. One hundred twenty two patients were involved (females 62%) with a mean (SD) age of 75.2 (7.9) years and disease duration of 2.9 (2.5) years. The majority were in AREDS-4 state, the better eye's ETDRS was 64.7 (15.4). EQ-5D and TTO revealed moderate deterioration of health (0.66 vs. 0.72, p = 0.131), happiness VAS was 6.3 (2.2). Correlation between EQ-5D and ETDRS was moderate (R = 0.242, p Subjective life-expectancy did not differ significantly from statistical life-expectancy and had no significant impact on TTO. The self-estimated mean EQ-5D score was 0.60, 0.40 and 0.24 for ages 70, 80 and 90 which is lower than the population norm of age-groups 65-74, 75-84 and 85+ (0.77, 0.63 and 0.63, respectively). Age, gender, current EQ-5D, need for informal care and happiness were deterministic factors of subjective health expectations. AMD patients with antiVEGF treatment have comparable HRQOL as the age-matched general public but expect a more severe deterioration of health with age. Older patients with worse HRQOL have worse

  2. Dopamine D2-receptor affinity of antipsychotics in relation to subjective well-being in patients with a psychotic disorder.

    Science.gov (United States)

    de Wit, Iris E; van Dijk, Floor A; Meijer, Carin J; van Tricht, Mirjam J; de Haan, Lieuwe

    2017-09-01

    Dopamine D2-receptor blockade by antipsychotic medication reduces psychotic symptoms, but may reduce subjective well-being. The current study aims to further explore the relation between dopamine D2-receptor affinity and subjective well-being within a large sample of patients with psychotic disorders. Patients participated in a longitudinal naturalistic cohort study: the Genetic Risk and Outcome of Psychosis (GROUP) study. Three groups of antipsychotic medication were created on the basis of their affinity for the D2-receptor: (i) loose or partial agonistic binding, (ii) moderate binding, and (iii) tight binding. Subjective well-being was assessed using the Subjective Well-being under Neuroleptics scale (SWN) at baseline and the 3-year follow-up. In addition, we compared changes in SWN scores when switching to a more 'loose or partial agonistic' binding agent or to a 'tighter' binding agent between baseline and the 3-year follow-up. The final group included 388 patients at baseline and 290 at the 3-year follow-up. No significant differences in the SWN scores were found between the three affinity groups at baseline and the 3-year follow-up. In addition, analyses yielded no significant changes in SWN scores after switching to a more 'loose or partial agonistic' or more 'tight' binding antipsychotic agent. We did not find further support for the hypothesis that subjective well-being is associated with antipsychotics affinity for dopamine D2-receptors. This might imply that the effect of antipsychotic D2-receptors binding on subjective well-being is not large enough to be detected in this cross-sectional study. Other factors besides dopamine antagonism are probably more relevant for subjective well-being.

  3. Should nonalcoholic fatty liver disease be included in the definition of metabolic syndrome? A cross-sectional comparison with Adult Treatment Panel III criteria in nonobese nondiabetic subjects

    National Research Council Canada - National Science Library

    Musso, Giovanni; Gambino, Roberto; Bo, Simona; Uberti, Barbara; Biroli, Giampaolo; Pagano, Gianfranco; Cassader, Maurizio

    2008-01-01

    The ability of the Adult Treatment Panel III (ATP III) criteria of metabolic syndrome to identify insulin-resistant subjects at increased cardiovascular risk is suboptimal, especially in the absence of obesity and diabetes...

  4. A multimethod investigation including direct observation of 3751 patient visits to 120 dental offices

    Directory of Open Access Journals (Sweden)

    Stephen Wotman

    2010-05-01

    Full Text Available Stephen Wotman1, Catherine A Demko1, Kristin Victoroff1, Joseph J Sudano2, James A Lalumandier11Department of Community Dentistry, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA; 2Center of Health Care Research and Policy, Case Western Reserve University, School of Medicine, Cleveland, OH, USAAbstract: This report defines verbal interactions between practitioners and patients as core activities of dental practice. Trained teams spent four days in 120 Ohio dental practices observing 3751 patient encounters with dentists and hygienists. Direct observation of practice characteristics, procedures performed, and how procedure and nonprocedure time was utilized during patient visits was recorded using a modified Davis Observation Code that classified patient contact time into 24 behavioral categories. Dentist, hygienist, and patient characteristics were gathered by questionnaire. The most common nonprocedure behaviors observed for dentists were chatting, evaluation feedback, history taking, and answering patient questions. Hygienists added preventive counseling. We distinguish between preventive procedures and counseling in actual dental offices that are members of a practice-based research network. Almost a third of the dentist’s and half of the hygienist’s patient contact time is utilized for nonprocedure behaviors during patient encounters. These interactions may be linked to patient and practitioner satisfaction and effectiveness of self-care instruction.Keywords: dental practice, dental practice core activities, direct observation of dental practice, Dental Davis Observation Code, dentist, hygienist patient behaviors

  5. The reliability of the N400 in single subjects: Implications for patients with disorders of consciousness

    Science.gov (United States)

    Cruse, Damian; Beukema, Steve; Chennu, Srivas; Malins, Jeffrey G.; Owen, Adrian M.; McRae, Ken

    2014-01-01

    Functional neuroimaging assessments of residual cognitive capacities, including those that support language, can improve diagnostic and prognostic accuracy in patients with disorders of consciousness. Due to the portability and relative inexpensiveness of electroencephalography, the N400 event-related potential component has been proposed as a clinically valid means to identify preserved linguistic function in non-communicative patients. Across three experiments, we show that changes in both stimuli and task demands significantly influence the probability of detecting statistically significant N400 effects — that is, the difference in N400 amplitudes caused by the experimental manipulation. In terms of task demands, passively heard linguistic stimuli were significantly less likely to elicit N400 effects than task-relevant stimuli. Due to the inability of the majority of patients with disorders of consciousness to follow task commands, the insensitivity of passive listening would impede the identification of residual language abilities even when such abilities exist. In terms of stimuli, passively heard normatively associated word pairs produced the highest detection rate of N400 effects (50% of the participants), compared with semantically-similar word pairs (0%) and high-cloze sentences (17%). This result is consistent with a prediction error account of N400 magnitude, with highly predictable targets leading to smaller N400 waves, and therefore larger N400 effects. Overall, our data indicate that non-repeating normatively associated word pairs provide the highest probability of detecting single-subject N400s during passive listening, and may thereby provide a clinically viable means of assessing residual linguistic function. We also show that more liberal analyses may further increase the detection-rate, but at the potential cost of increased false alarms. PMID:24936429

  6. Profiles of Urine Drug Test in Clinical Pain Patients vs Pain Research Study Subjects.

    Science.gov (United States)

    Lee, Cheng-ting; Vo, Trang T; Cohen, Abigail S; Ahmed, Shihab; Zhang, Yi; Mao, Jianren; Chen, Lucy

    2016-04-01

    To examine similarities and differences in urine drug test (UDT) results in clinical pain patients and pain subjects participating in pain research studies. An observational study with retrospective chart review and data analysis. We analyzed 1,874 UDT results obtained from 1) clinical pain patients (Clinical Group; n = 1,529) and 2) pain subjects consented to participate in pain research studies (Research Group; n = 345). Since several medications such as opioids used in pain management are drugs of abuse (DOA) and can result in a positive UDT, we specifically identified those cases of positive UDT due to nonprescribed DOA and designated these cases as positive UDT with DOA (PUD). We found that 1) there was a higher rate of PUD in clinical pain patients (41.3%) than in pain research study subjects (14.8%); 2) although subjects in the Research Group were informed ahead of time that UDT will be conducted as a screening test, a substantial number (14.8%) of pain research study subjects still showed PUD; 3) there were different types of DOA between clinical pain patients (cannabinoids as the top DOA) and research study subjects (cocaine as the top DOA); and 4) a common factor associated with PUD was opioid therapy in both Clinical Group and Research Group. These results support previous findings that PUD is a common finding in clinical pain patients, particularly in those prescribed opioid therapy, and we suggest that UDT be used as routine screening testing in pain research studies. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Preoperative Serum Interleukin-6 Is a Potential Prognostic Factor for Colorectal Cancer, including Stage II Patients

    Directory of Open Access Journals (Sweden)

    Kazuyoshi Shiga

    2016-01-01

    Full Text Available Aims. To evaluate the prognostic significance of serum interleukin-6 (IL-6 in colorectal cancer (CRC. Patients and Methods. Preoperative serum IL-6 was measured in 233 CRC patients and 13 healthy controls. Relationships between IL-6 and various clinicopathological factors were evaluated, and the overall survival (OS and disease-free survival (DFS rates according to IL-6 status were calculated for all patients and according to disease stage. Results. The mean IL-6 level was 6.6 pg/mL in CRC patients and 2.6 pg/mL in healthy controls. Using a cutoff of 6.3 pg/mL, obtained using receiver operating characteristic curve analysis, 57 patients had a high IL-6 level. The mean value was higher for stage II disease than for stage III disease. IL-6 status correlated with C-reactive protein (CRP and carcinoembryonic antigen levels, obstruction, and pT4 disease. The OS differed according to the IL-6 status for all patients, whereas the DFS differed for all patients and for those with stage II disease. The Cox proportional hazards model showed that pT4 disease was an independent risk factor for recurrence in all CRC patients; IL-6, CRP, and pT4 were significant risk factors in stage II patients. Conclusions. The preoperative IL-6 level influences the risk of CRC recurrence.

  8. Effect of cigarette smoking on subgingival bacteria in healthy subjects and patients with chronic periodontitis

    OpenAIRE

    Karasneh, Jumana,; Al Habashneh, Rola ,; Marzouka, Nour Aldain,; Thornhill, Martin,

    2016-01-01

    Background Cigarette smoking is known to increase the risk of periodontal destruction and developing chronic periodontitis (CP). It is also reported to affect the subgingival bacterial profile among CP patients. However, studies on the effect of smoking on the bacterial profile among healthy subjects are still limited. Therefore, the aim of this study was to investigate the impact of smoking on the subgingival bacterial profile in both healthy adults and CP patients. Methods Subgingival plaqu...

  9. Frataxin mRNA Isoforms in FRDA Patients and Normal Subjects: Effect of Tocotrienol Supplementation

    OpenAIRE

    Provvidenza Maria Abruzzo; Marina Marini; Alessandra Bolotta; Gemma Malisardi; Stefano Manfredini; Alessandro Ghezzo; Antonella Pini; Gianluca Tasco; Rita Casadio

    2013-01-01

    Friedreich's ataxia (FRDA) is caused by deficient expression of the mitochondrial protein frataxin involved in the formation of iron-sulphur complexes and by consequent oxidative stress. We analysed low-dose tocotrienol supplementation effects on the expression of the three splice variant isoforms (FXN-1, FXN-2, and FXN-3) in mononuclear blood cells of FRDA patients and healthy subjects. In FRDA patients, tocotrienol leads to a specific and significant increase of FXN-3 expression while not a...

  10. Automated Romberg testing in patients with benign paroxysmal positional vertigo and healthy subjects.

    Science.gov (United States)

    Adelsberger, Rolf; Valko, Yulia; Straumann, Dominik; Tröster, Gerhard

    2015-01-01

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. The underlying pathomechanism responsible for the recurrent vertigo attacks has been elucidated in detail and highly effective treatment strategies (liberation maneuvers) have been developed. However, many BPPV patients complain about problems of balance especially following liberation maneuvers. To objectively demonstrate differences in balance performance in BPPV patients compared to healthy subjects both prior and after BPPV liberation maneuvers. Seven patients with BPPV of the posterior semicircular canal and nine healthy subjects participated. To assess balance while standing, we analyzed the location and temporal stability of the center of pressure recorded by pressure-sensitive electronic soles during Romberg testing (on stable ground and on foam) and tandem stand. To assess regularity of gait, we analyzed the step frequency during walking of 50 m. All tests were performed prior and after liberation maneuvers in both groups. Healthy subjects and patients differ significantly in their balance performance and use different stabilization strategies both prior and after liberation maneuvers. Both Romberg tests indicated poorer balance in BPPV patients (mean COP shifted towards toes), especially in posttreatment tests, while tandem stand appeared unaltered. We did not observe differences in escorted (by an experimenter) walking regularities between patients and healthy subjects and between pre- and post-maneuver testing. Our findings confirm the typical clinical observation of a further posttreatment deterioration of already impaired postural performance in BPPV patients. While the etiology and the time course of this peculiar problem warrants further studies, the treating physician should be familiar with this transient side effect of therapeutic maneuvers to provide adequate counseling of patients. Finally, we successully demonstrated the pressure-sensitive electronic soles as a

  11. Demoralization in opioid dependent patients : a comparative study with cancer patients and community subjects

    NARCIS (Netherlands)

    Jong, C.A.J. de; Kissane, D.W.; Geessink, R.J.; Velden, D. van der

    2008-01-01

    Aim: To study existential distress or demoralization expressed as meaninglessness and helplessness in opioid dependent patients. xxx Method: Comparison of existential distress between opioid dependent patients (n=131), patients with advanced cancer (n=100) and a community based sample without severe

  12. Quantitative electroencephalogram (QEEG Spectrum Analysis of Patients with Schizoaffective Disorder Compared to Normal Subjects.

    Directory of Open Access Journals (Sweden)

    Mahdi Moeini

    2014-12-01

    Full Text Available The aim of this study was to achieve a better understanding of schizoaffective disorder. Therefore, we obtained electroencephalogram (EEG signals from patients with schizoaffective disorder and analyzed them in comparison to normal subjects.Forty patients with schizoaffective disorder and 40 normal subjects were selected randomly and their electroencephalogram signals were recorded based on 10-20 international system by 23 electrodes in open- and closed-eyes while they were sitting on a chair comfortably. After preprocessing for noise removal and artifact reduction, we took 60- second segments from each recorded signals. Then, the absolute and relative powers of these segments were evaluated in all channels and in 4 frequency bands (i.e., delta, theta, alpha and beta waves. Finally, Data were analyzed by independent t-test using SPSS software.A significant decrease in relative power in the alpha band, a significant decrease in power spectra in the alpha band and a significant increase in power spectra in the beta band were found in patients compared to normal subjects (P < 0.05. The predominant wave in the centro-parietal region was the beta wave in patients, but it was the alpha band in normal subjects (P = 0.048. Also, the predominant wave of the occipital region in patients was the delta wave, while it was the alpha wave in normal subjects (P = 0.038.Considering the findings, particularly based on the significant decrease of the alpha waves in schizoaffective patients, it can be concluded that schizoaffective disorder can be seen in schizophrenia spectrum.

  13. Changes in six-minute walking distance during pulmonary rehabilitation in patients with COPD and in healthy subjects

    Directory of Open Access Journals (Sweden)

    Imen Ben Cheikh Rejbi

    2010-07-01

    Full Text Available Imen Ben Cheikh Rejbi1, Yassine Trabelsi1, Afef Chouchene1, Wafa Ben Turkia1, Helmi Ben Saad1, Abdelkarim Zbidi1, Abdelhamid Kerken2, Zouhair Tabka11Department of Physiology and Lung Testing, Faculty of Medicine of Sousse, Tunisia; 2Department of Biophysics, Faculty of Medicine of Monastir, TunisiaBackground: The six-minute walking distance (6MWD test has demonstrated validity and reliability to assess changes in functional capacity following pulmonary rehabilitation in patients with chronic obstructive lung disease. However, no attempt has been made to establish an iterative measurement of 6MWD during the overall period of pulmonary rehabilitation. Therefore, the aim of this study was to evaluate the impact of a twelve-week rehabilitation program on the iterative weekly measurement of 6MWD in chronic obstructive pulmonary disease (COPD patients and healthy subjects.Methods: Twenty-six patients with COPD and nine age-matched healthy subjects were studied. Measurements were taken at baseline and after twelve weeks except for the 6MWD. The exercise measurements included a six-minute walking test (6MWT and an incremental exercise test. Oxygen saturation, heart rate, and dyspnea will be monitored during all these tests. Results: At baseline there were significant differences between groups, except in age, body mass index, and oxygen saturation. After 12 weeks, there was no significant change in lung function in patients with COPD and healthy subjects. The 6MWD, peak oxygen uptake VO2peak and anaerobic threshold increased significantly after training in both groups (P < 0.01. The averaged trace of the 6MWD of patients with COPD and healthy subjects was followed-up respectively by a logarithmic and linear fitting. 6MWD showed a plateau after eight weeks in patients with COPD, however, it increased continually overall in healthy subjects.Conclusion: Both patients with COPD and healthy subjects demonstrated functional responses to training but with

  14. FKRP mutations, including a founder mutation, cause phenotype variability in Chinese patients with dystroglycanopathies.

    Science.gov (United States)

    Fu, Xiaona; Yang, Haipo; Wei, Cuijie; Jiao, Hui; Wang, Shuo; Yang, Yanling; Han, Chunxi; Wu, Xiru; Xiong, Hui

    2016-12-01

    Mutations in the fukutin-related protein (FKRP) gene have been associated with dystroglycanopathies, which are common in Europe but rare in Asia. Our study aimed to retrospectively analyze and characterize the clinical, myopathological and genetic features of 12 Chinese patients with FKRP mutations. Three patients were diagnosed with congenital muscular dystrophy type 1C (MDC1C) and nine patients were diagnosed with limb girdle muscular dystrophy type 2I (LGMD2I). Three muscle biopsy specimens had dystrophic changes and reduced glycosylated α-dystroglycan staining, and two showed reduced expression of laminin α2. Two known and 13 novel mutations were identified in our single center cohort. Interestingly, the c.545A>G mutation was found in eight of the nine LGMD2I patients as a founder mutation and this founder mutation in Chinese patients differs from the one seen in European patients. Moreover, patients homozygous for the c.545A>G mutation were clinically asymptomatic, a less severe phenotype than in compound heterozygous patients with the c.545A>G mutation. The 13 novel mutations of FKRP significantly expanded the mutation spectrum of MDC1C and LGMD2I, and the different founder mutations indicate the ethnic difference in FKRP mutations.

  15. Prevention of urinary tract infections with vitamin D supplementation 20,000 IU per week for five years. Results from an RCT including 511 subjects.

    Science.gov (United States)

    Jorde, Rolf; Sollid, Stina T; Svartberg, Johan; Joakimsen, Ragnar M; Grimnes, Guri; Hutchinson, Moira Y S

    2016-01-01

    In observational studies vitamin D deficiency is associated with increased risk of infections, whereas the effect of vitamin D supplementation in randomized controlled trials is non-conclusive. Five hundred and eleven subjects with prediabetes were randomized to vitamin D3 (20,000 IU per week) versus placebo for five years. Every sixth month, a questionnaire on respiratory tract infections (RTI) (common cold, bronchitis, influenza) and urinary tract infection (UTI) was filled in. Mean baseline serum 25-hydroxyvitamin D (25(OH)D) level was 60 nmol/L. Two hundred and fifty-six subjects received vitamin D and 255 placebo. One hundred and sixteen subjects in the vitamin D and 111 in the placebo group completed the five-year study. Eighteen subjects in the vitamin D group and 34 subjects in the placebo group reported UTI during the study (p vitamin D on UTI was unrelated to baseline serum 25(OH)D level. Supplementation with vitamin D might prevent UTI, but confirmatory studies are needed.

  16. Subjective Well-being of Primary Health Care Patients in the ...

    African Journals Online (AJOL)

    Background: Patients living with a chronic illness face many challenges in their lives such as an altered body image, physical pain or discomfort, the need for frequent medical visits and the negative side effects of treatment. To this extent their sense of personal or subjective well-being may be compromised by the severity ...

  17. Subjective consequences of permanent pacemaker therapy in patients under the age of retirement

    DEFF Research Database (Denmark)

    Mickley, H; Petersen, J; Nielsen, B L

    1989-01-01

    During a 5-year period, 81 patients ages 20 to 60 years old had implantation of a permanent cardiac pacemaker at the University Hospital, Odense. At follow-up, during 1985, the 73 survivors received a semi-structured questionnaire regarding subjective consequences of pacemaker therapy, and 72...

  18. Quinine pharmacokinetics: ototoxic and cardiotoxic effects in healthy Caucasian subjects and in patients with falciparum malaria

    NARCIS (Netherlands)

    Claessen, F. A.; van Boxtel, C. J.; Perenboom, R. M.; Tange, R. A.; Wetsteijn, J. C.; Kager, P. A.

    1998-01-01

    To study the pharmacokinetic behaviour of quinine in Caucasians with and without malaria. Quinine-dihydrochloride was administered intravenously as a single dose of 300 mg to 12 healthy subjects and as multiple doses of 600 mg in 4 h every 8 h in 10 patients with falciparum malaria. Plasma quinine

  19. Quality of life of healthy subjects and patients with arthritis and ...

    African Journals Online (AJOL)

    healthy subjects and hospital patients respectively and the data analyzed. Results: The highest mean overall .... developed for the cross-sectional design following published ... single (26.09± 2.82) as compared to those who are married (18.09 ...

  20. Subjective vs objective predictors of functional knee joint performance in anterior cruciate ligament-reconstructed patients

    DEFF Research Database (Denmark)

    Holsgaard-Larsen, Anders; Jensen, Carsten; Aagaard, Per

    2014-01-01

    BACKGROUND: Associations between objective and subjective measures of knee function may facilitate rehabilitation in ACL-patients. AIM: The aim of this study is to investigate if a test-battery of functional and/or muscle outcomes are associated with Knee osteoarthritis outcome score (KOOS) subsc...

  1. ERP effects of subject-verb agreement violations in patients with Broca's aphasia

    NARCIS (Netherlands)

    Wassenaar, M.E.D.; Brown, C.M.; Hagoort, P.

    2004-01-01

    This article presents electrophysiological data on on-line syntactic processing during auditory sentence comprehension in patients with Broca's aphasia. Event-related brain potentials (ERPs) were recorded from the scalp while subjects listened to sentences that were either syntactically correct or

  2. Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus

    NARCIS (Netherlands)

    van Dijk, M.; Donga, E.; van Dijk, J. G.; Lammers, G. J.; van Kralingen, K. W.; Dekkers, O. M.; Corssmit, E. P. M.; Romijn, J. A.

    2011-01-01

    Decreased sleep duration and/or impaired sleep quality negatively influence glucoregulation. The aim of this study was to assess subjective sleep characteristics in patients with type 1 diabetes, to relate sleep characteristics to long-term glycaemic control and to assess possible risk factors for

  3. Subjective assessment by patients of the efficiency of two denture adhesive pastes

    NARCIS (Netherlands)

    Kulak, Y.; Ozcan, M.; Arikan, A.

    2005-01-01

    : PURPOSE: This study evaluated the subjective responses of 30 denture wearers with regard to the effectiveness of two denture adhesive pastes. MATERIALS AND METHODS: Thirty patients responded to questions related to retention, chewing ability, taste, duration of adhesives in the mouth, and removal;

  4. Relationship between subjective fatigue and physiological variables in patients with chronic obstructive pulmonary disease

    NARCIS (Netherlands)

    Breukink, SO; Strijbos, JH; Koorn, M; Koeter, GH; Breslin, EH; Van der Schans, CP

    Patients with chronic illnesses, such as chronic obstructive pulmonary disease (COPD), report an increase in the perception of fatigue in the clinical setting. Subjective fatigue associated with physiological factors has not been reported. The purpose of this study was to determine the relationship

  5. Comparison of Subjective and Objective Physical Functions in Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Agwubike EO

    2011-07-01

    Full Text Available Purpose: To compare the subjective and objective physical function scores of patients with Chronic Low Back Pain (CLBP. Method: A cross- sectional survey design was used. Fifty-one patients with CLBP of mechanical origin were recruited from the physiotherapy out patient clinics of the University of Nigeria Teaching Hospital and the National Orthopedic Hospital both in Enugu, Nigeria. The box numerical scale, Roland-Morris Questionnaire (RMQ-24 and the Back Performance Scale (BPS were used to assess the present pain intensity, the subjective and objective functional status of the participants respectively. Pearson correlation was used to determine relationships. Multiple Regressions were used to determine the predictors of objective function. Alpha level was set at 0.5. Results: The mean age and Body Mass Index of the participants were 49.04 ± 14.33 years and 26.57 ± 4.29 kg/m2 respectively. The mean Pain Intensity, subjective disability (RMQ and objective disability (BPS scores were 6.33 ± 2.09, 9.76 ± 5.14 and 6.43 ± 2.9 respectively. Stepwise multiple regressions showed that when all the variables were entered only marital status was a significant predictor of objective physical function. Conclusion: There is no significant association between subjective and objective functions in patients with CLBP. However, marital status (married is a significant predictor of objective function in CLBP.

  6. Cerebral small-resistance artery structure and cerebral blood flow in normotensive subjects and hypertensive patients

    Energy Technology Data Exchange (ETDEWEB)

    De Ciuceis, Carolina; Porteri, Enzo; Rizzoni, Damiano; Boari, Gianluca E.M.; Rosei, Enrico Agabiti [University of Brescia, Clinica Medica, Department of Clinical and Experimental Sciences, Brescia (Italy); Cornali, Claudio; Mardighian, Dikran; Fontanella, Marco M. [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Pinardi, Chiara [Spedali Civili, Medical Physics Unit, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); Rodella, Luigi F.; Rezzani, Rita [University of Brescia, Section of Anatomy, Department of Clinical and Experimental Sciences, Brescia (Italy); Gasparotti, Roberto [University of Brescia, Section of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy); University of Brescia, Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Brescia (Italy)

    2014-12-15

    The aim of this study was to prospectively investigate whether the structure of cerebral small-resistance arteries is related to cerebral perfusion parameters as measured with dynamic susceptibility-weighted contrast magnetic resonance imaging (DSC-MRI) in a selected cohort of hypertensive and normotensive patients. Ten hypertensive and 10 normotensive patients were included in the study. All patients underwent neurosurgical intervention for an intracranial tumor and were investigated with DSC-MRI at 1.5 T. Cerebral small-resistance arteries were dissected from a small portion of morphologically normal cerebral tissue and mounted on an isometric myograph for the measurement of the media-to-lumen (M/L) ratio. A quantitative assessment of cerebral blood flow (CBF) and volume (CBV) was performed with a region-of-interest approach. Correlation coefficients were calculated for normally distributed variables. The institutional review board approved the study, and informed consent was obtained from all patients. Compared with normotensive subjects, hypertensive patients had significantly lower regional CBF (mL/100 g/min) in the cortical grey matter (55.63 ± 1.90 vs 58.37 ± 2.19, p < 0.05), basal ganglia (53.34 ± 4.39 vs 58.22. ± 4.33, p < 0.05), thalami (50.65 ± 3.23 vs 57.56 ± 4.45, p < 0.01), subcortical white matter (19.32 ± 2.54 vs 22.24 ± 1.9, p < 0.05), greater M/L ratio (0.099 ± 0.013 vs 0.085 ± 0.012, p < 0.05), and lower microvessel density (1.66 ± 0.67 vs 2.52 ± 1.28, p < 0.05). A statistically significant negative correlation was observed between M/L ratio of cerebral arteries and CBF in the cortical grey matter (r = -0.516, p < 0.05), basal ganglia (r = -0.521, p < 0.05), thalami (r = -0.527 p < 0.05), and subcortical white matter (r = -0.612, p < 0.01). Our results indicate that microvascular structure might play a role in controlling CBF, with possible clinical consequences. (orig.)

  7. Potential factors, including activities of daily living, influencing home discharge for patients with putaminal haemorrhage.

    Science.gov (United States)

    Maeshima, Shinichiro; Okamoto, Sayaka; Okazaki, Hideto; Mizuno, Shiho; Asano, Naoki; Maeda, Hirofumi; Masaki, Mitsuko; Matsuo, Hiroshi; Tsunoda, Tetsuya; Sonoda, Shigeru

    2016-02-01

    Convalescent rehabilitation wards assist stroke patients in acquiring skills for activities of daily living to increase the likelihood of home discharge. However, an improvement in activities of daily living does not necessarily imply that patients are discharged home. We investigated the characteristics of patients with putaminal haemorrhage who are discharged home following convalescence in rehabilitation wards. The sample comprised 89 patients (58 men and 31 women) with putaminal haemorrhage hospitalised in the convalescent rehabilitation ward of our hospital between August 2012 and July 2013. Their age ranged from 29 to 88 years (61.9 ± 11.9 years). The lesion occurred on the right side in 48 and on the left in 41 patients. The mean period from onset to hospitalisation in the convalescent rehabilitation ward was 30.8 ± 17.2 days, and the mean hospitalisation period was 70.7 ± 31.8 days. We examined age, sex, haematoma volume, duration from onset to hospitalisation, neurological symptoms, cognitive function, functional independence measure, number of cohabitating family members and whether the patient lived alone before stroke, and the relationship among these factors and discharge destination (home or facility/hospital) was assessed. The discharge destination was home for 71 and a facility or hospital for 18 patients. Differences were observed in age, haematoma volume, neurological symptoms, cognitive function, functional independence measure score on admission and discharge, number of cohabitating family members and whether the patient lived alone before stroke for patients discharged home. Patients who required long-term care and were discharged home were more likely to be living with family members who were present during daytime. Home discharge was possible if functional independence measure score was ≥70 at the time of discharge for motor items and ≥24 for cognitive items, even if a patient lived alone before stroke. Although the

  8. Midterm results of endovascular stent graft treatment for descending aortic aneurysms including high-risk patients

    Directory of Open Access Journals (Sweden)

    Gussmann, Andreas

    2006-04-01

    Full Text Available Methods: 21 patients (17 men, 4 women; mean age 66.1 years, range 29-90 years with 15 true aneurysms, and 6 type B-dissections were treated by implantation of a TalentTM Endoluminal Stentgraft System from February 2000 to July 2003. In 3 cases it was necessary to overstent the left subclavian artery, in 1 case to overstent the left common carotid. Results: 2 patients (9.5% died during the first 30 days (1 myocardial infarction, 1 pneumonia. Two patients (9.5% suffered from cerebral ischemia and needed revascularisation. No paraplegia, no stroke occurred. One endoleak required additional stenting. No patient needed conversion. Follow-up, average 25.4 months (range 0-39, was 100% complete. During this another two patients died of myocardial infarction i.e. 9.5% (the above mentioned endoleak, but no late migration were detected in the remaining patients. In all cases the graft lumen stayed patent. Conclusions: Treatment of descending thoracic aortic aneurysm with an endovascular approach has acceptable mortality and morbidity-rates even in high risk patients. Procedural overstenting of the subclavian artery requires subclavian revascularisation in a minority of cases.

  9. Clinical characteristics of Pneumocystis pneumonia in non-HIV patients and prognostic factors including microbiological genotypes

    Directory of Open Access Journals (Sweden)

    Ito Yutaka

    2011-03-01

    Full Text Available Abstract Background The number of patients with non-HIV Pneumocystis pneumonia (PCP is increasing with widespread immunosuppressive treatment. We investigated the clinical characteristics of non-HIV PCP and its association with microbiological genotypes. Methods Between January 2005 and March 2010, all patients in 2 university hospitals who had been diagnosed with PCP by PCR were enrolled in this study. Retrospective chart review of patients, microbiological genotypes, and association with 30-day mortality were examined. Results Of the 82 adult patients investigated, 50 patients (61% had inflammatory diseases, 17 (21% had solid malignancies, 12 (15% had hematological malignancies, and 6 (7% had received transplantations. All patients received immunosuppressive agents or antitumor chemotherapeutic drugs. Plasma (1→3 β-D-glucan levels were elevated in 80% of patients, and were significantly reduced after treatment in both survivors and non-survivors. However, β-D-glucan increased in 18% of survivors and was normal in only 33% after treatment. Concomitant invasive pulmonary aspergillosis was detected in 5 patients. Fifty-six respiratory samples were stored for genotyping. A dihydropteroate synthase mutation associated with trimethoprim-sulfamethoxazole resistance was found in only 1 of the 53 patients. The most prevalent genotype of mitochondrial large-subunit rRNA was genotype 1, followed by genotype 4. The most prevalent genotype of internal transcribed spacers of the nuclear rRNA operon was Eb, followed by Eg and Bi. Thirty-day mortality was 24%, in which logistic regression analysis revealed association with serum albumin and mechanical ventilation, but no association with genotypes. Conclusions In non-HIV PCP, poorer general and respiratory conditions at diagnosis were independent predictors of mortality. β-D-glucan may not be useful for monitoring the response to treatment, and genotypes were not associated with mortality.

  10. Pharmacokinetics and renal excretion of desmopressin after intravenous administration to healthy subjects and renally impaired patients

    Science.gov (United States)

    Agersø, Henrik; Seiding Larsen, Lotte; Riis, Anders; Lövgren, Ulf; Karlsson, Mats O; Senderovitz, Thomas

    2004-01-01

    Objective To evaluate the influence of renal impairment on the pharmacokinetics of desmopressin. Methods Twenty-four subjects were enrolled in the study, 18 with varying degrees of renal impairment and six healthy volunteers. Each subject received a single intravenous dose of 2 µg desmopressin. Blood and urine samples were collected for 24 h and assayed for desmopressin by radioimmunoassay. Plasma concentrations and the amounts of desmopressin excreted in the urine were analysed simultaneously by use of mixed effects modelling. Results Only mild adverse events were observed. Both the renal and the nonrenal clearance of desmopressin were found to vary with the creatinine clearance (CrCL). A decrease of 1.67% in the CrCL (corresponding to 1 ml min−1 from 60 ml min−1) was found to cause a 1.74% decrease in the renal clearance and a 0.93% decrease in the nonrenal clearance. The fall in renal clearance caused the amount of desmopressin excreted in urine to decrease from 47% in healthy subjects to 21% in the patients with severe renal impairment. The mean systemic clearance of desmopressin was 10 litres h−1 in healthy subjects and 2.9 litres h−1 in patients with severe renal impairment (difference −7.5 litres h−1, 95% CI [−11; −4.3] litres h−1). Correspondingly, the mean terminal half-life, was 3.7 h in healthy subjects and 10 h in patients with severe renal impairment (difference 6.7 h, 95% CI [4.0; 9.4] h). Conclusion Although desmopressin appears to be safe and well-tolerated by patients with impaired renal function, great caution should be exercised when titrating towards an efficient dosage regimen if patients with moderately or severely impaired renal function are to be treated with desmopressin at all. PMID:15373927

  11. Subjective experiences of occupational performance of activities of daily living in patients with mild stroke

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Postat, Annemette; Poulsen, Trine

    2014-01-01

    and risk of accidents. Conclusion: It is important to view the patients with mild stroke as heterogeneous, and consider post-stroke fatigue and emotional reactions when evaluating rehabilitation needs. Therefore, it is important to look further into structured tools, which examine how well the participant......Aim: To investigate the subjective experiences of occupational performance of activities of daily living (ADL) in patients with mild stroke. Methodology: Data was generated from January – December 2011 and consisted of 41 individual ADL-I interviews with patients in hospital and another 41...

  12. Separation of Parkinson's patients in early and mature stages from control subjects using one EOG channel

    DEFF Research Database (Denmark)

    Christensen, Julie A.E.; Frandsen, Rune; Kempfner, Jacob

    2012-01-01

    In this study, polysomnographic left side EOG signals from ten control subjects, ten iRBD patients and ten Parkinson's patients were decomposed in time and frequency using wavelet transformation. A total of 28 features were computed as the means and standard deviations in energy measures from...... different reconstructed detail subbands across all sleep epochs during a whole night of sleep. A subset of features was chosen based on a cross validated Shrunken Centroids Regularized Discriminant Analysis, where the controls were treated as one group and the patients as another. Classification...

  13. [Subjective quality of life in severely disabled long-stay schizophrenic patients].

    Science.gov (United States)

    Franz, Michael; Meyer, Thorsten; Gallhofer, Bernd

    2002-09-01

    In the controversy about severely chronic mental patients, who still reside in the psychiatric hospital after decades of deinstitutionalization, their quality of life (QoL) has become a main topic. On the basis of a critique of the dominant, mere standardized approach to QoL this method is compared with a qualitative approach in such a schizophrenic "residual" patient group (n = 144). While in the standardized approach a high level of subjective QoL could be found that correlated positively with the duration of hospitalisation, the open interviews yielded specific experiences of deficiencies. The appraisal of the quality of life especially of chronic or hospitalized patients is reconsidered.

  14. Sacral nerve stimulation for faecal incontinence in patients with previous partial spinal injury including disc prolapse.

    Science.gov (United States)

    Jarrett, M E D; Matzel, K E; Christiansen, J; Baeten, C G M I; Rosen, H; Bittorf, B; Stösser, M; Madoff, R; Kamm, M A

    2005-06-01

    This study examined the use of sacral nerve stimulation (SNS) to treat faecal incontinence in patients with partial spinal injury. Patients selected for SNS had experienced more than one episode of faecal incontinence per week to liquid or solid stool for more than 1 year and had failed maximal conservative treatment. All patients had an intact external anal sphincter. Temporary SNS was performed in 13 patients (median age 58.5 (range 39-73) years). The spinal insults were disc prolapse (six), trauma (four), spinal stenosis (one) or occurred during neurosurgery (two). Twelve patients (eight women and four men) had successful temporary stimulation and proceeded to permanent implantation. The median follow-up time was 12 (range 6-24) months. The mean(s.d.) number of episodes of incontinence decreased from 9.33(7.64) per week at baseline to 2.39(3.69) at last follow-up (P = 0.012). The number of days per week with incontinence and staining decreased significantly (both P < 0.001). Ability to defer defaecation improved from a median of not being able to defer (range 0-1 min) to being able to defer for 5-15 (range 0 to over 15) min (P = 0.022). SNS can benefit patients with faecal incontinence following partial spinal injury. Copyright (c) 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  15. Effect of cognitive behavioral therapy on subjective well-being of patients with cardiovascular diseases

    Directory of Open Access Journals (Sweden)

    Sara Karimi

    2014-06-01

    Full Text Available Background: The cardiovascular diseases are as a chronic diseases. can naturally decrease the patients' mental health. Subjective well-being is one of the main components of life quality whose existence is essential for having a happy life and mental health. The present study was carried out to investigate the efficacy of cognitive behavioral therapy in the subjective well-being of the patients with cardiovascular diseases. Methods: Among all patients with cardiovascular diseases who had been admitted in Imam Ali Hospital of Kermanshah in May and June, 2013, 32 patients were selected through voluntary sampling and randomly divided into control and experimental groups.The intervention consisted of 10 weekly sessions (each session for 1.5 hours of cognitive behavioral therapy for the experimental group while the control group received the routine medical care. For data collection, the life satisfaction tools (Diner 1985 and positive and negative affect schedule (Watson 1988 were used. The results were analyzed by the statistical test of covariance analysis. Results: The results showed a significant increase in life satisfaction and positive affect for the experimental group compared to the control group (P<0.05 and a significant decrease in negative affect (P<0.05. Conclusion: The Cognitive Behavioral Therapy (CBT increased the subjective well-being of the patients with cardiovascular diseases.

  16. Relationships of Muscle Function and Subjective Knee Function in Patients After ACL Reconstruction.

    Science.gov (United States)

    Bodkin, Stephan; Goetschius, John; Hertel, Jay; Hart, Joe

    2017-07-01

    After anterior cruciate ligament reconstruction (ACLR), relationships between objective measures of muscle function and patient-reported outcomes may change over time. Examining these measures at different time frames after surgery may help develop individualized approaches to improve post-ALCR analysis. To examine the associations between subjective knee function and lower-extremity muscle function in individual patients at various time points after ACLR. Descriptive laboratory study. Fifty-one participants who underwent primary, unilateral ACLR (15 males, 36 females; mean age, 22.9 ± 4.5 years; mean height, 172.4 ± 10.1 cm; mean weight, 68.7 ± 13.1 kg) were separated into 3 groups depending on time since surgery (early, 5 years). Subjective knee function was quantified using the International Knee Documentation Committee (IKDC) subjective knee form and the Knee injury and Osteoarthritis Outcome Score (KOOS). Isometric knee extension and flexion strength were collected at 90 deg/s. Single-leg hop performance was measured using the single hop, triple hop, cross-over hop, and 6-m timed hop. Coefficient correlations were calculated between subjective knee function and objective measures of muscle function for each group. The early group demonstrated moderate correlations between the KOOS and unilateral measures of flexion peak torque (r = 0.514, P = .035) and flexion power (r = 0.54, P = .027). The middle group demonstrated the strongest correlations between the KOOS and symmetry measures of the single hop (r = 0.69, P = .002) and extension work (r = 0.71, P = .002) as well as unilateral measures of the triple hop (r = 0.52, P = .034) and extension work (r = 0.66, P = .004). The late group demonstrated strong correlations between the 6-m timed hop symmetry and the IKDC (r = 0.716, P = .001) and KOOS (r = 0.71, P = .001). Patients with a post-ACLR status of less than 2 years exhibited stronger relationships with unilateral strength measures to subjective function

  17. Should nonalcoholic fatty liver disease be included in the definition of metabolic syndrome? A cross-sectional comparison with Adult Treatment Panel III criteria in nonobese nondiabetic subjects.

    Science.gov (United States)

    Musso, Giovanni; Gambino, Roberto; Bo, Simona; Uberti, Barbara; Biroli, Giampaolo; Pagano, Gianfranco; Cassader, Maurizio

    2008-03-01

    The ability of the Adult Treatment Panel III (ATP III) criteria of metabolic syndrome to identify insulin-resistant subjects at increased cardiovascular risk is suboptimal, especially in the absence of obesity and diabetes. Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance and is emerging as an independent cardiovascular risk factor. We compared the strength of the associations of ATP III criteria and of NAFLD to insulin resistance, oxidative stress, and endothelial dysfunction in nonobese nondiabetic subjects. Homeostasis model assessment of insulin resistance (HOMA-IR) >2, oxidative stress (nitrotyrosine), soluble adhesion molecules (intracellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin), and circulating adipokines (tumor necrosis factor-alpha, leptin, adiponectin, and resistin) were cross-sectionally correlated to ATP III criteria and to NAFLD in 197 unselected nonobese nondiabetic subjects. NAFLD more accurately predicted insulin resistance than ATP III criteria: sensitivity 73 vs. 38% (P = 0.0001); positive predictive value: 81 vs. 62% (P = 0.035); negative predictive value 87 vs. 74% (P = 0.012); positive likelihood ratio 4.39 vs. 1.64 (P = 0.0001); and negative likelihood ratio 0.14 vs. 0.35 (P = 0.0001). Adding NAFLD to ATP III criteria significantly improved their diagnostic accuracy for insulin resistance. Furthermore, NAFLD independently predicted HOMA-IR, nitrotyrosine, and soluble adhesion molecules on logistic regression analysis; the presence of NAFLD entailed more severe oxidative stress and endothelial dysfunction, independent of adiposity or any feature of the metabolic syndrome in insulin-resistant subjects. NAFLD is more tightly associated with insulin resistance and with markers of oxidative stress and endothelial dysfunction than with ATP III criteria in nonobese nondiabetic subjects and may help identify individuals with increased cardiometabolic risk in this population.

  18. Subjective sleep quality in stable neuromuscular patients under non-invasive ventilation.

    Science.gov (United States)

    Crescimanno, Grazia; Misuraca, Angela; Purrazzella, Giuseppina; Greco, Francesca; Marrone, Oreste

    2014-10-01

    Patients with neuromuscular diseases improve their sleep when treated with noninvasive ventilation (NIV), but their sleep architecture during NIV may still be disturbed by side effects of NIV or inadequacy of the ventilator setting. Little is known about subjective sleep quality during NIV. The aims of this study were to evaluate subjective sleep quality of stable neuromuscular patients under long-term NIV by using Pittsburgh questionnaire (PSQI), and to assess its possible determinants. Fifty stable neuromuscular patients under long-term NIV were administered PSQI and underwent polysomnography. Arterial blood gases, forced vital capacity, and respiratory muscular strength were measured. Thirty-three patients had global PSQI ≥ 5 and were classified as bad sleepers. Good and poor sleepers differed in age (P = 0.005), base excess (BE) (P = 0.02), NIV inspiratory pressure (P = 0.04), %N1 (P = 0.0006), and %N3 sleep stage (P = 0.02). Percent N3 duration and Arousal/Awakening Index were correlated with rate of patient-ventilator asynchronies (r = -0.41 and 0.37, respectively, P sleep quality is often poor in neuromuscular patients under long-term NIV. Amount of slow wave sleep and chronic hypoventilation resulting in increased BE are independent predictors of subjective sleep quality. Since inadequate NIV setting or application can influence sleep structure and alveolar ventilation, great care should be paid to the setting and the correct application of NIV to ensure a better subjective sleep quality. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. The relationship between patients' knowledge of diabetes therapeutic goals and self-management behaviour, including adherence.

    Science.gov (United States)

    Waheedi, Mohammad; Awad, Abdelmoneim; Hatoum, Hind T; Enlund, Hannes

    2017-02-01

    Background The Middle East region has one the highest prevalence rates of diabetes in the world. Little is known about the determinants of adherence and the role of knowledge in diabetes self-management within these populations. Objective To investigate the relationship between patients knowledge of diabetes therapeutic targets with adherence to self-care measures in a sample of patients with type 2 diabetes in Kuwait. Setting Primary care chronic care clinics within the Ministry of Health of Kuwait. Methods A cross sectional survey was carried out with 238 patients from six clinics. A multistage stratified clustered sampling method was used to first randomly select the clinics and the patients. Self-reported adherence to three behaviours: medication taking, diet and physical activity. Results Respondents were able to correctly report a mean (SD) of 1.6 (1.3) out of 5 of the pre-specified treatment targets. Optimal adherence to physical activity, diet and medications was reported in 25, 33 and 47 % of the study cohort, respectively. A structural equation model analysis showed better knowledge of therapeutic goals and own current levels translated into better adherence to medications, diet and physical activity. Conclusion Knowledge of therapeutic goals and own recent levels is associated with adherence to medications, diet, or physical activity in this Kuwaiti cohort of patients with diabetes. Low adherence to self-care management and poor overall knowledge of diabetes is a big challenge to successful diabetes care in Kuwait.

  20. [Proteinase activity in Candida albicans strains isolated from the oral cavity of immunocompromised patients, with oral candidiasis and in healthy subjects].

    Science.gov (United States)

    Hernández-Solís, Sandra E; Rueda-Gordillo, Florencio; Rojas-Herrera, Rafael A

    2014-01-01

    Candida albicans has a variety of virulence factors, including secreted aspartyl proteases, which are determinant factors in the pathogenesis of this yeast in immunocompromised patients. Proteinase activity was identified in C. albicans strains isolated from the oral cavity of immunocompromised patients with cancer, diabetes and HIV+, with oral candidiasis and in healthy subjects. Two hundred and fifty C. albicans strains were analyzed, distributed in 5 different groups: patients with cancer, diabetes, HIV+, with oral candidiasis and healthy subjects. Proteolytic activity was identified in 46% of the strains from cancer patients, 54% from HIV+ patients, 60% from diabetics, 70% from oral candidiasis patients, and 42% from healthy subjects. Activity was higher in strains from immunocompromised and oral candidiasis patients than in healthy subjects. Differences were observed between the candidiasis-healthy, candidiasis-HIV+, and diabetic-healthy groups. No differences were observed between the oral candidiasis, diabetes and cancer patients, between the diabetes and HIV+ patients, or between the cancer patients, HIV+ patients and healthy subjects. The present results suggest that although secreted aspartyl proteases are important in the pathogenesis of C. albicans, their activity depends on host conditions. Copyright © 2012 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  1. Antibiotic susceptibility of staphylococci isolates from patients with chronic conjunctivitis: including associated factors and clinical evaluation.

    Science.gov (United States)

    Blanco, Claudia; Núñez, María Ximena

    2013-11-01

    To determine species of staphylococci in chronic conjunctivitis, their antibiotic susceptibility pattern, patient treatments, clinical course, and clinical conditions. In this prospective study, 243 conjunctival cultures were taken from 191 patients with chronic conjunctivitis, we obtained staphylococci susceptibility patterns with E-test, and they were analyzed in coagulase-positive and negative. The minimum inhibitory concentration for 90% of isolates (MIC90) was determined for Staphylococcus aureus and Staphylococcus epidermidis. Additionally, clinical follow-up and associated factors of all patients were analyzed depending on methicillin resistance (MR) or susceptibility (MS) bacterial state. One hundred and eight (44%) cultures were positive; 81 positive cultures were Gram-positive of which, 77 were staphylococci, 29 coagulase-positive with S. aureus as the most prevalent, 89% MS, and 11% MR. And 48 were coagulase-negative with S. epidermidis as the most isolated with 36% of MS and 64% of MR. Poor susceptibility was found in the staphylococcus coagulase-negative/MR group. Moxifloxacin and vancomycin show the best in vitro activity for all isolates. The MIC90 of moxifloxacin and vancomycin were 0.064/1.5, 0.64/3.0, and 1/3.0 for S. aureus-MS, S. epidermidis-MS, and S. epidermidis-MR, respectively. The most frequently associated factors found in patients with positive culture for staphylococcus were exposure to the health care system 23 (29.87%) of 77 patients and dry eye 23 (29.87%) of 77 patients. Both with a proportion of 3 in 10. Coagulase-negative staphylococci were the most frequently isolated from the conjunctiva with 58.33% of MR; even though multiresistance was detected, their susceptibility to a fourth-generation fluoroquinolone, commonly used, such as moxifloxacin, was preserved.

  2. [Predict factors associated with malnutrition from patient generated subjective global assessment (PG-SGA) in head and neck cancer patients].

    Science.gov (United States)

    Arribas, L; Hurtós, L; Milà, R; Fort, E; Peiró, I

    2013-01-01

    Patient Generated Subjective Global Assessment (PG-SGA) is a validated tool for nutrition evaluation in patients with cancer. The aim of our study was to estimate the prevalence of malnutrition in head and neck cancer patients at diagnosis and evaluate the independent prognostic factors for malnutrition from PG-SGA. All outpatients attending at the Head and Neck Cancer Multidisciplinary Meeting for primary diagnosis, staging and treatment were evaluated by an oncology dietitian using the patient generated subjective global assessment (PG-SGA). Patients with recurrences or secondary tumours will be excluded. 64 patients were evaluated (55 men and 9 women) with an average age of 63 years and body mass index (BMI) of 25.3 kg/m(2) (SD ± 5.18). After the nutritional assessment we observed that 43.8% of patients were malnourished or at risk of malnutrition. The most frequent symptom at diagnosis was dysphagia (48.4%) and anorexia (26.6%). From PG-SGA, the main prognostic factors (p<0,001) were the percentage of weight loss, serum albumin levels, BMI and the presence of dysphagia or/and anorexia prior diagnosis. Parameters as BMI, weight loss and low albumin levels at the time of diagnosis in head and neck cancer patients are independent predictors for malnutrition as well as the presence of anorexia or dysphagia.reaffirms the need for sustainability of interventions over time. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  3. [Spanish patients with central hypoventilation syndrome included in the European Registry. The 2015 data].

    Science.gov (United States)

    García Teresa, María Angeles; Porto Abal, Raquel; Rodríguez Torres, Silvia; García Urabayen, Diego; García Martínez, Silvia; Trang, Ha; Campos Barros, Angel; Llorente de la Fuente, Ana; Hernández González, Arturo; Bustinza Arriortua, Amaya; de la Cruz Moreno, Jesús; Pons Odena, Martí; Ventura Faci, Purificación; Rubio Ortega, Laura; Pérez Ruiz, Estela; Aguilar Fernández, Antonio; Pérez Ocón, Amaya; Osona, Borja; Delgado Pecellin, Isabel; Arroyo Carrera, Ignacio; Sayas Catalán, Javier; González Salas, Elvira; de Vicente, Carlos Martin

    2017-05-01

    Congenital Central Hypoventilation Syndrome (CCHS) is a very rare genetic disease. In 2012 the European Central Hypoventilation Syndrome (EuCHS) Consortium created an online patient registry in order to improve care. To determine the characteristics and outcomes of Spanish patients with CCHS, and detect clinical areas for improvement. An assessment was made on the data from Spanish patients in the European Registry, updated on December 2015. The Registry contained 38 patients, born between 1987 and 2013, in 18 hospitals. Thirteen (34.2%) were older than 18 years. Three patients had died. Genetic analysis identified PHOX2B mutations in 32 (86.5%) out of 37 patients assessed. The 20/25, 20/26 and 20/27 polyalanine repeat mutations (PARMs) represented 84.3% of all mutations. Longer PARMs had more, as well as more severe, autonomic dysfunctions. Eye diseases were present in 47%, with 16% having Hirschsprung disease, 13% with hypoglycaemia, and 5% with tumours. Thirty patients (79%) required ventilation from the neonatal period onwards, and 8 (21%) later on in life (late onset/presentation). Eight children (21%) were using mask ventilation at the first home discharge. Five of them were infants with neonatal onset, two of them, both having a severe mutation, were switched to tracheostomy after cardiorespiratory arrest at home. Approximately one-third (34.3%) of patients were de-cannulated and switched to mask ventilation at a mean age of 13.7 years. Educational reinforcement was required in 29.4% of children attending school. The implementation of the EuCHS Registry in Spain has identified some relevant issues for optimising healthcare, such as the importance of genetic study for diagnosis and assessment of severity, the high frequency of eye disease and educational reinforcement, as well as some limitations in ventilatory techniques. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast

    DEFF Research Database (Denmark)

    Nilsson, Anne C; Ostman, Elin M; Holst, Jens Juul

    2008-01-01

    tolerance and related variables after a subsequent standardized breakfast in healthy subjects (n = 15). At breakfast, blood was sampled for 3 h for analysis of blood glucose, serum insulin, serum FFA, serum triacylglycerides, plasma glucagon, plasma gastric-inhibitory peptide, plasma glucagon-like peptide-1...... (GLP-1), serum interleukin (IL)-6, serum IL-8, and plasma adiponectin. Satiety was subjectively rated after breakfast and the gastric emptying rate (GER) was determined using paracetamol as a marker. Breath hydrogen was measured as an indicator of colonic fermentation. Evening meals with barley kernel......-kernel bread compared with WWB. Breath hydrogen correlated positively with satiety (r = 0.27; P metabolic risk variables at breakfast...

  5. Reproducibility and responsiveness of a noninvasive EMG technique of the respiratory muscles in COPD patients and in healthy subjects

    NARCIS (Netherlands)

    Duiverman, ML; van Eykern, LA; Vennik, PW; Koeter, GH; Maarsingh, EJW; Wijkstra, PJ

    2004-01-01

    In the present study, we assessed the reproducibility and responsiveness of transcutaneous electromyography (EMG) of the respiratory muscles in patients with chronic obstructive pulmonary disease ( COPD) and healthy subjects during breathing against an inspiratory load. In seven healthy subjects and

  6. Management recommendations for invasive dental treatment in patients using oral antithrombotic medication, including novel oral anticoagulants

    NARCIS (Netherlands)

    van Diermen, D.E.; van der Waal, I.; Hoogstraten, J.

    2013-01-01

    Objective The aims were (1) to search the scientific literature from 2007 to 2012 for guidelines and new studies on the dental management of patients using oral antithrombotic medication; (2) to summarize the articles' evidence and recommendations; and (3) to propose an updated clinical practice

  7. Twenty patients including 7 probands with autosomal dominant cutis laxa confirm clinical and molecular homogeneity

    NARCIS (Netherlands)

    Hadj-Rabia, Smail; Callewaert, Bert L.; Bourrat, Emmanuelle; Kempers, Marlies; Plomp, Astrid S.; Layet, Valerie; Bartholdi, Deborah; Renard, Marjolijn; de Backer, Julie; Malfait, Fransiska; Vanakker, Olivier M.; Coucke, Paul J.; de Paepe, Anne M.; Bodemer, Christine

    2013-01-01

    Elastin gene mutations have been associated with a variety of phenotypes. Autosomal dominant cutis laxa (ADCL) is a rare disorder that presents with lax skin, typical facial characteristics, inguinal hernias, aortic root dilatation and pulmonary emphysema. In most patients, frameshift mutations are

  8. Measuring executive function in control subjects and TBI patients with question completion time (QCT).

    Science.gov (United States)

    Woods, David L; Yund, E William; Wyma, John M; Ruff, Ron; Herron, Timothy J

    2015-01-01

    Questionnaire completion is a complex task that places demands on cognitive functions subserving reading, introspective memory, decision-making, and motor control. Although computerized questionnaires and surveys are used with increasing frequency in clinical practice, few studies have examined question completion time (QCT), the time required to complete each question. Here, we analyzed QCTs in 172 control subjects and 31 patients with traumatic brain injury (TBI) who completed two computerized questionnaires, the 17-question Post-Traumatic Stress Disorder (PTSD) Checklist (PCL) and the 25-question Cognitive Failures Questionnaire (CFQ). In control subjects, robust correlations were found between self-paced QCTs on the PCL and CFQ (r = 0.82). QCTs on individual questions correlated strongly with the number of words in the question, indicating the critical role of reading speed. QCTs increased significantly with age, and were reduced in females and in subjects with increased education and computer experience. QCT z-scores, corrected for age, education, computer use, and sex, correlated more strongly with each other than with the results of other cognitive tests. Patients with a history of severe TBI showed significantly delayed QCTs, but QCTs fell within the normal range in patients with a history of mild TBI. When questionnaires are used to gather relevant patient information, simultaneous QCT measures provide reliable and clinically sensitive measures of processing speed and executive function.

  9. Quantitative electroencephalogram (QEEG) Spectrum Analysis of Patients with Schizoaffective Disorder Compared to Normal Subjects.

    Science.gov (United States)

    Moeini, Mahdi; Khaleghi, Ali; Amiri, Nasrin; Niknam, Zahra

    2014-10-01

    The aim of this study was to achieve a better understanding of schizoaffective disorder. Therefore, we obtained electroencephalogram (EEG) signals from patients with schizoaffective disorder and analyzed them in comparison to normal subjects. Forty patients with schizoaffective disorder and 40 normal subjects were selected randomly and their electroencephalogram signals were recorded based on 10-20 international system by 23 electrodes in open- and closed-eyes while they were sitting on a chair comfortably. After preprocessing for noise removal and artifact reduction, we took 60- second segments from each recorded signals. Then, the absolute and relative powers of these segments were evaluated in all channels and in 4 frequency bands (i.e., delta, theta, alpha and beta waves). Finally, Data were analyzed by independent t-test using SPSS software. A significant decrease in relative power in the alpha band, a significant decrease in power spectra in the alpha band and a significant increase in power spectra in the beta band were found in patients compared to normal subjects (P schizoaffective patients, it can be concluded that schizoaffective disorder can be seen in schizophrenia spectrum.

  10. Palliative sedation for cancer patients included in a home care program: a retrospective study.

    Science.gov (United States)

    Calvo-Espinos, Claudio; Ruiz de Gaona, Estefania; Gonzalez, Cristina; Ruiz de Galarreta, Lucia; Lopez, Cristina

    2015-06-01

    Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting. We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients. A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members. Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

  11. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Sasa Nie

    2017-10-01

    Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

  12. Handgrip dynamometry and patient-generated subjective global in patients with non-resectable lung cancer

    OpenAIRE

    Barata, A. T.; Santos, C.; Cravo, M; Vinhas, M. D. C.; Morais, C; Carolino, Elisabete; Vieira, J. Roldão; FONSECA, J

    2015-01-01

    Rationale: Undernutrition is frequently associated with advanced lung cancer. Accurate nutritional assessment tools are important to provide the proper nutritional therapy. Hand grip strength (HGS) has already been used in these patients and the findings suggest it is a good indicator of nutritional status. The aim of this study was to evaluate the association between nutritional status and hand grip strength in patients with nonresectable lung cancer.

  13. Functional networks of motor inhibition in conversion disorder patients and feigning subjects

    Directory of Open Access Journals (Sweden)

    Thomas Hassa

    2016-01-01

    Full Text Available The neural correlates of motor inhibition leading to paresis in conversion disorder are not well known. The key question is whether they are different of those of normal subjects feigning the symptoms. Thirteen conversion disorder patients with hemiparesis and twelve healthy controls were investigated using functional magnetic resonance tomography under conditions of passive motor stimulation of the paretic/feigned paretic and the non-paretic hand. Healthy controls were also investigated in a non-feigning condition. During passive movement of the affected right hand conversion disorder patients exhibited activations in the bilateral triangular part of the inferior frontal gyri (IFG, with a left side dominance compared to controls in non-feigning condition. Feigning controls revealed for the same condition a weak unilateral activation in the right triangular part of IFG and an activity decrease in frontal midline areas, which couldn't be observed in patients. The results suggest that motor inhibition in conversion disorder patients is mediated by the IFG that was also involved in inhibition processes in normal subjects. The activity pattern in feigning controls resembled that of conversion disorder patients but with a clear difference in the medial prefrontal cortex. Healthy controls showed decreased activity in this region during feigning compared to non-feigning conditions suggesting a reduced sense of self-agency during feigning. Remarkably, no activity differences could be observed in medial prefrontal cortex for patients vs healthy controls in feigning or non-feigning conditions suggesting self-agency related activity in patients to be in between those of non-feigning and feigning healthy subjects.

  14. Remote ischemic conditioning improves coronary microcirculation in healthy subjects and patients with heart failure

    Directory of Open Access Journals (Sweden)

    Kono Y

    2014-08-01

    Full Text Available Yasushi Kono,1 Shota Fukuda,1 Akihisa Hanatani,2 Koki Nakanishi,2 Kenichiro Otsuka,2 Haruyuki Taguchi,1 Kenei Shimada2 1Department of Medicine, Osaka Ekisaikai Hospital, Osaka, Japan; 2Department of Internal Medicine and Cardiology, Osaka City University School of Medicine, Osaka, Japan Background: Remote ischemic conditioning (RIC is a treatment modality that suppresses inflammation and improves endothelial function, which are factors involved in the pathogenesis of heart failure (HF with reduced left ventricular ejection fraction. Coronary flow reserve (CFR is a physiological index of coronary microcirculation and is noninvasively measured by transthoracic Doppler echocardiography (TTDE. This study aimed to investigate the effects of RIC on CFR in healthy subjects and patients with HF, through the assessment by TTDE. Methods: Ten patients with HF with left ventricular ejection fraction of less than 40%, and ten healthy volunteers were enrolled in this study. RIC treatment was performed twice a day for 1 week. Our custom-made RIC device was programmed to automatically conduct 4 cycles of 5 minutes inflation and 5 minutes deflation of a blood pressure cuff to create intermittent arm ischemia. CFR measurements and laboratory tests were examined before, and after 1 week of RIC treatment. Results: One week of RIC treatment was well tolerated in both groups. RIC treatment increased CFR from 4.0±0.9 to 4.6±1.3 (mean ± standard deviation in healthy subjects (P=0.02, and from 1.9±0.4 to 2.3±0.7 in patients with HF (P=0.03, respectively. Systolic blood pressure in healthy subjects, and heart rate in HF patients decreased after RIC treatment (both P<0.01. Conclusion: This study demonstrated that a 1 week course of RIC treatment improved coronary microcirculation in healthy subjects and patients with HF associated with reduced left ventricular ejection fraction. Keyword: echocardiography, coronary flow reserve, heart failure, preconditioning

  15. Body Experience and Mirror Behaviour in Female Eating Disorders Patients and non Clinical Subjects

    Directory of Open Access Journals (Sweden)

    Michel Probst

    2008-12-01

    Full Text Available Recently the attention for mirror exercises in therapies targeted specifically to body experience concerns has increased. This retrospective study will explore the mirror behaviour of anorexia nervosa (AN, bulimia nervosa (BN and non-clinical female subjects (CG and investigate whether mirror avoidance or checking are related to negative body experiences.The group of eating disorders consisted of 560 AN and 314 BN patients. The control group consisted of 1151 female subjects. The Body Attitude Test and the Eating Disorder Inventory subscales drive for thinness and body dissatisfaction were used. To explore the mirror behaviour, one item of the Body Attitude Test ‘I am observing my appearance in the mirror’ was used. Nonparametric analyses (Spearman rho correlations, Kruskal-Wallis and Mann Whitney test were used because of the categorical data.BN patients observed their body more often in the mirror than AN patients and the control subjects do. Age and BMI showed no significant main effect of mirror frequency. The relation between the frequency of mirror behaviour and body experience were significant but low (under .40. AN patients and control subjects with a mirror checking behaviour had a more negative body experience than those with mirror avoidance behaviour. In the BN group, no differences were found.There is support to integrate mirror exercises in a treatment of eating disorder patients. From a clinical point, mirror exercises are preferably combined with a body oriented therapy within a multidimensional cognitive behavioural approach. Recommendations for mirror exercises based on the clinical experience are given.

  16. A protective effect of the BDNF Met/Met genotype in obesity in healthy Caucasian subjects but not in patients with coronary heart disease.

    Science.gov (United States)

    Sustar, A; Nikolac Perkovic, M; Nedic Erjavec, G; Svob Strac, D; Pivac, N

    2016-08-01

    Brain-derived neurotrophic factor (BDNF) is a neurotrophic factor with an important role in the regulation of body weight, body mass index (BMI) and obesity. Increased BMI that leads to obesity is a substantial risk factor for coronary heart disease (CHD). The functional BDNF Val66Met polymorphism (rs6265) has been associated with CHD, obesity and BMI. The aim of the study was to determine the association between BDNF rs6265 polymorphism and CHD and/or BMI in patients with CHD and healthy control subjects. The study included 704 Caucasian subjects: 206 subjects with CHD and 498 healthy control subjects. The BDNF rs6265 genotype frequency was similar in male and female subjects, and there were no differences in the frequency of the BDNF rs6265 genotypes in 206 patients with CHD and in 498 healthy subjects. When study participants were subdivided according to the BMI categories into normal weight, overweight and obese subjects, significantly different BDNF rs6265 genotype frequency was found within healthy subjects, but not within patients with CHD. Healthy subjects, but not patients with CHD, subdivided into carriers of the Met/Met, Met/Val and Val/Val genotype, had different BMI scores. The BDNF rs6265 genotype frequency was similar in male and female subjects, and there were no differences in the frequency of the BDNF rs6265 genotypes in 206 patients with CHD and in 498 healthy subjects. When study participants were subdivided according to the BMI categories into normal weight, overweight and obese subjects, significantly different BDNF rs6265 genotype frequency was found within healthy subjects, but not within patients with CHD. Healthy subjects, but not patients with CHD, subdivided into carriers of the Met/Met, Met/Val and Val/Val genotype, had different BMI scores. BDNF rs6265 polymorphism was not associated with a diagnosis of CHD or with BMI categories among patients with CHD. In contrast, healthy Caucasians, carriers of the BDNF Met/Met genotype, had more

  17. The management of subjective quality of life by short-stay hospital patients: An exploratory study

    Directory of Open Access Journals (Sweden)

    Karlinski Evelyn

    2003-09-01

    Full Text Available Abstract Background This study tested the homeostatic model of subjective quality of life in a group of 47 short stay patients as they progressed through the stages of hospitalization for surgery. Method Participants completed a questionnaire measuring subjective quality of life, positive and negative affect, self-esteem, optimism and cognitive flexibility, the day prior to admission (T1, two days post-operation (T2 and one week after discharge (T3. Neuroticism and Extroversion were measured at Time 1. Results All variables remained stable across the three times, apart from positive affect, which dropped significantly post-operation but returned to its previous level post discharge. Conclusion Although the homeostatic model of subjective quality of life was supported at Time 1, the analyses raise doubts about the stability of personality. This finding is consistent with recent discussions of personality.

  18. Spectrum of mutations in RARS-T patients includes TET2 and ASXL1 mutations.

    Science.gov (United States)

    Szpurka, Hadrian; Jankowska, Anna M; Makishima, Hideki; Bodo, Juraj; Bejanyan, Nelli; Hsi, Eric D; Sekeres, Mikkael A; Maciejewski, Jaroslaw P

    2010-08-01

    While a majority of patients with refractory anemia with ring sideroblasts and thrombocytosis harbor JAK2V617F and rarely MPLW515L, JAK2/MPL-negative cases constitute a diagnostic problem. 23 RARS-T cases were investigated applying immunohistochemical phospho-STAT5, sequencing and SNP-A-based karyotyping. Based on the association of TET2/ASXL1 mutations with MDS/MPN we studied molecular pattern of these genes. Two patients harbored ASXL1 and another 2 TET2 mutations. Phospho-STAT5 activation was present in one mutated TET2 and ASXL1 case. JAK2V617F/MPLW515L mutations were absent in TET2/ASXL1 mutants, indicating that similar clinical phenotype can be produced by various MPN-associated mutations and that additional unifying lesions may be present in RARS-T. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  19. Blood flow in the forearm in patients with Rheumatoid arthritis and healthy subjects under local thermotherapy

    Directory of Open Access Journals (Sweden)

    C. Mucha

    2002-02-01

    Full Text Available Objectives: Muscle blood flow in the forearm of patients with rheuma-toid arthritis and healthy volunteers following treatment with temperature increasingarm baths, mudpacks and short- or decimeter-wave diathermy was studied in thisinvestigation. The aim of the study was to find out the difference of reactive hyperemia between the different temperature methods as well as the influence on theconsensual reaction. Subjects: Eighty patients with rheumatoid arthritis, stage 3 according toSteinbrocker, as well as 80 healthy human subjects had been assigned numerically in the four therapy- and controlgroups. Patients with diseases influencing the peripheral blood flow were excluded. Design: Blood flow was measured by venous occlusion plethysmography in both forearms with the subjects lyingsupine. The application of the local heat therapies had been excluded on the left forearm. The forearm blood flow wasmonitored before heat therapy, directly after as well as in two further 10 minutes intervals. An analysis of variancewas used to determine the influence on blood flow of the response to the heat therapies in patients with rheumatoidarthritis and healthy subjects.Results: Under homogeneous starting conditions and a statistically uniformed high blood flow in rest the reactive values of blood flow on the left-hand side of application and the right consensual side showed high significant differencesbetween all methods of therapy. Differences between the patients and the healthy subjects only showed tendencies withpartially lower reactions, concerning the patients with rheumatoid arthritis. All methods of heat therapy caused a statistically provable consensual reaction that turned out smaller after diathermic methods. Here the post therapeuticreaction of the blood flow on the side of application was also lower or rather shorter. Conclusion: Greater differences of the blood flow in rest between the patients with rheumatoid arthritis and healthysubjects

  20. The impact of pain on anxiety and depression is mediated by objective and subjective sleep characteristics in fibromyalgia patients.

    Science.gov (United States)

    Diaz-Piedra, Carolina; Catena, Andres; Miro, Elena; Martinez, Maria P; Sanchez, Ana I; Buela-Casal, Gualberto

    2014-10-01

    Pain is the cardinal feature in fibromyalgia syndrome (FM) and increases the risk of anxiety and depression. Patients with FM frequently report sleep disturbances as well. Sleep may mediate the association between pain and emotional symptoms, an idea which has been scarcely studied. The objective of this study was to uncover the role of subjective and objective sleep characteristics as mediators of the relationship between pain and anxiety and depression in FM. Fifty-five female with FM (mean age, 47.62 ± 7.64 y) were assessed to obtain self-reported measures of pain, sleep quality, anxiety and depression levels, and self-efficacy to cope with pain. An ambulatory polysomnographic recording was performed to assess sleep architecture. Subjective poor sleep quality was found in all participtants. Pain correlated with subjective and objective sleep parameters, self-efficacy, anxiety, and, marginally, with depression. The mediated regression analysis suggested that the best models to explain the impact of pain on anxiety and depression included, as mediators, subjective sleep quality, objective sleep efficiency, and self-efficacy (these models explained 34% of the variance), with objective sleep efficiency being the mediator with the highest influence (Panxiety and depression. In fact, the impact of chronic pain on the later emotional variables was mediated not only by self-efficacy but also by subjective sleep quality and, especially, by objective sleep efficiency.

  1. [Subjective concepts of patients, physicians and social workers about quality in cardiac and orthopaedic rehabilitation].

    Science.gov (United States)

    Grande, Gesine; Romppel, Matthias

    2008-02-01

    It is supposed that subjective concepts influence disease-related behaviour and health care utilization. But until now systematic knowledge of the importance of quality related subjective beliefs is lacking. To analyse subjective views of quality in rehabilitation and between-group differences, 625 patients, 203 physicians and 101 social workers were asked in a questionnaire to rate various indicators for their importance in judging the quality of a rehabilitation program. Based on a factor analysis seven quality dimensions were identified. "Skills of rehabilitation staff" is consistently judged as most significant dimension of quality, while "Psychosocial outcome quality" received the second highest importance score. Dedication and motivation of rehabilitation staff and the successful restoration of general functioning in every day life were regarded as the most important single indicators of good quality in rehabilitation programs. Differences in views of quality between groups mirror differing interests and tasks in relation to rehabilitation. Subjective views on the quality of health care should be taken into consideration by doctors in counselling and referring their patients. The role of quality indicators compared to other pragmatic or individual preferences remains unclear.

  2. Including indigestible carbohydrates in the evening meal of healthy subjects improves glucose tolerance, lowers inflammatory markers, and increases satiety after a subsequent standardized breakfast.

    Science.gov (United States)

    Nilsson, Anne C; Ostman, Elin M; Holst, Jens J; Björck, Inger M E

    2008-04-01

    Low-glycemic index (GI) foods and foods rich in whole grain are associated with reduced risk of type 2 diabetes and cardiovascular disease. We studied the effect of cereal-based bread evening meals (50 g available starch), varying in GI and content of indigestible carbohydrates, on glucose tolerance and related variables after a subsequent standardized breakfast in healthy subjects (n = 15). At breakfast, blood was sampled for 3 h for analysis of blood glucose, serum insulin, serum FFA, serum triacylglycerides, plasma glucagon, plasma gastric-inhibitory peptide, plasma glucagon-like peptide-1 (GLP-1), serum interleukin (IL)-6, serum IL-8, and plasma adiponectin. Satiety was subjectively rated after breakfast and the gastric emptying rate (GER) was determined using paracetamol as a marker. Breath hydrogen was measured as an indicator of colonic fermentation. Evening meals with barley kernel based bread (ordinary, high-amylose- or beta-glucan-rich genotypes) or an evening meal with white wheat flour bread (WWB) enriched with a mixture of barley fiber and resistant starch improved glucose tolerance at the subsequent breakfast compared with unsupplemented WWB (P carbohydrates of the evening meal may affect glycemic excursions and related metabolic risk variables at breakfast through a mechanism involving colonic fermentation. The results provide evidence for a link between gut microbial metabolism and key factors associated with insulin resistance.

  3. Differences in performance on the functional movement screen between chronic low back pain patients and healthy control subjects

    OpenAIRE

    Ko, Min-Joo; Noh, Kyung-Hee; Kang, Min-Hyeok; Oh, Jae-Seop

    2016-01-01

    [Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stabil...

  4. Hospitalized patients with atrial fibrillation compared to those included in recent trials on novel oral anticoagulants: a population-based study.

    Science.gov (United States)

    Joppi, R; Cinconze, E; Mezzalira, L; Pase, D; Poggiani, C; Rossi, E; Pengo, V

    2013-06-01

    Nonvalvular atrial fibrillation is associated with a substantial risk of stroke. Novel oral anticoagulants (NOACs) with predictable anticoagulant effect and no need for routine coagulation monitoring have recently shown good results when compared with warfarin in phase III clinical trials. To describe clinical features and pharmacological treatments of a population-based cohort of patients with nonvalvular atrial fibrillation and ascertain whether they are comparable with those included in the three main phase III clinical trials on NOACs. Of the 2,862,264 subjects considered for this study 13,360 patients (0.47%) were recently discharged from the hospital with a diagnosis of nonvalvular atrial fibrillation. Mean age was 76.3 (SD 10.7), 49.8% were men and 64.6% were ≥75 years of age. 50% of patients were treated with warfarin and 44.1% with antiplatelet agents. The proportion of patients on antiplatelet therapy increased with age up to a rate of 54.3% in subjects ≥85 years. 92.9% of the studied cohort was on polypharmacy (mean 8 drugs/patient). Around 20% of the entire cohort was treated with amiodarone, a drug potentially interfering with NOACs, and 3.6% from a subgroup analysis had renal failure, which is an exclusion criterion in trials on NOACs. In patients recently discharged from the hospital with the diagnosis of nonvalvular AF, warfarin use decreases and aspirin treatment increases with patients' age. These patients are older, more frequently female, and on multiple medications. The benefit of NOACs in these subjects needs to be confirmed in phase IV clinical studies. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  5. Additive prognostic value of subjective assessment with respect to clinical cardiological data in patients with chronic heart failure.

    Science.gov (United States)

    Majani, Giuseppina; Pierobon, Antonia; Pinna, Gian Domenico; Giardini, Anna; Maestri, Roberto; La Rovere, Maria Teresa

    2011-12-01

    Health-related quality of life tools that better reflect the unique subjective perception of heart failure (HF) are needed for patients with this disorder. The aim of this study was to explore whether subjective satisfaction of HF patients about daily life may provide additional prognostic information with respect to clinical cardiological data. One hundred and seventy-eight patients (age 51 ± 9 years) with moderate to severe HF [New York Heart Association (NYHA) class 2.0 ± 0.7; left ventricular ejection fraction (LVEF) 29 ± 8%] in stable clinical condition underwent a standard clinical evaluation and compiled the Satisfaction Profile (SAT-P) questionnaire focusing on subjective satisfaction with daily life. Cox regression analysis was used to assess whether SAT-P factors (psychological functioning, physical functioning, work, sleep/eating/leisure, social functioning) had any prognostic value. Forty-six cardiac deaths occurred during a median of 30 months. Patients who died had higher NYHA class, more depressed left ventricular function, reduced systolic blood pressure (SBP), increased heart rate (HR), and worse biochemistry (all p patients who died (p = 0.003). Using the best subset selection procedure, resistance to physical fatigue (RPF) was selected from among the items of the PF factor. RPF showed independent predictive value when entered into a prognostic model including NYHA class, LVEF, SBP, and HR with an adjusted hazard ratio of 0.86 per 10 units increase (95% CI 0.75-0.98, p = 0.02). Patients' dissatisfaction with physical functioning is associated with reduced long-term survival, after adjustment for known risk factors in HF. Given its user-friendly structure, simplicity, and significant prognostic value, the RPF score may represent a useful instrument in clinical practice.

  6. Glucose ingestion causes cardiac repolarization disturbances in type 1 Long QT syndrome patients and healthy subjects

    DEFF Research Database (Denmark)

    Hyltén-Cavallius, Louise; Iepsen, Eva W.; Christiansen, Michael

    2017-01-01

    BACKGROUND: Both hypoglycemia and severe hyperglycemia constitute known risk factors for cardiac repolarization changes potentially leading to malignant arrhythmias. Patients with loss of function mutations in KCNQ1 are characterized by long QT syndrome (LQTS) and may be at increased risk...... for glucose-induced repolarization disturbances. OBJECTIVE: The purpose of this study was to test the hypothesis that KCNQ1 LQTS patients are at particular risk for cardiac repolarization changes during the relative hyperglycemia that occurs after an oral glucose load. METHODS: Fourteen KCNQ1 LQTS patients....... RESULTS: QTc and MCS increased in both groups. MCS remained elevated until 150 minutes after glucose ingestion, and the maximal change from baseline was larger among KCNQ1 LQTS patients compared with control subjects (0.28 ± 0.27 vs 0.15 ± 0.13; P

  7. Sedation and memories of patients subjected to mechanical ventilation in an intensive care unit.

    Science.gov (United States)

    Costa, Jaquilene Barreto da; Marcon, Sonia Silva; Macedo, Claudia Rejane Lima de; Jorge, Amaury Cesar; Duarte, Péricles Almeida Delfino

    2014-01-01

    To investigate the relationship between sedation and the memories reported by patients subjected to mechanical ventilation following discharge from the intensive care unit. This prospective, observational, cohort study was conducted with individuals subjected to mechanical ventilation who remained in the intensive care unit for more than 24 hours. Clinical statistics and sedation records were extracted from the participants' clinical records; the data relative to the participants' memories were collected using a specific validated instrument. Assessment was performed three months after discharge from the intensive care unit. A total of 128 individuals were assessed, most of whom (84.4%) reported recollections from their stay in the intensive care unit as predominantly a combination of real and illusory events. The participants subjected to sedation (67.2%) at deep levels (Richmond Agitation-Sedation Scale [RASS] -4 and -5) for more than two days and those with psychomotor agitation (33.6%) exhibited greater susceptibility to occurrence of illusory memories (p>0.001). The probability of the occurrence of illusory memories was greater among the participants who were subjected to deep sedation. Sedation seems to be an additional factor that contributed to the occurrence of illusory memories in severely ill individuals subjected to mechanical ventilation.

  8. Subjective and physiological emotional response in euthymic bipolar patients: a pilot study.

    Science.gov (United States)

    Lemaire, Mathieu; Aguillon-Hernandez, Nadia; Bonnet-Brilhault, Frédérique; Martineau, Joëlle; El-Hage, Wissam

    2014-12-15

    The euthymic phase of bipolar disorders may be associated with residual emotional and/or subsyndromal symptoms. The aim of this study was to compare subjective and physiologic emotional response to negative, neutral and positive emotion eliciting pictures between euthymic bipolar patients (n=26) and healthy controls (n=30). We evaluated emotional response using an emotional induction method with emotional pictures from the International Affective Picture System. We measured subjective emotional response with the Self-Assessment Manikin and physiological emotional response by measuring pupil size. No difference was found between euthymic bipolar patients and controls regarding subjective emotional response. However, upon viewing positive pictures, pupil dilation was significantly lower in euthymic bipolar patients compared to controls. This finding suggests that euthymic bipolar phase may be associated with reduced physiologic emotional response to positive valence, which is consistent with a more general negative emotional bias or can be understood as a residual emotional subsyndromal symptom. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Subjective global assessment: a reliable nutritional assessment tool to predict outcomes in critically ill patients.

    Science.gov (United States)

    Fontes, Daniel; Generoso, Simone de Vasconcelos; Toulson Davisson Correia, Maria Isabel

    2014-04-01

    Nutritional assessment of critically ill patients has created controversy. However, it is well established that malnourished patients who are severely ill have worse outcomes than well-nourished patients. Therefore, assessing patients' nutritional status may be useful in predicting which patients may experience increased morbidity and mortality. One hundred eighty-five consecutively admitted patients were followed until discharge or death, and their nutritional status was evaluated using Subjective Global Assessment (SGA) as well as anthropometric and laboratory methods. Agreement between the methods was measured using the Kappa coefficient. Malnutrition was highly prevalent (54%), according to SGA. Malnourished patients had significantly higher rates of readmission to the intensive care unit (ICU) (OR 2.27; CI 1.08-4.80) and mortality (OR 8.12; CI 2.94-22.42). The comparison of SGA with other tests used to assess nutritional status showed that the correlation between the methods ranged from poor to superficial. SGA, an inexpensive and quick nutritional assessment method conducted at the bedside, is a reliable tool for predicting outcomes in critically ill patients. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Nutritional status of patients treated with radiotherapy as determined by subjective global assessment

    Energy Technology Data Exchange (ETDEWEB)

    Koom, Woong Sub; Keum, Ki Chang [Dept. of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Ahn, Seung Do [Dept. of Radiation Oncology, Asan Medical Center, Seoul (Korea, Republic of); and others

    2012-09-15

    The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). The mean age of patients in this study was 59.4 {+-} 11.9 years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss 5% (OR, 2.299). SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.

  11. Nutritional status of patients treated with radiotherapy as determined by subjective global assessment

    Science.gov (United States)

    Koom, Woong Sub; Ahn, Seung Do; Song, Si Yeol; Lee, Chang Geol; Moon, Sung Ho; Chie, Eui Kyu; Jang, Hong Seok; Oh, Young-Taek; Lee, Ho Sun

    2012-01-01

    Purpose The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. Materials and Methods A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). Results The mean age of patients in this study was 59.4 ± 11.9 years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss ≥5% (OR, 2.299). Conclusion SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments. PMID:23170292

  12. Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study

    Directory of Open Access Journals (Sweden)

    Hsi Wei-Li

    2006-12-01

    Full Text Available Abstract Background Metatarsalgia is related to repetitive high-pressure loading under the metatarsal head (MH that causes pain. The high pressure under the MH can be reduced by adequately applying metatarsal pads (MPs. Plantar pressure measurements may provide a method to objectively evaluate pressure loading under the MH. However, it is still unclear if the decrease in plantar pressure under the MH after MP treatment is associated with subjective improvement. This study aims to explore the correlations between subjective pain improvement and outcome rating, and the plantar pressure parameters in metatarsalgia patients treated using MPs. Methods Thirteen patients (a total of 18 feet with secondary metatarsalgia were included in this study. Teardrop-shaped MPs made of polyurethane foam were applied just proximal to the second MH by an experienced physiatrist. Insole plantar pressure was measured under the second MH before and after MP application. Visual analog scale (VAS scores of pain were obtained from all subjects before and after 2 weeks of MP treatment. The subjects rated using four-point subjective outcome scales. The Wilcoxon signed-rank test was used to analyze the difference between the plantar pressure parameters and VAS scores before and after treatment. The Kruskal-Wallis test was applied to compare the plantar pressure parameters in each outcome group. Pearson's correlation was applied to analyze the correlation between the changes in plantar pressure parameters and VAS scores. Statistical significance was set as p Results MP application decreased the maximal peak pressure (MPP and pressure-time integral (PTI under the second MH and also statistically improved subjective pain scores. However, neither the pre-treatment values of the MPP and PTI shift in the position of the MPP after treatment, nor the age, gender and body mass index (BMI of the subjects were statistically correlated with subjective improvement. Declines in the PTI

  13. Scored Patient-Generated Subjective Global Assessment, albumin and transferrin for nutritional assessment of gastrostomy fed head or neck cancer patients.

    Science.gov (United States)

    Correira Pereira, Marta Alexandra; Santos, Carla Adriana; Almeida Brito, José; Fonseca, Jorge

    2014-02-01

    Gastrostomy fed head or neck cancer patients frequently have impaired speech capacities. Enteral feeding teams frequently depend on laboratorial or anthropometrical parameters for nutritional assessment. In these patients, this study aimed to evaluate: (1) the practicability of Scored - Patient-Generated Subjective Global Assessment (PG-SGA); (2) their nutritional status using the Scored-PG-SGA; (3) association of serum albumin and transferrin values to the nutritional status rating using PG-SGA. On adult outpatients with head or neck cancer under prolonged (> 1 month) gastrostomy feeding, Scored-PGSGA, albumin and transferrin were evaluated during the same appointment. Scored-PG-SGA was easily feasible in 42 patients, even in patients with speech difficulties. Twenty-five patients were moderately/severely undernourished (PG-SGA/B+C). Scored-PG-SGA rated 41 patients as ≥ 2, thus needing nutritional/ pharmacologic intervention. Albumin was low in 13 patients. Transferrin was low in 19 patients. Average albumin and transferrin in moderately/severely undernourished patients (PG-SGA/B+C) was significantly lower than in well-nourished (PG-SGA/A). There was association between Scored- PG-SGA rating, albumin and transferrin. In PEG fed head or neck cancer patients, PGSGA was practicable and useful, even in patients with impaired speaking skills. Most patients displayed moderate/severe malnutrition (PG-SGA/B+C). Scored-PG-SGA rated 41 patients as needing for nutritional/pharmacological intervention. Scored-PG-SGA should be systematically included in the evaluation of these patients. In these patients, albumin and transferrin levels showed relation with Scored-PG-SGA and should be considered as nutritional biomarkers. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  14. Chronotype in patients with epilepsy: A controlled study in 60 subjects with late-onset focal epilepsy.

    Science.gov (United States)

    Manni, Raffaele; Cremascoli, Riccardo; De Icco, Roberto; Terzaghi, Michele

    2015-09-01

    Studies based on self-administered questionnaires indicate that most patients with epilepsy are morning-oriented. We aimed to investigate chronotype in patients with epilepsy with late-onset focal epilepsy by combining subjective data with dim light melatonin onset (DLMO) as an objective marker of the circadian phase. Sixty adult patients (mean age 46.5±13.8; 27 males) with late-onset focal epilepsy under pharmacological treatment were prospectively studied. Subjective chronotype was determined using the Morningness-Eveningness Questionnaire (MEQ) and circadian phase through analysis of salivary melatonin secretion, considering 3pg/ml as the dim light melatonin onset (DLMO) threshold. The mean MEQ score was significantly higher in the patients with epilepsy than in the controls, and significantly, more patients had a MEQ score indicative of the morning type (50.0% vs 30.0%, p=0.02). However, no significant differences were found in mean time of DLMO (21:38±01:21 vs 21:26±01:03; p=ns), and DLMO time was in the range indicative of an intermediate chronotype in both patients and controls. Sleep onset and sleep offset phase angles were significantly shorter in the patients. Patients whose global MEQ score identified them as morning types were significantly older than those with an intermediate or evening chronotype, and they had less social jet lag. No difference in epilepsy features and treatments was found between morning-oriented and nonmorning-oriented patients. Our analyses showed that the patients with epilepsy tended to be morning-oriented and to perceive themselves as morning types, even though this was not reflected in their DLMO values which did not differ significantly from those of controls and mostly fell within the intermediate chronotype range. Several factors may considerably influence subjective chronotype. We speculate that, in patients with epilepsy, the disease itself, prompting certain lifestyle choices, including a regular sleep schedule and

  15. Postprandial effects of test meals including concentrated arabinoxylan and whole grain rye in subjects with the metabolic syndrome: a randomised study.

    Science.gov (United States)

    Hartvigsen, M L; Lærke, H N; Overgaard, A; Holst, J J; Bach Knudsen, K E; Hermansen, K

    2014-05-01

    Prospective studies have shown an inverse relationship between whole grain consumption and the risk of type 2 diabetes, where short chain fatty acids (SCFA) may be involved. Our objective was to determine the effect of isolated arabinoxylan alone or in combination with whole grain rye kernels on postprandial glucose, insulin, free fatty acids (FFA), gut hormones, SCFA and appetite in subjects with the metabolic syndrome (MetS). Fifteen subjects with MetS participated in this acute, randomised, cross-over study. The test meals each providing 50 g of digestible carbohydrate were as follows: semolina porridge added concentrated arabinoxylan (AX), rye kernels (RK) or concentrated arabinoxylan combined with rye kernels (AXRK) and semolina porridge as control (SE). A standard lunch was served 4 h after the test meals. Blood samples were drawn during a 6-h period, and appetite scores and breath hydrogen were assessed every 30 min. The AXRK meal reduced the acute glucose (P=0.005) and insulin responses (P<0.001) and the feeling of hunger (P=0.005; 0-360 min) compared with the control meal. The AX and AXRK meals increased butyrate and acetate concentrations after 6 h. No significant differences were found for the second meal responses of glucose, insulin, FFA, glucagon-like peptide-1 or ghrelin. Our results indicate a stimulatory effect of arabinoxylan on butyrate and acetate production, however, with no detectable effect on the second meal glucose response. It remains to be tested in a long-term study if a beneficial effect on the glucose response of the isolated arabinoxylan will be related to the SCFA production.

  16. A Remarkable Improvement of Patients with Idiopathic Thrombocytopenic Purpura after appendectomy including Carcinoid tumor

    Directory of Open Access Journals (Sweden)

    Hamidreza Alizadeh-Otaghvar

    2011-09-01

    Full Text Available The assistance of chronic idiopathic thrombocytopenic purpura and appendiceal carcinoid tumor is so rare and has not been reported before .we present here in a 11 year old boy that is the known case of chronic idiopathic thrombocytopenic purpura (with the platelet count of 20000 when admitted. He reffered due to anorexia, pain and tenderness of right lower quadrant of abdomen and vomiting. He also had leukocytosis and abdominal free fluid in sonographic report. These findings suggested the diagnosis of acute appendicitis and the patient underwent appendectomy, after the operation, the platelet count became normal. The pathologic report of the specimen of the appendix was carcinoid tumor. Now the question is whether the appendiceal carcinoid tumor can be the reason of symptoms of chronic idiopathic.

  17. Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

    OpenAIRE

    Natasja Koitzsch Jensen; Katrine Schepelern Johansen; Marianne Kastrup; Allan Krasnik; Marie Norredam

    2014-01-01

    Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refu...

  18. Myofascial treatment for patients with acetabular labral tears: a single-subject research design study.

    Science.gov (United States)

    Cashman, Glenn E; Mortenson, W Ben; Gilbart, Michael K

    2014-08-01

    Single-subject research design using 4 consecutive patients. To assess whether treatment using soft tissue therapy (ART or Active Release Technique), stretching, and strengthening of the hip abductors, hip external rotators, and tensor fascia latae muscles reduces pain and improves self-reported hip function in patients with acetabular labral tears who also have posterolateral hip pain of suspected myofascial origin. Acetabular labral tears cause pain in some but not all patients. Pain commonly presents anteriorly but may also present posteriorly and laterally. The standard of care is arthroscopic repair, which helps many but not all patients. It is possible that these patients may present with extra-articular contributions to their pain, such as myofascial pain, making their clinical presentation more complex. No previous study has assessed soft tissue therapy as a treatment option for this subset of patients. This A-B-A design used repeated measures of the Hip Outcome Score and visual analog scale for pain. Four patients were treated for 6 to 8 weeks, using a combination of soft tissue therapy, stretching, and strengthening for the hip abductors, external rotators, and tensor fascia latae. Data were assessed visually, statistically, and by comparing mean differences before and after intervention. All 4 patients experienced both statistically significant and clinically meaningful improvement in posterolateral hip pain and hip-related function. Three patients also experienced reduction in anteromedial hip pain. Myofascial hip pain may contribute to hip-related symptoms and disability in patients with acetabular labral tears and posterolateral hip pain. These patients may benefit from soft tissue therapy combined with stretching and strengthening exercises targeting the hip abductors, tensor fascia latae, and hip external rotator muscles. Level of Evidence Therapy, level 4.

  19. Systemic lupus erythematosus patients contain significantly less igm against mono-methylated lysine than healthy subjects.

    Science.gov (United States)

    Guo, Sha; Liu, Ying; Ma, Younan; Zhao, Qing; Zhu, Liping; Shao, Yuehu; Gao, Fengying; Wu, Fengqi; Gao, Ruitong; Zhang, Wei

    2013-01-01

    Post-translational modifications on proteins are important in biological processes but may create neo-epitopes that induce autoimmune responses. In this study, we measured the serum IgG and IgM response to a set of non-modified or acetyl- and methyl-modified peptides corresponding to residues 1-19 of the histone 3 N-terminal tail in systemic lupus erythematosus (SLE) patients and healthy subjects. Our results indicated that the SLE patients and healthy subjects produced antibodies (Abs) to the peptides, but the two groups had different Ab isotype and epitope preferences. Abs to the non-modified form, H31-19, were of the IgG isotype and produced by SLE patients. They could not recognize the scrambled H31-19, which contained the same amino acid composition but a different sequence as H31-19. In comparison, healthy subjects in general did not produce IgG against H31-19. However, about 70% of the healthy subjects produced IgM Abs against mono-methylated K9 of H31-19 (H31-19K9me). Our further studies revealed that ε-amine mono-methylated lysine could completely inhibit the IgM binding to H31-19K9me, but lysine had no inhibitory effect. In addition, the IgM Abs could bind peptides containing a mono-methylated lysine residue but with totally different sequences. Thus, mono-methylated lysine was the sole epitope for the IgM. Interestingly, SLE patients had much lower levels of this type of IgM. There was no obvious correlation between the IgM levels and disease activity and the decreased IgM was unlikely caused by medical treatments.We also found that the IgM Abs were not polyreactive to dsDNA, ssDNA, lipopolysaccharide (LPS) or insulin and they did not exist in umbilical cord serum, implying that they were not natural Abs. The IgM Abs against mono-methylated lysine are present in healthy subjects but are significantly lower in SLE patients, suggesting a distinct origin of production and special physiological functions.

  20. Rheumatoid factor testing in Spanish primary care: A population-based cohort study including 4.8 million subjects and almost half a million measurements.

    Science.gov (United States)

    Morsley, Klara; Miller, Anne; Luqmani, Raashid; Fina-Aviles, Francesc; Javaid, Muhammad Kassim; Edwards, Christopher J; Pinedo-Villanueva, Rafael; Medina, Manuel; Calero, Sebastian; Cooper, Cyrus; Arden, Nigel; Prieto-Alhambra, Daniel

    2018-02-26

    Rheumatoid factor (RF) testing is used in primary care in the diagnosis of rheumatoid arthritis (RA); however a positive RF may occur without RA. Incorrect use of RF testing may lead to increased costs and delayed diagnoses. The aim was to assess the performance of RF as a test for RA and to estimate the costs associated with its use in a primary care setting. A retrospective cohort study using the Information System for the Development of Research in Primary Care database (contains primary care records and laboratory results of >80% of the Catalonian population, Spain). Participants were patients ≥18 years with ≥1 RF test performed between 01/01/2006 and 31/12/2011, without a pre-existing diagnosis of RA. Outcome measures were an incident diagnosis of RA within 1 year of testing, and the cost of testing per case of RA. 495,434/4,796,498 (10.3%) patients were tested at least once. 107,362 (21.7%) of those tested were sero-positive of which 2768 (2.6%) were diagnosed with RA within 1 year as were 1141/388,072 (0.3%) sero-negative participants. The sensitivity of RF was 70.8% (95% CI 69.4-72.2), specificity 78.7% (78.6-78.8), and positive and negative predictive values 2.6% (2.5-2.7) and 99.7% (99.6-99.7) respectively. Approximately €3,963,472 was spent, with a cost of €1432 per true positive case. Although 10% of patients were tested for RF, most did not have RA. Limiting testing to patients with a higher pre-test probability would significantly reduce the cost of testing. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  1. Predicting employment status and subjective quality of life in patients with schizophrenia

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    Haruo Fujino

    2016-03-01

    Full Text Available Although impaired social functioning, particularly poor employment status, is a cardinal feature of patients with schizophrenia and leads to decreased quality of life (QOL, few studies have addressed the relationship between these two clinical issues. The aim of this study was to determine whether employment status predicts subjective QOL and to evaluate a model in which functional capacity mediates the relationship between general cognitive performance and employment status. Ninety-three patients with schizophrenia were administered a comprehensive battery of cognitive tests, the UCSD Performance-based Skills Assessment-Brief version (UPSA-B, the Social Functioning Scale (SFS, and the Subjective Quality of Life Scale (SQLS. First, we evaluated a model for predicting the employment/occupation subscale score of the SFS using path analysis, and the model fitted well (χ2 (4 = 3.6, p = 0.46; CFI = 1.0; RMSEA < 0.001, with 90% CIs: 0–0.152. Employment status was predicted by negative symptoms and functional capacity, which was in turn predicted by general cognitive performance. Second, we added subjective QOL to this model. In a final path model, QOL was predicted by negative symptoms and employment status. This model also satisfied good fit criteria (χ2 (7 = 10.3, p = 0.17; CFI = 0.987; RMSEA = 0.072, with 90% CIs: 0–0.159. The UPSA-B and SFS scores were moderately correlated with most measures of cognitive performance. These results support the notion that better employment status enhances subjective QOL in patients with schizophrenia.

  2. Action potential simulation (APS) in patients with fibromyalgia syndrome (FMS): a controlled single subject experimental design.

    Science.gov (United States)

    Fengler, R K B; Jacobs, J W G; Bac, M; van Wijck, A J M; van Meeteren, N L U

    2007-03-01

    Action potential simulation (APS) is becoming a popular method of pain reduction. Nevertheless, little is known about the efficacy of this relatively new treatment. The aim of this study was to investigate whether APS helps to reduce pain, improves patients' perception of daily functioning and social participation in patients with fibromyalgia syndrome (FMS). Ten patients with FMS according to the American College of Rheumatology (ACR) criteria entered this double blind crossover single-case study. In a period of 20 weeks, the patients underwent two treatment periods of 4 weeks, one with verum and one with placebo, at random, in a double blind fashion. Outcome measures were evaluated on a weekly basis. Primary outcome measure was pain measured with the Fibromyalgia Impact Questionnaire (FIQ) questions 4 and 5, the number of tender points and the total tender point pain intensity score. Both visual inspection and statistical analysis were done to analyse the data from this single-subject design. Performing visual inspection and statistical analysis, no positive results of the APS treatment were found in this study. Remarkable is the fact that placebo APS had significantly better results than verum APS. In this single-case study with ten patients (all female), APS was not a helpful method to reduce pain, to improve patients' perception of daily functioning and social participation in patients with FMS.

  3. Radial distribution of esophageal peristaltic pressure in normal subjects and patients with esophageal diverticulum.

    Science.gov (United States)

    Dodds, W J; Stef, J J; Hogan, W J; Hoke, S E; Stewart, E T; Arndorfer, R C

    1975-09-01

    This study was designed to determine the radial profile of peristaltic pressure waves in the esophageal body of normal subjects and patients with isophageal diverticulum. We used a manometric assembly featuring four radial side hole recording orifices oriented at equidistant 90 degree angles. Each recording catheter was infused with water at a rate (6.1 ml per min) which provided high fidelity pressure recording. In normal subjects, the radially recorded peristaltic pressure complexes were similar in peak amplitude and wave form. The range of pressure differences between the four radial recordings averaged 9.0 +/- 4 SD mm Hg A range is less than or greater to 25 mm Hg occurring in 99% of observations. These variations in pressure amplitude showed no consistant spacial orientation. In 5 of the 6 patients with esophageal diverticulum, the range of radial peristaltic pressure differences exceeded 25 mm Hg in the region of the diverticulum, the lowest pressure occurring at the recording orifice facing the diverticulum mouth. In occasional peristaltic sequences abnormal wave forms featuring abrupt onsets or offsets were observed. These bizarre wave forms were probably caused by oralaboral diverticulum movement relative to the recording sensor during peristalsis. Two patients had abnormally high peristaltic pressure amplitudes, greater than 250 mm Hg. This latter finding introduces the possibility that hypertensive peristaltic contractions may contribute to diverticulum production in some patients.

  4. Objective and subjective assessment of masticatory function for patients with temporomandibular disorder in Korea.

    Science.gov (United States)

    Ahn, H J; Lee, Y S; Jeong, S H; Kang, S M; Byun, Y S; Kim, B I

    2011-07-01

    This study examined the differences in the masticatory function of patients with temporomandibular disorder (TMD) in Korea. The experimental groups were as follows: 23 patients with painful arthralgia classified as pain group according to the research diagnostic criteria for temporomandibular disorder (RDC/TMC) and 28 patients with pain-free disc displacement and reduction classified as clicking group. The subjects were obtained from those who had visited Yonsei University Dental Hospital from 2007 to 2008. Twenty dental students without TMD symptoms were enroled as the normal control group. The Mixing Ability Index (MAI) was used as the objective index, and the Food Intake Ability (FIA) Index, Visual Analogue Scale (VAS) and oral health impact profile (OHIP) were used as the subjective indices. The MAI, FIA and VAS were significantly lower in the pain group than in the normal and clicking groups (Pmasticatory function in patients with TMD in Korea, and the joint sound, not the masticatory function, affects the declining OHIP. © 2010 Blackwell Publishing Ltd.

  5. Salivary Myeloperoxidase, Assessed by 3,3'-Diaminobenzidine Colorimetry, Can Differentiate Periodontal Patients from Nonperiodontal Subjects.

    Science.gov (United States)

    Klangprapan, Supaporn; Chaiyarit, Ponlatham; Hormdee, Doosadee; Kampichai, Amonrujee; Khampitak, Tueanjit; Daduang, Jureerut; Tavichakorntrakool, Ratree; Panijpan, Bhinyo; Boonsiri, Patcharee

    2016-01-01

    Periodontal diseases, which result from inflammation of tooth supporting tissues, are highly prevalent worldwide. Myeloperoxidase (MPO), from certain white blood cells in saliva, is a biomarker for inflammation. We report our study on the salivary MPO activity and its association with severity of periodontal diseases among Thai patients. Periodontally healthy subjects (n = 11) and gingivitis (n = 32) and periodontitis patients (n = 19) were enrolled. Assessments of clinically periodontal parameters were reported as percentages for gingival bleeding index (GI) and bleeding on probing (BOP), whereas pocket depth (PD) and clinical attachment loss (CAL) were measured in millimeters and then made to index scores. Salivary MPO activity was measured by colorimetry using 3,3'-diaminobenzidine as substrate. The results showed that salivary MPO activity in periodontitis patients was significantly higher than in healthy subjects (p = 0.003) and higher than in gingivitis patients (p = 0.059). No difference was found between gingivitis and healthy groups (p = 0.181). Significant correlations were observed (p < 0.01) between salivary MPO activity and GI (r = 0.632, p < 0.001), BOP (r = 0.599, p < 0.001), PD (r = 0.179, p = 0.164), and CAL (r = 0.357, p = 0.004) index scores. Sensitivity (94.12%), specificity (54.55%), and positive (90.57%) and negative (66.67%) predictive values indicate that salivary MPO activity has potential use as a screening marker for oral health of the Thai community.

  6. Quality of life in glaucoma patients and normal subjects related to the severity of damage in each eye.

    Science.gov (United States)

    Pujol Carreras, O; Anton, A; Mora, C; Pastor, L; Gudiña, S; Maull, R; Vega, Z; Castilla, M

    2017-11-01

    To assess the quality of life in glaucoma patients and normal subjects, and to assess its relationship with the severity of damage in each eye. A cross-sectional study was conducted with prospective selection of cases. The study included 464 subjects and were distributed into 4categories. Subjects included in group 1 had both eyes normal, that is with a normal intraocular pressure (IOP), optic disk and visual fields (VF), or mild glaucoma, defined as untreated IOP>21mmHg and abnormal VF with mean defect (MD) over -6dB. Group 2 consisted of patients with both eyes with mild or moderate glaucoma, defined as untreated IOP>21mmHg and abnormal VF with MD between -6 and -12dB. Group 3 included patients with moderate to severe glaucoma, that is, untreated IOP>21mmHg and abnormal VF with MD of less than -12dB in both eyes. Group 4 consisted of patients with asymmetric glaucoma damage, that is, they had one eye with severe glaucoma and the other eye normal or with mild glaucoma. All subjects completed 3 different questionnaires. Global quality of life was evaluated with EuroQol-5D (EQ-5D). Vision related quality of life was assessed with Visual Function Questionnaire (VFQ-25). Quality of life related to ocular surface disease was measured with Ocular Surface Disease Index (OSDI). VFQ-25 showed that group 3 had significantly lower scores than group 1 in mental health (P=.006), dependence (P=.006), colour vision (P=.002), and peripheral vision (P=.002). EQ-5D showed no significant differences between any group, but a trend was found to greater difficulty in group 3 than in groups 1 and 2, and in all dimensions. OSDI showed a higher score, or which was the same as a major disability, in groups 2 and 3 than group 1 (P=.021 and P=.014, respectively). VFQ-25 only found significant differences between group 1 and group 4. Dimensions with significant differences were found between group 1 and 3 (both eyes with advanced or moderate glaucoma). These were not found between group 1 and

  7. Inappropriate Suppression of Thyrotropin Concentrations in Young Patients with Thyroid Nodules Including Thyroid Cancer: The Fukushima Health Management Survey.

    Science.gov (United States)

    Suzuki, Satoru; Nakamura, Izumi; Suzuki, Satoshi; Ohkouchi, Chiyo; Mizunuma, Hiroshi; Midorikawa, Sanae; Fukushima, Toshihiko; Ito, Yuko; Shimura, Hiroki; Ohira, Tetsuya; Matsuzuka, Takashi; Ohtsuru, Akira; Abe, Masafumi; Yamashita, Shunichi; Suzuki, Shinichi

    2016-05-01

    .583, respectively). TSH suppression can be present in response to illness, including thyroid nodules, in young subjects. Low TSH levels may be associated with the finding of papillary thyroid cancer as well as with thyroid nodules in children and adolescents.

  8. Levothyroxine improves subjective sleepiness in a euthyroid patient with narcolepsy without cataplexy.

    Science.gov (United States)

    Sobol, Danielle L; Spector, Andrew R

    2014-11-15

    We discuss the use of levothyroxine for excessive daytime sleepiness (EDS) and prolonged nocturnal sleep time in a euthyroid patient with narcolepsy. After failure of first-line narcolepsy treatments, a 48-year-old female began levothyroxine (25 mcg/day). After 12 weeks of treatment, the patient was evaluated for improvement in total sleep time and subjective daytime sleepiness assessed by Epworth Sleepiness Scale (ESS). At baseline, ESS score was 16 and total sleep time averaged 16 h/day. After 12 weeks, ESS was 13 and reported total sleep time was 13 h/day. Levothyroxine improved EDS and total sleep time in a euthyroid patient with narcolepsy without cataplexy after 12 weeks without side effects. © 2014 American Academy of Sleep Medicine.

  9. Cortisol and subjective stress responses to acute psychosocial stress in fibromyalgia patients and control participants.

    Science.gov (United States)

    Coppens, Eline; Kempke, Stefan; Van Wambeke, Peter; Claes, Stephan; Morlion, Bart; Luyten, Patrick; Van Oudenhove, Lukas

    2017-12-11

    Hypothalamic-pituitary-adrenal (HPA) axis dysfunction may play a role in fibromyalgia (FM) pathogenesis, but remains understudied in this disorder. Furthermore, early childhood adversities (ECA) are common in FM, but whether they moderate stress reactivity is unknown. Hence, we investigated cortisol and subjective responses to acute psychosocial stress in FM and controls, while adjusting for ECA. Twenty-seven female FM patients and 24 age-matched female controls were recruited in a tertiary care center and through advertisements, respectively. The Childhood Trauma Questionnaire was used to measure ECA history. Salivary cortisol levels and subjective stress ratings were measured at multiple time points before and after the Trier Social Stress Test (TSST) was administered. Significant main effects of group [F(1,43)=7.04, p=0.011, lower in FM] and ECA [F(1,43)=5.18, p=0.028, higher in participants with ECA] were found for cortisol responses. When excluding controls with ECA (n=5), a significant group-by-time interaction was found [F(6,39)=2.60, p=0.032], driven by a blunted response to the stressor in FM compared with controls (p=0.037). For subjective stress responses, a significant main effect of group [F(1,45)=10.69, p=0.002, higher in FM] and a trend towards a group-by-time interaction effect [F(6,45)=2.05, p=0.078, higher in FM 30 minutes before and 30 and 75 minutes after the TSST, and impaired recovery (difference immediately after - 30 minutes after the TSST) in FM] were found. Blunted cortisol responsivity to the TSST was observed in FM patients compared with controls without ECA. FM patients had higher subjective stress levels compared with controls, particularly at baseline and during recovery from the TSST. In FM patients, ECA history was not associated with cortisol or subjective stress levels, or with responsivity to the TSST. Future research should investigate the mechanisms underlying HPA axis dysregulation in FM.

  10. Objective assessment of mastication predominance in healthy dentate subjects and patients with unilateral posterior missing teeth.

    Science.gov (United States)

    Yamasaki, Y; Kuwatsuru, R; Tsukiyama, Y; Oki, K; Koyano, K

    2016-08-01

    We aimed to investigate mastication predominance in healthy dentate individuals and patients with unilateral posterior missing teeth using objective and subjective methods. The sample comprised 50 healthy dentate individuals (healthy dentate group) and 30 patients with unilateral posterior missing teeth (partially edentulous group). Subjects were asked to freely chew three kinds of test foods (peanuts, beef jerky and chewing gum). Electromyographic activity of the bilateral masseter muscles was recorded. The chewing side (right side or left side) was judged by the level of root mean square electromyographic amplitude. Mastication predominance was then objectively assessed using the mastication predominant score and the mastication predominant index. Self-awareness of mastication predominance was evaluated using a modified visual analogue scale. Mastication predominance scores of the healthy dentate and partially edentulous groups for each test food were analysed. There was a significant difference in the distribution of the mastication predominant index between the two groups (P < 0·05). The mastication predominant score was weakly correlated with self-awareness of mastication predominance in the healthy dentate group, whereas strong correlation was observed in the partially edentulous group (P < 0·05). The results suggest that the individuals with missing unilateral posterior teeth exhibited greater mastication predominance and were more aware of mastication predominance than healthy dentate individuals. Our findings suggest that an objective evaluation of mastication predominance is more precise than a subjective method. © 2016 John Wiley & Sons Ltd.

  11. Comparison of Lumbo-Pelvic Stability between Patients with Chronic Low Back Pain and Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Mohammad Hosseinifar

    2016-10-01

    Full Text Available Because of the importance of lumbo-pelvic stability as one of the suggested factors to prevent low back pain and since to date no study accomplished to compare lumbo-pelvic stability between chronic low back pain (CLBP and healthy subjects, the aim of this study was to determine and to compare lumbo-pelvic stability, lumbar lordosis, and lumbar mobility between CLBP and healthy subjects. Thirty CLBP patients and thirty healthy subjects through simple non-probability sampling participated in this cross-sectional analytical study. Lumbar lordosis, lumbar flexion and extension range of motion, lumbo-pelvic stability was measured through flexible ruler, modified modified schober test, and Pressure Biofeedback Unit (PBU respectively. ANCOVA test were used for statistical analysis (p0.05. Also lumbar lordosis, and lumbar flexion and extension range of motion did not significantly differ between two groups (p>0.05. There is no difference between CLBP and healthy subjects in terms of the lumbo-pelvic stability, lumbar lordosis, lumbar flexion and extension range of motion. The present study supported that lumbar lordosis, lumbar mobility, and lumbo-pelvic stability not affected by CLBP.

  12. Subjective memory complaints among patients on sick leave are associated with symptoms of fatigue and anxiety

    Directory of Open Access Journals (Sweden)

    Julie Kristine Aasvik

    2015-09-01

    Full Text Available Abstract: Objective: The aim of this study was to identify symptoms associated with subjective memory complaints among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety and insomnia. Methods: This was a cross-sectional study, subjects (n = 167 who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Index and Everyday Memory Questionnaire – Revised. General linear modeling (GLM was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value <= 0.001 and anxiety (p-value = 0.001 were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice.

  13. Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy

    Directory of Open Access Journals (Sweden)

    Steinhausen S

    2014-09-01

    Full Text Available Simone Steinhausen,1 Oliver Ommen,2 Sunya-Lee Antoine,1 Thorsten Koehler,3 Holger Pfaff,4 Edmund Neugebauer11Institute for Research in Operative Medicine (IFOM, Witten/Herdecke University, Campus Cologne-Merheim, Germany; 2Federal Centre for Health Education (BZgA, Cologne, Germany; 3Institute for Applied Social Sciences (infas, Bonn, Germany; 4Institute for Medical Sociology, Health Services Research and Rehabilitation Science (IMVR, Faculty of Human Science and Faculty of Medicine, University of Cologne, Germany Purpose: To investigate accident casualties’ long-term subjective evaluation of treatment outcome 6 weeks and 12 months after discharge and its relation to the experienced surgeon’s empathy during hospital treatment after trauma in consideration of patient-, injury-, and health-related factors. The long-term results are compared to the 6-week follow-up outcomes.Patients and methods: Two hundred and seventeen surgery patients were surveyed at 6 weeks, and 206 patients at 12 months after discharge from the trauma surgical general ward. The subjective evaluation of medical treatment outcome was measured 6 weeks and 12 months after discharge with the respective scale from the Cologne Patient Questionnaire. Physician Empathy was assessed with the Consultation and Relational Empathy Measure. The correlation between physician empathy and control variables with the subjective evaluation of medical treatment outcome 12 months after discharge was identified by means of logistic regression analysis under control of sociodemographic and injury-related factors.Results: One hundred and thirty-six patients were included within the logistic regression analysis at the 12-month follow-up. Compared to the 6-week follow-up, the level of subjective evaluation of medical treatment outcome was slightly lower and the association with physician empathy was weaker. Compared to patients who rated the empathy of their surgeon lower than 31 points, patients

  14. A pilot study of subjective well-being in colorectal cancer patients and their caregivers

    Directory of Open Access Journals (Sweden)

    Graham J

    2017-10-01

    Full Text Available Janet Graham,1 Pavlina Spiliopoulou,1 Rob Arbuckle,2 Julie Ann Bridge,3 James Cassidy1 1Department of Medical Oncology, Beatson, West of Scotland Cancer Center, Glasgow, UK, 2Adelphi Values, Adelphi Mill Macclesfield, Cheshire, UK; 3Eli Lilly Pty Ltd., West Ryde, NSW, Australia Background: Traditional endpoints in oncology are based on measuring the tumor size and combining this with a time factor. Current studies with immunotherapy show that even when median survival is unaltered, a significant proportion of patients can achieve prolonged survival. Objective tumor response does not always mean “overall” improvement, especially if toxicity is harsh. Novel agents are significantly expensive, and it is therefore crucial to measure the impact on “quality” of life, in addition to “quantity”.Materials and methods: We studied the preferences and experiences of cancer patients and their caregivers, measuring subjective well-being (SWB ratings, EQ5D descriptions and time trade-off preferences.Results: We studied 99 patients and 88 caregivers. Life satisfaction ratings were similar between the two groups, but daily mood was significantly lower in caregivers (P<0.1. Anxiety/depression affected SWB, while pain and mobility did not. Positive thoughts about health were associated with better daily moods in both groups, and stage IV cancer was associated with lower life satisfaction. Cancer in remission was associated with better daily moods, but, interestingly, not with patient life satisfaction. Patients with better daily mood and positive thoughts about family were less willing to “trade-off” life years.Conclusion: Caregivers are as anxious or depressed as patients, and report similar levels of life satisfaction but lower daily mood. A focus on SWB could provide a valid assessment of treatment benefit. Given the interesting results of this pilot study, we suggest a larger study should be conducted, measuring SWB over time. Keywords

  15. Subjective cognitive decline in patients with migraine and its relationship with depression, anxiety, and sleep quality.

    Science.gov (United States)

    Lee, Sun Hwa; Kang, Yeonwook; Cho, Soo-Jin

    2017-12-01

    Cognitive decline is a major concern in patients with migraine. Depression, anxiety, and/or poor sleep quality are well-known comorbidities of migraine, but available evidence on the subjective cognitive decline (SCD) is limited. This study aimed to investigate the presence and frequency of SCD and its relationship with anxiety, depression and sleep quality in patients with migraine. We enrolled patients with migraine who scored within the normal range of the Korean-Mini Mental State Examination and the Korean-Montreal Cognitive Assessment. Using the Subjective Cognitive Decline Questionnaire (SCD-Q), participants with ≥7 were assigned to the SCD group. The Headache Impact Test-6, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Pittsburgh Sleep Quality Index were used and analyzed between the two groups. A total of 188 patients with migraine, aged 38.1 ± 9.9 years, were enrolled. The mean SCD-Q score was 6.5 ± 5.5, and 44.7% of participants were identified as SCD. Migraineurs with SCD reported higher headache pain intensity and headache impact, as well as greater prevalence of anxiety, depression, reduced quality of sleep, and shorter sleep duration during weekdays compared to migraineurs without SCD. There were no significant differences in terms of age, sex, migraine type (chronic/episodic), medication, or sleep duration during weekends between the two groups. Upon multivariate logistic analysis adjusted for age, sex, headache characteristics, and psychological variables, depression was associated with increased risk of SCD (Odds ratio 1.31, 95% confidence interval 1.16-1.49) and sleep duration during weekdays was associated with decreased risk of SCD (Odds ratio 0.66, 95% confidence interval 0.44-0.97). A non-negligible number of patients with migraine complained of SCD. Depression and short sleep duration during weekdays were related to SCD among adult migraineurs.

  16. Assessment of quality of life with the WHOQOL-BREF in a group of Turkish psychiatric patients compared with diabetic and healthy subjects.

    Science.gov (United States)

    Akvardar, Yildiz; Akdede, Berna Binnur; Ozerdem, Ayşegül; Eser, Erhan; Topkaya, Sule; Alptekin, Köksal

    2006-12-01

    Decreased quality of life is often an important cause or consequence of psychiatric illness, and needs to be included in a comprehensive treatment plan. The authors aimed to identify how psychiatric patients characterize the quality of their lives compared to others who are suffering from a chronic physical illness (diabetes) and healthy individuals. A total of 100 psychiatric patients were recruited from Dokuz Eylül University Psychiatry Department outpatient clinic. Of these, 34 had 4(th) edition Diagnostic and Statistical Manual diagnosis of alcohol dependence, 38 had schizophrenia, and 28 had bipolar disorder. A total of 35 patients with diabetes and 49 healthy individuals were also included in the study. The World Health Organization's Quality of Life Questionnaire was used to measure the quality of life. Patients with alcohol dependence, bipolar disorder, and schizophrenia scored lower than healthy subjects on the physical aspects of quality of life. Patients with schizophrenia had lower scores in the psychological domain compared to patients with bipolar disorder, patients with diabetes, and healthy subjects. In the social relationship domain, patients with schizophrenia and alcohol dependence scored lower compared to healthy subjects. Patients with schizophrenia were worse with respect to social relationships than bipolar patients and diabetics. World Health Organization's Quality of Life Questionnaire is useful for evaluating the needs and targets for interventions in psychiatric patients.

  17. Subjective Factors of the Hospital Environment and Their Influence on Psychological Well-being of Patients

    Directory of Open Access Journals (Sweden)

    Agalarova K.N.

    2015-06-01

    Full Text Available The article is devoted to the study of the relationship between man and the space around him, namely between the patient and hospital environment. The article gives a little insight into the history of the issue. The study held in a number of hospitals explored the influence of hospital environment on the psychological state of patients and their recovery, as well as the searching of behavior patterns of patients staying in the hospital. There are several main factors in the right treatment: the doctor’s qualification, quality of medical equipment, novelty of medical technology and medicines prescribed to patients but also the conditions of the hospital environment and trusting relationship between patient and doctor as well. This theme is insufficiently explored especially in Russian medicine. Its studying will serve as a referral base for a more effective treatment of patients, and also for a creating a conducive hospital environment. This theme is interdisciplinary in nature. Mainly it refers to the subject of environmental psychology, also located at the junction of personality, health psychology and rehabilitation psychology.

  18. USE OF BACTERIAL LYSATES IN SUBJECTIVE IMPROVEMENT OF CLINICAL RESPONSE IN ALLERGIC RHINITIS PATIENTS

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    Vineel Muppidi

    2017-06-01

    Full Text Available BACKGROUND Allergic rhinitis is known to be one of the most common chronic diseases in the world. In this study, we provide an overview of allergic rhinitis responding to immunostimulating agents. According to the concept that allergic rhinitis patients generally suffer from an immune deficit in order to stimulate their immune system specifically or nonspecifically, immunomodulating agents from various sources such as synthetic compounds, tissue extracts or a mixture of bacterial extracts have been used. MATERIALS AND METHODS The aim of the present trial is to evaluate the efficacy of the treatment with an immunostimulating agent consisting of a freeze dried bacterial lysates (Ismigen and analyse the improvement in clinical response in allergic rhinitis patients. 50 allergic rhinitis patients were enrolled. For all patients, after 3 months of PMBL (polyvalent mechanical bacterial lysates treatment clinical response was analysed. RESULTS A clinical improvement in subjective symptoms was observed in 43 of the 50 patients treated with bacterial lysates (85.6%. The results are as follows- 45 patients (91.8%, we noticed a decrease in symptoms of nasal blockage and 38 patients (90.4% were relieved from rhinorrhea; purulent nasal discharge was reduced in 13 cases (81.5%, 30 patients (90.9% had a large improvement in nasal/palate itching and 15 patients (75% with headache were relieved. CONCLUSION From this study, bacterial lysates have shown to have a protective effect, which induces a significant reduction of the symptoms and duration related to allergic rhinitis. No negative side effects or worsening of the symptoms have been observed with this medication.

  19. Putative transcriptomic biomarkers in the inflammatory cytokine pathway differentiate major depressive disorder patients from control subjects and bipolar disorder patients.

    Directory of Open Access Journals (Sweden)

    Timothy R Powell

    Full Text Available Mood disorders consist of two etiologically related, but distinctly treated illnesses, major depressive disorder (MDD and bipolar disorder (BPD. These disorders share similarities in their clinical presentation, and thus show high rates of misdiagnosis. Recent research has revealed significant transcriptional differences within the inflammatory cytokine pathway between MDD patients and controls, and between BPD patients and controls, suggesting this pathway may possess important biomarker properties. This exploratory study attempts to identify disorder-specific transcriptional biomarkers within the inflammatory cytokine pathway, which can distinguish between control subjects, MDD patients and BPD patients. This is achieved using RNA extracted from subject blood and applying synthesized complementary DNA to quantitative PCR arrays containing primers for 87 inflammation-related genes. Initially, we use ANOVA to test for transcriptional differences in a 'discovery cohort' (total n = 90 and then we use t-tests to assess the reliability of any identified transcriptional differences in a 'validation cohort' (total n = 35. The two most robust and reliable biomarkers identified across both the discovery and validation cohort were Chemokine (C-C motif ligand 24 (CCL24 which was consistently transcribed higher amongst MDD patients relative to controls and BPD patients, and C-C chemokine receptor type 6 (CCR6 which was consistently more lowly transcribed amongst MDD patients relative to controls. Results detailed here provide preliminary evidence that transcriptional measures within inflammation-related genes might be useful in aiding clinical diagnostic decision-making processes. Future research should aim to replicate findings detailed in this exploratory study in a larger medication-free sample and examine whether identified biomarkers could be used prospectively to aid clinical diagnosis.

  20. Subjective disease perception and symptoms of depression in relation to healthcare-seeking behaviour in patients with rosacea.

    Science.gov (United States)

    Abram, Kristi; Silm, Helgi; Maaroos, Heidi-Ingrid; Oona, Marje

    2009-01-01

    Many patients with rosacea do not seek medical care. The aim of this study was to find predictors for healthcare-seeking behaviour among patients with rosacea. The study subjects were 70 consecutive patients attending a dermatologist (seekers) and 56 subjects with rosacea symptoms selected randomly from among the working population (non-seekers). All subjects completed an Estonian Mood Scale questionnaire, a screening instrument for depressive symptoms, and evaluated their subjective disease perception on a visual analogue scale (VAS). Multivariate analysis showed that the independent predictors for healthcare-seeking behaviour were VAS scores >5 and the presence of advanced forms of rosacea. Higher mean VAS scores were not related to severity of rosacea, but were associated with the presence of depressive symptoms among seekers. In conclusion, healthcare-seeking behaviour is associated with higher subjective disease perception. The presence of depressive symptoms is not related to severity of the disease, but to the subjective disease perception of rosacea patients.

  1. Comparison of methods of estimating body fat in normal subjects and cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Cohn, S.H. (Brookhaven National Lab., Upton, NY); Ellis, K.J.; Vartsky, D.; Sawitsky, A.; Gartenhaus, W.; Yasumura, S.; Vaswani, A.N.

    1981-12-01

    Total body fat can be indirectly estimated by the following noninvasive techniques: determination of lean body mass by measurement of body potassium or body water, and determination of density by underwater weighing or by skinfold measurements. The measurement of total body nitrogen by neutron activation provides another technique for estimating lean body mass and hence body fat. The nitrogen measurement can also be combined with the measurement of total body potassium in a two compartment model of the lean body mass from which another estimate of body fat can be derived. All of the above techniques are subject to various errors and are based on a number of assumptions, some of which are incompletely validated. These techniques were applied to a population of normal subjects and to a group of cancer patients. The advantages and disadvantages of each method are discussed in terms of their ability to estimate total body fat.

  2. Comparison of methods of estimating body fat in normal subjects and cancer patients.

    Science.gov (United States)

    Cohn, S H; Ellis, K J; Vartsky, D; Sawitsky, A; Gartenhaus, W; Yasumura, S; Vaswani, A N

    1981-12-01

    Total body fat can be indirectly estimated by the following noninvasive techniques: determination of lean body mass by measurement of body potassium or body water, and determination of density by underwater weighing or by skinfold measurements. The measurement of total body nitrogen by neutron activation provides another technique for estimating lean body mass and hence body fat. The nitrogen measurement can also be combined with the measurement of total body potassium in a two compartment model of the lean body mass from which another estimate of body fat can be derived. All of the above techniques are subject to various errors and are based on a number of assumptions, some of which are incompletely validated. These techniques were applied to a population of normal subjects and to a group of cancer patients. The advantages and disadvantages of each method are discussed in terms of their ability to estimate total body fat.

  3. Small Ubiquitin-Like Modifier 4 (SUMO4 Gene M55V Polymorphism and Type 2 Diabetes Mellitus: A Meta-analysis Including 6,823 Subjects

    Directory of Open Access Journals (Sweden)

    Yan-yan Li

    2017-11-01

    Full Text Available BackgroundMany studies suggest that the small ubiquitin-like modifier 4 (SUMO4 M55V gene polymorphism (rs237025 may be associated with an increased risk of type 2 diabetes mellitus (T2DM. However, due to other conflicting results, a clear consensus is lacking in the matter.Objective and methodsA meta-analysis consisting of 6,823 subjects from 10 studies was conducted to elucidate relationship between the SUMO4 M55V gene polymorphism and T2DM. Depending on the heterogeneity of the data, either a fixed or random-effects model would be used to assess the combined odds ratio (ORs and their corresponding 95% confidence interval (CI.ResultsSUMO4 gene M55V polymorphism was significantly associated with T2DM in the whole population under allelic (OR: 1.18, 95% CI: 1.10–1.28, P = 1.63 × 10−5, recessive (OR: 1.59, 95% CI: 1.14–2.23, P = 0.006, dominant (OR: 0.815, 95% CI: 0.737–0.901, P = 6.89 × 10−5, homozygous (OR: 1.415, 95% CI: 1.170–1.710, P = 0.0003, heterozygous (OR: 1.191, 95% CI: 1.072–1.323, P = 0.001, and additive genetic models (OR: 1.184, 95% CI: 1.097–1.279, P = 1.63 × 10−5. In our subgroup analysis, a significant association was found again in the Chinese population, but not in Japanese or Iranian population.ConclusionSUMO4 gene M55V polymorphism may correlate with increased T2DM risk. Chinese carriers of the V allele of the SUMO4 gene M55V polymorphism may be predisposed to developing T2DM.

  4. Clinical research, comparison of the subjective visual function in patients with epiphora and patients with second-eye cataract.

    Science.gov (United States)

    Kafil-Hussain, Namir; Khooshebah, Ramona

    2005-03-01

    To assess the subjective visual disability of patients with epiphora and to compare the results with that of patients waiting for second eye cataract surgery. A prospective, randomised, questionnaire-based study. Forty-six patients with epiphora listed for dacryocystorhinostomy and 50 patients having second eye cataract extraction were enrolled. A questionnaire focusing on functional visual disability in daily life and based on VF-14 was completed for each participant. Eighty-six percent of patients with epiphora and 41% of second-eye cataracts had difficulty reading small print (P vs. 42%) (P watching television (63.1% vs. 19%) (P vs. 10%) (P reading signs (39.1% vs. 4%) (P < 0.05), respectively. There is widespread recognition of the effect of cataract on visual function. This has resulted in substantial government funding to improve access to cataract surgery. In comparison, epiphora is rarely considered as a significant cause of visual disability. This study suggests that patients with epiphora suffer the same if not more of a visual handicap than patients awaiting second eye cataract surgery.

  5. Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

    Directory of Open Access Journals (Sweden)

    Graeme Kohler

    2017-11-01

    Full Text Available n a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs at decision-making points in primary healthcare (PHC based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.

  6. Comparison of Antioxidant Status and Vitamin D Levels between Multiple Sclerosis Patients and Healthy Matched Subjects

    Directory of Open Access Journals (Sweden)

    Ehsan Hejazi

    2014-01-01

    Full Text Available Objective. The aim of the present study was to compare the serum levels of total antioxidant status (TAS and 25(OH D3 and dietary intake of multiple sclerosis (MS patients with those of normal subjects. Method. Thirty-seven MS patients (31 women and the same number of healthy matched controls were compared for their serum levels and dietary intake of 25(OH D3 and TAS. Sun exposure and the intake of antioxidants and vitamin D rich foods were estimated through face-to-face interview and food frequency questionnaire. Results. Dietary intake of antioxidants and vitamin D rich foods, vitamin C, vitamin A, and folate was not significantly different between the two groups. There were also no significant differences in the mean levels of 25(OH D3 and TAS between the study groups. Both groups had low serum levels of 25(OH D3 and total antioxidants. Conclusion. No significant differences were detected in serum levels and dietary intake of vitamin D and antioxidants between MS patients and healthy controls. All subjects had low antioxidant status and vitamin D levels.

  7. Correlation between objective and subjective evaluation of profile in bimaxillary protrusion patients after orthodontic treatment.

    Science.gov (United States)

    Huang, Yi-Ping; Li, Wei-ran

    2015-07-01

    To correlate the objective cephalometric measurements with subjective facial esthetics in patients with bimaxillary protrusion. The sample consisted of 60 Asian-Chinese patients with bimaxillary protrusion who met the inclusion criteria. The facial esthetics of posttreatment profile and the change of profile on standardized lateral photographs were rated by a panel of 10 orthodontists and a panel of 10 lay persons with bimaxillary protrusion. All of the pretreatment and posttreatment cephalograms were digitized and traced. Twenty-five cephalometric measurements were constructed and analyzed. Correlations between the subjective facial esthetic scores and each cephalometric measurement were evaluated. The cephalometric measurements correlated with the facial esthetic scores of posttreatment profile given by the orthodontist and the lay persons were basically the same. For the evaluation of posttreatment profile in bimaxillary protrusion patients, the upper and lower lip to E-line, upper and lower incisor tip to AP plane, Pg-NB distance, mentolabial angle, and sulcus depth correlated significantly with the esthetic score. For the evaluation of profile change during orthodontic treatment, retraction of upper incisor relative to AP plane or the perpendicular line through sella (line Y), change of upper incisor inclination, change of mentolabial sulcus depth, and retraction of lips relative to E-line were correlated positively with the esthetic value. Cephalometric measurements of lip position, incisor position, and chin morphology were key parameters correlated to facial esthetics.

  8. A Comparison of Hemoglobin A2 Levels in Untreated and Treated Groups of HIV Patients on ART Including Zidovudine

    Directory of Open Access Journals (Sweden)

    Jitendra Singh Nigam

    2013-01-01

    Full Text Available Objective. To assess the level of haemoglobin A2 in HIV patients on antiretroviral therapy (ART including zidovudine with untreated HIV patients. Material and Methods. The study was a case control study. A total of 185 patients were included in the study; the case group included 125 HIV patients who were on antiretroviral therapy (ART including zidovudine and 60 were in the control group who were not receiving ART. The high-performance liquid chromatography (HPLC was done and hemoglobin A2 level was observed; value more than 3.5% was considered significant. The Hb A2 percentages of HIV patients were compared with those of control using an unpaired t-test. Results. The mean of Hb A2 in case group was 3.462% (SD 0.675 and in control group it was 2.815% (SD0.246. The higher Hb A2 value was seen in significant number of treated patients than control group (P<0.0001. Conclusion. The clinicians, pathologists, haematologists, and genetic counsellors should be aware of effects of nutritional anaemia and ART on Hb A2 to reduce the chances of misdiagnosis of β-thalassaemia especially in developing countries and for centres for antenatal screening.

  9. Is there a difference in subjective experience of cognitive function in patients with unipolar disorder versus bipolar disorder?

    DEFF Research Database (Denmark)

    Miskowiak, Kamilla; Vinberg, Maj; Christensen, Ellen Magrethe

    2012-01-01

    Background: Cognitive dysfunction in unipolar disorder (UD) and bipolar disorder (BD) may persist into remission and affect psychosocial function. Executive and memory deficits during remission may be more pronounced in BD than UD. However, patients' subjective experience of cognitive difficulties...... at their initial consultation at the clinic. Results: Patients experienced mild to moderate cognitive impairment despite being in partial or full remission, but there were no differences in subjective difficulties between BD and UD. Subjective cognitive dysfunction was predicted by depression severity, anxiety...

  10. [Assessment the lifestyle in patients after recent acute coronary syndrome qualified for cardiac rehabilitation and in healthy subjects].

    Science.gov (United States)

    Mejer, Anna; Irzmański, Robert; Pawlicki, Lucjan; Kowalski, Jan

    2013-07-01

    Results of a lot of research indicate that preventive activities consisting in the fighting of risk factors have the greatest influence on the reduction of the incidence of ischaemic heart disease. THE AIM OF THE STUDY was to assess the lifestyle in patients after recent acute coronary syndrome (ACS) qualified for cardiac rehabilitation and in healthy subjects (with no diagnosis of coronary thrombosis). The research included 86 patients, 64 men and 22 women aged 42-78 (mean age 61.7 +/- 9.6 years) after recent ACS, treated with PCI (percutaneous coronary interventions), and qualified for cardiac rehabilitation (stage II)--group I. The control group included 88 people, 54 men and 34 women aged 34-75 (mean age 56.2 +/- 9.7 years), who were clinically healthy--group II. The assessment of a lifestyle was performed based on the presence of four positive behaviours, i.e. eating appropriate amount of vegetables and (or) fruit every day, refraining from smoking, satisfactory levels of physical activity, and correct body mass. Based on these factors, a lifestyle index was calculated, from 0 (no positive health behaviours) to 4 (all positive health behaviours present), the so-called healthy lifestyle index. Among the examined elements of lifestyle index in ill and healthy subjects, satisfactory physical activity was the rarest (in 16.67% of men and in 9.09% women after ACS and in 16.22% of healthy men and 11.63% healthy women). Healthy lifestyle index was determined in 4.88% of patients after ACS. It was not found in healthy subjects. The analysis of the lifestyle index shows that a change of one's lifestyle is necessary as an initial and secondary prevention.

  11. Physical exercise, sickness absence and subjective employability: An 8-year longitudinal observational study among musculoskeletal patients.

    Science.gov (United States)

    Storm, Vera; Paech, Juliane; Ziegelmann, Jochen P; Lippke, Sonia

    2016-06-13

    Physical exercise recommendations become particularly effective when embedded into medical rehabilitation. However, little is known about long-term behaviour maintenance and its effect on sickness absence and subjective employability. The current longitudinal observational study investigated self-reported physical exercise, sickness absence and subjective employability over a period of 8 years. A total of 601 (T0) outpatients (mean age 45.14 years; standard deviation 10.73 years, age range 18-65 years) with different orthopaedic disorders were recruited during their 3-week medical rehabilitation in Germany. Of these, 61.7% (n = 371) were female. Follow-ups were carried out at 6 months (T1, n = 495), 12 months (T2, n = 340), 3 years (T3, n = 296) and 8 years (T4, n = 142) after baseline. Patient characteristics, exercise status, social-cognitive variables, sickness absence and subjective employability were obtained via self-report questionnaires. SPSS hierarchical regression models were used for data analysis, controlling for baseline measures and sociodemographic variables. Physical exercise status 6 months after rehabilitation treatment (T1) predicted sickness absence at 12 months (T2). Inactive people were 3.28 times more likely to be on sick leave at T2. In addition, physical exercise at T1 predicted subjective employability 12 months (T2) and 3 years (T3) later. Those who met the recommendations to be physically active for at least 40 min a week were more likely to feel able to work. Exercise appears to play an important role in reducing sickness absence and subjective employability and should be promoted within and after rehabilitation treatment.

  12. Sleep-wake difficulties in community-dwelling cancer patients receiving palliative care: subjective and objective assessment.

    Science.gov (United States)

    Bernatchez, Marie Solange; Savard, Josée; Savard, Marie-Hélène; Aubin, Michèle; Ivers, Hans

    2017-09-21

    Prevalence rates of sleep difficulties in advanced cancer patients have varied widely across studies (12 to 96%), and none of these employed a diagnostic interview to distinguish different types of sleep-wake disorders. Moreover, very limited information is available on subjective and objective sleep parameters in this population. Our study was conducted in palliative cancer patients and aimed to assess rates of sleep-wake disorders and subsyndromal symptoms and to document subjective and objective sleep-wake parameters across various types of sleep-wake difficulties. The sample was composed of 51 community-dwelling cancer patients receiving palliative care and having an Eastern Cooperative Oncology Group score of 2 or 3. Relevant sections of the Duke Interview for Sleep Disorders were administered over the phone. An actigraphic recording and a daily sleep diary were completed for 7 consecutive days. Overall, 68.6% of the sample had at least one type of sleep-wake difficulty (disorder or symptoms): 31.4% had insomnia and 29.4% had hypersomnolence as their main sleep-wake problem. Participants with insomnia as their main sleep difficulty had greater disruptions of subjective sleep parameters, while objectively-assessed sleep was more disrupted in patients with hypersomnolence comorbid with another sleep-wake difficulty. Significance of the Results: The high rates of sleep-wake difficulties found in this study indicate a need to screen more systematically for sleep-wake disorders, including insomnia and hypersomnolence, in both palliative care research and clinical practice, and to develop effective nonpharmacological interventions specifically adapted to this population.

  13. Comprehensive Echocardiographic and Cardiac Magnetic Resonance Evaluation Differentiates Among Heart Failure With Preserved Ejection Fraction Patients, Hypertensive Patients, and Healthy Control Subjects.

    Science.gov (United States)

    Mordi, Ify R; Singh, Satnam; Rudd, Amelia; Srinivasan, Janaki; Frenneaux, Michael; Tzemos, Nikolaos; Dawson, Dana K

    2017-08-11

    The aim of this study was to investigate the utility of a comprehensive imaging protocol including echocardiography and cardiac magnetic resonance in the diagnosis and differentiation of hypertensive heart disease and heart failure with preserved ejection fraction (HFpEF). Hypertension is present in up to 90% of patients with HFpEF and is a major etiological component. Despite current recommendations and diagnostic criteria for HFpEF, no noninvasive imaging technique has as yet shown the ability to identify any structural differences between patients with hypertensive heart disease and HFpEF. We conducted a prospective cross-sectional study of 112 well-characterized patients (62 with HFpEF, 22 with hypertension, and 28 healthy control subjects). All patients underwent cardiopulmonary exercise and biomarker testing and an imaging protocol including echocardiography with speckle-tracking analysis and cardiac magnetic resonance including T1 mapping pre- and post-contrast. Echocardiographic global longitudinal strain (GLS) and extracellular volume (ECV) measured by cardiac magnetic resonance were the only variables able to independently stratify among the 3 groups of patients. ECV was the best technique for differentiation between hypertensive heart disease and HFpEF (ECV area under the curve: 0.88; GLS area under the curve: 0.78; p ECV, an optimal cutoff of 31.2% gave 100% sensitivity and 75% specificity. ECV was significantly higher and GLS was significantly reduced in subjects with reduced exercise capacity (lower peak oxygen consumption and higher minute ventilation-carbon dioxide production) (p ECV and GLS). Both GLS and ECV are able to independently discriminate between hypertensive heart disease and HFpEF and identify patients with prognostically significant functional limitation. ECV is the best diagnostic discriminatory marker of HFpEF and could be used as a surrogate endpoint for therapeutic studies. Copyright © 2017 American College of Cardiology

  14. Regional distribution of pulmonary epithelial permeability in normal subjects and patients with asbestosis.

    OpenAIRE

    Gellert, A R; Lewis, C. A.; Langford, J A; Tolfree, S E; Rudd, R. M.

    1985-01-01

    The overall and regional clearance of an inhaled isotope labelled solute from the lungs was examined on the basis of a 15 minute period of data collection, for which a technique was developed that does not require intravenous injection to correct for blood-tissue background activity. The technique was applied to 52 normal subjects (31 non-smokers and 21 smokers) and to 37 patients with asbestosis (21 non-smokers and 16 smokers). In normal smokers solute clearance was faster in the upper and m...

  15. Research in the hospital setting on human subjects. Protecting the patient and the institution.

    Science.gov (United States)

    Scheuer, R

    1993-10-01

    A hospital's institutional review board is charged with the responsibility of fully protecting the rights of research subjects. In doing so, the board establishes that research protocols are based on sound scientific principles, that benefits to research subjects outweigh the risks, and that the subject's consent is informed and not coerced. Although it has been argued that risk management has no role in the activities of such boards, the literature indicates that risk management and quality assurance principles apply to all areas of the institution, including the activities of the board. The institution must ensure that its researchers and board members are as fully protected as possible from civil and criminal liability and that the integrity of those conducting the research is established and maintained. The institution must also provide sufficient support for the board to conduct its reviews and educate the research community and board members on current and evolving laws and regulations governing human research. Risk prevention and quality assurance strategies should recognize the rights of the research subject as paramount while protecting the institution, its researchers, and the community served.

  16. Subjective impact of minimally invasive dentistry in the oral health of older patients.

    Science.gov (United States)

    da Mata, Cristiane; Cronin, Michael; O'Mahony, Denis; McKenna, Gerald; Woods, Noel; Allen, Patrick Finbarr

    2015-04-01

    The aim of this study was to investigate if a minimally invasive oral health package with the use of atraumatic restorative treatment (ART) or a conventional restorative technique (CT) would result in any perceived benefit from the patients' perspective and if there would be any difference between the two treatment groups. In this randomised clinical trial, 99 independently living older adults (65-90 years) with carious lesions were randomly allocated to receive either ART or conventional restorations using minimally invasive/intervention dentistry (MID) principles. Patients completed an Oral Health Impact Profile (OHIP)-14 questionnaire before and 2 months after treatment. They were also asked to complete a global transition question about their oral health after treatment. At baseline, the mean OHIP-14 scores recorded were 7.34 (ART) and 7.44 (CT). Two months after treatment intervention, 90 patients answered the OHIP-14 and the mean scores were 7.23 (not significant (n.s.)) and 10.38 (n.s.) for the ART and CT groups, respectively. Overall, 75.5 % of patients stated that their oral health was better compared to the beginning of treatment. Although not shown by the OHIP-14, patients perceived an improvement in their overall oral status after treatment, as demonstrated by the global transition ratings in both groups. Dental treatment using minimally invasive techniques might be a good alternative to treat older individuals, and it can improve their oral health both objectively and subjectively.

  17. The ratio of the subjective audiometry in patients with acoustic trauma and “noisy” production workers

    Directory of Open Access Journals (Sweden)

    Shydlovska T.А.

    2014-11-01

    Full Text Available Introduction: The problem of diagnosis and treatment of sensorineural hearing loss (SHL, including forms developed under the influence of noise, takes one of the leading places in ot¬olaryngology. However, there are not many studies on acoustic trauma, although this problem has recently become more and more important. Objective: A comparison of subjective audiometry in patients with sensorineural hearing loss after acute acoustic trauma and chronic noise exposure. Materials and methods. In the work the results of exa¬mination of 84 patients with acoustic trauma, 15 healthy as the control group and 15 workers employed on 'noise' occupations as a comparison group are given. Subjective audiometry was fully carried out by clinical audiometer AC-40 «Interacoustics» (Denmark. Hearing indices were investigated in the conventional (0,125-8 kHz and extended (9-16 kHz frequency bands. Results: Subjective audiometry showed a reduction in sound perception in all patients. Ac¬cor¬ding to the threshold tone audiometry in patients with acoustic trauma hearing thresholds were authentically (P <0,05 increased by 4, 6 and 8 kHz tones of conventional (0,125-8 kHz frequency band and by 14-16 kHz tones of the extended (9-16 kHz in comparison with the control group, as with workers employed on noise occupations. All the examined patients had deterioration of speech-test audiometry and above-threshold audiometry. Conclusions: According to su¬b¬jective audiometry, the type similar disorders of auditory function are in patients with acoustic trauma as in patients with long-term noise exposure, but they are more pronounced and develop much faster. The most informative features which show the origin and progression of hearing loss in patients with acoustic trauma are: increasing hearing thresholds by 14 and 16 kHz tones of the extended (9-16 kHz frequency band and by 4, 6 and 8 kHz tones of con¬ven¬tional (0,125-8 kHz frequency band plus the reduction of

  18. Efficacy of yoga therapy on subjective well-being and basic living skills of patients having chronic schizophrenia

    Directory of Open Access Journals (Sweden)

    Babu Paikkatt

    2012-01-01

    Full Text Available Background: Scientific studies demonstrate efficacy of yogic treatment methods in stress and anxiety related disorders, psychosomatic disorders and physical illness. Very few studies have been conducted on schizophrenic patients. Aims: This study was conducted to determine the efficacy of yoga therapy on subjective well-being, basic living skills, self-care, interpersonal, communicational and routine functions of schizophrenic patients. Materials and Methods: Thirty chronic schizophrenic hospitalized patients were selected from Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi and were randomly assigned to the experimental group (yoga therapy along with Pharmacotherapy, n=15, and to control group (Pharmacotherapy alone, n=15. Baseline assessment was done using Post Graduate Institute general well-being measure (GWBM, Checklist for basic living skills and Indian disability evaluation and assessment scale (IDEAS. The experimental group attended yoga therapy every day for about 1΍ h including motivational and feedback session. After 1 month post-assessment was done for both the groups. Statistical Analysis: Pearson Chi-square test was used for comparing the results. Results: At the end of 1 month experimental group showed better rating in comparison to control group in PGI GWBM, basic living skills and IDEAS. Conclusion: Yoga could improve patients′ subjective well-being, their daily basic living functioning, personal hygiene, self-care, interpersonal activities and communication, and prompted more involvement in routine work.

  19. Whole body MRI, including diffusion-weighted imaging in follow-up of patients with testicular cancer.

    Science.gov (United States)

    Mosavi, Firas; Laurell, Anna; Ahlström, Håkan

    2015-11-01

    Whole body (WB) magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) has become increasingly utilized in cancer imaging, yet the clinical utility of these techniques in follow-up of testicular cancer patients has not been evaluated. The purpose of this study was to evaluate the feasibility of WB MRI with continuous table movement (CTM) technique, including multistep DWI in follow-up of patients with testicular cancer. WB MRI including DWI was performed in follow-up of 71 consecutive patients (median age, 37 years; range 19-84) with histologically confirmed testicular cancer. WB MRI protocol included axial T1-Dixon and T2-BLADE sequences using CTM technique. Furthermore, multi-step DWI was performed using b-value 50 and 1000 s/mm(2). One criterion for feasibility was patient tolerance and satisfactory image quality. Another criterion was the accuracy in detection of any pathological mass, compared to standard of reference. Signal intensity in DWI was used for evaluation of residual mass activity. Clinical, laboratory and imaging follow-up were applied as standard of reference for the evaluation of WB MRI. WB MRI was tolerated in nearly all patients (69/71 patients, 97%) and the image quality was satisfactory. Metal artifacts deteriorated the image quality in six patients, but it did not influence the overall results. No case of clinical relapse was observed during the follow-up time. There was a good agreement between conventional WB MRI and standard of reference in all patients. Three patients showed residual masses and DWI signal was not restricted in these patients. Furthermore, DWI showed abnormally high signal intensity in a normal-sized retroperitoneal lymph node indicating metastasis. The subsequent (18)F-FDG PET/CT could verify the finding. WB MRI with CTM technique including multi-step DWI is feasible in follow-up of patients with testicular cancer. DWI may contribute to important added-value data to conventional MRI sequences

  20. Differences in myocardial strain between pectus excavatum patients and healthy subjects assessed by cardiac MRI: a pilot study.

    Science.gov (United States)

    Lollert, André; Emrich, Tilman; Eichstädt, Jakob; Kampmann, Christoph; Abu-Tair, Tariq; Turial, Salmai; Düber, Christoph; Kreitner, Karl-Friedrich; Staatz, Gundula

    2017-09-11

    To evaluate differences in myocardial strain between pectus excavatum (PE) patients and healthy subjects (HS) assessed by cardiac MRI using the feature-tracking algorithm. Cardiac MRI was performed in 14 PE patients and 14 HS (9:5 male to female in each group; age 11-30 years) using a 3T scanner. Post-examination analysis included manual biventricular contouring with volumetry and ejection fraction measurement by two independent radiologists. Dedicated software was used for automated strain assessment. In five of the PE patients, the right ventricular ejection fraction was slightly impaired (40-44 %). PE patients had a significantly higher left ventricular longitudinal strain (P=0.004), mid (P=0.035) and apical (P=0.001) circumferential strain as well as apical circumferential strain rate (P=0.001), mid right ventricular circumferential strain (P=0.008) and strain rate (P=0.035), and apical right ventricular circumferential strain (P=0.012) and strain rate (P=0.044) than HS. The right ventricular longitudinal strain and strain rate did not differ significantly between PE patients and HS. Myocardial strain differs significantly between PE patients and HS. Higher myocardial strain in the mid and apical ventricles of PE patients indicates a compensation mechanism to enhance ventricular output against basal sternal compression. • The right ventricle is frequently affected by the pectus excavatum deformity. • Cardiac MRI revealed differences in myocardial strain in pectus excavatum patients. • Pectus excavatum patients exhibited higher strain in the mid/apical ventricles. • A compensation mechanism to enhance ventricular output against sternal compression is possible.

  1. Impact of Psychological Factors on Subjective Disease Activity Assessments in Patients With Severe Rheumatoid Arthritis

    Science.gov (United States)

    Cordingley, Lis; Prajapati, Rita; Plant, Darren; Maskell, Deborah; Morgan, Catharine; Ali, Faisal R; Morgan, Ann W; Wilson, Anthony G; Isaacs, John D; Barton, Anne

    2014-01-01

    Objective The Disease Activity Score in 28 joints (DAS28), used to assess disease activity in rheumatoid arthritis (RA), is a composite score comprising clinical, biochemical, and patient self-report measures. We hypothesized that psychological factors (cognitions and mood) would be more strongly associated with patient-reported components of the DAS28 than clinical or biochemical components. Methods A cross-sectional, observational study of 322 RA patients with active disease (mean DAS28 6.0) awaiting therapy with a biologic agent was undertaken. Patients' illness beliefs, treatment beliefs, and mood were measured using the Brief Illness Perception Questionnaire (IPQ), the Beliefs about Medicines Questionnaire (BMQ), and the Hospital Anxiety and Depression Scale (HADS), respectively. Relationships between psychological factors and 1) total DAS28 and 2) individual components of the DAS28 were analyzed using linear regression. Results Total DAS28 produced significant but weak associations with 2 of the Brief IPQ items, but no associations with BMQ or HADS scores. There were larger significant associations between the patient-reported visual analog scale (VAS) with 5 items of the Brief IPQ and with HADS depression. Low illness coherence was associated with higher tender joint count. Three Brief IPQ items and HADS anxiety scores were significantly associated with C-reactive protein level or erythrocyte sedimentation rate. No psychological factors were associated with the swollen joint count. Conclusion One of the subjective components of the DAS28, patient VAS, was highly correlated with cognitive factors and depression in those with severe RA. By reporting individual DAS28 components, clinicians may be better able to assess the impact of therapies on each component, adjusting approaches according to patients' needs. PMID:24339425

  2. Blood pressure differences between office and home settings among Japanese normotensive subjects and hypertensive patients.

    Science.gov (United States)

    Mori, Hisao; Ukai, Hiroshi; Yamamoto, Hareaki; Yuasa, Shouhei; Suzuki, Yoshiro; Chin, Keiichi; Katsumata, Takuma; Umemura, Satoshi

    2017-03-01

    This study attempted to clarify the differences in blood pressure (BP) between the office (clinic) and home settings in patients with controlled, sustained, masked or white-coat hypertension. The following formula was used: office mean systolic BP (omSBP)-mean morning home SBP (mmhSBP)/office mean diastolic BP (omDBP)-mean morning home DBP (mmhDBP). The paired t-test was used for statistical analysis. The omSBP-mmhSBP/omDBP-mmhDBP calculation yielded the following results: among normotensive subjects, -1.1±11.2/-1.7±8.5 mm Hg (mean SBP and mean DBP were higher at home than in the office; n=451, P=0.038 in SBP, P=0.000 in DBP); in controlled hypertensive patients, -0.42±10.9/-2.2±8.2 mm Hg (n=1362, P=0.160 in SBP, P=0.000 in DBP); among sustained hypertensive patients, 5.6±14.7/0.048±9.9 mm Hg (n=1370, P=0.000 in SBP, P=0.857 in DBP); in masked hypertensive patients, -15.3±12.9/-9.3±9.5 mm Hg (n=1308, both P=0.000); and among white-coat hypertensive patients, 23.7±13.2/8.2±9.1 mm Hg (n=580, both P=0.000). Our results showed a difference of 5 mm Hg in SBP among sustained hypertensive patients, as recommended by the Japanese Society of Hypertension Guidelines for the Management of Hypertension; however, in other hypertensive patient types, the differences in SBP and DBP between office and home measurements differed by >5 mm Hg. Office and home BP measurements should be interpreted cautiously, keeping in mind the clinical setting.

  3. Processes in healthcare teams that include nurse practitioners: what do patients and families perceive to be effective?

    Science.gov (United States)

    Kilpatrick, Kelley; Jabbour, Mira; Fortin, Chantal

    2016-03-01

    To explore patient and family perceptions of team effectiveness of teams those include nurse practitioners in acute and primary care. Nurse practitioners provide safe and effective care. Patients are satisfied with the care provided by nurse practitioners. Research examining patient and family perceptions of team effectiveness following the implementation of nurse practitioners in teams is lacking. A descriptive qualitative design was used. We used purposeful sampling to identify participants in four clinical specialties. We collected data from March 2014-January 2015 using semi-structured interviews and demographic questionnaires. Content analysis was used. Descriptive statistics were generated. Participants (n = 49) believed that the teams were more effective after the implementation of a nurse practitioner and this was important to them. They described processes that teams with nurse practitioners used to effectively provide care. These processes included improved communication, involvement in decision-making, cohesion, care coordination, problem-solving, and a focus on the needs of patients and families. Participants highlighted the importance of interpersonal team dynamics. A human approach, trust, being open to discussion, listening to patient and family concerns and respect were particularly valued by participants. Different processes emerged as priorities when data were examined by speciality. However, communication, trust and taking the time to provide care were the most important processes. The study provides new insights into the views of patients and families and micro-level processes in teams with nurse practitioners. The relative importance of each process varied according to the patient's health condition. Patients and providers identified similar team processes. Future research is needed to identify how team processes influence care outcomes. The findings can support patients, clinicians and decision-makers to determine the processes to focus on to

  4. Effect of cigarette smoking on subgingival bacteria in healthy subjects and patients with chronic periodontitis.

    Science.gov (United States)

    Karasneh, Jumana A; Al Habashneh, Rola A; Marzouka, Nour Aldain S; Thornhill, Martin H

    2017-03-21

    Cigarette smoking is known to increase the risk of periodontal destruction and developing chronic periodontitis (CP). It is also reported to affect the subgingival bacterial profile among CP patients. However, studies on the effect of smoking on the bacterial profile among healthy subjects are still limited. Therefore, the aim of this study was to investigate the impact of smoking on the subgingival bacterial profile in both healthy adults and CP patients. Subgingival plaque samples were collected from CP patients (30 nonsmokers and 9 smokers) and healthy subjects (37 non-smokers and 18 smokers). Genomic DNA was extracted and 25 bacterial species were detected using PCR of 16S rRNA. Comparing smokers to non-smokers from each group was conducted using chi2 and binary logistic regression analysis. After correcting for confounding factors, the odds of having Slackia exigua, Selenomonas sputigena and Campylobacter rectus was higher among healthy smokers (ORadj = 10.1, 6.62 and 5.62 respectively). While for CP group, the highest odds were observed for Treponema amylovorum, Treponema medium, Slackia exigua and Treponema vincentii (ORadj = 20.7, 7.97, 6.37 and 5.37 respectively) and the increase in Treponema amylovorum was statistically significant (p = 0.05). Smoking affects the subgingival bacterial profile in healthy individuals and is responsible for the depletion of beneficial bacteria and the increase in periodontopathogenic bacteria. In the CP patient group, our study suggests that subgingival bacteria (particularly Treponema species) make a more substantial contribution in the etiology of CP among non-smokers. Further studies using a larger sample set and more sensitive and quantitative techniques (such as real -time PCR) are needed to enhance our understanding of the exact effect of smoking on subgingival biofilm.

  5. Regional distribution of pulmonary epithelial permeability in normal subjects and patients with asbestosis.

    Science.gov (United States)

    Gellert, A R; Lewis, C A; Langford, J A; Tolfree, S E; Rudd, R M

    1985-10-01

    The overall and regional clearance of an inhaled isotope labelled solute from the lungs was examined on the basis of a 15 minute period of data collection, for which a technique was developed that does not require intravenous injection to correct for blood-tissue background activity. The technique was applied to 52 normal subjects (31 non-smokers and 21 smokers) and to 37 patients with asbestosis (21 non-smokers and 16 smokers). In normal smokers solute clearance was faster in the upper and middle zones, with a mean ratio of T1/2 LB (half time solute clearance from lungs to blood) in the upper two thirds to the lower one third of the lungs of 0.66 (0.28-1.33), compared with 1.24 (0.43-2.77) in normal non-smokers (p less than 0.002). In patients with asbestosis solute clearance was accelerated throughout the lungs even though radiographic abnormalities were limited to lower or lower to middle zones. Regional distribution of clearance was not affected by posture in normal subjects. Overall solute clearance was significantly faster in normal current smokers and in patients with asbestosis than in normal non-smokers (p less than 0.001 respectively). Among patients with asbestosis, smokers had faster overall clearance than non-smokers (p less than 0.01). Among normal non-smokers T1/2 LB was not significantly different between those who had never smoked and ex-smokers. Regional abnormalities in pulmonary epithelial permeability may offer insight into the pathogenesis of interstitial lung diseases and smoking related disorders.

  6. Circadian clock gene expression in brain regions of Alzheimer 's disease patients and control subjects.

    Science.gov (United States)

    Cermakian, Nicolas; Lamont, Elaine Waddington; Boudreau, Philippe; Boivin, Diane B

    2011-04-01

    Circadian oscillators have been observed throughout the rodent brain. In the human brain, rhythmic expression of clock genes has been reported only in the pineal gland, and little is known about their expression in other regions. The investigators sought to determine whether clock gene expression could be detected and whether it varies as a function of time of day in the bed nucleus of the stria terminalis (BNST) and cingulate cortex, areas known to be involved in decision making and motivated behaviors, as well as in the pineal gland, in the brains of Alzheimer's disease (AD) patients and aged controls. Relative expression levels of PERIOD1 (PER1 ), PERIOD2 (PER2), and Brain and muscle Arnt-like protein-1 (BMAL1) were detected by quantitative PCR in all 3 brain regions. A harmonic regression model revealed significant 24-h rhythms of PER1 in the BNST of AD subjects. A significant rhythm of PER2 was found in the cingulate cortex and BNST of control subjects and in all 3 regions of AD patients. In controls, BMAL1 did not show a diurnal rhythm in the cingulate cortex but significantly varied with time of death in the pineal and BNST and in all 3 regions for AD patients. Notable differences in the phase of clock gene rhythms and phase relationships between genes and regions were observed in the brains of AD compared to those of controls. These results indicate the presence of multiple circadian oscillators in the human brain and suggest altered synchronization among these oscillators in the brain of AD patients. © 2011 Sage Publications

  7. Gut microbial diversity in health and disease: experience of healthy Indian subjects, and colon carcinoma and inflammatory bowel disease patients.

    Science.gov (United States)

    Bamola, V Deepak; Ghosh, Arnab; Kapardar, Raj Kishor; Lal, Banwari; Cheema, Simrita; Sarma, Priyangshu; Chaudhry, Rama

    2017-01-01

    Background: The intestinal microbiota, through complex interactions with the gut mucosa, play a key role in the pathogenesis of colon carcinoma and inflammatory bowel disease (IBD). The disease condition and dietary habits both influence gut microbial diversity. Objective: The aim of this study was to assess the gut microbial profile of healthy subjects and patients with colon carcinoma and IBD. Healthy subjects included 'Indian vegetarians/lactovegetarians', who eat plant produce, milk and milk products, and 'Indian non-vegetarians', who eat plant produce, milk and milk products, certain meats and fish, and the eggs of certain birds and fish. 'Indian vegetarians' are different from 'vegans', who do not eat any foods derived wholly or partly from animals, including milk products. Design: Stool samples were collected from healthy Indian vegetarians/lactovegetarians and non-vegetarians, and colon cancer and IBD patients. Clonal libraries of 16S ribosomal DNA (rDNA) of bacteria were created from each sample. Clones were sequenced from one representative sample of each group. Approximately 500 white colonies were picked at random from each sample and 100 colonies were sequenced after amplified rDNA restriction analysis. Results: The dominant phylum from the healthy vegetarian was Firmicutes (34%), followed by Bacteroidetes (15%). The balance was reversed in the healthy non-vegetarian (Bacteroidetes 84%, Firmicutes 4%; ratio 21:1). The colon cancer and IBD patients had higher percentages of Bacteroidetes (55% in both) than Firmicutes (26% and 12%, respectively) but lower Bacteroidetes:Firmicutes ratios (3.8:1 and 2.4:1, respectively) than the healthy non-vegetarian. Bacterial phyla of Verrucomicrobiota and Actinobacteria were detected in 23% and 5% of IBD and colon patients, respectively. Conclusions: Ribosomal Database Project profiling of gut flora in this study population showed remarkable differences, with unique diversity attributed to different diets and disease

  8. Oral reading fluency analysis in patients with Alzheimer disease and asymptomatic control subjects.

    Science.gov (United States)

    Martínez-Sánchez, F; Meilán, J J G; García-Sevilla, J; Carro, J; Arana, J M

    2013-01-01

    Many studies highlight that an impaired ability to communicate is one of the key clinical features of Alzheimer disease (AD). To study temporal organisation of speech in an oral reading task in patients with AD and in matched healthy controls using a semi-automatic method, and evaluate that method's ability to discriminate between the 2 groups. A test with an oral reading task was administered to 70 subjects, comprising 35 AD patients and 35 controls. Before speech samples were recorded, participants completed a battery of neuropsychological tests. There were no differences between groups with regard to age, sex, or educational level. All of the study variables showed impairment in the AD group. According to the results, AD patients' oral reading was marked by reduced speech and articulation rates, low effectiveness of phonation time, and increases in the number and proportion of pauses. Signal processing algorithms applied to reading fluency recordings were shown to be capable of differentiating between AD patients and controls with an accuracy of 80% (specificity 74.2%, sensitivity 77.1%) based on speech rate. Analysis of oral reading fluency may be useful as a tool for the objective study and quantification of speech deficits in AD. Copyright © 2012 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  9. [Results of an artificial airway management protocol in critical patients subjected to mechanical ventilation].

    Science.gov (United States)

    Prieto-González, M; López-Messa, J B; Moradillo-González, S; Franzón-Laz, Z M; Ortega-Sáez, M; Poncela-Blanco, M; Alonso-Castañeira, I; Andrés-de Llano, J

    2013-01-01

    To determine the results of the implementation of a protocol in an intensive care unit (ICU) referred to critically ill patients requiring a prolonged artificial airway. A prospective, observational cohort study was carried out. Management strategies were established on the airway by endotracheal intubation (ETI) or tracheostomy, and guidelines were developed for action in the decannulation process. A polyvalent ICU. We studied 169 patients subjected to mechanical ventilation (MV), 67 with ETI ≥ 10 days of MV and 102 with percutaneous (PT) or surgical tracheostomy (TQ). ICU and hospital stays, days of ETI and MV, mortality, tracheostomy, anatomical risk factors, surgical complications, and postoperative decannulation period. ETI versus tracheotomy involved fewer days of MV (17 vs. 30 days, p<0.001), a shorter ICU stay (20 vs. 35 days, p<0.001), and a shorter hospital stay (34 vs. 51 days, p<0.001).There were more TQ procedures in patients with risk factors (47% TP vs. 89% TQ, p<0.001). Intraoperative minor bleeding was the most common complication, being associated with TQ (31% vs. 11%, p = 0.03). TP was associated with a shorter cannulationperiod (25 days vs. 34 days, p<0.04). The protocol variants showed no differences in terms of complications and mortality, when orienting application to patients with similar characteristics. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  10. Prepulse inhibition in euthymic bipolar disorder patients in comparison with control subjects.

    Science.gov (United States)

    Sánchez-Morla, E M; Mateo, J; Aparicio, A; García-Jiménez, M Á; Jiménez, E; Santos, J L

    2016-10-01

    Deficient prepulse inhibition (PPI) of the startle response, indicating sensorimotor gating deficits, has been reported in schizophrenia and other neuropsychiatric disorders. This study aimed to assess sensorimotor gating deficits in patients with euthymic bipolar. Furthermore, we analysed the relationships between PPI and clinical and cognitive measures. Prepulse inhibition was measured in 64 patients with euthymic bipolar and in 64 control subjects matched for age, gender, education level and smoking status. Clinical characteristics and level of functioning were assessed in all participants using Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS) and Functioning Assessment Short Test (FAST). Cognition was evaluated using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) and the Stroop test as an additional measure of executive function. Compared with controls, patients with bipolar disorder exhibited PPI deficits at 60- and 120-millisecond prepulse-pulse intervals. Among patients with bipolar disorder, PPI was correlated with the social cognition domain of the MCCB. PPI was not significantly correlated with other clinical, functional and neurocognitive variables in either group. Our data suggest that PPI deficit is a neurobiological marker in euthymic bipolar disorder, which is associated with social cognition but not with other clinical, functional or cognitive measures. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. RCT - subjective physical performance and quality of life after a 6-month programmed sports therapy (PST) in patients with haemophilia.

    Science.gov (United States)

    Runkel, B; Von Mackensen, S; Hilberg, T

    2017-01-01

    Musculoskeletal bleedings lead to limitations in the locomotor system and consequently, in health-related quality of life (HRQoL) in patients with haemophilia (PwH). Sports therapy is increasingly recommended to improve their physical performance. Until today, randomised controlled studies investigating changes in physical performance in PwH are rare. This study investigates the impact of programmed sports therapy on the subjective physical performance and the HRQoL in PwH. A randomised controlled trial (RCT) was conducted with a training intervention for over 6 months. For this purpose, 64 PwH with moderate (n = 5) or severe (n = 59) haemophilia A (n = 57) or B (n = 7) were randomised into two groups - intervention (IG) or control group (CG). The HRQoL was assessed with the SF-36 questionnaire and the disease-specific Haem-A-QoL before and after the intervention. The subjective physical performance was tested by the HEP-Test-Q. After the 6-month training intervention, PwH in the IG subjectively reported significant better 'endurance' (P = 0.000) in the HEP-Test-Q compared to the CG. In the SF-36, a significant difference in the domains 'general health perceptions' (P = 0.005) and 'mental health' (P = 0.001) was detected. The haemophilia-specific HRQoL questionnaire showed a significant improvement in the dimensions 'feeling' (P = 0.049), 'work' (P = 0.046) and 'family' (P = 0.040). In the first RCT evaluating the impact of a 6-month training intervention on the subjective perception of PwH, an increase in subjective physical performance and some domains of HRQoL was demonstrated in the IG. Specific sports therapy should be included into the comprehensive treatment under supervision and monitoring by experienced staff. © 2016 John Wiley & Sons Ltd.

  12. Performance of Patient-Generated Subjective Global Assessment (PG-SGA) in Patients With Advanced Cancer in Palliative Care.

    Science.gov (United States)

    Wiegert, Emanuelly Varea Maria; Padilha, Patricia de Carvalho; Peres, Wilza Arantes Ferreira

    2017-10-01

    The purpose of this study was to evaluate the prognostic significance of the Patient-Generated Subjective Global Assessment (PG-SGA) in patients receiving palliative care for advanced cancer. The PG-SGA was used to assess nutrition status of 120 patients admitted to the Palliative Care Unit at the National Cancer Institute in Brazil. According to the PG-SGA, 94.2% (n = 113) of the patients were evaluated as malnourished. The PG-SGA evaluated that xerostomia was the only symptom associated with a short survival (odds ratio [OR], 2.54; 95% confidence interval [CI], 1.2-5.38; P = .014). Survival was found to be significantly higher in well-nourished (PG-SGA A) than malnourished (PG-SGA B [ P = .021] or C [ P = .013]) patients. Total PG-SGA score (hazard ratio [HR], 1.06; 95% CI, 1.001-1.09; P = .045) and Karnofsky Performance Status of 20%-30% (HR, 15.4; 95% CI, 1.63-92.9; P = .001) and 40%-50% (HR, 10.0; 95% CI, 1.22-64.9; P = .031) were found to be independent prognostic survival factors. The scored PG-SGA is an independent prognostic factor of survival and thus can be a useful tool for nutrition evaluation in palliative care.

  13. Activities of Daily Living and Depressive Symptoms in Patients with Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer's Disease.

    Science.gov (United States)

    Stogmann, Elisabeth; Moser, Doris; Klug, Stefanie; Gleiss, Andreas; Auff, Eduard; Dal-Bianco, Peter; Pusswald, Gisela; Lehrner, Johann

    2016-01-01

    Subjective cognitive decline (SCD) may be an early indicator for an increased risk of dementia. The exact definition of SCD remains unclear and has recently become a major research interest. To determine impairments in activities of daily living (ADL) and depressive symptoms in elderly individuals with SCD, mild cognitive impairment (MCI), and Alzheimer's disease (AD). We included 752 consecutive patients suffering from SCD, non-amnestic (naMCI) or amnestic MCI (aMCI), AD, and 343 healthy controls into this prospective cohort study. A neuropsychological test battery, B-ADL and BDI-II was performed. SCD patients showed a decreased performance in ADL compared to controls. Performance in ADL declined concurrently with cognitive abilities along the controls-SCD-naMCI-aMCI-AD continuum. Individuals with cognitive complains, no matter if SCD, MCI, or AD patients, reported more often depressive symptoms compared to healthy controls without complaints. Within all five cognitive subgroups, patients with depressive symptoms reported more difficulties in ADL in comparison to patients without depressive symptoms. Adjusting for depressive symptoms, there was no significant group difference between the control versus the SCD group (OR 1.1, CI 0.6-1.7). SCD is a heterogeneous clinical condition. Specific features such as slightly impaired ADL and depressive symptoms are associated with SCD. Clinical markers may serve as an indicator for preclinical AD and in combination with biomarkers guide to an early diagnosis of a progressive neurodegenerative disease.

  14. Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

    Science.gov (United States)

    Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

    2017-03-06

    Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to

  15. Red Blood Cell Distribution Width in Patients With Chronic Obstructive Pulmonary Disease and Healthy Subjects.

    Science.gov (United States)

    Ozgul, Guler; Seyhan, Ekrem Cengiz; Özgül, Mehmet Akif; Günlüoğlu, Mehmet Zeki

    2017-03-01

    Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular disease (CVD). Red blood cell distribution width (RDW) is accepted as a powerful predictor of outcomes in patients with CVD. To study RDW in patients with COPD, and to compare the value of this measurement with clinical, echocardiographic, nutritional and laboratory status. Secondly, we aimed to determine the effect of smoking on RDW values in healthy subjects. One hundred and seventy-five patients with stable COPD and 210 healthy controls were enrolled in the study. Demographic, clinical, nutritional status, echocardiographic, and laboratory characteristics, RDW values were recorded and compared. RDW values were higher in the COPD group than in controls (15±2.3% vs. 13.8±2.5%, p<0.001). In COPD patients, RDW levels positively correlated with CRP levels (r=0.27, P<.001), albumin levels (r=0.23, P=.04), right ventricular dysfunction (RVD) (r=0.24, P=.001), pulmonary hypertension (PAH) (r=0.1, P=.02), and presence of CVD (r=0.24, P=.02). In multivariable logistic regression suggested that presence of CVD (4.3; 95% CI: 1.3 to 11; P=.01), and presence of RVD (3.1; 95% CI: 1.7 to 8.3; P=.02) were independently related to elevated RDW levels in COPD patients. In the healthy population, correlations analysis showed only a significant correlation between RDW and cigarette smoking years (r=0.57, P<.001). RDW is independently associated with CVD and RVD in patients with COPD. In the healthy population, RDW is also associated with smoking status. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Evaluation of Salivary Leptin Levels in Healthy Subjects and Patients with Advanced Periodontitis

    Directory of Open Access Journals (Sweden)

    Afshin Khorsand

    2016-08-01

    Full Text Available Objectives: Leptin is a hormone-like protein produced by the adipose tissue. It plays an important role in protection of host against inflammation and infection. Some studies have reported changes in leptin levels in the gingival crevicular fluid (GCF, saliva and blood serum of patients with periodontal disease compared to healthy individuals. The aim of the present study was to compare the salivary leptin levels in patients with advanced periodontitis and healthy individuals.Materials and Methods: In this case-control study, the salivary samples of healthy individuals and patients with advanced periodontitis with clinical attachment loss >5mm were obtained using a standardized method and the leptin levels were measured in the salivary samples by means of ELISA. The effects of the periodontal status and sex on the salivary leptin levels of both groups were statistically analyzed by two-way ANOVA.Results: The means ± standard deviation (SD of salivary leptin levels in healthy subjects and patients with advanced periodontitis were 34.27±6.88 and 17.87±5.89 pg/mL, respectively. Statistical analysis showed that the effect of sex on the salivary leptin levels was not significant (P=0.91, while the effect of advanced periodontitis on the salivary leptin levels was significant compared to healthy individuals (P<0.0001.Conclusions: In patients with advanced periodontitis, the salivary leptin levels were significantly lower compared to healthy individuals. Thus, assessment of salivary leptin can be done as a non-invasive and simple method to determine the susceptibility of patients to advanced periodontitis.

  17. Patients included in randomised controlled trials do not represent those seen in clinical practice: focus on antimicrobial agents.

    Science.gov (United States)

    Falagas, Matthew E; Vouloumanou, Evridiki K; Sgouros, Konstantinos; Athanasiou, Stavros; Peppas, George; Siempos, Ilias I

    2010-07-01

    Clinicians rely on the findings of randomised controlled trials (RCTs) to formulate clinical decisions regarding individual patients. We examined whether patients included in RCTs focusing on antimicrobial agents are representative of those encountered in real-life clinical situations. PubMed was searched for RCTs referring to the field of infectious diseases. Data regarding the exclusion criteria of the identified RCTs were extracted and critically evaluated. In total, 30 trials (17 referring to respiratory tract, 5 to skin and soft-tissue, 4 to intra-abdominal, 2 to gynaecological and 2 to bloodstream infections) were included in the study. All retrieved RCTs reported extensive exclusion criteria. After comparing in a qualitative manner (based on our clinical experience) the eligible patient population in the identified RCTs with the respective population that would be encountered in general practice, it was observed that the abovementioned patient populations differ considerably. In conclusion, RCTs in the field of infectious diseases use extensive and stringent exclusion criteria, a fact that may lead to considerable difference between the patient populations of RCTs and those viewed in clinical practice. The application of the findings of RCTs to the care of individual patients should be performed cautiously. (c) 2010 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  18. Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Atsushi Hashimoto

    2017-01-01

    Full Text Available Objective. Rheumatoid arthritis (RA may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH including pneumocystis pneumonia (PCP in patients with RA. Methods. We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs for factors associated with the occurrence of IRH. Results. In a total of 9210 patient-years (2688 patients, there were 373 IRH (3.7/100 patient-years. Respiratory tract infections were most frequent (n=154, and additionally 16 PCP, followed by urinary tract infections (n=50. Significant factors for PCP included higher age (≥70 years; OR 3.5, male sex (6.6, underlying lung disease (3.0, use of corticosteroids (4.8, and use of biologics (5.4. Use of methotrexate (5.7 was positively associated with PCP but negatively with total infections (0.7. Additionally, functional disorders and higher RA disease activity were also related to total infections. Conclusions. Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.

  19. Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis.

    Science.gov (United States)

    Frih, Bechir; Mkacher, Wajdi; Jaafar, Hamdi; Frih, Ameur; Ben Salah, Zohra; El May, Mezry; Hammami, Mohamed

    2018-04-01

    The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients. Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n = 26) or a control group (resistance-endurance training only, n = 23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale. All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group. In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only. Implications for rehabilitation Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities. Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.

  20. Gastric emptying of solid radiopaque markers: studies in healthy subjects and diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Feldman, M.; Smith, H.J.; Simon, T.R.

    1984-10-01

    The purpose of these studies was to develop a radiologic method for assessing gastric emptying of an indigestible solid in humans and to apply this technique to the evaluation of patients with diabetes mellitus. Thirty healthy subjects ingested 10 solid radiopaque markers (small pieces of nasogastric tubing) together with a standard meal (donuts and 7-Up). Radiographs of the upper abdomen were obtained hourly for up to 6 h until all markers had emptied from the stomach. In some experiments, 99mTc-labeled scrambled eggs were added to the meal so that emptying of this digestible solid, assessed by scintigraphy, could be compared with emptying of liquids and solid radiopaque markers. In healthy subjects, the digestible solid emptied more slowly than the liquid (t 1/2 . 154 +/- 11 min vs. 30 +/- 3 min, p less than 0.001), but emptying of digestible solid was significantly faster than the emptying of the indigestible solid radiopaque markers. In diabetics, emptying rates for the digestible solid and liquid were close to normal (t 1/2 . 178 +/- 5 min and 40 +/- 3 min, respectively), whereas indigestible solid markers were retained in the stomach 6 h after the meal in 50% of the patients. Radiopaque markers proved to be a simple method for measuring gastric emptying of indigestible solids in humans. Using this technique, patients with insulin-dependent diabetes mellitus had a high incidence of abnormally slow gastric emptying of indigestible solids; the method may be a more sensitive indicator of gastric motor dysfunction than radionuclide scintigraphy.

  1. Impact of oral diseases on quality of life in subjects attending out-patient department of a dental hospital, India

    Directory of Open Access Journals (Sweden)

    N Saimadhavi

    2013-01-01

    Full Text Available Context: Currently there is a growing interest in oral health outcomes in how oral health affects quality of life. When oral health related quality of life measures are used alongside traditional clinical methods of measuring oral health status, a more comprehensive assessment of the impact of oral diseases on the several dimensions of subjective wellbeing becomes possible. In this context, we attempted to study the impact of oral diseases on quality of life, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Aims: To evaluate the impact of different oral diseases on quality of life using a modified OHIP-14 questionnaire, so as to address the patient′s needs in an appropriate way and thereby improving one′s quality of life. Settings and Design: The study was carried out among 302 subjects, attending the outpatient department a dental hospital, India, for check up and treatment of their oral condition. Subjects aged above 20 years, who gave their consent for the study were included. Materials and Methods: The study sample was categorized in to two groups based upon the duration of the affecting disease - group 1 consisted of subjects suffering with chronic diseases and group 2 of subjects suffering with acute diseases. All the subjects were asked to fill up their responses in the given OHIP-14 questionnaires. The completed questionnaires were then collected and statistically analyzed. Statistical Analysis Used: To evaluate the role of age on QOL, age was divided in to 2 groups using median split procedure. For inter and intragroup comparisions, independent sample t test, anova followed by post hoc test and Chi-square tests were employed. Results: Chi square test revealed a moderately impaired quality of life among all the diseases investigated. On comparing the mean domain and total OHIP score between the two groups, the domain of psychological discomfort and disability and the total

  2. [The rehabilitative treatment of the patients presenting with chronic obstructive pulmonary disease including the application of the manual handling methods].

    Science.gov (United States)

    Ayrapetova, N S; Eremushkin, M A; Antonovich, I V; Kuznetsov, O F; Samorukov, A E; Budylin, S P; Tarasova, L Yu; Derevnina, N A

    2017-01-01

    The objective of the present study was to identify the peculiar features and advantages of different methods for the mechanical impact on the thoracic tissues of the patients presenting with chronic obstructive pulmonary disease (COPD) and to develop specific indications for their clinical applications. This randomized prospective comparative study included 137 patients with COPD. In accordance with the currently accepted classification (GOLD, 2013), all the patients had COPD of medium severity. The smoldering inflammatory process was diagnosed in 75 (54.7%) patients, grade I and II respiratory insufficiency in 80 (58.4%) and 57 (41.6%) patients, respectively. The external respiration function was evaluated by means of pneumotachometry techniques during the forced expiratory maneuver and by spirometry. The pulmonary hemodynamics and myocardial contractility of the right ventricle were studied with the use of rheopulmonography and central hemodynamics by tetrapolar thoracic rheography. The routine inflammatory and immune tests were employed. Investigations of the systemic circulation have demonstrated the prevalence of its hyperkinetic type (54,0%) over the hypokinetic and eukinetic ones (23,3% and 22,7% respectively). All the patients were divided into three group identical in terms of clinical and functional characteristics. The patients comprising group 1 (n=46) were prescribed the rehabilitative treatment in the form of classical chest massage, those of group 2 (n=47) were treated by means of intense massage of asymmetric chest zones, and the patients included in group 3 (n=44) underwent manual therapy. It was shown that intense massage produced the most pronounced beneficial effect. Classical massage also resulted in the reduction of the inflammatory manifestations but its effectiveness was significantly lower than that of the intense treatment (рManual therapy failed to cause any appreciable changes in the character and severity of the inflammatory process (

  3. Patient self-reported concerns in inflammatory bowel diseases: A gender-specific subjective quality-of-life indicator.

    Directory of Open Access Journals (Sweden)

    Valérie Pittet

    Full Text Available Patient-reported disease perceptions are important components to be considered within a holistic model of quality of care. Gender may have an influence on these perceptions. We aimed to explore gender-specific concerns of patients included in a national bilingual inflammatory bowel disease cohort.Following a qualitative study, we built a questionnaire comprising 37 items of concern. Answers were collected on a visual analog scale ranging from 0 to 100. Principal axis factor analysis was used to explore concern domains. Linear multiple regressions were conducted to assess associations with patient characteristics.Of 1102 patients who replied to the survey, 54% were female and 54% had Crohn's disease. We identified six domains of concern: socialization and stigmatization, disease-related constraints and uncertainty, symptoms and their impact on body and mind, loss of body control (including sexuality, disease transmission, and long-term impact of the disease. Cancer concerns were among the highest scored by all patients (median 61.8. Severity of symptoms was the only factor associated with concerns, unrelated to dimension and gender (p40 years decreased disease-related constraints and uncertainty concerns, and being at home or unemployed increased them. Treatments were associated with increased socialization and stigmatization and with increased disease-related constraints and uncertainty concerns in men. Overall, psychosomatic characteristics were highly associated with concerns for both men and women. Depending on the concern dimensions, increased levels of concern were associated with the highest signs of anxiety in women or depression in men, as well as lower health-related quality of life in men.Patients have numerous concerns related to their illness that need to be reassessed regularly. Concerns differ between men and women, suggesting that information and communication about the disease should take gender differences and subjective

  4. Patient self-reported concerns in inflammatory bowel diseases: A gender-specific subjective quality-of-life indicator.

    Science.gov (United States)

    Pittet, Valérie; Vaucher, Carla; Froehlich, Florian; Burnand, Bernard; Michetti, Pierre; Maillard, Michel H

    2017-01-01

    Patient-reported disease perceptions are important components to be considered within a holistic model of quality of care. Gender may have an influence on these perceptions. We aimed to explore gender-specific concerns of patients included in a national bilingual inflammatory bowel disease cohort. Following a qualitative study, we built a questionnaire comprising 37 items of concern. Answers were collected on a visual analog scale ranging from 0 to 100. Principal axis factor analysis was used to explore concern domains. Linear multiple regressions were conducted to assess associations with patient characteristics. Of 1102 patients who replied to the survey, 54% were female and 54% had Crohn's disease. We identified six domains of concern: socialization and stigmatization, disease-related constraints and uncertainty, symptoms and their impact on body and mind, loss of body control (including sexuality), disease transmission, and long-term impact of the disease. Cancer concerns were among the highest scored by all patients (median 61.8). Severity of symptoms was the only factor associated with concerns, unrelated to dimension and gender (pwomen, being >40 years decreased disease-related constraints and uncertainty concerns, and being at home or unemployed increased them. Treatments were associated with increased socialization and stigmatization and with increased disease-related constraints and uncertainty concerns in men. Overall, psychosomatic characteristics were highly associated with concerns for both men and women. Depending on the concern dimensions, increased levels of concern were associated with the highest signs of anxiety in women or depression in men, as well as lower health-related quality of life in men. Patients have numerous concerns related to their illness that need to be reassessed regularly. Concerns differ between men and women, suggesting that information and communication about the disease should take gender differences and subjective

  5. Impact of depressive symptoms on subjective well-being: the importance of patient-reported outcomes in schizophrenia

    Directory of Open Access Journals (Sweden)

    Haro JM

    2011-09-01

    Full Text Available Jorge Mauriño1, Julio Sanjúan2, Josep Maria Haro3, Teresa Díez1, Javier Ballesteros41AstraZeneca Medical Department, Madrid, Spain; 2Department of Psychiatry, University of Valencia, CIBERSAM, Valencia, Spain; 3Parc Sanitari Sant Joan de Deu, CIBERSAM, Sant Boi de Llobregat, Spain; 4Department of Neuroscience-Psychiatry, University of the Basque Country, UPV/EHU, CIBERSAM, Leioa, SpainObjective: The subjective experience of psychotic patients toward treatment is a key factor in medication adherence, quality of life, and clinical outcome. The aim of this study was to assess the subjective well-being in patients with schizophrenia and to examine its relationship with the presence and severity of depressive symptoms.Methods: A multicenter, cross-sectional study was conducted with clinically stable outpatients diagnosed with schizophrenia. The Subjective Well-Being under Neuroleptic Scale – short version (SWN-K and the Calgary Depression Scale for Schizophrenia (CDSS were used to gather information on well-being and the presence and severity of depressive symptoms, respectively. Spearman’s rank correlation was used to assess the associations between the SWN-K total score, its five subscales, and the CDSS total score. Discriminative validity was evaluated against that criterion by analysing the area under the curve (AUC.Results: Ninety-seven patients were included in the study. Mean age was 35 years (standard deviation = 10 and 72% were male. Both the total SWN-K scale and its five subscales correlated inversely and significantly with the CDSS total score (P < 0.0001. The highest correlation was observed for the total SWN-K (Spearman’s rank order correlation [rho] = –0.59, being the other correlations: mental functioning (–0.47, social integration (–0.46, emotional regulation (–0.51, physical functioning (–0.48, and self-control (–0.41. A total of 33 patients (34% were classified as depressed. Total SWN-K showed the highest AUC

  6. Severe osteonecrosis of the jaws in a compromised patient subjected to bisphosphonate therapy

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    Juliana Dreyer de Menezes

    Full Text Available Bisphosphonate-related osteonecrosis of the jaws is characterized by alveolar bone exposure, especially after mucosal trauma or after surgical procedures, in patients who have previously received or who are currently receiving bisphosphonates without a history of radiation therapy in the maxillofacial region. The condition is refractory to treatment, and attempts at debridement are not completely effective in eradicating the necrotic bone. We report here a case of a severe osteonecrosis of the jaws in a 77-year-old male patient, who had been subjected to chemotherapy and treatment with zoledronic acid and corticosteroid. The patient also had comorbidities such as diabetes and periodontal disease, which might have contributed to the lesion development. Bisphosphonate-related osteonecrosis of the jaws has become a reality in dental clinical practice. Although palliative treatment aiming at controlling pain, infection and injury progression is indicated, the therapeutic strategy is still challenging. So far, the best approach available is prevention, based on oral care before, during, and after bisphosphonate therapy.

  7. Patient experienced continuity of care in the psychiatric healthcare system-a study including immigrants, refugees and ethnic danes.

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

    2014-09-17

    The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups.

  8. Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

    Science.gov (United States)

    Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

    2014-01-01

    Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. PMID:25233017

  9. Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

    Directory of Open Access Journals (Sweden)

    Natasja Koitzsch Jensen

    2014-09-01

    Full Text Available Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes. Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups.

  10. Population pharmacokinetics of pregabalin in healthy subjects and patients with post-herpetic neuralgia or diabetic peripheral neuropathy

    Science.gov (United States)

    Shoji, Satoshi; Suzuki, Misaki; Tomono, Yoshiro; Bockbrader, Howard N; Matsui, Shigeyuki

    2011-01-01

    AIM Pregabalin, a chemical analogue of the mammalian neurotransmitter γ-aminobutyric acid, has been approved in many countries for partial-onset seizures, generalized anxiety disorder and various other pain disorders, including neuropathic pain associated with post-herpetic neuralgia and diabetic peripheral neuropathy and fibromyalgia. The aim of this study was to develop a population pharmacokinetic model and quantify the influence of covariates on the parameters. METHODS This pregabalin population pharmacokinetic analysis was conducted on data from 14 clinical trials involving healthy subjects, subjects with impaired renal function and patients with post-herpetic neuralgia or diabetic peripheral neuropathy (n = 616). The data analysis was performed using nonlinear mixed effects modelling methodology as implemented by NONMEM. RESULTS A one-compartment model with first-order absorption and elimination adequately described pregabalin pharmacokinetics. The model indicated that pregabalin apparent clearance (CL/F) was proportional to estimated creatinine clearance (CLcr). The pregabalin systemic exposure in patients with lower renal function who received pregabalin 150 mg twice daily was almost equal to that of patients with normal renal function administered pregabalin 300 mg twice daily. The systemic exposure stratified by lower or normal renal function was similar between patients with post-herpetic neuralgia and diabetic peripheral neuropathy. CONCLUSION The developed model identified CLcr and ideal body weight as clinically influential covariates on CL/F and volume of distribution, respectively. This study indicates that renal function accounts for variability in the apparent clearance of pregabalin which is consistent with what is known about the elimination of this drug. PMID:21306415

  11. Induced Opening of the Gastroesophageal Junction Occurs at a Lower Gastric Pressure in Gerd Patients and in Hiatal Hernia Subjects than in Normal Control Subjects

    Directory of Open Access Journals (Sweden)

    Anil Vegesna

    2010-01-01

    Full Text Available Purpose. To determine intragastric pressure threshold for inducing gastroesophageal junction (GEJ opening in normal control subjects with and without hiatal hernia, and in patients with gastroesophageal reflux disease. Methods. This study was performed in 13 normal volunteers, 5 volunteers with hiatal hernia, and 3 patients with gastroesophageal reflux disease. During endoscopy a pressure transducer was used to measure baseline gastric pressures. The pressure in the stomach was measured while air was insufflated into the stomach until the gastroesophageal junction opened on endoscopic view. Results. There were two patterns of GEJ opening in normal volunteers. The mean opening pressure for Gastroesophageal junction in normal pattern-I, normal pattern-II, hiatal hernia, and Gastroesophageal reflux patients was 11.5, 12.6, 3.4, and 1.3 mmHg, respectively. Conclusions. GEJ opening is induced at a significantly lower pressure in subjects with hiatal hernia and in patients with gastroesophageal reflux disease than in normal volunteers.

  12. [Psychological characteristics of patients with vasovagal syncope: and observational study on sixty subjects].

    Science.gov (United States)

    Bonadies, Maria; Di Trani, Michela; Solano, Luigi; Tumbiolo, Francesca; Piacentini, Francesca; Ammirati, Fabrizio

    2006-04-01

    Based on the relevant literature, the aim of this study was to analyze the psychosocial characteristics of patients with vasovagal syncope and to evaluate these factors as possible etiopathological components. The study sample consisted of 60 subjects divided as follows: the syncope group (n = 30) and the control group (n = 30, without prominent diseases). The two groups were matched with regard to age, sex, education and civil status. Each participant filled in the Twenty-Item Toronto Alexithymia Scale, acceptance of emotions scale, profile of mood state, attachment style questionnaire, and childhood traumatic events scale. The syncope group showed a higher number of somatic diseases (p vasovagal syncope. These data show that syncope could be at least partiality due to a relational and emotional imbalance that finds expression through the body in the presence of insufficient mental processing. Treatment of this syndrome should therefore take these aspects into consideration.

  13. Comparison Between Sequential Therapy and Modified Bismuth-Included Quadruple Therapy for Helicobacter pylori Eradication in Chinese Patients.

    Science.gov (United States)

    Yang, Xiuhong; Tan, Pengsheng; Song, Lianying; Lu, Zhanying

    To compare the efficacy and safety of sequential therapy and modified bismuth-included quadruple therapy as a first-line Helicobacter pylori eradication in China. The patients were randomized to receive sequential therapy [n = 90; rabeprazole (20 mg twice daily) and amoxicillin (1 g twice daily) for 5 days, followed by rabeprazole (20 mg twice daily), tinidazole (500 mg twice daily) plus clarithromycin (500 mg twice daily) for another 5 days] or modified bismuth-included quadruple therapy [n = 109; rabeprazole (20 mg twice daily), levofloxacin hydrochloride (400 mg twice daily), clarithromycin (500 mg twice daily), and colloidal bismuth pectin (200 mg 3 times a day) for 7 days]. A follow-up urea breath test was applied 4 weeks later. A total of 199 patients were diagnosed with H. pylori infection. The intention-to-treat and per-protocol (PP) eradication rates were 91.7% and 92.6%, respectively, in the modified bismuth-included quadruple therapy group, and 74.4% and 76.1%, respectively, in the sequential therapy group. The eradication rates were significantly higher in the modified bismuth-included quadruple therapy group, compared with the sequential therapy group (P = 0.001 for intention to treat and P = 0.001 for PP). Adverse effects were reported by patients from both groups, but the difference did not reach significant level (P = 0.280). The modified bismuth-included quadruple therapy seemed to be superior to the sequential therapy as the first-line regimen for H. pylori eradication in Chinese patients.

  14. Gastric emptying of solid radiopaque markers: studies in healthy subjects and diabetic patients.

    Science.gov (United States)

    Feldman, M; Smith, H J; Simon, T R

    1984-10-01

    The purpose of these studies was to develop a radiologic method for assessing gastric emptying of an indigestible solid in humans and to apply this technique to the evaluation of patients with diabetes mellitus. Thirty healthy subjects ingested 10 solid radiopaque markers (small pieces of nasogastric tubing) together with a standard meal (donuts and 7-Up). Radiographs of the upper abdomen were obtained hourly for up to 6 h until all markers had emptied from the stomach. Although most of the liquid component of the meal, labeled with 111In, emptied during the first hour (as assessed simultaneously by radionuclide scintigraphy), few radiopaque markers emptied from the stomach during the first 2 h after the meal. Most markers emptied during the fourth postprandial hour, and all 10 markers had emptied by 6 h in 45 of 46 experiments. In contrast, not all of the solid radiopaque markers emptied from the stomach by 6 h in 16 of 26 experiments in patients with diabetes mellitus (p less than 0.001 vs. healthy controls). In some experiments, 99mTc-labeled scrambled eggs were added to the meal so that emptying of this digestible solid, assessed by scintigraphy, could be compared with emptying of liquids and solid radiopaque markers. In healthy subjects, the digestible solid emptied more slowly than the liquid (t 1/2 = 154 +/- 11 min vs. 30 +/- 3 min, p less than 0.001), but emptying of digestible solid was significantly faster than the emptying of the indigestible solid radiopaque markers. In diabetics, emptying rates for the digestible solid and liquid were close to normal (t 1/2 = 178 +/- 5 min and 40 +/- 3 min, respectively), whereas indigestible solid markers were retained in the stomach 6 h after the meal in 50% of the patients. Radiopaque markers proved to be a simple method for measuring gastric emptying of indigestible solids in humans. Using this technique, patients with insulin-dependent diabetes mellitus had a high incidence of abnormally slow gastric emptying of

  15. Genotype analysis of Malassezia restricta as the major cutaneous flora in patients with atopic dermatitis and healthy subjects.

    Science.gov (United States)

    Sugita, Takashi; Tajima, Mami; Amaya, Misato; Tsuboi, Ryoji; Nishikawa, Akemi

    2004-01-01

    Lipophilic yeasts of the genus Malassezia colonize the skin surface of humans and are an exacerbating factor in atopic dermatitis (AD). Two species, M. restricta and M. globosa are major cutaneous microflora in both AD patients and healthy subjects. We compared the DNA sequences of the intergenic spacer (IGS) region, located between the 26S and 5S rRNA genes of M. restricta colonizing the skin surfaces of 13 AD patients and 12 healthy subjects, and of three CBS stock strains as references. The IGS 1 sequences were divided into two major groups, corresponding to AD patients and healthy subjects. These findings suggest that a specific genotype of M. restricta plays a significant role in AD, although M. restricta commonly colonizes both AD patients and healthy subjects.

  16. Conditions affecting the activity of glucocerebrosidase purified from spleens of control subjects and patients with type 1 Gaucher disease

    NARCIS (Netherlands)

    Aerts, J. M.; Sa Miranda, M. C.; Brouwer-Kelder, E. M.; van Weely, S.; Barranger, J. A.; Tager, J. M.

    1990-01-01

    Glucocerebrosidase was purified to homogeneity from spleens of control subjects and Type 1 Gaucher disease patients by immunoaffinity chromatography. Activation of the enzyme by taurocholate, phosphatidylserine and sphingolipid activator protein 2 (saposin C; SAP-2) was investigated by titration of

  17. Pharmacokinetics of flucloxacillin and cloxacillin in healthy subjects and patients on chronic intermittent haemodialysis.

    Science.gov (United States)

    Nauta, E H; Mattie, H

    1975-01-01

    1 A pharmacokinetic study on flucloxacillin and cloxacillin was performed to investigate the factors contributing to the higher serum concentrations reported for the former after oral administration. 2 The results obtained in a study performed in a group of volunteers with flucloxacillin administered orally and by continuous infusion, were compared with the results of a similar investigation with cloxacillin. Patients on chronic intermittent haemodialysis received flucloxacillin orally and as a single i.v. injection. The results of this part of the study were compared with those of an earlier study on cloxacillin in haemodialysis patients. Serum and urine concentrations of flucloxacillin and cloxacillin were determined by bio-assay, and a one-compartment model was used for the calculations. 3 Higher serum concentrations reached after oral administration of flucloxacillin as compared with cloxacillin were based not only on better oral absorption (53.7% and 32.9%, respectively) but also on slower (renal and extra-renal) elimination (T1/2 : 46 and 32 min, respectively). A significant difference between the apparent volumes of distribution of flucloxacillin and cloxacillin, which could contribute to higher serum concentrations, could not be demonstrated. Considerable individual variation occurs in the rate and amount of oral absorption, especially in patients. The elimination rate of flucloxacillin in haemodialysis patients (T1/2 : 2h 53 min) corresponds with the extra-renal elimination rate in healthy subjects. No influence of haemodialysis on the elimination rate constant of flucloxacillin was found; total plasma clearance was, however, slightly but significantly higher during dialysis. PMID:1234495

  18. Subjective Sleep Quality in Temporomandibular Disorder Patients and Association with Disease Characteristics and Oral Health-Related Quality of Life.

    Science.gov (United States)

    Benoliel, Rafael; Zini, Avraham; Zakuto, Avraham; Slutzky, Hulio; Haviv, Yaron; Sharav, Yair; Almoznino, Galit

    2017-01-01

    To measure sleep quality in temporomandibular disorder (TMD) patients, to compare it with that of control subjects, and to analyze its association with disease characteristics and oral health-related quality of life (OHRQoL). The collected data included demographics, tobacco use, the Pittsburgh Sleep Quality Index (PSQI), trauma history, presence of coexisting headaches and/or body pain, parafunctional habits, pain scores, muscle tenderness to palpation scores, and the Oral Health Impact Profile-14 (OHIP-14). Differences between groups were examined with Pearson chi-square test for categorical variables and independent t test and analysis of variance (ANOVA) for numeric variables. Significant differences were then further tested with multivariate backward stepwise linear regression analysis. The final analysis was performed on 286 individuals (187 TMD patients and 99 controls). Poor sleep (PSQI global score > 5) was exhibited in 43.3% of the TMD group and in 28.3% of the control group (P = .013) (mean ± standard deviation [SD] PSQI score = 5.53 ± 2.85 for TMD patients and 4.41 ± 2.64 for controls, P = .001). TMD patients had significantly worse scores in the sleep quality component of the PSQI questionnaire (P = .006). Higher PSQI global scores and poor sleep were positively associated with whiplash history (P = .009 and P = .004, respectively), coexisting headaches (P = .005 and P = .002), body pain (P = .001 and P quality was positively associated with TMD disease characteristics, comorbid pain conditions, and poorer OHRQoL. Assessing sleep quality should be a routine part of the diagnostic work-up of TMD patients. A multidisciplinary management approach is needed to address all the factors-including sleep-that modulate pain experience.

  19. Circulating Her-2/neu extracellular domain in breast cancer patients-correlation with prognosis and clinicopathological parameters including steroid receptor, Her-2/neu receptor coexpression.

    Science.gov (United States)

    Barić, Marina; Kulić, Ana; Sirotković-Skerlev, Maja; Dedić Plavetić, Natalija; Vidović, Marina; Horvatić-Herceg, Gordana; Vrbanec, Damir

    2015-07-01

    HER-2/neu extracellular domain (ECD) can be detected in blood as a soluble circulating protein. The aim of this study was to analyze the relationship between HER-2/neu extracellular domain in the serum and the prognosis in breast cancer patients. We also correlated HER-2/neu ECD with various clinicopathological factors including steroid receptor, HER-2/neu receptor coexpression. The serum from seventy nine patients with invasive breast cancer and twenty individuals without malignancy was analyzed using the enzyme-linked immune adsorbent assay method. The cut-off value was estimated by the ROC curve analysis (15.86 μg/L). HER-2/neu ECD values in the serum of patients with breast cancer were significantly higher than in control subjects. Circulating HER-2/neu ECD was significantly associated with the histological grade of tumors and the status of axillary lymph nodes. Negative correlation was observed between HER-2/neu ECD in the serum and estrogen receptor positivity. When we analyzed HER-2/neu ECD in relation with coexpression of steroid receptor and HER-2/neu receptor in tissue, statistically higher values were found in the subgroup of patients with steroid receptor negative, HER-2/neu negative tumors than in the other subgroups. HER-2/neu ECD was not an independent factor in the univariate and multivariate analysis. However, elevated HER-2/neu ECD levels were found in patients with breast cancer possessing more aggressive phenotype.

  20. Optic nerve demyelination induced by human serum: patients with multiple sclerosis or optic neuritis and normal subjects.

    Science.gov (United States)

    Sergott, R C; Brown, M J; Polenta, R M; Lisak, R P; Silberberg, D H

    1985-10-01

    We injected guinea pig optic nerves with serum from patients with MS or acute optic neuritis (ON), or normal subjects. Serum from 12 of 17 MS patients, 3 of 3 patients with ON, and 5 of 11 normal age- and sex-matched controls produced myelin vesiculation and demyelination 24 hours after injection. Nerves injected with demyelinating serum contained oligodendrocytes with pyknotic nuclei and edematous, rarefied cytoplasm. Nerves injected with serum that did not cause demyelination did not have these oligodendrocyte changes. Serum from normal subjects or patients with MS may induce in vivo demyelination in mammalian CNS.

  1. Single nucleotide polymorphism profiling across the methotrexate pathway in normal subjects and patients with rheumatoid arthritis.

    Science.gov (United States)

    Ranganathan, Prabha; Culverhouse, Robert; Marsh, Sharon; Ahluwalia, Ranjeet; Shannon, William D; Eisen, Seth; McLeod, Howard L

    2004-07-01

    Methotrexate (MTX) is a commonly used disease-modifying antirheumatic drug in rheumatoid arthritis (RA). Polymorphisms occur in several genes encoding key enzymes in the folic acid pathway, which is influenced by MTX, but have not been evaluated in patients with RA. The effect of race on allele frequency has also not been evaluated. In this study, the allele frequencies of polymorphisms in six key enzymes in the MTX-folate pathway in patients with RA and healthy controls, including several common racial groups were studied. European- and African-American patients with RA and European and African healthy controls were genotyped for 22 genetic loci in six genes in the MTX cellular pathway. Differences in genotype distributions between the different racial groups were evaluated using chi(2) tests. Allele frequencies were significantly different (p racial differences exist between the allele frequencies of several polymorphisms in enzymes in the MTX-folate pathway in patients with RA and healthy controls. Whether such differences contribute to a differential response to MTX in patients with RA deserves to be investigated.

  2. Short-Term Effect of Gabapentin on Subjective Tinnitus in Acoustic Trauma Patients

    Directory of Open Access Journals (Sweden)

    Ali Goljanian Tabrizi

    2017-03-01

    Full Text Available Introduction:Although several treatment approaches have been proposed for tinnitus, there are currently no Food and Drug Administration (FDA-approved agents available to treat this condition. In this study, we evaluated the effect of gabapentin on the sensation of subjective tinnitus in patients with acoustic trauma referring to the ear, nose and throat (ENT clinic of Taleghani Hospital during 2014. Materials and Methods:In this double-blind, randomized clinical trial, 103 patients with tinnitus due to acoustic trauma who were referred to the ENT clinic of Taleghani Hospital during 2014 were randomized to the gabapentin (300 mg bid, n=55 or control (n=48 groups. The two groups were then compared before and after 6 weeks of treatment using a visual analog scale (VAS. At least a 30% reduction in VAS was considered a response to treatment. Results:Differences between the two groups regarding sex, age, duration of disease, and audiometry results was not significant (P>0.05. After 6 weeks’ treatment, the VAS significantly decreased in both groups (P

  3. Frataxin mRNA Isoforms in FRDA Patients and Normal Subjects: Effect of Tocotrienol Supplementation

    Science.gov (United States)

    Bolotta, Alessandra; Malisardi, Gemma; Manfredini, Stefano; Pini, Antonella; Tasco, Gianluca

    2013-01-01

    Friedreich's ataxia (FRDA) is caused by deficient expression of the mitochondrial protein frataxin involved in the formation of iron-sulphur complexes and by consequent oxidative stress. We analysed low-dose tocotrienol supplementation effects on the expression of the three splice variant isoforms (FXN-1, FXN-2, and FXN-3) in mononuclear blood cells of FRDA patients and healthy subjects. In FRDA patients, tocotrienol leads to a specific and significant increase of FXN-3 expression while not affecting FXN-1 and FXN-2 expression. Since no structural and functional details were available for FNX-2 and FXN-3, 3D models were built. FXN-1, the canonical isoform, was then docked on the human iron-sulphur complex, and functional interactions were computed; when FXN-1 was replaced by FXN-2 or FNX-3, we found that the interactions were maintained, thus suggesting a possible biological role for both isoforms in human cells. Finally, in order to evaluate whether tocotrienol enhancement of FXN-3 was mediated by an increase in peroxisome proliferator-activated receptor-γ (PPARG), PPARG expression was evaluated. At a low dose of tocotrienol, the increase of FXN-3 expression appeared to be independent of PPARG expression. Our data show that it is possible to modulate the mRNA expression of the minor frataxin isoforms and that they may have a functional role. PMID:24175286

  4. Frataxin mRNA Isoforms in FRDA Patients and Normal Subjects: Effect of Tocotrienol Supplementation

    Directory of Open Access Journals (Sweden)

    Provvidenza Maria Abruzzo

    2013-01-01

    Full Text Available Friedreich’s ataxia (FRDA is caused by deficient expression of the mitochondrial protein frataxin involved in the formation of iron-sulphur complexes and by consequent oxidative stress. We analysed low-dose tocotrienol supplementation effects on the expression of the three splice variant isoforms (FXN-1, FXN-2, and FXN-3 in mononuclear blood cells of FRDA patients and healthy subjects. In FRDA patients, tocotrienol leads to a specific and significant increase of FXN-3 expression while not affecting FXN-1 and FXN-2 expression. Since no structural and functional details were available for FNX-2 and FXN-3, 3D models were built. FXN-1, the canonical isoform, was then docked on the human iron-sulphur complex, and functional interactions were computed; when FXN-1 was replaced by FXN-2 or FNX-3, we found that the interactions were maintained, thus suggesting a possible biological role for both isoforms in human cells. Finally, in order to evaluate whether tocotrienol enhancement of FXN-3 was mediated by an increase in peroxisome proliferator-activated receptor-γ (PPARG, PPARG expression was evaluated. At a low dose of tocotrienol, the increase of FXN-3 expression appeared to be independent of PPARG expression. Our data show that it is possible to modulate the mRNA expression of the minor frataxin isoforms and that they may have a functional role.

  5. [Risk of developmental dysplasia of the hip in patients subjected to the external cephalic version].

    Science.gov (United States)

    Sarmiento Carrera, Nerea; González Colmenero, Eva; Vázquez Castelo, José Luis; Concheiro Guisán, Ana; Couceiro Naveira, Emilio; Fernández Lorenzo, José Ramón

    2017-05-03

    Developmental dysplasia of the hip (DDH) refers to the spectrum of abnormalities of maturation and development of the hip. Breech presentation is associated with DDH. This risk factor can be modified by external cephalic version (ECV). The aim of this study is to evaluate the incidence of DDH in patients who successfully underwent ECV, as well as to evaluate need for these children (breech for a period during gestation) to be included in the DDH screening protocol. A prospective cohort study was conducted in the Hospital Universitario de Vigo from January 1, 2015 to December 31, 2015. It included children born in cephalic presentation after a successful ECV, as well as children born in breech presentation. They all were screened for DDH by ultrasound examination of the hip. Out of a total of 122 newborns included in the study, ECV was attempted on 67 (54.9%), of which 35 (52.2%) were successful. Out of the 14 children diagnosed with DDH, 3 of those born in cephalic presentation after a successful ECV were found to be normal on physical examination. Successful ECV is associated with a lower incidence of DDH as regards breech presentation. However, these patients should be included in the DDH screening protocol for the early detection of this disorder. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  6. Emergence of Lamivudine-Resistant HBV during Antiretroviral Therapy Including Lamivudine for Patients Coinfected with HIV and HBV in China

    Science.gov (United States)

    Li, Yijia; Zhu, Ting; Song, Xiaojing; Huang, Ying; Yang, Feifei; Guan, Shuo; Xie, Jing; Gohda, Jin; Hosoya, Noriaki; Kawana-Tachikawa, Ai; Liu, Wenjun; Gao, George Fu; Iwamoto, Aikichi; Li, Taisheng; Ishida, Takaomi

    2015-01-01

    In China, HIV-1-infected patients typically receive antiretroviral therapy (ART) that includes lamivudine (3TC) as a reverse-transcriptase inhibitor (RTI) (ART-3TC). Previous studies from certain developed countries have shown that, in ART-3TC, 3TC-resistant HBV progressively emerges at an annual rate of 15–20% in patients coinfected with HIV-1 and HBV. This scenario in China warrants investigation because >10% of all HIV-infected patients in China are HBV carriers. We measured the occurrence of 3TC-resistant HBV during ART-3TC for HIV-HBV coinfection and also tested the effect of tenofovir disoproxil fumarate (TDF) used as an additional RTI (ART-3TC/TDF) in a cohort study in China. We obtained 200 plasma samples collected from 50 Chinese patients coinfected with HIV-1 and HBV (positive for hepatitis B surface antigen) and examined them for the prevalence of 3TC-resistant HBV by directly sequencing PCR products that covered the HBV reverse-transcriptase gene. We divided the patients into ART-3TC and ART-3TC/TDF groups and compared the efficacy of treatment and incidence of drug-resistance mutation between the groups. HIV RNA and HBV DNA loads drastically decreased in both ART-3TC and ART-3TC/TDF groups. In the ART-3TC group, HBV breakthrough or insufficient suppression of HBV DNA loads was observed in 20% (10/50) of the patients after 96-week treatment, and 8 of these patients harbored 3TC-resistant mutants. By contrast, neither HBV breakthrough nor treatment failure was recorded in the ART-3TC/TDF group. All of the 3TC-resistant HBV mutants emerged from the cases in which HBV DNA loads were high at baseline. Our results clearly demonstrated that ART-3TC is associated with the emergence of 3TC-resistant HBV in patients coinfected with HIV-1 and HBV and that ART-3TC/TDF reduces HBV DNA loads to an undetectable level. These findings support the use of TDF-based treatment regimens for patients coinfected with HIV-1 and HBV. PMID:26288093

  7. Emergence of Lamivudine-Resistant HBV during Antiretroviral Therapy Including Lamivudine for Patients Coinfected with HIV and HBV in China.

    Directory of Open Access Journals (Sweden)

    Lijun Gu

    Full Text Available In China, HIV-1-infected patients typically receive antiretroviral therapy (ART that includes lamivudine (3TC as a reverse-transcriptase inhibitor (RTI (ART-3TC. Previous studies from certain developed countries have shown that, in ART-3TC, 3TC-resistant HBV progressively emerges at an annual rate of 15-20% in patients coinfected with HIV-1 and HBV. This scenario in China warrants investigation because >10% of all HIV-infected patients in China are HBV carriers. We measured the occurrence of 3TC-resistant HBV during ART-3TC for HIV-HBV coinfection and also tested the effect of tenofovir disoproxil fumarate (TDF used as an additional RTI (ART-3TC/TDF in a cohort study in China. We obtained 200 plasma samples collected from 50 Chinese patients coinfected with HIV-1 and HBV (positive for hepatitis B surface antigen and examined them for the prevalence of 3TC-resistant HBV by directly sequencing PCR products that covered the HBV reverse-transcriptase gene. We divided the patients into ART-3TC and ART-3TC/TDF groups and compared the efficacy of treatment and incidence of drug-resistance mutation between the groups. HIV RNA and HBV DNA loads drastically decreased in both ART-3TC and ART-3TC/TDF groups. In the ART-3TC group, HBV breakthrough or insufficient suppression of HBV DNA loads was observed in 20% (10/50 of the patients after 96-week treatment, and 8 of these patients harbored 3TC-resistant mutants. By contrast, neither HBV breakthrough nor treatment failure was recorded in the ART-3TC/TDF group. All of the 3TC-resistant HBV mutants emerged from the cases in which HBV DNA loads were high at baseline. Our results clearly demonstrated that ART-3TC is associated with the emergence of 3TC-resistant HBV in patients coinfected with HIV-1 and HBV and that ART-3TC/TDF reduces HBV DNA loads to an undetectable level. These findings support the use of TDF-based treatment regimens for patients coinfected with HIV-1 and HBV.

  8. Population Pharmacokinetic Analysis of Cefiderocol, a Parenteral Siderophore Cephalosporin, in Healthy Subjects, Subjects with Various Degrees of Renal Function, and Patients with Complicated Urinary Tract Infection or Acute Uncomplicated Pyelonephritis.

    Science.gov (United States)

    Kawaguchi, Nao; Katsube, Takayuki; Echols, Roger; Wajima, Toshihiro

    2018-02-01

    Cefiderocol, a novel parenteral siderophore cephalosporin, exhibits potent efficacy against most Gram-negative bacteria, including carbapenem-resistant strains. The aim of this study was to perform a population pharmacokinetic (PK) analysis based on plasma cefiderocol concentrations in healthy subjects, subjects with various degrees of renal function, and patients with complicated urinary tract infection (cUTI) or acute uncomplicated pyelonephritis (AUP) caused by Gram-negative pathogens and to calculate the fraction of the time during the dosing interval where the free drug concentration in plasma exceeds the MIC ( fT MIC ). Population PK models were developed with three renal function markers, body surface area-adjusted estimated glomerular filtration rate (eGFR), absolute eGFR, and creatinine clearance, on the basis of 2,571 plasma concentrations from 91 subjects without infection and 238 patients with infection. The population PK models with each renal function marker adequately described the plasma cefiderocol concentrations. Clear relationships of total clearance (CL) to all renal function markers were observed. Body weight and disease status (with or without infection) were also significant covariates. The CL in patients with infection was 26% higher than that in subjects without infection. The fT MIC values were more than 75% in all patients (and were 100% in most patients), suggesting that a sufficient exposure to cefiderocol was provided by the tested dose regimens (2 g every 8 h as the standard dose regimen) for the treatment of cUTI or AUP caused by Gram-negative pathogens. Copyright © 2018 Kawaguchi et al.

  9. Comparison of hamstring muscle behavior for anterior cruciate ligament (ACL) patient and normal subject during local marching

    Science.gov (United States)

    Amineldin@Aminudin, Nurul Izzaty Bt.; Rambely, A. S.

    2014-09-01

    This study aims to investigate the hamstring muscle activity after the surgery by carrying out an electromyography experiment on the hamstring and to compare the behavior of the ACL muscle activity between ACL patient and control subject. Electromyography (EMG) is used to study the behavior of muscles during walking activity. Two hamstring muscles involved which are semitendinosus and bicep femoris. The EMG data for both muscles were recorded while the subject did maximum voluntary contraction (MVC) and marching. The study concluded that there were similarities between bicep femoris of the ACL and control subjects. The analysis showed that the biceps femoris muscle of the ACL subject had no abnormality and the pattern is as normal as the control subject. However, ACL patient has poor semitendinosus muscle strength compared to that of control subject because the differences of the forces produced. The force of semitendinosus value for control subject was two times greater than that of the ACL subject as the right semitendinosus muscle of ACL subject was used to replace the anterior cruciate ligament (ACL) that was injured.

  10. Communication subjective assessments of patients undergoing compulsory treatment with the severity of negative symptoms and cognitive functioning level

    Directory of Open Access Journals (Sweden)

    Kabanov T.N.

    2015-04-01

    Full Text Available The article presents the results of studies on the relationship of subjective assessments of the mentally ill with the severity of negative symptoms and cognitive functioning level. The features of patients perception of various aspects of compulsory treatment and subjective satisfaction with treatment. In a study of 94 male patients with a diagnosis of organic mental disorder and schizophrenia was used diagnostic system, consisting of patopsihologicheskogo study, formal survey map, the scale of assessment of negative symptoms SANS, questionnaire symptom levels SCL-90, self-existing problems, as well as - in Test authoring tool sheet to treatment and hospital stay (VG Bulygin, Kabanov, TN, 2011. The differences in subjective assessments of aspects of compulsory treatment and social functioning of patients with varying degrees of severity of negative symptoms and dependence of subjective assessments of the level of cognitive functioning.

  11. CHARACTERISTICS OF PATIENTS WITH CEREBRAL STROKE OR TRANSIENT ISCHEMIC ATTACK, INCLUDED INTO THE LIS-2 REGISTER (LYUBERTSY STUDY OF MORTALITY IN PATIENTS AFTER STROKE

    Directory of Open Access Journals (Sweden)

    S. Yu. Martsevich

    2015-01-01

    Full Text Available Aim. To provide final data on the three-year period of the inclusion of patients; to give most accurate "portrait" of patients hospitalized with a brain stroke within the framework of the LIS-2 register (Lyubertsy study of mortality in patients after stroke.Material and methods. All patients (n=960 admitted to the Lyubertsy district hospital №2 with stroke for the period from 01.2009 to 12.2011 were included into the study.Results. Men accounted for 37.5%, women - 62.5%, mean age was 71.1±9.8 years. The history of hypertension was present in 833 patients (86.8%, atrial fibrillation in 252 (26.8% patients, 199 (20.7% patients had previously undergone stroke. In-hospital mortality was 21.6% (207 patients had died; mean age 72.9±9.8 years. Low frequency of the antihypertensive therapy (34.5%, lipid-lowering therapy (0.7%, antiplatelet agents (5.7%, anticoagulation therapy prescription in patients with atrial fibrillation was detected.Conclusion. Insufficient assignment of drugs with a proven effect on the prognosis in patients with risk factors prior to the development of the reference stroke draws attention. High incidence of recurrent strokes indicates an underactive secondary prevention.

  12. Subjective evaluation of uncorrected vision in patients undergoing cataract surgery with (diffractive multifocal lenses and monovision

    Directory of Open Access Journals (Sweden)

    Stock RA

    2017-07-01

    Full Text Available Ricardo Alexandre Stock, Thaís Thumé, Luan Gabriel Paese, Elcio Luiz Bonamigo Universidade do Oeste de Santa Catarina, Rua Getúlio Vargas, Joaçaba, Santa Catarina, Brazil Purpose: To analyze patient satisfaction and difficulties with bilateral multifocal intraocular lenses (IOLs implantation and aspheric monofocal IOLs implantation using monovision, after cataract surgery.Materials and methods: A total of 61 participants were included in the study, 29 with monovision and 32 with multifocal lenses. The inclusion criteria were patients undergoing phacoemulsification for bilateral visual impairment due to cataracts and presenting with postoperative visual acuity of 20/30 or better for distance and line J3 or better for near vision.Results: The 2 groups had similar results regarding difficulties with daily activities such as distance vision, near vision, watching television, reading, cooking, using a computer or cellphone, shaving/putting on makeup and shopping. There were differences in responses between the groups regarding difficulty with night vision (P=0.0565 and night driving (P=0.0291. Degree of satisfaction in terms of distance vision without glasses was statistically significantly better in monovision group (P=0.0332, but not for near (P=0.9101.Conclusion: Both techniques yielded satisfactory results regarding visual acuity for different activities without the need to use glasses. Multifocal lenses are a good option for patients with the exception of night driving, and who desire independence from glasses. Keywords: cataract extraction, aphakia, postcataract, patient satisfaction, night vision

  13. [Study of the nutritional status of patients over 65 years included in the home care program in an urban population].

    Science.gov (United States)

    Muñoz Díaz, Belén; Arenas de Larriva, Antonio P; Molina-Recio, Guillermo; Moreno-Rojas, Rafael; Martínez de la Iglesia, Jorge

    2018-02-01

    To analyse the nutritional status of patients older than 65 years included in the home care program (PAD). Croos-sectional study. 3 urban health centers. 218 patients in the PAD. Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be Pnutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition. More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  14. Dutch Patient-Generated Subjective Global Assessment (PG-SGA): training improves scores for comprehensibility and difficulty

    NARCIS (Netherlands)

    Faith Ottery; Jan Roodenburg; Anne van der Braak; Dr. C.P. van der Schans; Martine J. Sealy; Danique Haven; Harriët Jager-Wittenaar

    2015-01-01

    Rationale: The Patient-Generated Subjective Global Assessment (PG-SGA) is a validated instrument to assess and monitor malnutrition, which consists of both patient-reported and professional-reported items. A professional should be able to correctly interpret all items. Untrained professionals may

  15. Validation of reaction time as a measure of cognitive function and quality of life in healthy subjects and patients

    DEFF Research Database (Denmark)

    Jakobsen, Lene Holm; Sorensen, Janice Marie; Rask, Ingeborg Krarup

    2011-01-01

    Malnutrition is a common problem in hospitalized patients and is related to decreased cognitive function and impaired quality of life (QoL). We investigated the validity of reaction time as a simple bedside tool for measuring cognitive function in healthy subjects and patients, and additionally...

  16. ADAM10 gene expression in the blood cells of Alzheimer's disease patients and mild cognitive impairment subjects

    NARCIS (Netherlands)

    Manzine, Patricia Regina; Marcello, Elena; Borroni, Barbara; Kamphuis, Willem; Hol, Elly; Padovani, Alessandro; Nascimento, Carla Crispim; De Godoy Bueno, Patricia; Assis Carvalho Vale, Francisco; Iost Pavarini, Sofia Cristina; Di Luca, Monica; Cominetti, Márcia Regina

    2015-01-01

    ADAM10 is a potential biomarker for Alzheimer's disease (AD). ADAM10 protein levels are reduced in platelets of AD patients. The aim was to verify the total blood and platelet ADAM10 gene expression in AD patients and to compare with mild cognitive impairment (MCI) and healthy subjects. No

  17. Metabolic syndrome and aerobic fitness in patients with first-episode schizophrenia, including a 1-year follow-up

    DEFF Research Database (Denmark)

    Nyboe, L.; Vestergaard, C. H.; Moeller, M. K.

    2015-01-01

    : Patients with FES (N=99) and healthy controls (N=50) were included in the study. MetS was defined according to IDF based on waist circumference (WC), blood pressure (BP), triglycerides (TG), high-density lipoprotein (HDL), and fasting-glucose. Data on physical activity, aerobic fitness, smoking....... In multivariate analyses low aerobic fitness was the most consistent and significant predictor of metabolic abnormalities and MetS. CONCLUSION: MetS and metabolic abnormalities are highly prevalent in patients with FES, and both increase significantly during 1year of treatment. Apart from confirming the metabolic...... adverse effects of antipsychotics, our study highlights that low aerobic fitness is a significant risk factor for MetS. Promoting a healthier lifestyle should be part of psychiatric treatment and rehabilitation....

  18. Microdeletions including FMR1 in three female patients with intellectual disability - further delineation of the phenotype and expression studies

    DEFF Research Database (Denmark)

    Zink, A M; Wohlleber, E; Engels, H

    2014-01-01

    Fragile X syndrome (FXS) is one of the most common causes of intellectual disability/developmental delay (ID/DD), especially in males. It is caused most often by CGG trinucleotide repeat expansions, and less frequently by point mutations and partial or full deletions of the FMR1 gene. The wide...... clinical spectrum of affected females partly depends on their X-inactivation status. Only few female ID/DD patients with microdeletions including FMR1 have been reported. We describe 3 female patients with 3.5-, 4.2- and 9.2-Mb de novo microdeletions in Xq27.3-q28 containing FMR1. X-inactivation was random...

  19. Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

    DEFF Research Database (Denmark)

    Francolini, Giulio; Thomsen, Mette S; Yates, Esben S

    2017-01-01

    BACKGROUND AND PURPOSE: To report on a Quality assessment (QA) of Skagen Trial 1, exploring hypofractionation for breast cancer patients with indication for regional nodal radiotherapy. MATERIAL AND METHODS: Deviations from protocol regarding target volume delineations and dose parameters (Dmin......, Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS). Dice similarity scores (DSC) with original delineations were measured....... Dose parameters measured in the two delineations were reported to assess their dosimetric outcome. RESULTS: Assessment included 88 plans from 12 centres in 4 countries. DSC showed high agreement in contouring, 99% and 96% of the patients had a complete delineation of target volumes and organs at risk...

  20. Illicit Internet availability of drugs subject to recall and patient safety consequences.

    Science.gov (United States)

    Mackey, Tim K; Aung, Phyo; Liang, Bryan A

    2015-12-01

    Permanently recalled drugs are a public health concern if they remain accessible in violation of applicable regulation. Illicit online pharmacies act as an alternative form of access and have been associated with the sale to patients of counterfeit/falsified/fraudulent/substandard drugs. We wished to determine if permanently recalled and significantly restricted drugs were illegally marketed for sale online. The study was conducted in two phases with two objectives. The first phase attempted to identify drugs subject to permanent recall in certain major pharmaceutical markets as well as those listed as recalled or significantly restricted by the United Nations. We also examined the market authorization status of identified drugs in China and India. The second phase used structured searches on the Internet to determine if identified drugs were marketed for sale online. The World Wide Web. After identification of permanently recalled and restricted drugs we conducted Internet searches for illegal "no prescription" marketing events. We assessed the form of marketing, whether a site offered direct-to-patient sale, use of social media marketing, and the site's compliance status with external monitoring bodies. Number of recalled drugs marketed as available for purchase on the Internet. We identified 16 class I equivalent permanently recalled or restricted drugs, 56.3 % (n = 9) of which maintained market authorization in either China or India. Half (n = 8) were marketed for sale online without a prescription direct-to-patient. Use of social media marketing was mixed, with only 18.8 % (n = 3) of recalled drugs having a presence on Facebook, though 50.0 % (n = 8) had content on Twitter. We also found the majority (68.8 %, n = 11) were available and marketed for sale by vendors on the wholesale/business-to-business website alibaba.com primarily as active pharmaceutical ingredient. Despite efforts in several countries to restrict access to these drugs or permanently remove

  1. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ko Matsudaira

    Full Text Available To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS.Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment.In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms had an odds ratio (OR of 3.31 (95% confidence interval [CI]: 1.50-7.31; absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65; <1-year duration of illness had an OR of 3.81 (95% CI: 1.46-9.98; and hypertension had an OR of 2.09 (95% CI: 0.92-4.78.The predictive factors for subjective symptom improvement with nonsurgical treatment in LSS patients were the presence of only radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.

  2. Do ICF core sets for low back pain include patients' self-reported activity limitations because of back problems?

    Science.gov (United States)

    Lygren, Hildegunn; Strand, Liv Inger; Anderson, Bodil; Magnussen, Liv Heide

    2014-06-01

    The aim of this study was to investigate content validity of the International Classification of Functioning, Disability and Health (ICF) Core Sets for low back pain (LBP), by examining whether common activities reported as difficult to perform are included in the Core Sets. A cross-sectional design was used. Ninety-eight patients with long-lasting back pain (>3 months) between 18 and 65 years of age were consecutively recruited from a Multidisciplinary Outpatient Spine Clinic. Difficulties with daily life and work task activities because of back pain were examined by asking the patients two questions: 1) can you specify activities that are difficult to perform because of your back pain? and 2) are there specific work tasks that you are unable to do because of your back pain? Two raters independently classified the written responses according to the ICF Core Sets' component Activities and Participation. Activities and work tasks were linked to 15 of 29 categories (52%) in the Comprehensive Core Set, and 9 of 12 (75%) in the Brief Core Set, and the initial agreement between the two raters in coding the answers according to the Core Sets was (83%, k = 0.80) and (93%, k = 0.9), respectively, before consensus was reached. The Comprehensive Core Set for LBP to a large degree contains daily life and work-related activities frequently reported as difficult to perform by patients with long-lasting LBP. The categories, however, are very broad and do not provide specified descriptions of the most frequently reported activity limitations such as sitting, standing and walking. The Brief Core Set does not include categories for frequently reported activities such as pulling/pushing and leisure/recreation activities. ICF Core Sets for LBP seem suitable for obtaining a gross overview of the patients' functional limitations, but do not give sufficient information from a therapeutic point of view. © 2013 John Wiley & Sons, Ltd.

  3. Nitric oxide and regulation of heart rate in patients with postural tachycardia syndrome and healthy subjects.

    Science.gov (United States)

    Gamboa, Alfredo; Okamoto, Luis E; Raj, Satish R; Diedrich, André; Shibao, Cyndya A; Robertson, David; Biaggioni, Italo

    2013-02-01

    The objective is to study the role of nitric oxide (NO) on cardiovascular regulation in healthy subjects and postural tachycardia syndrome (POTS) patients. Reduced neuronal NO function, which could contribute to a hyperadrenergic state, and increased NO-induced vasodilation, which could contribute to orthostatic intolerance, have been reported in POTS. In protocol 1, 13 healthy volunteers (33 ± 3 years) underwent autonomic blockade with trimethaphan and were administered equipressor doses of Nω-monomethyl-L-arginine (L-NMMA, a NO synthase inhibitor) and phenylephrine to determine the direct chronotropic effects of NO (independent of baroreflex modulation). In protocol 2, we compared the effects of L-NMMA in 9 POTS patients (31 ± 3 years) and 14 healthy (32 ± 2 years) volunteers, during autonomic blockade. During autonomic blockade, L-NMMA and phenylephrine produced similar increases in systolic blood pressure (27 ± 2 versus 27 ± 3 mm Hg). Phenylephrine produced only minimal heart rate changes, whereas L-NMMA produced a modest, but significant, bradycardia (-0.8 ± 0.4 versus -4.8 ± 1.2 bpm; P=0.011). There were no differences between POTS and healthy volunteers in the systolic blood pressure increase (22 ± 2 and 28 ± 5 mm Hg) or heart rate decrease (-6 ± 2 and -4 ± 1 bpm for POTS and controls, respectively) produced by L-NMMA. In the absence of baroreflex buffering, inhibition of endogenous NO synthesis results in a significant bradycardia, reflecting direct tonic modulation of heart rate by NO in healthy individuals. We found no evidence of a primary alteration in NO function in POTS. If NO dysfunction plays a role in POTS, it is through its interaction with the autonomic nervous system.

  4. Effect of Stress-free Therapy on Cerebral Blood Flow: Comparisons among patients with metabolic cardiovascular disease, healthy subjects and placebo-treated subjects

    Science.gov (United States)

    Ryotokuji, Kenji; Ishimaru, Keisou; Kihara, Kazuhiko; Namiki, Yoshihisa; Nakashima, Takuma; Otani, Satoru

    2014-01-01

    Background and aims: We have developed a Stress-free Therapy® device wherein “Pinpoint Plantar Long-wavelength Infrared Light Irradiation (PP-LILI)” increases peripheral-deep body temperature and blood flow volume and stabilizes blood pressure as well as significantly reduces stress hormones such as adrenocorticotrophic hormone and cortisol without using drugs. Moreover, we have found this therapy to significantly improve blood glucose and insulin resistance in patients with type 2 diabetes. Based on this background of clinical efficacy, we validated changes in cerebral blood flow in patients with metabolic cardiovascular disease and examined the efficacy of Stress-free Therapy® on cerebral blood flow as compared to that in healthy control subjects and placebo-treated patients. Results: The change in cerebral blood flow volume during 15-minute PP-LILI was 5.1 ± 1.8 mL/min in patients with metabolic cardiovascular disease, showing a significant increase (P<0.05) of 3.1 mL/min as compared with the mean blood flow value after resting for 15 minutes. Conclusions: Our results suggested Stress-free Therapy® to significantly increase cerebral blood flow, possibly leading to the prevention of metabolic cardiovascular disease. PMID:24771966

  5. Assessment of Eustachian tube function in patients with tympanic membrane retraction and in normal subjects.

    Science.gov (United States)

    Canali, Inesângela; Petersen Schmidt Rosito, Letícia; Siliprandi, Bruno; Giugno, Cláudia; Selaimen da Costa, Sady

    The diagnosis of Eustachian tube dysfunctions is essential for better understanding of the pathogenesis of chronic otitis media. A series of tests to assess tube function are described in the literature; however, they are methodologically heterogeneous, with differences ranging from application protocols to standardization of tests and their results. To evaluate the variation in middle ear pressure in patients with tympanic membrane retraction and in normal patients during tube function tests, as well as to evaluate intra-individual variation between these tests. An observational, contemporary, cross-sectional study was conducted, in which the factor under study was the variation in middle ear pressure during tube function tests (Valsalva maneuver, sniff test, Toynbee maneuver) in healthy patients and in patients with mild and moderate/severe tympanic retraction. A total of 38 patients (76 ears) were included in the study. Patients underwent tube function tests at two different time points to determine pressure measurements after each maneuver. Statistical analysis was performed using SPSS software, version 18.0, considering p-values <0.05 as statistically significant. Mean (standard deviation) age was 11 (2.72) years; 55.3% of patients were male and 44.7% female. The prevalence of type A tympanogram was higher among participants with healthy ears and those with mild retraction, whereas type C tympanograms were more frequent in the moderate/severe retraction group. An increase in middle ear pressure was observed during the Valsalva maneuver at the first time point evaluated in all three groups of ears (p=0.012). The variation in pressure was not significant either for the sniff test or for the Toynbee maneuver at the two time points evaluated (p≥0.05). Agreement between measurements obtained at the two different time points was weak to moderate for all tests in all three groups of ears, and the variations in discrepancy between measurements were higher in ears

  6. Assessment of Eustachian tube function in patients with tympanic membrane retraction and in normal subjects,

    Directory of Open Access Journals (Sweden)

    Inesângela Canali

    Full Text Available Abstract Introduction The diagnosis of Eustachian tube dysfunctions is essential for better understanding of the pathogenesis of chronic otitis media. A series of tests to assess tube function are described in the literature; however, they are methodologically heterogeneous, with differences ranging from application protocols to standardization of tests and their results. Objective To evaluate the variation in middle ear pressure in patients with tympanic membrane retraction and in normal patients during tube function tests, as well as to evaluate intra-individual variation between these tests. Methods An observational, contemporary, cross-sectional study was conducted, in which the factor under study was the variation in middle ear pressure during tube function tests (Valsalva maneuver, sniff test, Toynbee maneuver in healthy patients and in patients with mild and moderate/severe tympanic retraction. A total of 38 patients (76 ears were included in the study. Patients underwent tube function tests at two different time points to determine pressure measurements after each maneuver. Statistical analysis was performed using SPSS software, version 18.0, considering p-values <0.05 as statistically significant. Results Mean (standard deviation age was 11 (2.72 years; 55.3% of patients were male and 44.7% female. The prevalence of type A tympanogram was higher among participants with healthy ears and those with mild retraction, whereas type C tympanograms were more frequent in the moderate/severe retraction group. An increase in middle ear pressure was observed during the Valsalva maneuver at the first time point evaluated in all three groups of ears (p = 0.012. The variation in pressure was not significant either for the sniff test or for the Toynbee maneuver at the two time points evaluated (p ≥ 0.05. Agreement between measurements obtained at the two different time points was weak to moderate for all tests in all three groups of ears, and the

  7. Treadmill training for ataxic patients: a single-subject experimental design.

    Science.gov (United States)

    Vaz, Daniela Virgínia; Schettino, Renata de Carvalho; Rolla de Castro, Teresa Regina; Teixeira, Valéria Reis; Cavalcanti Furtado, Sheyla Rossana; de Mello Figueiredo, Elyonara

    2008-03-01

    To investigate changes in gait quality, balance and mobility associated with treadmill training for ataxic individuals. Single-subject ABA design. Baseline phases (A) lasted three weeks and intervention (B) lasted four weeks. University rehabilitation clinic. A woman (25 years) and a man (53 years) with chronic ataxia due to head trauma. Three 20-minute treadmill training sessions each week with progression in velocity and step length. Rivermead Visual Gait Assessment, Timed Up and Go, time to complete a balance task, walking speed, cadence, and stride length assessments three times a week during the 10 weeks. Data were analysed with the celeration line technique and two standard deviation band. Both individuals demonstrated gains in all parameters over initial baseline and subsequent phases, with performance increases ranging from 26% to 233% when first and last assessments were compared. Significantly superior effects of treadmill training over baseline conditions on cadence were detected (Psubject 2 (Psubject 1. Results suggest that the association between repeated testing and treadmill training might have been responsible for the observed gains in the two ataxic patients.

  8. Psychophysiology and psychoacoustics of music: Perception of complex sound in normal subjects and psychiatric patients

    Science.gov (United States)

    Iakovides, Stefanos A; Iliadou, Vassiliki TH; Bizeli, Vassiliki TH; Kaprinis, Stergios G; Fountoulakis, Konstantinos N; Kaprinis, George S

    2004-01-01

    Perception of complex sound is a process carried out in everyday life situations and contributes in the way one perceives reality. Attempting to explain sound perception and how it affects human beings is complicated. Physics of simple sound can be described as a function of frequency, amplitude and phase. Psychology of sound, also termed psychoacoustics, has its own distinct elements of pitch, intensity and tibre. An interconnection exists between physics and psychology of hearing. Music being a complex sound contributes to communication and conveys information with semantic and emotional elements. These elements indicate the involvement of the central nervous system through processes of integration and interpretation together with peripheral auditory processing. Effects of sound and music in human psychology and physiology are complicated. Psychological influences of listening to different types of music are based on the different characteristics of basic musical sounds. Attempting to explain music perception can be simpler if music is broken down to its basic auditory signals. Perception of auditory signals is analyzed by the science of psychoacoustics. Differences in complex sound perception have been found between normal subjects and psychiatric patients and between different types of psychopathologies. PMID:15050030

  9. Expanding subjectivities

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda; Soldz, Stephen

    2012-01-01

    A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understa...

  10. Use of an abridged scored Patient-Generated Subjective Global Assessment (abPG-SGA) as a nutritional screening tool for cancer patients in an outpatient setting.

    Science.gov (United States)

    Gabrielson, Denise K; Scaffidi, Donna; Leung, Elizabeth; Stoyanoff, Linda; Robinson, Jennifer; Nisenbaum, Rosane; Brezden-Masley, Christine; Darling, Pauline B

    2013-01-01

    The scored Patient-Generated Subjective Global Assessment tool (PG-SGA), regarded as the most appropriate means of identifying malnutrition in cancer patients, is often challenging to implement in a busy outpatient setting. We assessed the validity of an abridged version of the PG-SGA (abPG-SGA), which forgoes the physical examination, and compared its usefulness in discerning malnutrition to the full PG-SGA and Malnutrition Screening Tool (MST). The nutritional status of 90 oncology outpatients receiving chemotherapy was assessed according to SGA global rating, PG-SGA, and MST. Receiver operating characteristic (ROC) curves were generated to estimate the sensitivity and specificity of various cut-off scores for malnutrition. Thirty-six percent of patients were malnourished (SGA). The abPG-SGA yielded 94% sensitivity and 78% specificity and area under the curve (AUC) = 0.956, which was slightly lower than PG-SGA (97% sensitivity, 86% specificity, AUC = 0.967) and higher than MST (81% sensitivity, 72% specificity, AUC = 0.823). Patient reported symptoms included loss of appetite (30%), altered taste (31%), fatigue (30%), and decreased ability to perform activities of daily living (53%). In conclusion, the abPG-SGA is a practical, informative and valid tool for detecting malnutrition in the outpatient oncology setting.

  11. Measurement of effective alveolar carbon dioxide tension during spontaneous breathing in normal subjects and patients with chronic airways obstruction.

    Science.gov (United States)

    Jordanoglou, J; Koulouris, N; Kyroussis, D; Rapakoulias, P; Vassalos, P; Madianos, J

    1995-03-01

    The measurement of effective alveolar carbon dioxide tension (PA-CO2eff) is still a matter of debate. It has, however, become common practice to use arterial instead of alveolar CO2 tension for computing alveolar oxygen tension (PAO2) and physiological dead space, not only in normal subjects but also in patients. The purpose of this study was to estimate alveolar CO2 tension during spontaneous breathing with a new bedside technique which is simple and non-invasive, and to compare these values with arterial CO2 tension measured in normal subjects and patients with chronic airways obstruction. The subjects breathed quietly through the equipment assembly (mouthpiece, monitoring ring, Fleisch transducer head) connected to a pneumotachograph and a fast response infrared CO2 analyser. The method is a computerised calculation of the volume weighted effective alveolar CO2 tension obtained from the simultaneously recorded expiratory flow and CO2 concentration versus time curves. An arterial blood sample was taken to measure PaCO2 for comparison during the study. The results showed a mean difference (PACO2eff-PaCO2) of -0.205 kPa in 20 normal subjects and -0.460 kPa in 46 patients. The 95% confidence interval of the bias was -0.029 to -0.379 kPa in normal subjects and -0.213 to -0.707 kPa in patients. The limits of agreement between PACO2eff and PaCO2 were 0.526 to -0.935 in normal subjects and 1.170 to -2.088 in patients. The volume weighted effective alveolar PCO2 in normal subjects and patients with chronic airways obstruction is lower than the arterial PCO2 and is recommended as a better estimate in the classical equations for estimating dead space and intrapulmonary shunt.

  12. A review of the literature on symptom clusters in studies that included oncology patients receiving primary or adjuvant chemotherapy.

    Science.gov (United States)

    Ward Sullivan, Carmen; Leutwyler, Heather; Dunn, Laura B; Miaskowski, Christine

    2017-08-31

    To summarise the current state of knowledge of symptom clusters research from studies that included, as part of their sample, patients who were receiving primary or adjuvant chemotherapy. Since the concept of a symptom cluster was first introduced into the oncology literature in 2001, only four comprehensive reviews of symptom clusters research in oncology patients were identified that provide insights into this important concept in symptom management research. A comprehensive review of the literature. A comprehensive literature search was conducted for the years 2000 to 2016. Only 19 studies met the inclusion criteria for this literature review. These studies were evaluated in terms of the symptom assessment instruments used; the statistical analysis methods used; the symptom dimension(s) used to create the symptom cluster(s); the number and types of symptom clusters identified; and whether the specific symptom clusters changed over time. The number of symptom clusters identified ranged from one-seven. The majority of the studies used some type of factor analysis to create the symptom clusters. The most common symptom dimension used to create the clusters was symptom severity. A "gastrointestinal symptom cluster" was the most common symptom cluster identified. Across the eight longitudinal studies, for half of these studies the symptom clusters remained relatively stable over time. Additional research is needed in oncology patients to address the assessment of symptom clusters, the specific nature of symptom clusters and whether symptom clusters change over time. © 2017 John Wiley & Sons Ltd.

  13. Clinical Immunology Review Series: an approach to the patient with recurrent orogenital ulceration, including Behçet's syndrome.

    LENUS (Irish Health Repository)

    Keogan, M T

    2009-04-01

    Patients presenting with recurrent orogenital ulcers may have complex aphthosis, Behçet\\'s disease, secondary complex aphthosis (e.g. Reiter\\'s syndrome, Crohn\\'s disease, cyclical neutropenia) or non-aphthous disease (including bullous disorders, erythema multiforme, erosive lichen planus). Behçet\\'s syndrome is a multi-system vasculitis of unknown aetiology for which there is no diagnostic test. Diagnosis is based on agreed clinical criteria that require recurrent oral ulcers and two of the following: recurrent genital ulcers, ocular inflammation, defined skin lesions and pathergy. The condition can present with a variety of symptoms, hence a high index of suspicion is necessary. The most common presentation is with recurrent mouth ulcers, often with genital ulcers; however, it may take some years before diagnostic criteria are met. All patients with idiopathic orogenital ulcers should be kept under review, with periodic focused assessment to detect evolution into Behçet\\'s disease. There is often a delay of several years between patients fulfilling diagnostic criteria and a diagnosis being made, which may contribute to the morbidity of this condition. Despite considerable research effort, the aetiology and pathogenesis of this condition remains enigmatic.

  14. Screening of ARHSP-TCC patients expands the spectrum of SPG11 mutations and includes a large scale gene deletion.

    Science.gov (United States)

    Denora, Paola S; Schlesinger, David; Casali, Carlo; Kok, Fernando; Tessa, Alessandra; Boukhris, Amir; Azzedine, Hamid; Dotti, Maria Teresa; Bruno, Claudio; Truchetto, Jeremy; Biancheri, Roberta; Fedirko, Estelle; Di Rocco, Maja; Bueno, Clarissa; Malandrini, Alessandro; Battini, Roberta; Sickl, Elisabeth; de Leva, Maria Fulvia; Boespflug-Tanguy, Odile; Silvestri, Gabriella; Simonati, Alessandro; Said, Edith; Ferbert, Andreas; Criscuolo, Chiara; Heinimann, Karl; Modoni, Anna; Weber, Peter; Palmeri, Silvia; Plasilova, Martina; Pauri, Flavia; Cassandrini, Denise; Battisti, Carla; Pini, Antonella; Tosetti, Michela; Hauser, Erwin; Masciullo, Marcella; Di Fabio, Roberto; Piccolo, Francesca; Denis, Elodie; Cioni, Giovanni; Massa, Roberto; Della Giustina, Elvio; Calabrese, Olga; Melone, Marina A B; De Michele, Giuseppe; Federico, Antonio; Bertini, Enrico; Durr, Alexandra; Brockmann, Knut; van der Knaap, Marjo S; Zatz, Mayana; Filla, Alessandro; Brice, Alexis; Stevanin, Giovanni; Santorelli, Filippo M

    2009-03-01

    Autosomal recessive spastic paraplegia with thinning of corpus callosum (ARHSP-TCC) is a complex form of HSP initially described in Japan but subsequently reported to have a worldwide distribution with a particular high frequency in multiple families from the Mediterranean basin. We recently showed that ARHSP-TCC is commonly associated with mutations in SPG11/KIAA1840 on chromosome 15q. We have now screened a collection of new patients mainly originating from Italy and Brazil, in order to further ascertain the spectrum of mutations in SPG11, enlarge the ethnic origin of SPG11 patients, determine the relative frequency at the level of single Countries (i.e., Italy), and establish whether there is one or more common mutation. In 25 index cases we identified 32 mutations; 22 are novel, including 9 nonsense, 3 small deletions, 4 insertions, 1 in/del, 1 small duplication, 1 missense, 2 splice-site, and for the first time a large genomic rearrangement. This brings the total number of SPG11 mutated patients in the SPATAX collection to 111 cases in 44 families and in 17 isolated cases, from 16 Countries, all assessed using homogeneous clinical criteria. While expanding the spectrum of mutations in SPG11, this larger series also corroborated the notion that even within apparently homogeneous population a molecular diagnosis cannot be achieved without full gene sequencing. 2008 Wiley-Liss, Inc.

  15. Multi-Modal Imaging Including Optical Coherence Tomography Angiography in Patients With Posterior Multifocal Placoid Pigment Epitheliopathy.

    Science.gov (United States)

    Werner, Jens Ulrich; Enders, Christian; Lang, Gerhard Klaus; Lang, Gabriele Elisabeth

    2017-09-01

    New imaging methods provide novel insights into the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Four patients (eight eyes) in acute, subacute, and late phases of the disease were analyzed with multi-modal imaging methods including optical coherence tomography angiography (OCTA), structural OCT, fundus photography, and fundus autofluorescence. One patient was observed during the entire disease course. In acute and subacute phases of the disease, an early blockage in fluorescein angiography was found. OCTA showed perfusion defects in choriocapillaris and choroid slabs. During the course of disease, perfusion deficits observed in OCTA imaging resolved first in the choroid and then in the choriocapillaris slab. Multi-modal imaging including OCTA supports the thesis that the underlying pathology of APMPPE is an inflammatory impairment of the choroidal circulation with secondary damage to the outer retina. OCTA might be able to replace fluorescein and indocyanine angiography in the diagnostic work-up of APMPPE. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:727-733.]. Copyright 2017, SLACK Incorporated.

  16. Cross-country variation in additive effects of socio-economics, health behaviors, and comorbidities on subjective health of patients with diabetes.

    Science.gov (United States)

    Assari, Shervin

    2014-02-21

    This study explored cross-country differences in the additive effects of socio-economic characteristics, health behaviors and medical comorbidities on subjective health of patients with diabetes. The study analyzed data from the Research on Early Life and Aging Trends and Effects (RELATE). The participants were 9,179 adults with diabetes who were sampled from 15 countries (i.e. China, Costa Rica, Puerto Rico, United States, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, India, Ghana, South Africa, and Russia). We fitted three logistic regressions to each country. Model I only included socio-economic characteristics (i.e. age, gender, education and income). In Model II, we also included health behaviors (i.e. smoking, drinking, and exercise). Model III included medical comorbidities (i.e. hypertension, respiratory disease, heart disease, stroke, and arthritis), in addition to the previous blocks. Our models suggested cross-country differences in the additive effects of socio-economic characteristics, health behaviors and comorbidities on perceived health of patients with diabetes. Comorbid heart disease was the only condition that was consistently associated with poor subjective health regardless of country. Countries show different profiles of social and behavioral determinants of subjective health among patients with diabetes. Our study suggests that universal programs that assume that determinants of well-being are similar across different countries may be over-simplistic. Thus instead of universal programs that use one protocol for health promotion of patients in all countries, locally designed interventions should be implemented in each country.

  17. Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect.

    Science.gov (United States)

    Evers, Christina; Fischer, Christine; Dikow, Nicola; Schott, Sarah

    2017-01-01

    The German Consortium for hereditary breast/ovarian cancer (GC-HBOC) aims for nationwide access to professional, individualized yet structured care for families at high risk. The identification of such families remains key for optimal care. Our study evaluates counselees' characteristics, referral practices, expectations and motivations in respect to their first genetic consultation. The impact of the Angelina Jolie Effect (AJE) was prospectively assessed. All counselees could participate through a questionnaire. Groups were built in respect to neoadjuvant chemotherapy (FT) and before/after AJE. The 917 (88.5%) counselees (FT: 8.2%) were on average female (97.3%), with a mean age of 44.6, had children (71.9%), higher education (88%), personal (46.4%) or at least one first-degree relative (74.6%) with BC/OC or known BRCA1/2 mutation (11.8%), were in a relationship (76.1%), and living in a village (40.7%). The AJE is associated with significantly fewer cancelations (p = 0.005), more attendance among men (4.2% vs. 0.8%, p = 0.002), and people with familial BRCA1/2 (14.8% vs. 7.5%, p = 0.003). The majority seek information regarding their cancer risk (83%) or relatives' risk (74.8%), HBOC (69.1%), and surveillance programs for themselves (66.6%) or relatives (60.6%). Enhanced media awareness of genetic cancer motivates patients, including other patient groups. A higher number of participants, including more men, are attending GC due to the AJE. In terms of the rising complexity of genetic testing, the analysis of patients' expectations and initiators for GC suggests that there is an urgent need to develop to participate motivation analysis. The factors revealed as impediments to accessing GC-HBOC guide recommendations to optimize access to genetic counseling. Medical educational programs for primary gynecologists and families at risk might be options to reach more participants.

  18. Automated short-axis cardiac magnetic resonance image acquisitions: accuracy of left ventricular dimension measurements in normal subjects and patients.

    Science.gov (United States)

    Danilouchkine, Mikhail G; Westenberg, Jos J M; Reiber, Johan H C; Lelieveldt, Boudewijn P F

    2004-12-01

    This study investigates the use of an automated observer-independent planning system for short-axis cardiovascular magnetic resonance (MR) acquisitions in the clinical environment. The capacity of the automated method to produce accurate measurements of left ventricular dimensions and function was quantitatively assessed in normal subjects and patients. Fourteen healthy volunteers and 8 patients underwent cardiovascular MR (CMR) acquisitions for ventricular function assessment. Short-axis datasets of the left ventricle (LV) were acquired in 2 ways: manually planned and generated in an automatic fashion. End-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and left ventricular mass (LVM) were derived from the 2 datasets. The agreement between the manual and automatic planning methods was assessed. The mean differences between the manual and automated CMR planning methods for the normal subjects and patients were 5.89 mL and 1.93 mL (EDV), 1.14 mL and -0.41 mL (ESV), 0.81% and 0.89% (EF), and 4.35 g and 3.88 g (LVM), respectively. There was no significant difference in ESV and EF. LVM significantly differed in both groups, whereas EDV was significantly different in the normal subjects and insignificantly different in the patients. The variability coefficients were 2.8 and 3.59 (EDV), 3.3 and 5.03 (ESV), 1.79 and 2.65 (EF), and 4.36 and 2.27 (LVM) for the normal subjects and patients, respectively. The mean angular deviation of the LV axes turned out to be 8.58 +/- 5.76 degrees for the normal subjects and 8.35 +/- 5.15 degrees for the patients. Automated CMR planning method can provide accurate measurements of LV dimensions in normal subjects and patients, and therefore, can be used in the clinical environment for functional assessment of the human cardiovascular system.

  19. Subjective memory complaints in primary care patients and death from all causes: a four-year follow-up

    DEFF Research Database (Denmark)

    Siersma, Volkert Dirk; Waldemar, Gunhild; Waldorff, Frans Boch

    2013-01-01

    -related quality of life were collected at the enrolment primary care consultation. Dates of death from all causes occurring during the four-year follow-up were retrieved from the national databases. Cox proportional hazard regression models on time to death (censored after four years) were used to examine......OBJECTIVE: To investigate the prognostic value of subjective memory complaints for all-cause mortality in order to determine whether elderly persons with subjective memory complaints may be regarded as a group of vulnerable patients who need close follow-up. DESIGN: Prospective cohort study...... the influence of subjective memory complaints on all-cause mortality. RESULTS: 88 patients died during the four-year follow-up. The association between subjective memory complaints and mortality had a statistically not significant hazard ratio (HR) of 0.91, adjusting for known confounders. Statistically...

  20. Lack of effect of risperidone or olanzapine dose reduction on subjective experiences in stable patients with schizophrenia.

    Science.gov (United States)

    Takeuchi, Hiroyoshi; Suzuki, Takefumi; Remington, Gary; Watanabe, Koichiro; Mimura, Masaru; Uchida, Hiroyuki

    2014-08-15

    Sixty-one patients with schizophrenia stably treated with risperidone or olanzapine were randomly assigned to dose-reduction-by-half group or dose maintenance group. Subjective experiences were assessed at baseline and 28 weeks using three different self-rating scales. No significant differences in changes of subjective experiences were observed between the two groups. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Agent-patient similarity affects sentence structure in language production: evidence from subject omissions in Mandarin

    Science.gov (United States)

    Hsiao, Yaling; Gao, Yannan; MacDonald, Maryellen C.

    2014-01-01

    Interference effects from semantically similar items are well-known in studies of single word production, where the presence of semantically similar distractor words slows picture naming. This article examines the consequences of this interference in sentence production and tests the hypothesis that in situations of high similarity-based interference, producers are more likely to omit one of the interfering elements than when there is low semantic similarity and thus low interference. This work investigated language production in Mandarin, which allows subject noun phrases to be omitted in discourse contexts in which the subject entity has been previously mentioned in the discourse. We hypothesize that Mandarin speakers omit the subject more often when the subject and the object entities are conceptually similar. A corpus analysis of simple transitive sentences found higher rates of subject omission when both the subject and object were animate (potentially yielding similarity-based interference) than when the subject was animate and object was inanimate. A second study manipulated subject-object animacy in a picture description task and replicated this result: participants omitted the animate subject more often when the object was also animate than when it was inanimate. These results suggest that similarity-based interference affects sentence forms, particularly when the agent of the action is mentioned in the sentence. Alternatives and mechanisms for this effect are discussed. PMID:25278915

  2. Assessment of Left Ventricular Torsion in Short Axis View between Healthy Subjects and Significant Coronary Artery Disease Patients

    Directory of Open Access Journals (Sweden)

    Zahra Arab

    2013-09-01

    Full Text Available Background: Coronary artery disease causes changes in biomechanical parameters and function of myocardial. Recently, torsion angle is one of the most important mechanical parameters. Therefore in this study, torsion angle in healthy subjects and LAD significant coronary artery disease patients, using echo tracking method in short axis view, was evaluated.Materials and Methods: In cross sectional study, 14 healthy subjects and 10 patients with significant stenosis of LAD were evaluated. Two dimensional echocardiography images were scanned in apical and basal parasternal short axis view were recorded. Successive ultrasonic images were processed by echo tracking under block matching algorithm and peak torsion angle were estimated. Difference between healthy group and patient group were extracted by using peak torsion angle by the confidence level of 95%.Results: In this study, basal rotation angle, apical rotation angle and torsion angle in short axis view in significant coronary artery disease patients significantly decreased 33%, 44% and 38% relative to healthy subjects, respectively. Also time to reach peak torsion angle in LAD coronary artery stenosis patients increased 19% relative to healthy group.Conclusion: It seems, torsion angle in short axis view, can diagnose LAD coronary artery stenosis patients reative to healthy subject.

  3. Analysis of cervical and global spine alignment under Roussouly sagittal classification in Chinese cervical spondylotic patients and asymptomatic subjects.

    Science.gov (United States)

    Yu, Miao; Zhao, Wen-Kui; Li, Mai; Wang, Shao-Bo; Sun, Yu; Jiang, Liang; Wei, Feng; Liu, Xiao-Guang; Zeng, Lin; Liu, Zhong-Jun

    2015-06-01

    To explore the relationship between cervical spine and the global spine alignment and to postulate the hypotheses that a lordotic alignment of cervical spine is not the only standard to identify asymptomatic subjects, and the degenerative modification of cervical curves depends primarily on their spinal-pelvic alignment. A cohort of 120 cases of Chinese asymptomatic subjects and a cohort of 121 cases of Chinese cervical spondylotic patients were recruited prospectively from 2011 to 2012. Roussouly Classification was utilized to categorize all subjects and patients according to their thoracic spine, lumbar spine and pelvic alignment. The cervical alignments were evaluated as lordosis, straight, sigmoid or kyphosis. Through the lateral X-ray images of neutral cervical and global spine, a number of parameters were measured and analyzed, including pelvic incidence, pelvic tilt, sacral slope, thoracic kyphosis (TK), lumbar lordosis, global cervical angles (angles between two lines parallel with posterior walls of C2 and C7), practical cervical angles (the addition of different cervical end plate angles from C3 to C7, and inter-vertebral angles from C23 to C67), T1 slope, spinal sacral angles (SSA), Hip to C7/Hip to Sacrum and C0-C2 angle. The percentages of cervical lordosis were 28.3% and 36.4% in asymptomatic and spondylotic group, respectively. The cervical spine alignments correlated with Roussouly types of global spine alignment in both asymptomatic and cervical spondylotic group (P Roussouly Type 2 and 4, Type 3 and 4, Type 1 and 3 in cervical angles in spondylotic group (P Roussouly Type 4 (P = 0.00 and 0.01, respectively), and there were significant differences in inter-vertebral angle in Roussouly Type 2 at C4-5 and C5-6 levels (P = 0.04 and 0.04, respectively), and in Roussouly Type 3 at C6-7 level (P = 0.01). The SSA showed significant difference between Roussouly Type 2 and 4 in asymptomatic subjects (P = 0.00), and between Type 1 and 3, 1 and 4, 2 and 3, 2

  4. Clinical and treatment-related determinants of subjective quality of life in patients with first-episode psychosis.

    Science.gov (United States)

    Kwong, Vivian Wing Yan; Chang, Wing Chung; Chan, Gloria Hoi Kei; Jim, Olivia Tsz Ting; Lau, Emily Sin Kei; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

    2017-03-01

    Subjective quality of life (SQoL) has been increasingly studied in first-episode psychosis (FEP). Prior research primarily examined the impact of psychiatric symptoms on SQoL. Relationship between treatment-related factors and SQoL is under-studied. In this study, 159 Chinese patients who had completed 2-year treatment from early intervention service in Hong Kong were recruited. Assessments on premorbid adjustment, clinical profiles including social anxiety measure, functioning, antipsychotic-induced extrapyramidal side-effects and attitude toward medication treatment were conducted. SQoL was evaluated by Chinese version SF36 which generated mental and physical component summary (MCS and PCS) scores for analysis. Our results showed that more severe positive symptoms, higher level of depression, greater social anxiety, more negative attitude toward antipsychotic medications and greater degree of akathisia independently predicted lower MCS score. Higher social anxiety level and poorer functioning predicted lower PCS score. Our results indicate that affective and positive symptoms, functioning, and treatment-related variables are critical determinants of SQoL in FEP patients. These identified factors thus represent potentially malleable therapeutic targets for early detection and prompt intervention to promote enhancement of SQoL in the early stage of illness. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

    Directory of Open Access Journals (Sweden)

    Andreas Michalsen

    2013-01-01

    Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

  6. [Clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery].

    Science.gov (United States)

    Zhou, Zhou; Han, Xiaotong; Ning, Fengling; Wen, Hui; Fan, Maiying; Yuan, Xia; Luo, Jieying; Zhang, Yi

    2017-03-01

    To investigate the clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery. A retrospective case control study was conducted. Seventy-six patients with pulmonary infection after abdominal surgery admitted to the First Affiliated Hospital of Hunan Normal University from September 2015 to September 2016 were enrolled. According to whether accept the pulmonary rehabilitation therapy or not, the patients were divided into two groups. In the control group (n = 35), the conventional expectoration method was adopted. The patients in pulmonary rehabilitation group (n = 41) received both methods of the control group and pulmonary rehabilitation treatment, including respiratory exercise (effective cough, lip reduction breathing), respiratory exercise device (respiratory exerciser tri-ball), and vibrated expectoration. The 24-hour sputum volume, degree of comfort, inflammatory and pulmonary function parameters, and recovery situation were recorded in the two groups. (1) There were no significant differences in the parameters of inflammation and pulmonary function before treatment between the two groups. After treatment, the white blood cell (WBC) and C-reactive protein (CRP) in both groups were significantly decreased, and the forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were significantly increased. The above changes in pulmonary rehabilitation group were more significant than those of the control group [WBC (×109/L): 11.12±2.88 vs. 13.42±2.62 at 3 days, 8.22±1.48 vs. 9.27±1.92 at 5 days; CRP (mg/L): 13.47±4.77 vs. 16.03±4.94 at 3 days, 9.69±1.56 vs. 11.77±1.41 at 5 days; FEV1 (L): 2.48±0.14 vs. 2.29±0.16 at 3 days, FEV1/FVC: 0.78±0.04 vs. 0.75±0.04 at 3 days; all P rehabilitation group were significantly higher than that of the control group (mL: 30.51±4.15 vs. 18.30±3.64 at 1 day, 31.08±3.22 vs. 20.37±3

  7. Intensive lifestyle intervention including high-intensity interval training program improves insulin resistance and fasting plasma glucose in obese patients

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2015-01-01

    Conclusion: Following a 9-month intensive lifestyle intervention combining HIIT and MedD counseling, obese subjects experienced significant improvements of FPG and insulin resistance. This is the first study to expose the effects of a long-term program combining HIIT and MedD on glycemic control parameters among obese subjects.

  8. District nursing practice for the death of patients subject to deprivation of liberty safeguards.

    Science.gov (United States)

    Griffith, Richard

    2015-02-01

    The Chief Coroner of England and Wales has issued guidance to coroners on whether the death of a person subject to a deprivation of liberty safeguard should be subject to an inquest. The guidance was issued in response to the tenfold increase in people being made subject to the safeguards since the Supreme Court's decision in Cheshire West and Chester Council v P [2014]. It is the Chief Coroner's view that all deaths where a person is subject to a deprivation of liberty safeguard or Court of Protection welfare order allowing a deprivation of liberty must be investigated by the coroner with an inquest held. This article considers the impact of the Chief Coroner's guidance on district nurse practice. It discusses whether a person subject to a deprivation of liberty safeguard is in state detention and whether an inquest is necessary in every case.

  9. Incidence and Risk Factors for Infection When Teicoplanin Is Included for Prophylaxis in Patients with Hip Fracture.

    Science.gov (United States)

    Capdevila, Aina; Navarro, Margarita; Bori, Guillem; Tornero, Eduard; Camacho, Pilar; Bosch, Jordi; García, Sebastián; Mensa, Josep; Soriano, Alex

    2016-08-01

    Surgical site infection (SSI) rate after surgery for hip fracture is about 4%. The aim of the present study was to review the efficacy of dual prophylaxis using teicoplanin plus cefuroxime and risk factors for SSI. Operations for hip fracture from 2012 to 2013 were retrospectively reviewed. Relevant information was gathered: Demographics, comorbidities, ASA score, laterality, type of fracture, type of surgery, d from admission to surgery, length of surgery, hemoglobin value at admission, urinary or respiratory infections, and the need for pre-operative, intra-operative, and post-operative red blood cell (RBC) transfusion. Prophylaxis consisted of cefuroxime and teicoplanin during the induction of anesthesia. U.S. Centers for Disease Control and Prevention (CDC) criteria for superficial and deep SSI were applied. Univariate and multivariable analysis were performed. Six hundred fifty-seven patients were included in the study. Thirteen (2.0%) SSI were identified, six superficial (0.9%), and seven deep (1.1%). Staphylococcus aureus was isolated in two infections (one superficial and one deep). The SSI rate was 2.4% in intra-medullary nails (n = 334), 1.4% in prostheses (n = 211), and 1.8% in other synthesis (n = 112). Parameters independently associated with SSI were: Intra-operative RBC transfusion (OR: 11.6, p = 0.002), length of surgery >120 min (OR: 4.5, p = 0.02), and having a urinary infection (OR: 4.28, p = 0.02). Dual prophylaxis including cefuroxime and teicoplanin was associated with a 2% rate of SSI. Staphylococcus aureus caused only two SSIs. Reducing SSI is of utmost importance for patients' quality of life and to avoid additional cost of surgical procedures. Therefore, more experience with dual prophylaxis is needed to confirm our results.

  10. Congruence of the Medical Record and Subject Interview on Time of Symptom Onset in Patients Diagnosed With Acute Coronary Syndrome.

    Science.gov (United States)

    Davis, Leslie L; McCoy, Thomas P; Riegel, Barbara; McKinley, Sharon; Doering, Lynn V; Dracup, Kathleen; Moser, Debra K

    Past research has shown discrepancies between the time of symptom onset for patients with acute coronary syndrome (ACS) as documented in the medical record (MR) and patients' recall of the time assessed through subject interviews done later by researchers. The aim of this study is to determine if there were differences between the time of symptom onset documented in the MR and subject interview taking into consideration sex, age group, and recall period for patients admitted to the emergency department for symptoms suggestive of ACS. A secondary analysis was conducted on data from the PROMOTION (Patient Response to Myocardial Infarction Following a Teaching Intervention Offered by Nurses) trial, a multicenter randomized clinical trial to reduce patient prehospital delay to treatment in ACS. Of the 3522 subjects with CAD enrolled into the trial, 3087 subjects completed 2-year follow-up. Of these, 331 subjects sought treatment in the emergency department for ACS symptoms and 276 patients (83%) had complete information on the time of symptom onset from both sources. Of the 276 patients, 25 (9%) had differing times more than 48 hours and were thus excluded. The median difference between the 2 sources was 45.0 minutes. When both times were examined, there were no significant differences in time by sex (P = .720) or by age group (P = .188). The median number of days between the interview and the date of symptom onset was 29.5 days. There was a significant correlation between differences in the time of symptom onset and the length of recall period (rs = 0.148, P = .023). In multivariable modeling, a longer recall period was associated with greater median differences in the symptom onset time (b = 13.2, P = .023). These results suggest that the time of symptom onset obtained at the time of the index event and documented in the MR is not interchangeable with data obtained later by research staff, especially if the interview is not conducted near the time of the index event.

  11. Task-related oxygen uptake and symptoms during activities of daily life in CHF patients and healthy subjects.

    Science.gov (United States)

    Spruit, Martijn A; Wouters, Emiel F M; Eterman, Rose-Mieke A; Meijer, Kenneth; Wagers, Scott S; Stakenborg, Koen H P; Uszko-Lencer, Nicole H M K

    2011-08-01

    Patients with chronic heart failure (CHF) have a significantly lower peak aerobic capacity compared to healthy subjects, and, may therefore experience more inconvenience during the performance of domestic activities of daily life (ADLs). To date, the extent to which task-related oxygen uptake, heart rate, ventilation and symptoms during the performance of ADLs in CHF patients is different than in healthy subjects remains uncertain. General demographics, pulmonary function, body composition and peak aerobic capacity were assessed in 23 CHF outpatients and 20 healthy peers. In addition, the metabolic requirement of five simple self-paced domestic ADLs was assessed using a mobile oxycon. Task-related oxygen uptake (ml/min) was similar or lower in CHF patients compared to healthy subjects. In contrast, patients with CHF performing ADLs consumed oxygen at a higher proportion of their peak aerobic capacity than healthy subjects (p CHF experience use a higher proportion of their peak aerobic capacity, peak ventilation and peak heart rate during the performance of simple self-paced domestic ADL than their healthy peers. These findings represent a necessary step in improving our understanding of improving what troubles patients the most-not being able to do the things that they could when they were healthy.

  12. [Serum myeloperoxidase activity and serum paraoxonase-1 activity in patients with silicosis and observation subjects and their clinical significance].

    Science.gov (United States)

    Zou, Wei-hua; Qiu, Sheng-qiang; Hong, Xiao-ping; Wu, Quan

    2013-01-01

    To investigate the serum myeloperoxidase (MPO) activity and serum paraoxonase-1 (PON-1) activity in patients with silicosis and observation subjects and their clinical significance. Seventy-two patients with silicosis (stage I: 30 cases, stage II: 22 cases, stage III: 20 cases) and 37 observation subjects were selected as a case group, and 110 healthy men were selected as a control group. Serum MPO activity was measured by double-antibody sandwich enzyme-linked immunosorbent assay, and serum PON-1 activity was measured by chemical spectrophotometry. Serum MPO activity was significantly higher in the case group than in the control group [(102.1 ± 15.7) U/L vs. (62.4 ± 11.4) U/L, P silicosis than in the observation subjects [(91.3 ± 13.5) U/L, (85.7 ± 14.4) U/L, and (88.6 ± 14.5) U/L vs. (128.4 ± 16.4) U/L, P silicosis increased; serum PON-1 activity was significantly lower in the patients with stages II and III silicosis than in the observation subjects and the patients with stage I silicosis [(70.4 ± 11.4) U/ml and (67.6 ± 13.7) U/ml vs. (101.5 ± 14.0) U/ml and (89.1 ± 10.1) U/ml, P silicosis and evaluation of patient's condition.

  13. Predictive Factors for Subjective Improvement in Lumbar Spinal Stenosis Patients with Nonsurgical Treatment: A 3-Year Prospective Cohort Study.

    Science.gov (United States)

    Matsudaira, Ko; Hara, Nobuhiro; Oka, Hiroyuki; Kunogi, Junichi; Yamazaki, Takashi; Takeshita, Katsushi; Atsushi, Seichi; Tanaka, Sakae

    2016-01-01

    To assess the predictive factors for subjective improvement with nonsurgical treatment in consecutive patients with lumbar spinal stenosis (LSS). Patients with LSS were enrolled from 17 medical centres in Japan. We followed up 274 patients (151 men; mean age, 71 ± 7.4 years) for 3 years. A multivariable logistic regression model was used to assess the predictive factors for subjective symptom improvement with nonsurgical treatment. In 30% of patients, conservative treatment led to a subjective improvement in the symptoms; in 70% of patients, the symptoms remained unchanged, worsened, or required surgical treatment. The multivariable analysis of predictive factors for subjective improvement with nonsurgical treatment showed that the absence of cauda equina symptoms (only radicular symptoms) had an odds ratio (OR) of 3.31 (95% confidence interval [CI]: 1.50-7.31); absence of degenerative spondylolisthesis/scoliosis had an OR of 2.53 (95% CI: 1.13-5.65); radicular symptoms, absence of degenerative spondylolisthesis/scoliosis, and an illness duration of <1 year.

  14. Familial breast cancer: Genetic counseling over time, including patients´ expectations and initiators considering the Angelina Jolie effect.

    Directory of Open Access Journals (Sweden)

    Christina Evers

    Full Text Available The German Consortium for hereditary breast/ovarian cancer (GC-HBOC aims for nationwide access to professional, individualized yet structured care for families at high risk. The identification of such families remains key for optimal care. Our study evaluates counselees' characteristics, referral practices, expectations and motivations in respect to their first genetic consultation. The impact of the Angelina Jolie Effect (AJE was prospectively assessed.All counselees could participate through a questionnaire. Groups were built in respect to neoadjuvant chemotherapy (FT and before/after AJE.The 917 (88.5% counselees (FT: 8.2% were on average female (97.3%, with a mean age of 44.6, had children (71.9%, higher education (88%, personal (46.4% or at least one first-degree relative (74.6% with BC/OC or known BRCA1/2 mutation (11.8%, were in a relationship (76.1%, and living in a village (40.7%. The AJE is associated with significantly fewer cancelations (p = 0.005, more attendance among men (4.2% vs. 0.8%, p = 0.002, and people with familial BRCA1/2 (14.8% vs. 7.5%, p = 0.003. The majority seek information regarding their cancer risk (83% or relatives' risk (74.8%, HBOC (69.1%, and surveillance programs for themselves (66.6% or relatives (60.6%.Enhanced media awareness of genetic cancer motivates patients, including other patient groups. A higher number of participants, including more men, are attending GC due to the AJE. In terms of the rising complexity of genetic testing, the analysis of patients' expectations and initiators for GC suggests that there is an urgent need to develop to participate motivation analysis. The factors revealed as impediments to accessing GC-HBOC guide recommendations to optimize access to genetic counseling. Medical educational programs for primary gynecologists and families at risk might be options to reach more participants.

  15. [Efficiency and safety of the intravenous application of esomeprazole (nexium - Astra Zeneca) in high risk patients subjected to mechanic ventilation].

    Science.gov (United States)

    Stefanov, Ch; Batashki, I; Dimitrov, D; Dimov, G; Dobrev, K; Kirina, V; Petrov, A; Karakolev, Zh

    2007-01-01

    The aim of the research was to determine the effectivity and the safety of the intravenous application of Esomeprazole (Nexium - Astra Zeneca) like prevention of the development of stress-ulcers of the gastric mucous with high risk patients at ICU with mechanic ventilation. 47 patients subjected to mechanic ventilation over 48 hours with availability of just one more risk factor for development of stress-ulcers of gastric musous were included in the study. Samples of gastric juice for determination of the acidity and presence of fresh erythrocytes and microbiological cultures from gastric contents, wash away of the mouth cavity and tracheal aspiration were tested on the 1st, the 3rd and the 5th day from the start of the treatment. At the end of the therapy there has been determinated the outcome - survivor or died and total quantity of the haemotransfusions. The acidity of the gastric juice changed in the range over pH 5 during the 24 hours by the application of esomeprazole. Fibrogastroscopic examinations were performed of patients who were found to have fresh erythrocytes in the gastric contents. No one was registered with bleeding of the gastric mucous. The isolated microorganisms of the gastric juice and wash away of mouth cavity were identical with those of tracheobronchial aspiration in about 13 %. In our study the application of esomeprazole i.v. was effective and safe approach for profilaxy of the stress-ulcers and the bleeding of the gastric mucous. Comparative studies with H2-blockers and sucralfat are necessary for clarifying and objectifying the significance of the microbiologic isolates of the gastric contents and wash away from mouth cavity and their relation to the development of nosocomial pneumonia.

  16. Pulsatile Stress in Middle-Aged Patients With Type 1 or Type 2 Diabetes Compared With Nondiabetic Control Subjects

    Science.gov (United States)

    Philips, Jean-Christophe; Marchand, Monique; Scheen, André J.

    2010-01-01

    OBJECTIVE Arterial pulse pressure is considered to be an independent cardiovascular risk factor. We compared pulse pressure during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes and corresponding nondiabetic control subjects. RESEARCH DESIGN AND METHODS Forty patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, and BMI 23.0 kg/m2) were compared with 40 nonhypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, and 29.7 kg/m2). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres) in standing (1 min), squatting (1 min), and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects. RESULTS Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher pulse pressure, heart rate, and double product of pulse pressure and heart rate (PP×HR) (type 1: 5,263 vs. 4,121 mmHg/min, P = 0.0004; type 2: 5,359 vs. 4,321 mmHg, P = 0.0023) levels than corresponding control subjects. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding pulse pressure (59 vs. 58 mmHg), heart rate (89 vs. 88/min), and PP×HR (5,263 vs. 5,359 mmHg/min). CONCLUSIONS Patients with type 1 diabetes have increased levels of peripheral PP, an indirect marker of arterial stiffness, and PP×HR, an index of pulsatile stress, comparable to those of nonhypertensive patients with type 2 diabetes at similar mean age of 50 years. PMID:20693351

  17. Similar elimination rates of glucagon-like peptide-1 in obese type 2 diabetic patients and healthy subjects

    DEFF Research Database (Denmark)

    Vilsbøll, T; Agersø, H; Krarup, T

    2003-01-01

    We have previously shown that type 2 diabetic patients have decreased plasma concentrations of glucagon-like peptide 1 (GLP-1) compared with healthy subjects after ingestion of a standard mixed meal. This decrease could be caused by differences in the metabolism of GLP-1. The objective...... response seen after ingestion of a standard breakfast meal must therefore be caused by a decreased secretion of GLP-1 in type 2 diabetic patients....

  18. The 10-year Course of Physically Self-destructive Acts Reported by Borderline Patients and Axis II Comparison Subjects

    Science.gov (United States)

    Zanarini, Mary C.; Frankenburg, Frances R.; Reich, D. Bradford; Fitzmaurice, Garrett; Weinberg, Igor; Gunderson, John G.

    2013-01-01

    Objective The purpose of this paper was to determine the frequency and methods of two forms of physically self-destructive acts (i.e., self-mutilation and suicide attempts) reported by borderline patients and axis II comparison subjects over ten years of prospective follow-up. Methods 290 borderline patients and 72 axis II comparison subjects were interviewed about their physically self-destructive acts during their index admission and at five contiguous two-year follow-up periods. Results It was found that a high percentage of borderline patients reported multiple acts and methods of each of these two forms of physically self-destructive behavior prior to their index admission. It was also found that the percentage of borderline patients reporting multiple acts and methods declined significantly over time. However, these acts remained significantly more common among borderline patients than axis II comparison subjects. Conclusions The course of self-mutilation and suicide attempts among borderline patients is initially more serious and ultimately more benign than previously recognized. PMID:18241308

  19. Evaluation of genotoxicity in patients subjected to panoramic radiography by micronucleus assay on epithelial cells of the oral mucosa.

    Directory of Open Access Journals (Sweden)

    Pallak Arora

    2014-02-01

    Full Text Available Radiography is one of the most valuable diagnostic tools used in comprehensive dental care. Although there is no safe level of radiation exposure, the possible risk associated with exposure to radiation, must be elucidated. To date, a variety of assays have been proposed to assess the mutagenic potential of genotoxicants; however, these methods are typically laborious and time consuming. The aim of the present study was to evaluate the possible genotoxic effect of routinely used panoramic radiation exposure in exfoliated epithelial cells as measured by the formation of micronuclei and to compare the genotoxicity of X-rays on keratinized epithelial gingival cells and the nonkeratinized buccal epithelial cells.The study included 53 healthy individuals with a mean age of 25.21 ±12.67 years. Specimens of exfoliated epithelial cells were collected from patients subjected to panoramic radiography before and 10 days after radiation exposure. The cells were stained with Giemsa and evaluated for micronuclei by scoring 1000 cells per slide.In our study, the genotoxic effect of radiation exposure from panoramic radiography showed a statistically significant increase in the MN frequency in buccal epithelial cells. A significant correlation was observed between the age of the subjects and micronuclei, although no such correlation was found between gender and micronuclei count.MN test serves as a simple biomarker indicating the direct exposure to DNA damaging agents such as ionizing radiation, emphasizing great sensitivity even for exposure to low doses during radiation screening. Thus, panoramic dental radiography should be cautiously used only when necessary.

  20. Evaluation of Nutritional Status of Cancer Patients during Treatment by Patient-Generated Subjective Global Assessment: a Hospital-Based Study.

    Science.gov (United States)

    Sharma, Dibyendu; Kannan, Ravi; Tapkire, Ritesh; Nath, Soumitra

    2015-01-01

    Cancer patients frequently experience malnutrition. Cancer and cancer therapy effects nutritional status through alterations in the metabolic system and reduction in food intake. In the present study, fifty seven cancer patients were selected as subjects from the oncology ward of Cachar Cancer Hospital and Research Centre, Silchar, India. Evaluation of nutritional status of cancer patients during treatment was carried out by scored Patient-Generated Subjective Global Assessment (PG-SGA). The findings of PG-SGA showed that 15.8% (9) were well nourished, 31.6% (18) were moderately or suspected of being malnourished and 52.6% (30) were severely malnourished. The prevalence of malnutrition was highest in lip/oral (33.33%) cancer patients. The study showed that the prevalence of malnutrition (84.2%) was high in cancer patients during treatment.

  1. Comparison of Dietary Macro and Micro Nutrient Intake between Iranian Patients with Long-term Complications of Sulphur Mustard Poisoning and Healthy Subjects.

    Science.gov (United States)

    -Mood, Mahdi Balali; Zilaee, Marzie; -Mobarhan, Majid Ghayour; Sheikh-Andalibi, Mohammad Sobhan; Mohades-Ardabili, Hossein; Dehghani, Hamideh; Ferns, Gordon

    2014-01-01

    Patients with long-term complications of sulfur mustard (SM) poisoning are often less able to undertake optimum levels of physical activity and adequately control their dietary intake. The aim of present study was to investigate the dietary intake of patients with SM poisoning in comparison to a control group Methods: The study was undertaken on 55 Iranian male veterans, who had > 25% disabilities due to long-term complications of SM poisoning and 55 men age-matched healthy subjects. A previously validated food frequency questionnaire (FFQ) was used for measuring dietary macro/micro nutrient intake for both groups; and the results were analysed using Dietplan6 software. Analysis of macro/micro nutrients in dietary intakes of the patients versus the controls showed a significantly lower intake of several nutrients including selenium and carbohydrate. On the other hand, the dietary intake of trans-fatty acids and iodine were significantly higher in these patients. Long-term complications of SM poisoning in the Iranian veterans induce both chemical and physical disabilities. Macro/micro nutrient intake in these patients was significantly different in comparison with matched, healthy subjects. Dietary advice for these patients should be strongly recommended to these patients in order to prevent other chronic diseases.

  2. Comparative gut microbiota and resistome profiling of intensive care patients receiving selective digestive tract decontamination and healthy subjects.

    Science.gov (United States)

    Buelow, Elena; Bello González, Teresita D J; Fuentes, Susana; de Steenhuijsen Piters, Wouter A A; Lahti, Leo; Bayjanov, Jumamurat R; Majoor, Eline A M; Braat, Johanna C; van Mourik, Maaike S M; Oostdijk, Evelien A N; Willems, Rob J L; Bonten, Marc J M; van Passel, Mark W J; Smidt, Hauke; van Schaik, Willem

    2017-08-14

    The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown. Here, we characterize the composition of the gut microbiota and its antimicrobial resistance genes ("the resistome") of ICU patients during SDD and of healthy subjects. From ten patients that were acutely admitted to the ICU, 30 fecal samples were collected during ICU stay. Additionally, feces were collected from five of these patients after transfer to a medium-care ward and cessation of SDD. Feces from ten healthy subjects were collected twice, with a 1-year interval. Gut microbiota and resistome composition were determined using 16S rRNA gene phylogenetic profiling and nanolitre-scale quantitative PCRs. The microbiota of the ICU patients differed from the microbiota of healthy subjects and was characterized by lower microbial diversity, decreased levels of Escherichia coli and of anaerobic Gram-positive, butyrate-producing bacteria of the Clostridium clusters IV and XIVa, and an increased abundance of Bacteroidetes and enterococci. Four resistance genes (aac(6')-Ii, ermC, qacA, tetQ), providing resistance to aminoglycosides, macrolides, disinfectants, and tetracyclines, respectively, were significantly more abundant among ICU patients than in healthy subjects, while a chloramphenicol resistance gene (catA) and a tetracycline resistance gene (tetW) were more abundant in healthy subjects. The gut microbiota of SDD-treated ICU patients deviated strongly from the gut microbiota of healthy subjects. The negative effects on the resistome were limited to selection

  3. Intra-arterial infusion of prostaglandin E1 in normal subjects and patients with peripheral arterial disease

    DEFF Research Database (Denmark)

    Nielsen, P E; Nielsen, S L; Holstein, P

    1976-01-01

    Acute vasodilatation was produced by infusion of prostaglandin E1 (PGE1) in the femoral artery in 6 patients with occlusive arterial disease of the legs and in 3 normal subjects. The effect on blood flow and on blood pressure was measured at different segments of the leg with the strain gauge...

  4. Effects of a warm compress containing menthol on the tear film in healthy subjects and dry eye patients

    Science.gov (United States)

    Arita, Reiko; Morishige, Naoyuki; Sakamoto, Ichiro; Imai, Natsuko; Shimada, Yuko; Igaki, Michihito; Suzuki, Atsushi; Itoh, Kouzo; Tsubota, Kazuo

    2017-04-01

    Menthol is thought to stimulate lacrimation via activation of cold-sensitive primary afferent neurons in the cornea. We evaluated a warm compress containing menthol as a potential treatment for dry eye by examining its effects on the tear film in healthy subjects (n = 20) and dry eye patients (n = 35). Disposable eyelid-warming steamers that either did (MH) or did not (HO) contain menthol were applied to one eye of each subject either once only for 10 min or repeatedly over 2 weeks. Single application of MH significantly increased tear meniscus volume (P = 8.6 × 10-5, P = 1.3 × 10-5) and tear film breakup time (P = 0.006, P = 0.002) as well as improved meibum condition in healthy subjects and dry eye patients, respectively. Repeated application of MH significantly increased tear meniscus volume (P = 0.004, P = 1.7 × 10-4) and tear film breakup time (P = 0.037, P = 0.010) in healthy subjects and dry eye patients, respectively. Repeated application of MH thus induced persistent increases in tear fluid volume and tear film stability in dry eye patients, suggesting that repeated use of a warm compress containing menthol is a potential novel treatment for dry eye disease.

  5. Cerebrospinal fluid A beta 42 is the best predictor of clinical progression in patients with subjective complaints

    NARCIS (Netherlands)

    van Harten, A.C.; Visser, P.J.; Pijnenburg, Y.A.L.; Teunissen, C.E.; Blankenstein, M.A.; Scheltens, P.; van der Flier, W.M.

    2013-01-01

    Background: The need to recognize Alzheimer's disease (AD) as early as possible led us to evaluate the predictive value of amyloid β(1-42) (Aβ42), total tau (tau), and phosphorylated tau (ptau) in cerebrospinal fluid (CSF) for clinical progression in patients with subjective complaints. Methods: We

  6. Acute effects of progressive muscle relaxation on state anxiety and subjective well-being in chronic Bulgarian patients with schizophrenia.

    Science.gov (United States)

    Georgiev, Asen; Probst, Michel; De Hert, Marc; Genova, Valentina; Tonkova, Anastasiya; Vancampfort, Davy

    2012-12-01

    Recently, there has been an interest in the relative effectiveness of progressive muscle relaxation (PMR) within the multidisciplinary treatment of patients with schizophrenia.The present study is aimed at providing evidence on the efficacy of PMR as means of alleviating the state anxiety and psychological distress and a way to increase subjective well-being in chronic patients with schizophrenia. Sixty four schizophrenia patients underwent 2 sessions of PMR. On the third session they were randomly allocated to either the PMR or the reading control condition. The State Anxiety Inventory (SAI) was used to assess state anxiety and the Subjective Exercise Experience Scale (SEES) to assess psychological distress and subjective well-being before and after the third session for both groups. Our data show a significant time by group interaction for the SAI and SEES (Wilks λ=0.58, p<0.001). Effect sizes for PMR were -0.22 (95%CI=-0.73 to 0.19) for state anxiety, -0.96 (95%CI=-0.41 to -1.43) for psychological stress, and +1.01 (95%CI=0.45 to 1.54) for subjective well-being. The present study provides scientific evidence for the utility of PMR in the chronic psychiatric settings for patients with schizophrenia.

  7. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands.

    Science.gov (United States)

    Leensen, Monique C J; Groeneveld, Iris F; Heide, Iris van der; Rejda, Tomas; van Veldhoven, Peter L J; Berkel, Sietske van; Snoek, Aernout; Harten, Wim van; Frings-Dresen, Monique H W; de Boer, Angela G E M

    2017-06-15

    To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes. Longitudinal prospective intervention study using a one-group design. Two hospitals in the Netherlands. Of the eligible patients, 56% participated; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included. Patients completed questionnaires on RTW, the importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise programme 1-repetition maximum (1RM) muscle strength and cardiorespiratory fitness (VO 2 peak) were assessed. Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (pfatigue levels were significantly reduced. After completing the exercise programme, 1RM muscle strength was significantly increased but there was no improvement in VO 2 peak level. RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Apathy/depression, but not subjective fatigue, is related with cognitive dysfunction in patients with multiple sclerosis.

    Science.gov (United States)

    Niino, Masaaki; Mifune, Nobuhiro; Kohriyama, Tatsuo; Mori, Masahiro; Ohashi, Takashi; Kawachi, Izumi; Shimizu, Yuko; Fukaura, Hikoaki; Nakashima, Ichiro; Kusunoki, Susumu; Miyamoto, Katsuichi; Yoshida, Kazuto; Kanda, Takashi; Nomura, Kyoichi; Yamamura, Takashi; Yoshii, Fumihito; Kira, Jun-ichi; Nakane, Shunya; Yokoyama, Kazumasa; Matsui, Makoto; Miyazaki, Yusei; Kikuchi, Seiji

    2014-01-06

    Cognitive impairment could affect quality of life for patients with multiple sclerosis (MS), and cognitive function may be correlated with several factors such as depression and fatigue. This study aimed to evaluate cognitive function in Japanese patients with MS and the association between cognitive function and apathy, fatigue, and depression. The Brief Repeatable Battery of Neuropsychological tests (BRB-N) was performed in 184 Japanese patients with MS and 163 healthy controls matched for age, gender, and education. The Apathy Scale (AS), Fatigue Questionnaire (FQ), and Beck Depression Inventory Second Edition (BDI-II) were used to evaluate apathy, fatigue, and depression, respectively. Student's t-test was used to compare MS patients and healthy controls. Correlations between two factors were assessed using the Pearson correlation test, and multiple regression analysis was used to evaluate how much each factor affected the BRB-N score. In all BRB-N tests, patients with MS scored significantly lower than controls, and the effect size of symbol digit modalities test was the highest among the 9 tests of the BRB-N. Patients with MS had higher AS (p depression in Japanese patients with MS. Despite the association between cognitive variables and depression/apathy, cognitive function was impaired beyond the effect of depression and apathy. However, subjective fatigue is not related with cognitive impairment. Taken together, this suggests that different therapeutic approaches are needed to improve subjective fatigue and cognition, and thereby quality of life, in patients with MS.

  9. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases.

    Science.gov (United States)

    Arimura, Eiko; Matsumoto, Chota; Nomoto, Hiroki; Hashimoto, Shigeki; Takada, Sonoko; Okuyama, Sachiko; Shimomura, Yoshikazu

    2011-01-05

    To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP). The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases.

  10. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  11. Molecular cytogenetic studies in three patients with partial trisomy 2p, including CGH from paraffin-embedded tissue.

    Science.gov (United States)

    Aviram-Goldring, A; Fritz, B; Bartsch, C; Steuber, E; Daniely, M; Lev, D; Chaki, R; Barkai, G; Frydman, M; Rehder, H

    2000-03-06

    We report on three cases of partial trisomy 2p in which the identification and exact localization of the duplicated chromosome segment was possible only by application of molecular cytogenetic techniques. These included fluorescence in situ hybridization by use of wcp2, N-myc, and subtelomeric 2p probes and comparative genomic hybridization with DNA isolated from blood samples, frozen fetal tendon, and formalin fixed, paraffin-embedded fetal lung tissue. Two of the cases concerned fetuses of gestational week 20 and 24 with duplication of nonoverlapping terminal (2pter-->p24) and more proximal (2p25-->p23) segments and with distinctly different phenotypes. The third case was due to a de novo inverted duplication of 2p25-->p23, with loss of the subtelomeric region of 2p. This 53-month-old girl was a Bloom syndrome carrier. The patient had prenatal growth failure, borderline microcephaly, dilated lateral horns of the cerebral ventricles, transient cortical blindness, myopia, muscle hypotonia, and dilatation of the left renal collecting system. Dermal cysts were found on the glabella, the soles of both feet, and the vocal cord, causing respiratory embarrassment. Previously reported cases of pure trisomy 2p are reviewed, in an attempt to correlate clinical findings to overlapping regions in 2p. These cases illustrate the effectiveness of molecular cytogenetic methods in resolving subtle chromosomal aberrations in order to coordinate more accurately a chromosome regionspecific phenotype.

  12. Objective and subjective sleep quality: Melatonin versus placebo add-on treatment in patients with schizophrenia or bipolar disorder withdrawing from long-term benzodiazepine use.

    Science.gov (United States)

    Baandrup, Lone; Glenthøj, Birte Yding; Jennum, Poul Jørgen

    2016-06-30

    Benzodiazepines are frequently long-term prescribed for the treatment of patients with severe mental illness. This prescribing practice is problematic because of well-described side effects including risk of dependence. We examined the efficacy of prolonged-release melatonin on objective and subjective sleep quality during benzodiazepine discontinuation and whether sleep variables were associated with benzodiazepine withdrawal. Eligible patients included adults with a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder and long-term use of benzodiazepines in combination with antipsychotics. All participants gradually tapered the use of benzodiazepines after randomization to add-on treatment with melatonin versus placebo. Here we report a subsample of 23 patients undergoing sleep recordings (one-night polysomnography) and 55 patients participating in subjective sleep quality ratings. Melatonin had no effect on objective sleep efficiency, but significantly improved self-reported sleep quality. Reduced benzodiazepine dosage at the 24-week follow-up was associated with a significantly decreased proportion of stage 2 sleep. These results indicate that prolonged-release melatonin has some efficacy for self-reported sleep quality after gradual benzodiazepine dose reduction, and that benzodiazepine discontinuation is not associated with rebound insomnia in medicated patients with severe mental illness. However, these findings were limited by a small sample size and a low retention rate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. The 10-year course of adult aggression toward others in patients with borderline personality disorder and axis II comparison subjects.

    Science.gov (United States)

    Zanarini, Mary C; Temes, Christina M; Ivey, Alexandra M; Cohn, Danielle M; Conkey, Lindsey C; Frankenburg, Frances R; Fitzmaurice, Garrett M

    2017-06-01

    This study had two aims. The first was to assess and compare various types of aggressive behavior toward others reported by borderline patients and axis II comparison subjects over time. The second was to determine the best baseline and time-varying predictors of aggressive behavior in these borderline patients. At baseline, a series of interviews and self-report measures were administered to 290 borderline patients and 72 axis II comparison subjects. Measures assessing aggression toward others, axis I and II disorders as well as adult adversity were re-administered every two years over the course of ten years. It was found that borderline patients reported significantly higher rates of verbal, emotional, and physical aggression toward others than comparison subjects but the rates of these forms of aggression toward others declined significantly for those in both study groups. Multivariate analyses indicated that the strongest predictors of adult aggression towards others were severity of adult adversity and a substance use disorder. Taken together, these results suggest that borderline patients commonly report aggression toward others but that this aggression declines significantly over time. These results also suggest that this aggression toward others is most strongly associated with adult experiences of adversity and concurrent substance abuse. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. Phase 2 study of the JAK kinase inhibitor ruxolitinib in patients with refractory leukemias, including postmyeloproliferative neoplasm acute myeloid leukemia

    Science.gov (United States)

    Eghtedar, Alireza; Verstovsek, Srdan; Estrov, Zeev; Burger, Jan; Cortes, Jorge; Bivins, Carol; Faderl, Stefan; Ferrajoli, Alessandra; Borthakur, Gautam; George, Solly; Scherle, Peggy A.; Newton, Robert C.; Kantarjian, Hagop M.

    2012-01-01

    We conducted a phase 2 study of ruxolitinib in patients with relapsed/refractory leukemias. Patients with acceptable performance status (0-2), adequate organ function, and no active infection, received ruxolitinib 25 mg orally twice a day for 4 weeks (1 cycle). Response was assessed after every 2 cycles of treatment, and patients who completed 2 cycles were allowed to continue treatment until disease progression. Dose escalation to 50 mg twice daily was permitted in patients demonstrating a benefit. Thirty-eight patients, with a median age of 69 years (range, 45-88), were treated. The median number of prior therapies was 2 (range, 1-6). Twelve patients had JAK2V617F mutation. Patients received a median of 2 cycles of therapy (range, 1-22). Three of 18 patients with postmyeloproliferative neoplasm (MPN) acute myeloid leukemia (AML) showed a significant response; 2 achieved complete remission (CR) and one achieved a CR with insufficient recovery of blood counts (CRi). The responding patients with palpable spleens also had significant reductions in spleen size. Overall, ruxolitinib was very well tolerated with only 4 patients having grade 3 or higher toxicity. Ruxolitinib has modest antileukemic activity as a single agent, particularly in patients with post-MPN AML. The study was registered at www.clinicaltrials.gov as NCT00674479. PMID:22422826

  15. Phase 2 study of the JAK kinase inhibitor ruxolitinib in patients with refractory leukemias, including postmyeloproliferative neoplasm acute myeloid leukemia.

    Science.gov (United States)

    Eghtedar, Alireza; Verstovsek, Srdan; Estrov, Zeev; Burger, Jan; Cortes, Jorge; Bivins, Carol; Faderl, Stefan; Ferrajoli, Alessandra; Borthakur, Gautam; George, Solly; Scherle, Peggy A; Newton, Robert C; Kantarjian, Hagop M; Ravandi, Farhad

    2012-05-17

    We conducted a phase 2 study of ruxolitinib in patients with relapsed/refractory leukemias. Patients with acceptable performance status (0-2), adequate organ function, and no active infection, received ruxolitinib 25 mg orally twice a day for 4 weeks (1 cycle). Response was assessed after every 2 cycles of treatment, and patients who completed 2 cycles were allowed to continue treatment until disease progression. Dose escalation to 50 mg twice daily was permitted in patients demonstrating a benefit. Thirty-eight patients, with a median age of 69 years (range, 45-88), were treated. The median number of prior therapies was 2 (range, 1-6). Twelve patients had JAK2V617F mutation. Patients received a median of 2 cycles of therapy (range, 1-22). Three of 18 patients with postmyeloproliferative neoplasm (MPN) acute myeloid leukemia (AML) showed a significant response; 2 achieved complete remission (CR) and one achieved a CR with insufficient recovery of blood counts (CRi). The responding patients with palpable spleens also had significant reductions in spleen size. Overall, ruxolitinib was very well tolerated with only 4 patients having grade 3 or higher toxicity. Ruxolitinib has modest antileukemic activity as a single agent, particularly in patients with post-MPN AML. The study was registered at www.clinicaltrials.gov as NCT00674479.

  16. Subjective global assessment of nutritional status of patients with chronic renal insufficiency and end stage renal disease on dialysis.

    Science.gov (United States)

    Tapiawala, Shruti; Vora, H; Patel, Zamrud; Badve, S; Shah, B

    2006-12-01

    (1)To assess the nutritional status of chronic renal insufficiency (CRI) and dialysis patients using the subjective global assessment (SGA) method. (2) To validate SGA in assessing the nutritional status of this group of patients. The nutritional status of 81 patients was evaluated using dietary recall, anthropometry, biochemical parameters and SGA. There were 51 males and 30 females. Their mean +/- SD age was 53.8 +/- 14.3 years. There were 27 patients with (CRI) on conservative management, 38 patients with end stage renal disease (ESRD) on maintenance hemodialysis (HD) and 16 patients with ESRD on continuous ambulatory peritoneal dialysis (CAPD). SGA was done using seven variables derived from medical history and physical examination. Each variable was scored from 1-7 depending on the severity. The SGA scores were correlated with the standard methods. Thirteen (48%) patients with CRI, 22 (58%) patients on HD and 8 (50%) patients on CAPD were malnourished. It was seen that the dietary protein & calorie intake and serum albumin level did not correlate well with the SGA scores. The anthropometric measures correlated with the SGA scores (Skinfolds and SGA r = 0.2, MAC and SGA r = 0.5 and MAMC and SGA r = 0.5). Malnutrition is an important complication in CRI patients and ESRD patients on dialysis. SGA is a reliable method of assessing nutritional status. Most important is the fact that it can detect the changing trend of nutritional status, which may be missed by one-time anthropometry and biochemical methods.

  17. Colour Doppler ultrasonography evaluation of vascularization in the wrist and finger joints in rheumatoid arthritis patients and healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Carotti, M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Salaffi, F., E-mail: fsalaff@tin.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Morbiducci, J. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Ciapetti, A., E-mail: ciapetti.a@libero.it [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Bartolucci, L. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Gasparini, S. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy); Ferraccioli, G. [Division of Rheumatology, Catholic University of the Sacred Heart, Rome (Italy); Giuseppetti, G.M. [Department of Radiology, Poliytechnic University of Marche, Ancona (Italy); Grassi, W. [Department of Rheumatology, Poliytechnic University of Marche, Ospedale A. Murri - Via dei Colli 52, 60035 Jesi, Ancona (Italy)

    2012-08-15

    Objectives: To evaluate the presence of blood flow by colour Doppler ultrasonography (CDUS) in the wrist and finger joints of rheumatoid arthritis (RA) patients and healthy subjects and to define a cut-off value of CDUS resistive index (RI). Methods: Forty-three patients with RA and 43 healthy controls were examined by CDUS. The wrists, second and third metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were evaluated in each patient and healthy subject. Spectral Doppler analysis was performed in order to characterize the type of flow and a mean RI was measured to define a cut-off level. The area under receiver operating characteristic curve was used to evaluate the screening method's performance. Results: Flow was detected in 219 of the 430 total joints (50.9%) of RA patients (111 in the wrists, 49 in the MCP and 30 in the PIP joints). Healthy subjects had a quantifiable flow in 45 of the 430 joints (10.5%) and, in particular, 39 (86.4%) in the wrist, 5 (11.14%) in the MCP and 1 (2.2%) in the PIP joints. The intra- and inter-reader agreements for the detection of Doppler signal were very good (kappa 0.82 and 0.89, respectively). Mean RI values were 0.72 {+-} 0.06 in RA patients and 0.86 {+-} 0.06 in healthy subjects (p < 0.01). At cut-off point of RI < 0.79 the sensitivity was 89.6% and the specificity was 78.8% (positive likelihood ratio 4.22). Conclusion: DUS is a useful tool for the detection of abnormal blood flow in inflammatory joints of RA patients.

  18. SERUM ANALYSIS OF AMYLOID BETA-PROTEIN 1-40 IN HEALTHY SUBJECTS, AUTISTIC CHILDREN AND ALZHEIMER’S PATIENTS

    Directory of Open Access Journals (Sweden)

    Vijendra K. SINGH

    2008-06-01

    Full Text Available Amyloid beta-protein1-40 (AP40 is a low molecu­lar weight peptide produced throughout life during normal cell metabolism and neurodegenerative diseases. Owing to its neurotrophic and neurotoxic effects, the present study was conducted to evalu­ate serum levels of AP40 in healthy subjects, au­tistic children and Alzheimer’s disease patients. Serum AP40 was measured by enzyme-linked im­munosorbent assay (ELISA. AP40 was signifi­cantly higher in normal children compared to nor­mal older controls, in normal children compared to autistic children, and in autistic children compared to Alzheimer’s patients (p value was less than 0.05 for all groups. This finding suggests an age-re­lated decline of serum AP40 in normal aging, as well as in autism and Alzheimer’s disease. This decline may result from abnormal processing of amyloid beta-protein precursor (APP during nor­mal aging and age-related diseases such as autism in children and Alzheimer’s disease in elderly. Possible explanations for this decline may include age-related increased interactions of AP40 with cytoskeletal proteins for brain tissue deposition, increased serine proteases for APP metabolism or hyperimmune reaction (antibodies to AP40 for removal of circulating AP40. To conclude, the AP40 metabolism declines with normal aging and in addition to its role in Alzheimer’s disease this protein might also be a contributing factor in au­tism.

  19. A comparison of seminal vesicle size on CT between autosomal dominant polycystic kidney disease (ADPKD) patients and normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Ijin; Kim, Seung Hyup; Cho, Jeong Yeon (Dept. of Radiology, Seoul National Univ. College of Medicine, Inst. of Radiation Medicine, Seoul National Univ., Seoul (Korea)), e-mail: kimsh@radcom.snu.ac.kr

    2010-06-15

    Background: Extrarenal manifestations are common in autosomal dominant polycystic kidney disease (ADPKD). Although seminal vesicles can also be involved in patients with ADPKD, little is known about the size differences of the seminal vesicles between ADPKD patients and normal subjects. Purpose: To determine whether the size of seminal vesicles in ADPKD patients is larger than that in normal subjects with the use of three-dimensional (3D) CT. Material and Methods: Using a retrospective case-control study design, we reviewed the findings of 696 male patients with an age range of 20-69 years who underwent contrast enhanced multi-detector computed tomography (MDCT) imaging of the kidney in our institution from August 2007 to July 2008. A total of 68 male patients with ADPKD comprised the study group. Another 68 age-matched non-ADPKD male patients comprised the control group. The size of bilateral seminal vesicles was assessed by measurement of the short dimension on axial, coronal, and sagittal images by the use of a picture archiving and communication system (PACS). Results: The mean width of seminal vesicles in ADPKD patients was 1.70+-0.40 cm (axial images), 1.86+-0.45 cm (coronal), and 1.59+-0.39 cm (sagittal). For control group subjects, the mean width was 1.53+-0.29 cm (axial), 1.68+-0.43 cm (coronal), and 1.48+-0.31 cm (sagittal). The mean size differences between the ADPKD and control groups for the measured widths on axial and coronal images were statistically significant (P=0.01 and P=0.02, respectively). The width as measured on axial images showed a decrease with age in the control group subjects (linear trend, P=0.005), but no significant decrease was noted in ADPKD patients. Conclusion: The seminal vesicles were demonstrated to be larger in ADPKD patients as compared with normal subjects as determined with the use of 3D CT . Keywords: Autosomal dominant polycystic kidney disease (ADPKD), seminal vesicle, computed tomography, CT

  20. [Vitamin D deficiency prediction by patient questionnaire and secondary hyperparathyroidism in a cohort of 526 healthy subjects in their fifties].

    Science.gov (United States)

    Laroche, Michel; Nigon, Delphine; Gennero, Isabelle; Lassoued, Slim; Pouilles, Jean-Michel; Trémolières, Florence; Vallet, Marion; Tack, Ivan

    2015-01-01

    Can vitamin D deficiency be predicted by patient questionnaire? Does it lead to secondary hyperparathyroidism that may cause excessive bone resorption? We studied non-osteoporotic subjects in their fifties, in whom vitamin D levels are often tested. Patients hospitalised for degenerative osteoarthritis or consulting for assessment of menopause, without renal failure and not treated with vitamin D, completed a questionnaire on sun exposure and underwent measurement of serum calcium, creatinine, 25OH vitamin D, PTH and CTX. Five hundred and twenty-six subjects, mean age 54.6 years (71% women), were investigated throughout the year. 25OH vitamin D levels were correlated with sun exposure and varied according to the month of the year, unlike PTH and CTX levels. From November to May, over 90% of subjects had 25OH vitamin D levelsvitamin D levelsvitamin D. Serum CTX levels were not correlated with PTH or 25OH vitamin D. Only 13% of subjects presented with secondary hyperparathyroidism, characterised by serum calcium65pg/mL, associated with increased CTX levels. Vitamin D deficiency can be predicted by patient questionnaire. It very rarely leads to secondary hyperparathyroidism. Copyright © 2015. Published by Elsevier Masson SAS.

  1. Direct labelling of ipratropium bromide aerosol and its deposition pattern in normal subjects and patients with chronic bronchitis.

    Science.gov (United States)

    Spiro, S G; Singh, C A; Tolfree, S E; Partridge, M R; Short, M D

    1984-06-01

    A technique for the direct labelling of ipratropium bromide with bromine-77, with reconstitution of the drug in a metered dose inhaler so as to be identical to the commercial product, was used to study drug deposition patterns in seven normal subjects and seven patients with chronic bronchitis (mean FEV1 32% (SD 12.2%) predicted normal). The gamma camera image of the thorax was divided into a middle zone--the mediastinal zone--and the lung itself into a central zone comprising its medial third and a peripheal zone, the lateral two thirds. Measurements after 10 inhalations of labelled ipratropium bromide showed similar results for the two groups of subjects. The total lung dose inhaled was 11.2% of 203 micrograms and 11.7% of 186 micrograms in the normal subjects and the patients respectively. In contrast to the deposition patterns seen in aerosol studies using steady state inhalation methods, there was no difference in deposition pattern--that is, the distribution between the central and the peripheral lung zones--between the normal subjects and the patients with airways obstruction.

  2. The tongue microbiome in healthy subjects and patients with intraoral halitosis

    NARCIS (Netherlands)

    Seerangaiyan, Kavitha; van Winkelhoff, Arie Jan; Harmsen, Hermie J. M.; Rossen, John W. A.; Winkel, Edwin G.

    2017-01-01

    Intra-oral halitosis (IOH) is an unpleasant odor emanating from the oral cavity. It is thought that the microbiota of the dorsal tongue coating plays a crucial role in this condition. The aim of the study was to investigate the composition of the tongue microbiome in subjects with and without IOH. A

  3. Reliability of the 7-point subjective global assessment scale in assessing nutritional status of dialysis patients

    NARCIS (Netherlands)

    Visser, R.; Dekker, F. W.; Boeschoten, E. W.; Stevens, P.; Krediet, R. T.

    1999-01-01

    Subjective global assessment (SGA) is a method to score nutritional status in a standardized way. The original 3-point scale has been replaced by a 7-point scale. The reliability of the latter scale has never been tested. We therefore assessed inter-observer and intra-observer reliability.

  4. Subjective Factors of the Hospital Environment and Their Influence on Psychological Well-being of Patients

    OpenAIRE

    Agalarova K.N.

    2015-01-01

    The article is devoted to the study of the relationship between man and the space around him, namely between the patient and hospital environment. The article gives a little insight into the history of the issue. The study held in a number of hospitals explored the influence of hospital environment on the psychological state of patients and their recovery, as well as the searching of behavior patterns of patients staying in the hospital. There are several main factors in the right treatment: ...

  5. Outcome of Triple Antiplatelet Therapy Including Cilostazol in Elderly Patients with ST-Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention: Results from the INTERSTELLAR Registry.

    Science.gov (United States)

    Jang, Ho-Jun; Park, Sang-Don; Park, Hyun Woo; Suh, Jon; Oh, Pyung Chun; Moon, Jeonggeun; Lee, Kyounghoon; Kang, Woong Chol; Kwon, Sung Woo; Kim, Tae-Hoon

    2017-06-01

    Compared with dual antiplatelet therapy including aspirin and clopidogrel, triple antiplatelet therapy including cilostazol has a mortality benefit in patients with ST-segment elevation myocardial infarction. However, whether the mortality benefit persists in elderly patients is not clear. From 2007 to 2014, 1278 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were retrospectively analyzed. The patients were divided into four groups by age (myocardial infarction. Although this benefit was strong in patients aged <75 years, no definite increase in major bleeding was seen for elderly patients (aged ≥75 years).

  6. The interaction of subjective experience and attitudes towards specific antipsychotic-related adverse effects in schizophrenia patients.

    Science.gov (United States)

    Fischel, T; Krivoy, A; Kotlarov, M; Zemishlany, Z; Loebstein, O; Jacoby, H; Weizman, A

    2013-08-01

    Discontinuation of antipsychotic drugs in schizophrenia patients is a major concern, since it results in relapse and re-hospitalizations. Non-adherence is strongly associated with negative-subjective response to antipsychotics, which is composed of the subjective experience of negative drug effects and attitude towards the treatment. To investigate the elements of subjective experience and subjective attitude towards specific drug-related adverse effects, leading to a generally negative-subjective attitude towards antipsychotics. Schizophrenia inpatients (n=84) were administered a questionnaire measuring attitude and experience on eight subscales: weight gain, sedation, sexual anhedonia, extra-pyramidal syndrome, affective flattening, excessive sleep, diminished sociability and metabolic syndrome. DAI-30 was used to measure attitude towards drugs, and PANSS to assess psychopathology. Weak correlation was found between subjective experience and attitude on most of the subscales. The only strong, albeit inverse, correlation between experience and attitude that was found was with regard to affective flattening, experienced by 37% of the sample, and it also predicted negative drug attitude as measured by the DAI-30, RR: 1.87 (95% CI: 1.06-3.3, df=1, χ(2)=4.525, Pattitude towards most adverse drug effects did not correlate with personal experience. Drug-related affective flattening should be evaluated routinely, since experiencing it may predict negative attitude towards drugs, potentially leading to poor compliance and relapse. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Mortality and recurrence rates among systemically untreated high risk breast cancer patients included in the DBCG 77 trials

    DEFF Research Database (Denmark)

    Jensen, Maj Britt; Nielsen, Torsten O.; Knoop, Ann S.

    2018-01-01

    Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient characte......Background: Following loco-regional treatment for early breast cancer accurate prognostication is essential for communicating benefits of systemic treatment. The aim of this study was to determine time to recurrence and long-term mortality rates in high risk patients according to patient...

  8. Community-acquired pneumonia by Legionella pneumophila. Do we need to include new recommendations for inflammatory bowel disease patients under immunomodulators?

    National Research Council Canada - National Science Library

    Fernández Llamas, Tania; Sánchez Torres, Antonio; Egea Valenzuela, Juan

    2016-01-01

    .... Following this and other similar cases reported in literature, we propose to include recommendations to prevent this infection in patients starting treatment with immunosuppressant drugs through...

  9. Investigation of mean platelet volume in patients with type 2 diabetes mellitus and in subjects with impaired fasting glucose: a cost-effective tool in primary health care?

    Science.gov (United States)

    Ozder, Aclan; Eker, Hasan Huseyin

    2014-01-01

    The aim of this study was to compare mean platelet volume (MPV) in patients with type 2 diabetes mellitus (T2DM), in subjects with impaired fasting glucose (IFG), and in non-diabetic controls. A total of 201 adults with T2DM and 201 subjects with IFG from the Family Medicine out-patient clinic as well as 201 healthy controls were included in the study. We measured blood fasting glucose, complete blood count and LDL-cholesterol and compared the results between the groups enrolled. In the patients with diabetes and subjects with IFG, MPV was significantly higher (10.66 ± 0.94 fL and 10.49 ± 0.96 fL, respectively ) as compared to the non-diabetic group (10.04 ± 1.01 fL) (p = 0.000). Among the diabetic subjects, a positive statistical Pearson correlation was seen between MPV and HbA1c levels (r = 0.357; p = 0.000) and fasting blood glucose (FBG) levels (r = 0.306; p = 0.000). The mean MPV in patients having HbA1C < 7.5% was 10.17 ± 0.83 fL and significantly lower than that of patients with HbA1c ≥ 7.5% (10.80 ± 0.92 fL) (p = 0.001). MPV could be used as a simple and cost-effective tool to monitor the progression and control of T2DM and thereby in preventing vascular events in primary health care. PMID:25232423

  10. Randomized placebo controlled trial of furosemide on subjective perception of dyspnoea in patients with pulmonary oedema because of hypertensive crisis.

    Science.gov (United States)

    Holzer-Richling, Nina; Holzer, Michael; Herkner, Harald; Riedmüller, Eva; Havel, Christof; Kaff, Alfred; Malzer, Reinhard; Schreiber, Wolfgang

    2011-06-01

    To compare the administration of furosemide with placebo on the subjective perception of dyspnoea in patients with acute pulmonary oedema because of hypertensive crisis. Design  Randomized, controlled and double-blinded clinical trial. Municipal emergency medical service system and university-based emergency department. Fifty-nine patients with pulmonary oedema because of hypertensive crisis. Additional to administration of oxygen, morphine-hydrochloride and urapidil until the systolic blood pressure was below 160mmHg, the patients were randomized to receive furosemide 80mg IV bolus (furosemide group) or saline placebo (placebo group). The primary outcome was the subjective perception of dyspnoea as measured with a modified BORG scale at one hour after randomization. Secondary outcome parameters were the subjective perception of dyspnoea of patients as measured with a modified BORG scale and a visual analogue scale at 2, 3 and 6h after randomization of the patient; course of the systolic arterial pressure and peripheral oxygen saturation and lactate at admission and at 6h after admission. In 25 patients in the furosemide group and in 28 patients in the placebo group, a BORG score could be obtained. There was no statistically significant difference in the severity of dyspnoea at one hour after randomization (P=0·40). The median BORG score at 1h after randomization in the furosemide group was 3 (IQR 2 to 4) compared to 3 (IQR 2 to 7) in the placebo group (P=0·40). Those patients who were randomized to the placebo group needed higher doses of urapidil at 20min after randomization. There were no significant differences in the rate of adverse events, nonfatal cardiac arrests or death between the two groups. The subjective perception of dyspnoea in patients with hypertensive pulmonary oedema was not influenced by the application of a loop-diuretic. Therefore, additional furosemide therapy needs to be scrutinized in the therapy of these patients. © 2010 The Authors

  11. Subjective health complaints in patients with chronic Whiplash Associated Disorders (WAD. Relationships with physical, psychological, and collision associated factors

    Directory of Open Access Journals (Sweden)

    Camilla Ihlebæk

    2009-10-01

    Full Text Available  Aims: Investigate subjective health complaints (SHC in chronic whiplash associated disorder (WAD, grade I & II patients, and to identify physical, psychological, and collision associated factors that might be associated with high levels of comorbidity. Method: During the years 2000-2002 171 chronic WAD patients filled in questionnaires and underwent physical examination. The prevalence of SHC was recorded and compared with a representative sample of the Norwegian population (n=1014. Results: The chronic WAD patients reported higher number of subjective health complaints (median: 9 than the general population (median: 5. They showed significantly higher risk of reporting all musculoskeletal complaints, palpitation, heat flushes, sleep problems, tiredness, dizziness, anxiety, depression, breathing difficulties, chest pain, coughing, heartburn, gas discomfort, and obstipation. The patients with the highest level of comorbid subjective health complaints also reported more function loss, reading difficulties, poorer quality of life, higher psychological distress, higher use of medication, and less optimism about their situation. There were no differences however, in any collision factors or physical meassures recorded by physiotherapists between the high, medium and low comorbidity groups. Conclusion: The high comorbidity of other complaints, the strong relationships between degree of comorbidity and psychological factors, and the lack of relationships between degree of comorbidity and collision factors and physical tests, suggest that chronic WAD is best understood as a syndrome and not simply as a neck injury. Sensitization is suggested as a possible psychobiological mechanism

  12. DIFFERENT ACUTE METABOLISM OF FRUCTOSE IN DIALYSIS PATIENTS COMPARED TO HEALTHY SUBJECTS

    Directory of Open Access Journals (Sweden)

    Björn Anderstam

    2012-06-01

    We conclude that a fatty meal is associated with a delayed post-prandial fructose absorption and/or metabolism, as well as increased uric acid levels in HD patients. In an ongoing new study, the fructose metabolism will be further studied in CKD patients, diabetics and healthy controls.

  13. Automated romberg testing in patients with benign paroxysmal positional vertigo and healthy subjects

    OpenAIRE

    Adelsberger, Rolf; Valko, Yulia; Straumann, Dominik; Troester, Gerhard

    2015-01-01

    Objective: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. The underlying pathomechanism responsible for the recurrent vertigo attacks has been elucidated in detail, and highly effective treatment strategies (liberation maneuvers) have been developed. However, many BPPV patients complain about problems of balance especially following liberation maneuvers. Aim: To objectively demonstrate differences in balance performance in BPPV patients compared to healthy ...

  14. Diagnoses of Patients with Severe Subjective Health Complaints in Scandinavia: A Cross Sectional Study

    DEFF Research Database (Denmark)

    Maeland, Silje; Werner, Erik L.; Rosendal, Marianne

    2012-01-01

    Patienter med symptomer, der ikke umiddelbart passer med en kendt medicinsk diagnose, er hyppige i almen praksis. Praktiserende læger blev i denne undersøgelse bedt om at sætte en diagnosekode på disse patienter, og der viste sig at være en meget stor variation i valget med op til 31 forskellige ...

  15. Dental needs in Brazilian patients subjected to head and neck radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rosales, Ana Carolina de Mesquita Netto; Jorge, Jacks; Almeida, Oslei Paes de; Lopes, Marcio Ajudarte [University of Campinas (UNICAMP), Piracicaba, SP (Brazil). Piracicaba Dental School. Dept. of Oral Diagnosis], e-mail: malopes@fop.unicamp.br; Esteves, Sergio Carlos Barros [Center of Oncology, Piracicaba, SP (Brazil)

    2009-07-01

    In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy have several side effects in the head and neck region. The evaluation of oral conditions by a dentist is important to prevent or minimize these problems. The aim of this retrospective review was to analyze the dental needs in 357 patients who received radiotherapy in the head and neck region and were treated at Orocentro/FOP/UNICAMP, between January 1990 and December 2004. Review of patient files showed that dental examination before radiotherapy was not performed in 148 patients (41.5%) and was done in 209 patients (58.5%). From the total of examined patients, 94 (45%) did not require dental procedures at the moment of examination, while 115 (55%) presented some sort of dental need. Following the patients after the radiotherapy, it was observed that the group of patients that was evaluated before radiation presented less need of restorations, root canal filling and dental extractions than those who were not evaluated. The results of this study confirm that the evaluation of oral conditions prior to radiotherapy is essential to minimize the dental needs, emphasizing the importance of the dentist in the multidisciplinary team that treats cancer patients. (author)

  16. Mortality in patients with traumatic spinal cord injury: descriptive analysis of 62 deceased subjects.

    NARCIS (Netherlands)

    Thietje, R.; Pouw, M.H.; Schulz, A.P.; Kienast, B.; Hirschfeld, S.

    2011-01-01

    STUDY DESIGN: Retrospective study. OBJECTIVE: To investigate the causes of death in patients who were patients with tSCI who survived a minimum

  17. A Proposal for Including Patient-Generated Web-based Creative Writing Material into Psychotherapy: Advantages and Challenges.

    Science.gov (United States)

    Lawver, Timothy

    2008-06-01

    Creative writing presents both a challenging and promising modality for psychotherapy. Though it has been used in various settings, the application within a session can be difficult. This case study presents a use of a web-based format to engage a resistant patient through her creative writing. Benefits and potential pitfalls of using a patient's writing in therapy are discussed.

  18. Comparison of treatment outcome in metastatic colorectal cancer patients included in a clinical trial versus daily practice in The Netherlands

    NARCIS (Netherlands)

    Mol, L.; Koopman, M.; Gils, C.W. van; Ottevanger, P.B.; Punt, C.J.A.

    2013-01-01

    Abstract The external validity of trial results is a matter of debate, and no strong evidence is available to support whether a trial may have a positive or a negative effect on the outcome of patients. Methods. We compared the results of stage IV colorectal cancer patients treated within a large

  19. Predictors of acamprosate efficacy: results from a pooled analysis of seven European trials including 1485 alcohol-dependent patients

    NARCIS (Netherlands)

    Verheul, Roel; Lehert, Philippe; Geerlings, Peter J.; Koeter, Maarten W. J.; van den Brink, Wim

    2005-01-01

    Rationale: Acamprosate is a proven effective intervention in the treatment of alcohol dependence. However, acamprosate prevents lapses or relapses only in a minority of patients. An important question, therefore, is whether there is a specific subgroup of patients who respond particularly well to

  20. Molecular pathology of haemophilia B: identification of five novel mutations including a LINE 1 insertion in Indian patients.

    NARCIS (Netherlands)

    Mukherjee, S.; Mukhopadhyay, A.; Banerjee, D.; Chandak, G.R.; Ray, K.

    2004-01-01

    Heterogeneous mutations in factor IX (FIX) gene cause haemophilia B and a large number of mutations have been characterized. However, reports on gene defects among Indian haemophilia B patients are rare despite a high estimate of such patients in the country. We report identification of 22

  1. Patients previously treated for nonfunctioning pituitary macroadenomas have disturbed sleep characteristics, circadian movement rhythm, and subjective sleep quality.

    Science.gov (United States)

    Biermasz, N R; Joustra, S D; Donga, E; Pereira, A M; van Duinen, N; van Dijk, M; van der Klaauw, A A; Corssmit, E P M; Lammers, G J; van Kralingen, K W; van Dijk, J G; Romijn, J A

    2011-05-01

    Fatigue and excessive sleepiness have been reported after treatment of nonfunctioning pituitary macroadenomas (NFMA). Because these complaints may be caused by disturbed nocturnal sleep, we evaluated objective sleep characteristics in patients treated for NFMA. We conducted a controlled cross-sectional study. We studied 17 patients (8 women; mean age, 54 yr) in remission of NFMA during long-term follow-up (8 yr; range, 1-18 yr) after surgery (n = 17) and additional radiotherapy (n = 5) without comorbidity except for hypopituitarism and 17 controls matched for age, gender, and body mass index. Sleep was assessed by nocturnal polysomnography, sleep and diurnal movement patterns by actigraphy, and quality of life and subjective sleep characteristics by questionnaires. Compared to controls, patients had reduced sleep efficiency, less rapid eye movement sleep, more N1 sleep, and more awakenings in the absence of excessive apnea or periodic limb movements. Actigraphy revealed a longer sleep duration and profound disturbances in diurnal movement patterns, with more awakenings at night and less activity during the day. Patients scored higher on fatigue and reported impaired quality of life. Patients previously treated for NFMA suffer from decreased subjective sleep quality, disturbed distribution of sleep stages, and disturbed circadian movement rhythm. These observations indicate that altered sleep characteristics may be a factor contributing to impaired quality of life and increased fatigue in patients treated for NFMA.

  2. The repeatability of computed tomography lung volume measurements: Comparisons in healthy subjects, patients with obstructive lung disease, and patients with restrictive lung disease.

    Science.gov (United States)

    Shin, Jae Min; Kim, Tae Hoon; Haam, Seokjin; Han, Kyunghwa; Byun, Min Kwang; Chang, Yoon Soo; Kim, Hyung Jung; Park, Chul Hwan

    2017-01-01

    In this study, we examined the repeatability of computed tomography (CT) lung volume measurements in healthy individuals and patients with obstructive and restrictive lung diseases. To do this, we retrospectively enrolled 200 healthy individuals (group 1), 100 patients with obstructive lung disease (group 2), and 100 patients with restrictive lung disease (group 3) who underwent two consecutive chest CT scans within a 1-year period. The CT lung volume was measured using a threshold-based, three-dimensional auto-segmentation technique at a default range from -200 to -1024 HU. The within-subject standard deviation, repeatability coefficient, within-subject coefficient variability, and intraclass correlation coefficient were evaluated. No significant differences were identified between the two consecutive CT lung volume measurements in any of the groups (p> 0.05). The within-subject standard deviations for groups 1, 2, and 3 were 441.1, 387.0, and 288.6, respectively, while the repeatability coefficients were 1222.6, 1072.6, and 800.1, respectively. The within-subject coefficient variabilities for groups 1, 2, and 3 were 0.097, 0.083, and 0.090, respectively, while the intraclass correlation coefficients were 0.818, 0.881, and 0.910, respectively. The two CT lung volume measurements showed excellent agreement in healthy individuals and patients with obstructive or restrictive lung disease. However, the repeatability was lower in healthy individuals than it was in patients with lung diseases.

  3. Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lenferink, Anke; Brusse-Keizer, Marjolein; van der Valk, Paul Dlpm; Frith, Peter A; Zwerink, Marlies; Monninkhof, Evelyn M; van der Palen, Job; Effing, Tanja W

    2017-08-04

    Chronic Obstructive Pulmonary Disease (COPD) self-management interventions should be structured but personalised and often multi-component, with goals of motivating, engaging and supporting the patients to positively adapt their behaviour(s) and develop skills to better manage disease. Exacerbation action plans are considered to be a key component of COPD self-management interventions. Studies assessing these interventions show contradictory results. In this Cochrane Review, we compared the effectiveness of COPD self-management interventions that include action plans for acute exacerbations of COPD (AECOPD) with usual care. To evaluate the efficacy of COPD-specific self-management interventions that include an action plan for exacerbations of COPD compared with usual care in terms of health-related quality of life, respiratory-related hospital admissions and other health outcomes. We searched the Cochrane Airways Group Specialised Register of trials, trials registries, and the reference lists of included studies to May 2016. We included randomised controlled trials evaluating a self-management intervention for people with COPD published since 1995. To be eligible for inclusion, the self-management intervention included a written action plan for AECOPD and an iterative process between participant and healthcare provider(s) in which feedback was provided. We excluded disease management programmes classified as pulmonary rehabilitation or exercise classes offered in a hospital, at a rehabilitation centre, or in a community-based setting to avoid overlap with pulmonary rehabilitation as much as possible. Two review authors independently assessed trial quality and extracted data. We resolved disagreements by reaching consensus or by involving a third review author. Study authors were contacted to obtain additional information and missing outcome data where possible. When appropriate, study results were pooled using a random-effects modelling meta-analysis. The primary

  4. Psychosocial, demographic, and treatment-seeking strategic behavior, including faith healing practices, among patients with epilepsy in northwest India.

    Science.gov (United States)

    Pal, Surender Kumar; Sharma, Krishan; Prabhakar, Sudesh; Pathak, Ashis

    2008-08-01

    The data on sociocultural, demographic, and psychosocial aspects and types of treatment strategies adopted by families of patients with epilepsy in northwestern India were collected by the interview schedule method from 400 patients (200 idiopathic and 200 symptomatic) at the outpatient department of the Neurology and Epilepsy Clinic of the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. Epilepsy was classified as idiopathic or symptomatic on the basis of clinical tests (EEG, CT scan, and MRI). It was observed that socioeconomic factors had no bearing on epilepsy in the present sample. Early onset, that is, before 20 years of age, reduced the chances of patients' finding a spouse among those who disclosed the disease information, thereby impacting the nuptial and fertility rates of patients with epilepsy. The present sample of patients was well informed about and sensitized to the efficacy of the modern system of medicine, as 80% of patients sought medical treatment on the very same day as or within a week of onset of seizures. The data were compatible with the framed hypothesis that well-being and safety of the patient would override the stigma burden factor, as 94% of the affected families made no attempt to hide the disease from their neighbors, friends, and colleagues, and teachers of the affected patients. Surprisingly, only 7.5% of the families admitted that they consulted a faith healer. Families did adopt some culturally prevalent methods to control involuntary movements during seizures. It can be concluded that trust in faith healers exists strongly as an undercurrent, but is not overtly admitted by the majority of patients. Some families concurrently visited modern hospitals and occult healers seeking a cure for the disease. The fear of having a child with epilepsy or other abnormalities discouraged married patients from becoming pregnant after developing epilepsy.

  5. Subjective pleasure experience in patients with recent-onset schizophrenia: A preliminary report.

    Science.gov (United States)

    Lui, Simon S Y; Wang, Yi; Shi, Yan-fang; Au, Angie C W; Wong, Peony T Y; Chu, Zoe L S; Kring, Ann M; Cheung, Eric F C; Chan, Raymond C K

    2015-07-30

    Little is known about subjective pleasure experience in recent-onset schizophrenia, and its relationship with neurocognitive functions. Twenty-seven recent-onset schizophrenia people and 26 controls completed the TEPS and neuropsychological tests. The results showed that schizophrenia people self-reported less anticipatory pleasure than controls. Semantic verbal fluency was apparently correlated with anticipatory pleasure. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Anomalous subjective experience among first-admitted schizophrenia spectrum patients: empirical investigation

    DEFF Research Database (Denmark)

    Parnas, Josef; Handest, Peter; Jansson, Lennart

    2005-01-01

    Our research group has for several years conducted philosophically informed, phenomenological-empirical studies of morbid alterations of conscious experience (subjectivity) in schizophrenia (Sz) and its spectrum of disorders. Some of these experiential alterations constitute, in our view, the vul......Our research group has for several years conducted philosophically informed, phenomenological-empirical studies of morbid alterations of conscious experience (subjectivity) in schizophrenia (Sz) and its spectrum of disorders. Some of these experiential alterations constitute, in our view......, the vulnerability markers to Sz--indicators that are intrinsic to this disorder and which were historically considered as constituting the phenotypic anchor of the very concept and the diagnostic validity of Sz spectrum disorders. In a more pragmatic clinical context, these indicators, considered here as symptoms......, with special emphasis on the experiences of perplexity, disorders of self-awareness, perceptual disorders and anomalous bodily experiences. The a priori scales derived from the item pool of a slightly modified OPCRIT and BSABS were used for analyses. Sz and schizotypal disorder scored equally on the subjective...

  7. Extreme bradycardia after first doses of sofosbuvir and daclatasvir in patients receiving amiodarone: 2 cases including a rechallenge.

    Science.gov (United States)

    Renet, Sophie; Chaumais, Marie-Camille; Antonini, Teresa; Zhao, Alexandre; Thomas, Laure; Savoure, Arnaud; Samuel, Didier; Duclos-Vallée, Jean-Charles; Algalarrondo, Vincent

    2015-11-01

    Sofosbuvir and daclatasvir are direct-acting antiviral drugs used to treat chronic hepatitis C virus infection. In 2015, the Food and Drug Administration and European Medical Agency warned that bradycardia could occur when amiodarone was administered in combination with sofosbuvir, but no case reports had been published. We report extreme bradycardia within 2 hrs after intake of sofosbuvir and daclatasvir by 2 patients receiving amiodarone. The first patient had a cardiac asystole 30 min after receiving sofosbuvir and daclatasvir. Amiodarone, sofosbuvir, and daclatasvir treatment were stopped; after 10 days, the cardiac evaluation was normal and patient was discharged. The second patient was taking amiodarone and propranolol; 2 hrs after receiving sofosbuvir and daclatasvir, he had an extreme sinus node dysfunction (heart rate of 27beats/min). Amiodarone and propranolol were stopped, but the patient continued receiving sofosbuvir and daclatasvir for 3 days and sinus bradycardia was recorded each day, 2 hrs after intake of these drugs. When he stopped taking the drugs, no bradycardia was observed. Administration of sofosbuvir and daclatasvir on day 13 induced bradycardia 2 hrs after intake. However, no bradycardia occurred following a rechallenge 8 weeks after the patient stopped taking amiodarone. These observations indicate that patients treated with amiodarone should be continuously monitored within the first 48 hrs following the initiation of sofosbuvir and daclatasvir. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  8. Treatment responses in five patients with Ribbing disease including two with 466C>T missense mutations in TGFβ1.

    Science.gov (United States)

    Savoie, Anne; Gouin, François; Maugars, Yves; Isidor, Bertrand; Larrose, Catherine; Berthelot, Jean-Marie

    2013-12-01

    To assess 5-year treatment responses and TGFB1 gene abnormalities in five patients with ribbing disease. PCR analysis and bidirectional sequencing of TGFβ1 exons 1 through 7 were performed in all five patients. The five patients, four women and one man with a mean age of 34 years at symptom onset, shared the following features: severe diaphyseal pain predominating in the lower limbs with diaphyseal hyperostosis; increased radionuclide uptake at sites of pain and, in some cases at other cortical sites; asymmetric or asynchronous lesions; long symptom duration (5-18 years) despite a variety of treatments; and a delay of several years (2-15) between symptom onset and the diagnosis. Of our five patients, two had a heterozygous missense mutation in exon 2 of TGFβ1 (c.466C>T, p.Arg156Cys, previously described in Camurati-Engelmann syndrome) and three had commonly found TGFβ1 polymorphisms. Intravenous bisphosphonate therapy was used in all five patients but induced substantial improvements in a single patient. Of the three patients given bolus methylprednisolone therapy, two experienced a lasting response; the exception was one of the two women with a TGFβ1 mutation. Considerable heterogeneity in the clinical presentations, genetic abnormalities, and treatment responses contribute to the diagnostic challenges raised by ribbing disease. Detailed genetic studies are needed. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  9. The customer is always right? Subjective target symptoms and treatment preferences in patients with psychosis.

    Science.gov (United States)

    Moritz, Steffen; Berna, Fabrice; Jaeger, Susanne; Westermann, Stefan; Nagel, Matthias

    2017-06-01

    Clinicians and patients differ concerning the goals of treatment. Eighty individuals with schizophrenia were assessed online about which symptoms they consider the most important for treatment, as well as their experience with different interventions. Treatment of affective and neuropsychological problems was judged as more important than treatment of positive symptoms (p experience with Occupational and Sports Therapy, only a minority had received Cognitive-Behavioral Therapy, Family Therapy, and Psychoeducation with family members before. Patients appraised Talk, Psychoanalytic, and Art Therapy as well as Metacognitive Training as the most helpful treatments. Clinicians should carefully take into consideration patients' preferences, as neglect of consumers' views may compromise outcome and adherence to treatment.

  10. Nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) is associated with qualities of diet and life in Korean cerebral infarction patients.

    Science.gov (United States)

    Lim, Hyun Jung; Choue, Ryowon

    2010-01-01

    Assessment of the nutritional status of patients with cerebral infarction (CI) is important because their nutritional status influences disease outcome. The purpose of this study was to assess the nutritional status of patients with CI using the scored Patient-Generated Subjective Global Assessment (PG-SGA) and to investigate the relation of the quality of their diet and life with their nutritional status. Seventy-three patients with CI were recruited from Kyung Hee University Oriental Medical Center in Seoul, Korea, from May to July 2007. The subjects' PG-SGA, dietary quality (Dietary Diversity Score, Dietary Variety Score, and Diet Quality Index-International), and quality of life (Stroke-Specific Quality of Life, modified Barthel Index, and Beck Depression Inventory) were investigated. The patients were classified by PG-SGA categories as well nourished (26.0%), moderately malnourished (49.3%), or severely malnourished (24.7%). Quality of diet assessed by the Dietary Diversity Score and Dietary Variety Score was significantly lower in severely malnourished patients (P SGA is a useful nutritional assessment tool for patients with CI with stable vital signs. When patients with CI were categorized according to their PG-SGA score, well-nourished patients demonstrated better diet quality and better quality of life. 2010 Elsevier Inc. All rights reserved.

  11. Muscle mass gain observed in patients with short bowel syndrome subjected to resistance training.

    Science.gov (United States)

    Araújo, Ellen Cristini Freitas; Suen, Vivian Marques Miguel; Marchini, Julio Sergio; Vannucchi, Helio

    2008-02-01

    Few studies are available about the evaluation of resistance training in patients with protein-energy malnutrition. To assess the effects of resistance training on the recovery of nutritional status of patients with short bowel syndrome, with a small bowel remnant of less than 100 cm, 9 patients of both sexes with protein-energy malnutrition after extensive resection of the small bowel were submitted to resistance training of progressive intensity consisting of concentric and eccentric work exercises for the upper limbs, trunk, and lower limbs, with the individuality and limitations of each patients being respected. Food consumption was monitored by 24-hour food recall performed during the initial phase of the study, before and 7 and 14 weeks after physical training, and by a dietary record for a period of 3 days of oral feeding. The nutrients administered by the enteral and parenteral route were recorded. A significant increase in total arm area (P mass (P gain of lean mass.

  12. Subjective Experiences of Speech and Language Therapy in Patients with Parkinson's Disease: A Pilot Study

    National Research Council Canada - National Science Library

    Spurgeon, Laura; Clarke, Carl E; Sackley, Cath

    2015-01-01

    .... This was the aim of the present study. Methods. Semistructured interviews, using themes derived from the literature, were conducted with nine Parkinson's disease patients, all of whom had undergone speech-language therapy...

  13. Evaluation of potential salivary acetaldehyde production from ethanol in oral cancer patients and healthy subjects

    National Research Council Canada - National Science Library

    Kocaelli, H; Apaydin, A; Aydil, B; Ayhan, M; Karadeniz, A; Ozel, S; Yılmaz, E; Akgün, B; Eren, B

    2014-01-01

    .... In this study, saliva samples from oral cancer patients and healthy individuals were incubated in vitro with ethanol in order to investigate factors which can influence salivary acetaldehyde production...

  14. Assessment and comparison of anemia of chronic disease in healthy subjects and chronic periodontitis patients: A clinical and hematological study

    Directory of Open Access Journals (Sweden)

    Rajashri A Kolte

    2014-01-01

    Full Text Available Background: Bacteremia is associated with periodontal diseases whose extent is related to the severity of inflammation in periodontal tissues. The purpose of this study was to assess and compare the various blood parameters in healthy subjects and severe chronic periodontitis patients. Materials and Methods: 100 patients with severe chronic periodontitis (test group and 100 periodontally healthy subjects (control group in the age group 35-60 years participated in the study. Blood parameters were recorded with blood samples drawn from the antecubital fossa by venous puncture. Results: Periodontitis group showed lower erythrocyte count and mean corpuscular hemoglobin concentration (MCHC, and increased total leukocyte count (TLC and neutrophil, lymphocyte, and eosinophil count, compared to the healthy control group. Conclusions: To conclude, periodontitis may tend toward anemia and there is marked leukocytosis due to increased number of circulating neutrophils and lymphocytes.

  15. Reliability of scored patient generated subjective global assessment for nutritional status among HIV infected adults in TASO, Kampala.

    Science.gov (United States)

    Mokori, A; Kabehenda, M K; Nabiryo, C; Wamuyu, M G

    2011-08-01

    Establish the reliability of the scored Patient Generated-Subjective Global Assessment (PG-SGA) in determining nutritional status among Antiretroviral Therapy (ART) naive HIV-infected adults. A descriptive, cross sectional study among outpatient medical clinics, in The AIDS Support Organization (TASO), Mulago Centre, Kampala, Uganda. The study group (n=217) consisted of male (n=60) and female (n=157) HIV patients (18-67 years). Purposive sampling was used. Anthropometry (weight, height, BMI), nutritional history (body weight, dietary intake, gastrointestinal symptoms, functional capacity and infections), and clinical status were assessed. Sensitivity and specificity of PG-SGA were determined using Receiver Operating Characteristic (ROC) curve. Data collection was done from April-May 2008. Only 12% of the subjects were underweight and over half (58.2%) had normal weight. The PG-SGA had low sensitivity (69.2%) and specificity (57.1%) at categorizing the risk for malnutrition indicated by BMInutritional status in this population.

  16. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention

    DEFF Research Database (Denmark)

    Lamberts, Morten; Olesen, Jonas Bjerring; Ruwald, Martin Huth

    2012-01-01

    Uncertainty remains over optimal antithrombotic treatment of patients with atrial fibrillation presenting with myocardial infarction and/or undergoing percutaneous coronary intervention. We investigated the risk and time frame for bleeding following myocardial infarction/percutaneous coronary int...

  17. Effect of yoga regimen on lung functions including diffusion capacity in coronary artery disease patients: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Asha Yadav

    2015-01-01

    Conclusions: Yoga regimen was found to improve lung functions and diffusion capacity in CAD patients besides improving cardiovascular functions. Thus, it can be used as a complimentary or adjunct therapy along with the conventional medicine for their treatment and rehabilitation.

  18. Is There a Need for Including Spiritual Care in Interdisciplinary Rehabilitation of Chronic Pain Patients? Investigating an Innovative Strategy

    NARCIS (Netherlands)

    Garschagen, A.; Steegers, M.A.H.; Bergen, A.H. van; Jochijms, J.A.; Skrabanja, T.L.M.; Vrijhoef, H.J.; Smeets, R.J.E.M.; Vissers, K.C.P.

    2015-01-01

    OBJECTIVE: Chronic noncancer pain influences patient's quality of life and their ability to cope. Pain relieving medication and other specific treatments commonly integrated in biopsychosocial rehabilitation demonstrate modest benefits in pain relief and improved functioning of individuals.

  19. Study of Pharmacodynamic and Pharmacokinetic Interaction of Bojungikki-Tang with Aspirin in Healthy Subjects and Ischemic Stroke Patients

    OpenAIRE

    Jung-Hwa Yoo; Sung-Vin Yim; Byung-Cheol Lee

    2018-01-01

    Background. Bojungikki-tang (BJIKT) is a widely used traditional herbal formula in China, Japan, and Korea. There have been reports that several herbs among BJIKT have interactions with antiplatelet drugs, such as aspirin. This study aimed to assess whether BJIKT interacts with aspirin in terms of pharmacokinetics (PK) and pharmacodynamics (PD) in healthy subjects and ischemic stroke patients. Methods. The phase I interaction trial was a randomized, open-label, crossover study of 10 healthy m...

  20. Intra-arterial infusion of prostaglandin E1 in normal subjects and patients with peripheral arterial disease

    DEFF Research Database (Denmark)

    Nielsen, P E; Nielsen, S L; Holstein, P

    1976-01-01

    Acute vasodilatation was produced by infusion of prostaglandin E1 (PGE1) in the femoral artery in 6 patients with occlusive arterial disease of the legs and in 3 normal subjects. The effect on blood flow and on blood pressure was measured at different segments of the leg with the strain gauge...... technique, isotope clearance technique, and photoelectric technique. Skin temperature was measured at different levels by using thermocouples. The blood pressure on the legs decreased at all segments during vasodilatation as well in patients as in controls. The blood flow increased in all segments in normal...

  1. Sexual dysfunction in testicular cancer patients subjected to post-chemotherapy retroperitoneal lymph node dissection: a focus beyond ejaculation disorders.

    Science.gov (United States)

    Dimitropoulos, K; Karatzas, A; Papandreou, C; Daliani, D; Zachos, I; Pisters, L L; Tzortzis, V

    2016-05-01

    Post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) represents an integral part of multidisciplinary treatment of advanced germ cell cancer; however, it is associated with a high complications rate. The present study aimed to describe sexual disorders in 53 patients with testicular cancer who underwent full bilateral, non-nerve-sparing PC-RPLND in our institution, focusing beyond ejaculatory dysfunction. The International Index for Erectile Function (IIEF) questionnaire was used as diagnostic tool of male sexual functioning pre-operatively and three months after RPLND, while post-operatively patients were asked to describe and evaluate changes in selected sexual parameters. Study findings demonstrate mixed pattern of changes in sexual functioning, with no difference in erectile functioning before and after operation. However, orgasmic function and intercourse and overall sexual satisfaction were found significantly impaired post-operatively. Sexual desire and frequency of attempted sexual intercourses were found significantly increased post-operatively, in comparison with pre-operative levels. With regard to patients' subjective perception on sexual functioning alterations after PC-RPLND, a significant number of patients reported higher levels of sexual desire, no difference in erectile function and worse orgasmic function and satisfaction post-operatively. Thus, patients subjected to PC-RPLND should be closely and routinely evaluated due to close relationship of sexual dissatisfaction with secondary psychological disorders. © 2015 Blackwell Verlag GmbH.

  2. Cortical atrophy rates in Alzheimer's patients and subjects with mild cognitive impairment from the AddNeuroMed data collection

    DEFF Research Database (Denmark)

    Eskildsen, Simon Fristed; Westman, Eric; Gwadry-Sridhar, Femida

    Background: The AddNeuroMed project is a multi-centre European project which aims to identify biomarkers in Alzheimer's disease (AD). In this study we measured the rate of cortical atrophy in AD patients, subjects with mild cognitive impairment (MCI), and healthy controls (HC) using MRI. Methods......: High resolution sagittal 3D T1w MP-RAGE scans were acquired from patients diagnosed with AD (n = 58,MMSE:21.6 ± 4.4), MCI subjects (n = 85,MMSE:27.2 ± 1.6), and HC (n = 75,MMSE:29.0 ± 1.3) at baseline, and at three and 12 months follow-up. Only subjects with three completed scans which all passed...... rates can be found in AD patients compared to HC and MCI. Even three months after baseline accelerated atrophy can be observed in AD compared to HC, however, the results indicate that three months is too short a period to distinguish the atrophy rates in AD and MCI. The results suggest that atrophy...

  3. Machine-Learned Data Structures of Lipid Marker Serum Concentrations in Multiple Sclerosis Patients Differ from Those in Healthy Subjects.

    Science.gov (United States)

    Lötsch, Jörn; Thrun, Michael; Lerch, Florian; Brunkhorst, Robert; Schiffmann, Susanne; Thomas, Dominique; Tegder, Irmgard; Geisslinger, Gerd; Ultsch, Alfred

    2017-06-07

    Lipid metabolism has been suggested to be a major pathophysiological mechanism of multiple sclerosis (MS). With the increasing knowledge about lipid signaling, acquired data become increasingly complex making bioinformatics necessary in lipid research. We used unsupervised machine-learning to analyze lipid marker serum concentrations, pursuing the hypothesis that for the most relevant markers the emerging data structures will coincide with the diagnosis of MS. Machine learning was implemented as emergent self-organizing feature maps (ESOM) combined with the U*-matrix visualization technique. The data space consisted of serum concentrations of three main classes of lipid markers comprising eicosanoids ( d = 11 markers), ceramides ( d = 10), and lyosophosphatidic acids ( d = 6). They were analyzed in cohorts of MS patients ( n = 102) and healthy subjects ( n = 301). Clear data structures in the high-dimensional data space were observed in eicosanoid and ceramides serum concentrations whereas no clear structure could be found in lysophosphatidic acid concentrations. With ceramide concentrations, the structures that had emerged from unsupervised machine-learning almost completely overlapped with the known grouping of MS patients versus healthy subjects. This was only partly provided by eicosanoid serum concentrations. Thus, unsupervised machine-learning identified distinct data structures of bioactive lipid serum concentrations. These structures could be superimposed with the known grouping of MS patients versus healthy subjects, which was almost completely possible with ceramides. Therefore, based on the present analysis, ceramides are first-line candidates for further exploration as drug-gable targets or biomarkers in MS.

  4. Heart Rate Dynamics and their Relation with the Cyclic Alternating Pattern of Sleep in Normal Subjects and NFLE Patients

    Science.gov (United States)

    González, Jose S.; Dorantes, Guadalupe; Alba, Alfonso; Méndez, Martin O.; Camacho, Sergio; Luna-Rivera, Martin; Parrino, Liborio; Riccardi, Silvia; Terzano, Mario G.; Milioli, Giulia

    The aim of this work is to study the behavior of the autonomic system through variations in the heart rate (HR) during the Cyclic Alternating Pattern (CAP) which is formed by A-phases. The analysis was carried out in 10 healthy subjects and 10 patients with Nocturnal Front Lobe Epilepsy (NFLE) that underwent one whole night of polysomnographic recordings. In order to assess the relation of A-phases with the cardiovascular system, two time domain features were computed: the amplitude reduction and time delay of the minimum of the R-R intervals with respect to A-phases onset. In addition, the same process was performed over randomly chosen R-R interval segments during the NREM sleep for baseline comparisons. A non-parametric bootstrap procedure was used to test differences of the kurtosis values of two populations. The results suggest that the onset of the A-phases is correlated with a significant increase of the HR that peaks at around 4s after the A-phase onset, independently of the A-phase subtype and sleep time for both healthy subjects and NFLE patients. Furthermore, the behavior of the reduction in the R-R intervals during the A-phases was significantly different for NFLE patients with respect to control subjects.

  5. Gaussian fitting for carotid and radial artery pressure waveforms: comparison between normal subjects and heart failure patients.

    Science.gov (United States)

    Liu, Chengyu; Zheng, Dingchang; Zhao, Lina; Liu, Changchun

    2014-01-01

    It has been reported that Gaussian functions could accurately and reliably model both carotid and radial artery pressure waveforms (CAPW and RAPW). However, the physiological relevance of the characteristic features from the modeled Gaussian functions has been little investigated. This study thus aimed to determine characteristic features from the Gaussian functions and to make comparisons of them between normal subjects and heart failure patients. Fifty-six normal subjects and 51 patients with heart failure were studied with the CAPW and RAPW signals recorded simultaneously. The two signals were normalized first and then modeled by three positive Gaussian functions, with their peak amplitude, peak time, and half-width determined. Comparisons of these features were finally made between the two groups. Results indicated that the peak amplitude of the first Gaussian curve was significantly decreased in heart failure patients compared with normal subjects (PGaussian curves (PGaussian curves (both PGaussian modeling, which should provide essential tools for further understanding the underlying physiological mechanisms of the artery pressure waveform.

  6. Evaluation of the optic nerve using strain and shear wave elastography in patients with multiple sclerosis and healthy subjects.

    Science.gov (United States)

    İnal, Mikail; Tan, Sinan; Yumusak, Erhan M; Şahan, Mehmet Hamdi; Alpua, Murat; Örnek, Kemal

    2017-01-31

    Our aim was to evaluate the elasticity features of the optic nerve using strain (SE) and shear wave elastography (SWE) in multiple sclerosis (MS) patients in comparison with healthy subjects. One hundred and seven optic nerves from 54 MS patients and 118 optic nerves from 59 healthy subjects were examined prospectively by SE and SWE. Optic nerves were divided into three types in accordance to the elasticity designs, as follows: type 1 predominantly blue (hardest tissue); type 2 predominantly blue/green (hard tissue); and type 3 predominantly green (intermediate tissue). Quantitative measurements of optic nerve hardness with SWE were analyzed in kilopascals. Elastographic images from healthy volunteers showed mostly type 3 optic nerves (61.9%); type 2 was also found (38.1%), but type 1 was not observed. Elastographic examination of MS patients showed mostly type 2 optic nerves (88%), while some type 1 (4.6%) and type 3 optic nerves (6.5%) were rarely observed. There was a statistically significant difference in terms of elasticity patterns between patients and healthy volunteers (p<0.001). Statistically significant differences were observed between patients and healthy volunteers in the analysis of SWE values (10.381±3.48 kPa and 33.87±11.64 p<0.001). The receiver operating characteristic curve analysis was perfect (0.993; 95% confidence interval [CI]=0.971-0.999), and a cut-off value of 18.3 kPa shear had very high sensitivity and specificity for the patient group. No significant differences were observed between patients with and without previous optic neuritis. SE and SWE examination findings concerning the optic nerve in MS patients demonstrated remarkable differences according to the healthy group.

  7. Outcomes of cardiopulmonary resuscitation and predictors of survival in patients undergoing coronary angiography including percutaneous coronary interventions.

    Science.gov (United States)

    Sprung, Juraj; Ritter, Matthew J; Rihal, Charanjit S; Warner, Mary E; Wilson, Gregory A; Williams, Brent A; Stevens, Susanna R; Schroeder, Darrell R; Bourke, Denis L; Warner, David O

    2006-01-01

    We studied the outcome of cardiopulmonary resuscitation (CPR) in patients undergoing coronary angiography (CA) and/or percutaneous coronary interventions (PCI). Of 51,985 CA and PCI patients treated between January 1, 1990, and December 31, 2000, 114 required CPR. Records were reviewed for relationships between patient characteristics and various procedures and short-term survival. Long-term survival was compared with that of a matched cohort of patients who did not have an arrest during catheterization and a matched cohort from the general Minnesota population. Over the 11-year period, the overall incidence of CPR was 21.9 per 10,000 procedures. This rate decreased from 33.9 per 10,000 before 1995 to 13.1 per 10,000 after 1995. Overall survival to hospital discharge after CPR was 56.1%. Survival to discharge was less frequent with a history of congestive heart failure, previous coronary artery bypass graft surgery, hemodynamic instability during the procedure, and with prolonged or emergent catheterizations. Pulseless electrical activity (versus asystole or ventricular fibrillation) indicated very poor short-term survival. Interestingly, short-term survival was not related to the extent of coronary artery disease. Long-term survival of patients who survived cardiac arrest was comparable to that of those who did not have arrest during catheterization. In conclusion, the incidence of periprocedural CPR during diagnostic or interventional coronary procedures decreased after 1995. Patients who received CPR in the cardiac catheterization lab have a remarkably frequent survival to hospital discharge rate. Long-term survival of these patients is only minimally reduced.

  8. Wide Disagreement Between Alternative Assessments of Premorbid Physical Activity: Subjective Patient and Surrogate Reports and Objective Smartphone Data.

    Science.gov (United States)

    Gluck, Samuel; Summers, Matthew J; Goddard, Thomas P; Andrawos, Alice; Smith, Natalie C; Lange, Kylie; Iwashyna, Theodore J; Deane, Adam M

    2017-10-01

    Surrogate-decision maker and patient self-reported estimates of the distances walked prior to acute illness are subjective and may be imprecise. It may be possible to extract objective data from a patient's smartphone, specifically, step and global position system data, to quantify physical activity. The objectives were to 1) assess the agreement between surrogate-decision maker and patient self-reported estimates of distance and time walked prior to resting and daily step-count and 2) determine the feasibility of extracting premorbid physical activity (step and global position system) data from critically ill patients. Prospective cohort study. Quaternary ICU. Fifty consecutively admitted adult patients who owned a smartphone, who were ambulatory at baseline, and who remained in ICU for more than 48 hours participated. There was no agreement between patients and surrogates for all premorbid walking metrics (mean bias 108% [99% lower to 8,700% higher], 83% [97% to 2,100%], and 71% [96% to 1,080%], for distance, time, and steps, respectively). Step and/or global position system data were successfully extracted from 24 of 50 phones (48%; 95% CI, 35-62%). Surrogate-decision makers, but not patient self-reported, estimates of steps taken per day correlated with smartphone data (surrogates: n = 13, ρ = 0.56, p smartphones was feasible in approximately 50% of patients.

  9. Endothelial dysfunction assessment by noninvasive peripheral arterial tonometry in patients with chronic obstructive pulmonary disease compared with healthy subjects.

    Science.gov (United States)

    Malerba, Mario; Radaeli, Alessandro; Nardin, Matteo; Clini, Enrico; Carpagnano, Giovanna Elisiana; Sciatti, Edoardo; Salghetti, Francesca; Bonadei, Ivano; Platto, Fabio; Vizzardi, Enrico

    2017-08-05

    Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular disease. The endothelial dysfunction likely plays a central role in increasing cardiovascular risk. This cross-sectional, study investigated the prevalence and extent of endothelial dysfunction in patients with stable COPD. Peripheral arterial tonometry (PAT) was measured by post-ischemic reactive hyperemia index (RHI) in 16 COPD patients, 16 healthy controls and 16 subjects with treated systemic arterial hypertension (AH) and analysed with covariates condition (dyslipidemia, and medications). The prevalence of endothelial dysfunction was significantly higher in COPD group than in the other groups. Mean RHI was significantly lower in COPD patients compared with the other groups. At linear regression FEV 1 and RHI were directly correlated (Spearman index = 0.553; P = .026). COPD patients in groups C and D according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages showed lower RHI compared with patients classified as A and B (P < .01). At multiple regression analysis the presence of dyslipidemia, COPD and AH were associated with the presence of endothelial dysfunction. Endothelial dysfunction in stable COPD patients is probably implicated in the high cardiovascular comorbidity. This study suggests the potential utility of endothelial dysfunction evaluation in patients with COPD to a timely assessment and treatment for cardiac complications. © 2017 John Wiley & Sons Ltd.

  10. Correlation between morphological characteristics in spectral-domain-optical coherence tomography, different functional tests and a patient's subjective handicap in acute central serous chorioretinopathy.

    Science.gov (United States)

    Gerendas, Bianca S; Kroisamer, Julia-Sophie; Buehl, Wolf; Rezar-Dreindl, Sandra M; Eibenberger, Katharina M; Pablik, Eleonore; Schmidt-Erfurth, Ursula; Sacu, Stefan

    2018-01-16

    The purpose of this study was to identify quantitatively measurable morphologic optical coherence tomography (OCT) characteristics in patients with an acute episode of central serous chorioretinopathy (CSC) and evaluate their correlation to functional and psychological variables for their use in daily clinical practice. Retinal thickness (RT), the height, area and volume of subretinal fluid (SRF)/pigment epithelium detachments were evaluated using the standardized procedures of the Vienna Reading Center. These morphologic characteristics were compared with functional variables [best-corrected visual acuity (BCVA), contrast sensitivity (CS), retinal sensitivity/microperimetry, fixation stability], and patients' subjective handicap from CSC using the National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25). Data from 39 CSC patients were included in this analysis. Three different SRF height measures showed a high negative correlation (r = -0.7) to retinal sensitivity within the central 9°, which was also negatively correlated with SRF area and volume (r = -0.6). The CS score and fixation stability (fixation points within 2°) showed a moderate negative correlation (r = -0.4) with SRF height variables. Comparison of the subjective handicap with morphological characteristics in spectral-domain (SD)-OCT showed SRF height had the highest correlation (r = -0.4) with the subjective problems reported and overall NEI VFQ-25 score. In conclusion, SRF height measured in SD-OCT showed the best correlation with functional variables and patients' subjective handicap caused by the disease and therefore seems to be the best variable to look at in daily clinical routine. Even though area and volume also show a correlation, these cannot be so easily measured as height and are therefore not suggested for daily clinical routine. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. Real-Time Classification of Patients with Balance Disorders vs. Normal Subjects Using a Low-Cost Small Wireless Wearable Gait Sensor

    Directory of Open Access Journals (Sweden)

    Bhargava Teja Nukala

    2016-11-01

    Full Text Available Gait analysis using wearable wireless sensors can be an economical, convenient and effective way to provide diagnostic and clinical information for various health-related issues. In this work, our custom designed low-cost wireless gait analysis sensor that contains a basic inertial measurement unit (IMU was used to collect the gait data for four patients diagnosed with balance disorders and additionally three normal subjects, each performing the Dynamic Gait Index (DGI tests while wearing the custom wireless gait analysis sensor (WGAS. The small WGAS includes a tri-axial accelerometer integrated circuit (IC, two gyroscopes ICs and a Texas Instruments (TI MSP430 microcontroller and is worn by each subject at the T4 position during the DGI tests. The raw gait data are wirelessly transmitted from the WGAS to a near-by PC for real-time gait data collection and analysis. In order to perform successful classification of patients vs. normal subjects, we used several different classification algorithms, such as the back propagation artificial neural network (BP-ANN, support vector machine (SVM, k-nearest neighbors (KNN and binary decision trees (BDT, based on features extracted from the raw gait data of the gyroscopes and accelerometers. When the range was used as the input feature, the overall classification accuracy obtained is 100% with BP-ANN, 98% with SVM, 96% with KNN and 94% using BDT. Similar high classification accuracy results were also achieved when the standard deviation or other values were used as input features to these classifiers. These results show that gait data collected from our very low-cost wearable wireless gait sensor can effectively differentiate patients with balance disorders from normal subjects in real time using various classifiers, the success of which may eventually lead to accurate and objective diagnosis of abnormal human gaits and their underlying etiologies in the future, as more patient data are being collected.

  12. Differential Phenotypes of Myeloid-Derived Suppressor and T Regulatory Cells and Cytokine Levels in Amnestic Mild Cognitive Impairment Subjects Compared to Mild Alzheimer Diseased Patients

    Directory of Open Access Journals (Sweden)

    Aurélie Le Page

    2017-07-01

    Full Text Available Alzheimer disease (AD is the most prevalent form of dementia although the underlying cause(s remains unknown at this time. However, neuroinflammation is believed to play an important role and suspected contributing immune parameters can be revealed in studies comparing patients at the stage of amnestic mild cognitive impairment (aMCI to healthy age-matched individuals. A network of immune regulatory cells including regulatory T cells (Tregs and myeloid-derived suppressor cells (MDSCs maintains immune homeostasis but there are very few data on the role of these cells in AD. Here, we investigated the presence of these cells in the blood of subjects with aMCI and mild AD (mAD in comparison with healthy age-matched controls. We also quantitated several pro- and anti-inflammatory cytokines in sera which can influence the development and activation of these cells. We found significantly higher levels of MDSCs and Tregs in aMCI but not in mAD patients, as well as higher serum IL-1β levels. Stratifying the subjects based on CMV serostatus that is known to influence multiple immune parameters showed an absence of differences between aMCI subjects compared to mAD patients and healthy controls. We suggest that the increase in MDSCs and Tregs number in aMCI subjects may have a beneficial role in modulating inflammatory processes. However, this protective mechanism may have failed in mAD patients, allowing progression of the disease. This working hypothesis obviously requires testing in future studies.

  13. Real-Time Classification of Patients with Balance Disorders vs. Normal Subjects Using a Low-Cost Small Wireless Wearable Gait Sensor.

    Science.gov (United States)

    Nukala, Bhargava Teja; Nakano, Taro; Rodriguez, Amanda; Tsay, Jerry; Lopez, Jerry; Nguyen, Tam Q; Zupancic, Steven; Lie, Donald Y C

    2016-11-29

    Gait analysis using wearable wireless sensors can be an economical, convenient and effective way to provide diagnostic and clinical information for various health-related issues. In this work, our custom designed low-cost wireless gait analysis sensor that contains a basic inertial measurement unit (IMU) was used to collect the gait data for four patients diagnosed with balance disorders and additionally three normal subjects, each performing the Dynamic Gait Index (DGI) tests while wearing the custom wireless gait analysis sensor (WGAS). The small WGAS includes a tri-axial accelerometer integrated circuit (IC), two gyroscopes ICs and a Texas Instruments (TI) MSP430 microcontroller and is worn by each subject at the T4 position during the DGI tests. The raw gait data are wirelessly transmitted from the WGAS to a near-by PC for real-time gait data collection and analysis. In order to perform successful classification of patients vs. normal subjects, we used several different classification algorithms, such as the back propagation artificial neural network (BP-ANN), support vector machine (SVM), k-nearest neighbors (KNN) and binary decision trees (BDT), based on features extracted from the raw gait data of the gyroscopes and accelerometers. When the range was used as the input feature, the overall classification accuracy obtained is 100% with BP-ANN, 98% with SVM, 96% with KNN and 94% using BDT. Similar high classification accuracy results were also achieved when the standard deviation or other values were used as input features to these classifiers. These results show that gait data collected from our very low-cost wearable wireless gait sensor can effectively differentiate patients with balance disorders from normal subjects in real time using various classifiers, the success of which may eventually lead to accurate and objective diagnosis of abnormal human gaits and their underlying etiologies in the future, as more patient data are being collected.

  14. Clearance and synthesis rates of beta 2-microglobulin in patients undergoing hemodialysis and in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Floege, J.; Bartsch, A.; Schulze, M.; Shaldon, S.; Koch, K.M.; Smeby, L.C. (Department of Nephrology, University Hospital of Hannover (Germany))

    1991-08-01

    Retention of {beta} 2-microglobulin in patients undergoing hemodialysis is associated with a {beta} 2-microglobulin-derived amyloidosis. Removal of {beta} 2-microglobulin by renal replacement therapy has been proposed for the prevention of this amyloidosis. Currently, however, data on the {beta} 2-microglobulin synthesis rate in patients undergoing hemodialysis are scarce, and consequently it remains speculative how much removal would be necessary to counterbalance synthesis. The plasma kinetics of iodine 131-labeled {beta} 2-microglobulin were therefore examined in 11 patients with anuria who were undergoing long-term hemodialysis. Five healthy persons served as controls. Kinetic modeling of the plasma curves showed that the data fitted a two-pool model (r2 greater than 0.96) consisting of a rapid 2 to 4 hour distribution phase followed by a less steep curve, described by the plasma (metabolic) clearance (Clp). Synthetic rates were calculated from Clp and the {beta} 2-microglobulin steady state plasma concentration (plus {beta} 2-microglobulin removal during hemodialysis in the case of high flux hemodialysis). The results showed a significantly higher Clp in normal controls as compared with patients undergoing hemodialysis (65.5 {plus minus} 12.8 ml/min (mean {plus minus} SD) versus 3.4 {plus minus} 0.7 ml/min). In contrast, the {beta} 2-microglobulin synthesis rate in the patient group (3.10 {plus minus} 0.79 mg/kg/day) was not significantly different from that of normal controls (2.40 {plus minus} 0.67 mg/kg/day), which was due to markedly elevated {beta} 2-microglobulin plasma concentrations in the patients (37.6 {plus minus} 14.1 mg/L vs 1.92 {plus minus} 0.27 mg/L). These findings suggest that the presence of end-stage renal disease does not have a significant impact on the beta 2-microglobulin generation rate.

  15. The relationship between subjective perception and the psychological effects of patients in spatial isolation

    Directory of Open Access Journals (Sweden)

    Ibert, Fabienne

    2017-08-01

    Full Text Available Background: Spatial isolation is a common infection control measure, but negative psychological effects are often neglected. We investigated which factors influence the perception of single room isolated patients.Methods: In the present correlative cross-sectional study, 32 isolated patients have been interviewed within three departments of the Heidelberg University Hospital, one of Germany’s largest hospitals. The following questionnaires were used: 10-Item Big Five Inventory (BFI-10, Positive and Negative Affect Schedule (PANAS, Hospital Anxiety and Depression Scale (HADS and a self-developed questionnaire to evaluate the individual experience of isolation. Data were analysed using correlation and regression analysis.Results: A significant positive correlation was found between the isolation period and anxiety (r=.42, p<.05. Interestingly, a significant positive correlation was demonstrated between the duration of contact to nursing staff and negative daydreaming (r=.89, p<.01. The activity watching television was associated with higher levels of anxiety (r=.38, p<.05. Surfing the internet had a positive relationship with thinking about beautiful things (r=.41, p<.05. Conclusions: Our study results have implications how to improve the psychological situation of patients during spatial isolation. Contact between nursing staff and patients is crucial, since this contact significantly associated with negative daydreaming, probably due to increased neediness of emotional and physical care in some patients. The duration of the isolation has an influence on the experience of anxiety. Activities to cope with the isolation, however, not always have positive effects on the well-being of the patient.

  16. SCA1 patients may present as hereditary spastic paraplegia and must be included in spastic-ataxias group.

    Science.gov (United States)

    Pedroso, José Luiz; de Souza, Paulo Victor Sgobbi; Pinto, Wladimir Bocca Vieira de Rezende; Braga-Neto, Pedro; Albuquerque, Marcus Vinicius Cristino; Saraiva-Pereira, Maria Luiza; Jardim, Laura Bannach; Barsottini, Orlando Graziani Povoas

    2015-10-01

    The combination of cerebellar ataxia and spasticity is common. However, autosomal dominant genetic diseases presenting with spastic-ataxia are a smaller group. Pyramidal signs have been frequently observed in several SCA subtypes, particularly in spinocerebellar ataxia type 1. We prospectively evaluated the pyramidal signs and spasticity in SCA1 patients, and correlated the data with genetic and clinical features. In this study, we observed that spasticity may be an early and presenting feature of SCA1, since 3 patients had pyramidal signs and spasticity as the first neurological sign. SCA1 patients with spasticity were significantly younger. SCA1 may rarely present with pure spastic paraplegia, resembling hereditary spastic paraplegia, before the appearance of cerebellar signs. This observation may confuse the neurologist when a genetic testing is requested for an autosomal dominant spastic paraplegia, directing research to hereditary spastic paraplegia group. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Objective and subjective financial burden and its associations with health-related quality of life among lung cancer patients.

    Science.gov (United States)

    Chen, Jieling Elaine; Lou, Vivian Weiqun; Jian, Hong; Zhou, Zhen; Yan, Meiqiong; Zhu, Jingfen; Li, Guohong; He, Yaping

    2017-11-06

    The purpose of this study is to examine the effect of financial burden, using objective and subjective indicators, on the health-related quality of life (HRQOL) in lung cancer patients. A total of 227 patients diagnosed with lung cancer (from the inpatient unit of the department of internal medicine-chest oncology, in Shanghai Chest Hospital, China) participated in the study. Financial information was measured by direct medical costs, direct nonmedical costs, healthcare-cost-to-income ratio, and perceived financial difficulty. HRQOL was measured using the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale. Catastrophic health spending, defined as a healthcare-cost-to-income ratio of more than 40%, was reported in 72.7% of the participants, whereas 37.0% reported that healthcare costs exceeded annual household income. Financial difficulty was perceived in 83.7% of the participants. Patients whose healthcare costs exceeded their annual household income and who perceived financial difficulty reported a clinically meaningful difference in overall HRQOL (> 6 points on the FACT-L) compared with participants without catastrophic health spending or perceived financial difficulty. Healthcare costs did not show a significant effect on HRQOL. Healthcare costs exceeding total annual household income and perceived financial difficulty are associated with poorer HRQOL in lung cancer patients. Subjective indicator of financial burden has a stronger effect on quality of life than objective indicators. Health-cost-to-income ratio and perceived financial difficulty can be implied as objective and subjective indicators of financial burden to identify the patients who may need additional assistance. Communication on deciding on cost-effective treatments can be facilitated.

  18. Comparison of Autonomic Reactions during Urodynamic Examination in Patients with Spinal Cord Injuries and Able-Bodied Subjects.

    Directory of Open Access Journals (Sweden)

    Yu-Hui Huang

    Full Text Available This study compares heart rate variability (HRV and systolic blood pressure (SBP changes of spinal cord injury (SCI patients during urodynamic study (UDS with able-bodied controls.Twenty four complete suprasacral SCI patients (12 tetraplegia and 12 paraplegia and 12 age-matched able-bodied volunteers received BP and HRV evaluation throughout urodynamic examination. We chose seven time points during the examinations: resting, Foley catheter insertion, start of infusion, and infused volume reaching 1/4, 2/4, 3/4 and 4/4 of maximal capacity. At each time point, electrocardiogram with a duration of 5 min was used for power spectral density analysis of HRV.Only control subjects displayed significant elevation of SBP during Foley catheter insertion compared to resting values. Both control and tetraplegic groups experienced significant elevation of SBP at maximal bladder capacity compared to resting values. Tetraplegic values were also significantly greater than the other two groups. Control subjects displayed significant elevation of low frequency/high frequency (LF/HF ratios during Foley catheter insertion and when approaching maximum bladder capacity. These findings were not seen in the paraplegic and tetraplegic groups. However, subgroup analysis of tetraplegic subjects with SBP elevation >50 mmHg demonstrated a similar LF/HF response to the able-bodied controls.Tetraplegic patients experienced BP elevation but did not experience significant changes in HRV during bladder distension. This finding may imply that different neurological pathways contribute to AD reaction and HRV changes during bladder distension. However, profound AD during UDS in tetraplegic patients was associated with corresponding changes in HRV. Whether HRV monitoring would be beneficial in SCI patients presenting with significant AD, it needs further studies to elucidate.

  19. Variation of Carbohydrate-Active Enzyme Patterns in the Gut Microbiota of Italian Healthy Subjects and Type 2 Diabetes Patients

    Science.gov (United States)

    Soverini, Matteo; Turroni, Silvia; Biagi, Elena; Quercia, Sara; Brigidi, Patrizia; Candela, Marco; Rampelli, Simone

    2017-01-01

    The human gut microbiota (GM) has been associated, to date, with various complex functions, essentials for the host health. Among these, it is certainly worth noting the degradation of the so-called microbiota-accessible carbohydrates (MACs), which the GM breaks down through specific enzymes, referred to as carbohydrate-active enzymes (CAZymes). This degradation constitutes the first step in the production of short-chain fatty acids (SCFAs), key microbial small molecules having multiple health-promoting effects for the host organism. The decline in MAC dietary intake in urban Western populations forced the shrinkage of CAZyme repertoire in the GM, as shown by the literature comparing the microbiome layout between Western urban citizens and traditional rural populations. Even if this reduction in GM functional complexity has been associated with the onset of the so-called “diseases of civilization,” only few information regarding the CAZyme variation within Western populations has been provided to date, and its connections with diet and health are still unexplored. In this scenario, here we explore the GM-encoded CAZyme repertoire across two Italian adult cohorts, including healthy lean subjects consuming a Mediterranean diet and obese patients affected by type 2 diabetes, consuming a high-fat diet. In order to impute the CAZyme panel, a pipeline consisting of publicly available software – QIIME, FragGeneScan and HMMER – was specifically implemented. Our study highlighted the existence of robust clusters of bacterial species sharing a common MAC degradation profile in the Italian GM, allowing the stratification of the individual GM into different steady states according to the carbohydrate degradation profile, with possible connections with diet and health. PMID:29114246

  20. Antipyrine, oxazepam, and indocyanine green clearance in patients with chronic pancreatitis and healthy subjects

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Sonne, J; Larsen, S

    1999-01-01

    Hepatic drug metabolism was examined in patients with chronic pancreatitis and healthy controls by using a cocktail design with three different model compounds: antipyrine to express phase-I oxidation, oxazepam to express phase-II conjugation, and indocyanine green (ICG), a high-clearance compound....

  1. The location of the mandibular canal in prognathic patients compared to subjects with normal occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Yun Hoa; Nah, Kyung Soo; Cho, Bong Hae [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-12-15

    The purpose of this study was to compare the location of the mandibular canal in Class {iota}{iota}{iota} patients and 26 normal patients were observed. Four measurements were taken on cross sectional tomography between the first and second molars: the distance from the mandibular canal to the inner surface of both the buccal and lingual cortices, the distance from the mandibular canal to the inferior border of the mandible, and the buccolingual width of the mandible. The buccolingual location of the canals was classified as lingual, central, of buccal. Each measurement was analyzed with an independent test to compare Class {iota}{iota}{iota} malocclusion to normal occlusion. Compared to the control group, the prognathic group had a shorter distance from the canal to the inner surface of the lingual cortex and to the base of the mandible. A higher percentage of the canals were located lingually in the prognathic group. This study showed that the mandibular canal was located more lingually and interiorly in prognathic patients than in patients with normal occlusion. These results could help surgeons to reduce injuries to the inferior alveolar nerve.

  2. Fostering Bilateral Patient-Clinician Engagement in Active Self-Tracking of Subjective Experience

    DEFF Research Database (Denmark)

    Larsen, Jakob Eg; Christiansen, Thomas Blomseth; Eskelund, Kasper

    2017-01-01

    In this position paper we describe select aspects of our experience with health-related self-tracking, the data generated, and processes surrounding those. In particular we focus on how bilateral patient-clinician engagement may be fostered by the combination of technology and method. We exemplify...

  3. The Comparison of Ginkgo biloba and Cinnarizine effectiveness in tinnitus intensity of patients with subjective tinnitus

    Directory of Open Access Journals (Sweden)

    Hamidreza Khazraei

    2015-01-01

    Conclusion: It was found that after two months of treatment with Ginkgo biloba (120-140 mg daily tinnitus severity and the adverse changes on quality of life significantly decreased in the patients, whereas Cinnarizine did not reduce the latter significantly. However, no significant difference was observed between the two groups (Cinnarizine & Ginko biloba.

  4. Quality of life of healthy subjects and patients with arthritis and ...

    African Journals Online (AJOL)

    destruction with serious pain, inflammation and disability severely affect patients QOL [12, 13]. The presence and ... pains, X-ray, and erythrocyte sedimentation rate. For diabetes mellitus diagnosis was by using various tests such as ..... in Parkinson's disease. Euro Neurol Rev 2014;. 9(1):19–26. 6. Hepler CD, Strand LN.

  5. The effect of physical therapy treatment in patients with subjective tinnitus : A systematic review

    NARCIS (Netherlands)

    Michiels, S.; Naessens, S.; Van de Heyning, P.; Braem, M.; Visscher, C.M.; Gilles, A.; De Hertogh, W.

    2016-01-01

    Background: Tinnitus is a very common symptom that often causes distress and decreases the patient's quality of life. Apart from the well-known causes, tinnitus can in some cases be elicited by dysfunctions of the cervical spine or the temporomandibular joint (TMJ). To date however, it is unclear