Brodsky, Martin B; Huang, Minxuan; Shanholtz, Carl; Mendez-Tellez, Pedro A; Palmer, Jeffrey B; Colantuoni, Elizabeth; Needham, Dale M
Nearly 60% of patients who are intubated in intensive care units (ICUs) experience dysphagia after extubation, and approximately 50% of them aspirate. Little is known about dysphagia recovery time after patients are discharged from the hospital. To determine factors associated with recovery from dysphagia symptoms after hospital discharge for acute respiratory distress syndrome (ARDS) survivors who received oral intubation with mechanical ventilation. This is a prospective, 5-year longitudinal cohort study involving 13 ICUs at four teaching hospitals in Baltimore, Maryland. The Sydney Swallowing Questionnaire (SSQ), a 17-item visual analog scale (range, 0-1,700), was used to quantify patient-perceived dysphagia symptoms at hospital discharge, and at 3, 6, 12, 24, 36, 48, and 60 months after ARDS. An SSQ score greater than or equal to 200 was used to indicate clinically important dysphagia symptoms at the time of hospital discharge. Recovery was defined as an SSQ score less than 200, with a decrease from hospital discharge greater than or equal to 119, the reliable change index for SSQ score. Fine and Gray proportional subdistribution hazards regression analysis was used to evaluate patient and ICU variables associated with time to recovery accounting for the competing risk of death. Thirty-seven (32%) of 115 patients had an SSQ score greater than or equal to 200 at hospital discharge; 3 died before recovery. All 34 remaining survivors recovered from dysphagia symptoms by 5-year follow-up, 7 (23%) after 6 months. ICU length of stay was independently associated with time to recovery, with a hazard ratio (95% confidence interval) of 0.96 (0.93-1.00) per day. One-third of orally intubated ARDS survivors have dysphagia symptoms that persist beyond hospital discharge. Patients with a longer ICU length of stay have slower recovery from dysphagia symptoms and should be carefully considered for swallowing assessment to help prevent complications related to dysphagia.
Arzu Yagiz On
Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.
common syndrome ” (Cleeland, et al., 2003). The growing recognition of the importance of patterns of symptoms in impairing the function and well-being...cancer patients (Stein, Jacobsen , Blanchard, & Thors, 2004; Stein, Martin, Hann, & Jacobsen , 1998). The MFSI-SF comprises 30 items using a 5-point...Tunceli, K. (2005). Employment pathways in a large cohort of adult cancer survivors. Cancer, 103, 1292-1301. Stein, K., Jacobsen , P., Blanchard, C
Appelbaum, Steven H.; Delage, Claude; Labib, Nadia; Gault, George
Downsizing can result in remaining staff developing "survivor syndrome," experiencing low morale, stress, and other psychosocial problems. If downsizing is necessary, precautions include managing perceptions and communications and empowering employees to take career ownership. (SK)
Langerud, Anne Kathrine; Rustøen, Tone; Småstuen, Milada Cvancarova; Kongsgaard, Ulf; Stubhaug, Audun
There is growing interest in potential long-term outcomes following intensive care, but few researchers have studied the prevalence of multiple symptoms or the association between pain and other symptoms. To investigate the prevalence of anxiety, depression, fatigue, sleep disturbance and post-traumatic stress symptoms (PTSS) among intensive care survivors 3 months and 1 year after being discharged from an intensive care unit (ICU) and to determine whether pain is associated with higher prevalence of these symptoms 3 months and 1 year after ICU stay. Exploratory, longitudinal cohort of intensive care survivors from two mixed ICUs in a tertiary referral hospital in Norway. Intensive care survivors completed surveys at 3 months (n = 118) and 1 year (n = 89) after ICU discharge. Clinical Trials: NCT02279212. Prevalence rates of intensive care survivors' symptoms were pain 58 (49·2%), anxiety/depression 24/118 (20·8%), fatigue 18/118(15·3%), PTSS 15 (12·8%) and sleep disturbance 58/118 (49·2%) at 3 months after ICU discharge (n = 118). Prevalence rates at 1 year (n = 89) changed only slightly to pain 34 (38·2%), anxiety/depression 17 (20·0%), fatigue 12 (13·8%), PTSS 13 (15·1%) and sleep disturbance 40/89 (46·5%). Associations were strong between pain and presence of sleep disturbance, anxiety/depression, PTSS and fatigue. Intensive care survivors have multiple symptoms and the prevalence rates of these symptoms remained almost unchanged from 3 months to 1 year after ICU discharge. The presence of pain was associated with high odds for the presence of sleep disturbance, anxiety/depression, PTSS and fatigue, compared to a no-pain group. ICU survivors may benefit from targeted interventions designed to alleviate the symptom burden. Knowledge about ICU survivor's prevalence and risk for having multiple symptoms may help health care professionals to give better care, if needed, to the ICU survivors. © 2017 British Association of Critical Care
Feuerstein, Michael; Bruns, Gina L.; Pollman, Courtney; Todd, Briana L.
Quality health care for survivors of cancer must evaluate and manage symptoms that are reported at the surveillance visit but are not linked to a cancer recurrence or a new cancer. At present, this does not always occur. This article analyzes quality of health care for survivors of cancer, taking empirical evidence and clinical expertise into consideration. Although emotional distress on the part of the survivor of cancer may exacerbate or even explain the presence of experienced symptoms, there are other potential explanations as well. When survivors present with persistent symptoms (even if unexplained) after cancer diagnosis and treatment, the symptoms can impact the survivor's function and well-being. Oncologists and other providers need to assess and directly target these symptoms for appropriate triage to those who can best help these survivors reduce the symptoms and their impact. PMID:21358961
van den Born-van Zanten, Sascha A.; Dongelmans, Dave A.; Dettling-Ihnenfeldt, Daniela; Vink, Roel; van der Schaaf, Marike
BACKGROUND: Many intensive care unit survivors (ICU) are confronted with undesirable and long-lasting impairments in physical, cognitive, and mental health, but not only patients are at risk of developing this post-intensive care syndrome (PICS). Family members can experience symptoms of depression,
van den Born-van Zanten, Sascha A.; Dongelmans, Dave A.; Dettling-Ihnenfeldt, Daniela; Vink, Roel; van der Schaaf, Marike
Many intensive care unit survivors (ICU) are confronted with undesirable and long-lasting impairments in physical, cognitive, and mental health, but not only patients are at risk of developing this post-intensive care syndrome (PICS). Family members can experience symptoms of depression, anxiety,
Langeveld, N. E.; Grootenhuis, M. A.; Voûte, P. A.; de Haan, R. J.
Background. Previous research suggests that posttraurnatic stress disorder (PTSD) is present in survivors of childhood cancer. The aim of the current study was to explore posttraurnatic stress symptoms in a sample of young adult survivors of childhood cancer. In addition, the impact of demographic,
Tuomikoski, Pauliina; Savolainen-Peltonen, Hanna
A vast majority of menopausal women suffer from vasomotor symptoms, such as hot flushes and night sweats, the mean duration of which may be up to 7-10 years. In addition to a decreased quality of life, vasomotor symptoms may have an impact on overall health. Vasomotor symptoms are associated with overactivity of the sympathetic nervous system, and sympathetic overdrive in turn is associated with metabolic syndrome, which is a known risk factor for cardiovascular disease. Menopausal hot flushes have a complex relationship to different features of the metabolic syndrome and not all data point towards an association between vasomotor symptoms and metabolic syndrome. Thus, it is still unclear whether vasomotor symptoms are an independent risk factor for metabolic syndrome. Research in this area is constantly evolving and we present here the most recent data on the possible association between menopausal vasomotor symptoms and the metabolic syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.
Grant, Joan S; Clay, Olivio J; Keltner, Norman L; Haley, William E; Wadley, Virginia G; Perkins, Martinique M; Roth, David L
Studies suggest that family caregiver well-being (ie, depressive symptoms and life satisfaction) may affect stroke survivor depressive symptoms. We used mediation analysis to assess whether caregiver well-being might be a factor explaining stroke survivor depressive symptoms, after controlling for demographic factors and stroke survivor impairments and problems. Caregiver/stroke participant dyads (N = 146) completed measures of stroke survivor impairments and problems and depressive symptoms and caregiver depressive symptoms and life satisfaction. Mediation analysis was used to examine whether caregiver well-being mediated the relationship between stroke survivor impairments and problems and stroke survivor depressive symptoms. As expected, more stroke survivor problems and impairments were associated with higher levels of stroke survivor depressive symptoms (P symptoms (32.95%). Although these measures combined to account for 40.50% of the relationship between survivor problems and impairments and depressive symptoms, the direct effect remained significant. Findings indicate that stroke survivor impairments and problems may affect family caregivers and stroke survivors and a high level of caregiver distress may result in poorer outcomes for stroke survivors. Results highlight the likely importance of intervening with both stroke survivors and family caregivers to optimize recovery after stroke.
Taylor-Piliae, Ruth E; Hepworth, Joseph T; Coull, Bruce M
Depression is a common yet often unrecognized consequence of stroke, affecting between 25% and 70% of all survivors. Untreated depression post-stroke leads to a poorer prognosis and increased mortality. However, the pattern and profile of post-stroke depression in chronic stroke are poorly understood. The aim of this study was to examine the independent predictors of depressive symptoms in chronic stroke. Community-dwelling stroke survivors (n = 100) completed the Center for Epidemiological Studies-Depression (CES-D) scale, Multidimensional Scale of Perceived Social Support, Medical Outcomes Study Short Form-36, and the Pittsburgh Sleep Quality Index. Functional disability and cognitive impairment were assessed using standardized procedures. Multiple linear regression was conducted to explore potential independent predictors of depressive symptoms. Subjects were, on average, 70 ± 10 years old and 39 ± 49 months post-stroke. The majority were white/European-American (78%), college educated (79%), and retirees (77%). Annual income was $50 000 or greater for 32%. Hemiparesis was common (right side, 39%; left side, 42%); 35% had a Center for Epidemiological Studies-Depression scale score of 16 or higher, and 21% had a history of major depression. Approximately 64% of the variance in depressive symptoms could be explained by the independent variables in the model: quality of life, sleep quality, social support, cognitive impairment, functional disability, months post-stroke, age, gender, history of major depression, and lesion location (R = 0.64, F12,87 = 12.97, P symptoms among these stroke survivors. Depressive symptoms are prevalent in chronic stroke survivors, even among an educated and economically advantaged population. Our findings are similar to reports by others that poor quality of life and low social support are major contributors to depressive symptoms in chronic stroke and should be routinely assessed and monitored to improve long-term rehabilitation
van den Born-van Zanten, Sascha A; Dongelmans, Dave A; Dettling-Ihnenfeldt, Daniela; Vink, Roel; van der Schaaf, Marike
Many intensive care unit survivors (ICU) are confronted with undesirable and long-lasting impairments in physical, cognitive, and mental health, but not only patients are at risk of developing this post-intensive care syndrome (PICS). Family members can experience symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). This cluster of complications is called PICS-family. To describe the level of caregiver strain and posttraumatic stress-related symptoms in relatives of ICU survivors. We conducted a cohort study in a general hospital between July 2010 and May 2014. Relatives of ICU survivors, mechanically ventilated for > 48 h in the ICU, were asked to complete a questionnaire 3 months after discharge from critical care. Symptoms of PTSD and caregiving concerns were assessed using the Trauma Screening Questionnaire and the Caregiver Strain Index (CSI). A total of 94 relatives visiting our post-ICU clinic completed the questionnaires. Twenty-one percent of the caregivers had a CSI score of 7 or more, indicating high levels of strain. Six percent had CSI scores indicating severe strain (CSI > 10). PTSD-related symptoms were seen in 21% of the caregivers. The mean time spent on caregiving was 10 h (interquartile range 6-17 h) per week. This study shows that relatives of ICU survivors could experience strain 3 months after hospital discharge and are at risk of developing PTSD-related symptoms. This complements existing data that relatives are at risk of psychological symptoms. Knowledge can lead to improvements and means to prevent these symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Gonzalez, Patricia; Castañeda, Sheila F; Dale, Jennifer; Medeiros, Elizabeth A; Buelna, Christina; Nuñez, Alicia; Espinoza, Rebeca; Talavera, Gregory A
Depression is common among patients diagnosed with cancer and may be inversely associated with spiritual well-being. While numerous strategies are employed to manage and cope with illness, spiritual well-being has become increasingly important in cancer survivorship research. This study examined the association between spiritual well-being and depressive symptoms. This cross-sectional study utilized self-report data from 102 diverse cancer survivors recruited from peer-based cancer support groups in San Diego County. Depression was measured with the Patient Health Questionnaire-8 (PHQ-8) and spiritual well-being was measured with the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) comprised of two subscales (Meaning/Peace and Faith). Hierarchal regression analysis indicated that Meaning/Peace significantly predicted depressive symptoms after adjusting for socio-demographics, cancer stage, time since diagnosis, and Faith (p Meaning/Peace has a unique advantage over Faith in protecting cancer survivors from the effects of depression symptoms; therefore, turning to Faith as source of strength may improve psychological well-being during survivorship. Future programs and healthcare providers should be cognizant of the influential role of spiritual well-being in depression symptoms in an effort to improve psychological well-being among cancer survivors.
... Diagnosis Treatment Jet Lag Overview Symptoms & Self Test Treatment Narcolepsy Overview & Facts Symptoms Self-Tests & Diagnosis Treatment Restless Legs Syndrome Overview & Facts Causes & Symptoms Self- ...
Wang, Sophia; Mosher, Chris; Gao, Sujuan; Kirk, Kayla; Lasiter, Sue; Khan, Sikander; Kheir, You Na; Boustani, Malaz; Khan, Babar
Nearly 30% of intensive care unit (ICU) survivors have depressive symptoms 2-12 months after hospital discharge. We examined the prevalence of depressive symptoms and risk factors for depressive symptoms in 204 patients at their initial evaluation in the Critical Care Recovery Center (CCRC), an ICU survivor clinic based at Eskenazi Hospital in Indianapolis, Indiana. Thirty-two percent (N = 65) of patients had depressive symptoms on initial CCRC visit. For patients who are not on an antidepressant at their initial CCRC visit (N = 135), younger age and lower education level were associated with a higher likelihood of having depressive symptoms. For patients on an antidepressant at their initial CCRC visit (N = 69), younger age and being African American race were associated with a higher likelihood of having depressive symptoms. Future studies will need to confirm these findings and examine new approaches to increase access to depression treatment and test new antidepressant regimens for post-ICU depression. © 2017 Society of Hospital Medicine.
... Pinterest Email Print What are the symptoms of Cushing syndrome? Most people with Cushing syndrome have a range of symptoms, 1 and ... of other conditions. 3 , 4 Physically, someone with Cushing syndrome might: Be heavy or obese above the ...
... Pinterest Email Print What are the symptoms of Rett syndrome? The first symptom of Rett syndrome is usually ... problems Intellectual disability In addition, a person with Rett syndrome may experience one or more of the following ...
... Share Dialog × Print What are common symptoms of Down syndrome? The symptoms of Down syndrome vary from person to person, and people with Down syndrome may have different problems at different times of ...
Chueh, Hee Won; Yoo, Jae Ho
The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients' circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.
Hee Won Chueh
Full Text Available The number of childhood cancer survivors is increasing as survival rates improve. However, complications after treatment have not received much attention, particularly metabolic syndrome. Metabolic syndrome comprises central obesity, dyslipidemia, hypertension, and insulin resistance, and cancer survivors have higher risks of cardiovascular events compared with the general population. The mechanism by which cancer treatment induces metabolic syndrome is unclear. However, its pathophysiology can be categorized based on the cancer treatment type administered. Brain surgery or radiotherapy may induce metabolic syndrome by damaging the hypothalamic-pituitary axis, which may induce pituitary hormone deficiencies. Local therapy administered to particular endocrine organs directly damages the organs and causes hormone deficiencies, which induce obesity and dyslipidemia leading to metabolic syndrome. Chemotherapeutic agents interfere with cell generation and growth, damage the vascular endothelial cells, and increase the cardiovascular risk. Moreover, chemotherapeutic agents induce oxidative stress, which also induces metabolic syndrome. Physical inactivity caused by cancer treatment or the cancer itself, dietary restrictions, and the frequent use of antibiotics may also be risk factors for metabolic syndrome. Since childhood cancer survivors with metabolic syndrome have higher risks of cardiovascular events at an earlier age, early interventions should be considered. The optimal timing of interventions and drug use has not been established, but lifestyle modifications and exercise interventions that begin during cancer treatment might be beneficial and tailored education and interventions that account for individual patients' circumstances are needed. This review evaluates the recent literature that describes metabolic syndrome in cancer survivors, with a focus on its pathophysiology.
Full Text Available Acute Respiratory Distress Syndrome (ARDS continues to have a high mortality. Currently, there are no biomarkers that provide reliable prognostic information to guide clinical management or stratify risk among clinical trial participants. The objective of this study was to probe the bronchoalveolar lavage fluid (BALF proteome to identify proteins that differentiate survivors from non-survivors of ARDS. Patients were divided into early-phase (1 to 7 days and late-phase (8 to 35 days groups based on time after initiation of mechanical ventilation for ARDS (Day 1. Isobaric tags for absolute and relative quantitation (iTRAQ with LC MS/MS was performed on pooled BALF enriched for medium and low abundance proteins from early-phase survivors (n = 7, early-phase non-survivors (n = 8, and late-phase survivors (n = 7. Of the 724 proteins identified at a global false discovery rate of 1%, quantitative information was available for 499. In early-phase ARDS, proteins more abundant in survivors mapped to ontologies indicating a coordinated compensatory response to injury and stress. These included coagulation and fibrinolysis; immune system activation; and cation and iron homeostasis. Proteins more abundant in early-phase non-survivors participate in carbohydrate catabolism and collagen synthesis, with no activation of compensatory responses. The compensatory immune activation and ion homeostatic response seen in early-phase survivors transitioned to cell migration and actin filament based processes in late-phase survivors, revealing dynamic changes in the BALF proteome as the lung heals. Early phase proteins differentiating survivors from non-survivors are candidate biomarkers for predicting survival in ARDS.
Bhargava, Maneesh; Becker, Trisha L.; Viken, Kevin J.; Jagtap, Pratik D.; Dey, Sanjoy; Steinbach, Michael S.; Wu, Baolin; Kumar, Vipin; Bitterman, Peter B.; Ingbar, David H.; Wendt, Christine H.
Acute Respiratory Distress Syndrome (ARDS) continues to have a high mortality. Currently, there are no biomarkers that provide reliable prognostic information to guide clinical management or stratify risk among clinical trial participants. The objective of this study was to probe the bronchoalveolar lavage fluid (BALF) proteome to identify proteins that differentiate survivors from non-survivors of ARDS. Patients were divided into early-phase (1 to 7 days) and late-phase (8 to 35 days) groups based on time after initiation of mechanical ventilation for ARDS (Day 1). Isobaric tags for absolute and relative quantitation (iTRAQ) with LC MS/MS was performed on pooled BALF enriched for medium and low abundance proteins from early-phase survivors (n = 7), early-phase non-survivors (n = 8), and late-phase survivors (n = 7). Of the 724 proteins identified at a global false discovery rate of 1%, quantitative information was available for 499. In early-phase ARDS, proteins more abundant in survivors mapped to ontologies indicating a coordinated compensatory response to injury and stress. These included coagulation and fibrinolysis; immune system activation; and cation and iron homeostasis. Proteins more abundant in early-phase non-survivors participate in carbohydrate catabolism and collagen synthesis, with no activation of compensatory responses. The compensatory immune activation and ion homeostatic response seen in early-phase survivors transitioned to cell migration and actin filament based processes in late-phase survivors, revealing dynamic changes in the BALF proteome as the lung heals. Early phase proteins differentiating survivors from non-survivors are candidate biomarkers for predicting survival in ARDS. PMID:25290099
... Thromboembolism Aortic Aneurysm More Symptoms and Diagnosis of Metabolic Syndrome Updated:Apr 13,2017 What are the symptoms ... Syndrome? This content was last reviewed August 2016. Metabolic Syndrome • Home • About Metabolic Syndrome • Why Metabolic Syndrome Matters • ...
Biglia, Nicoletta; Bounous, Valentina Elisabetta; Sgro, Luca Giuseppe; D'Alonzo, Marta; Gallo, Martina
Different treatments (surgery, radiotherapy, chemotherapy) for gynaecological cancers may cause ovarian failure or increase menopausal symptoms. There is a widespread reluctance among physicians to prescribe hormone replacement therapy (HRT) to the survivors of gynaecological cancer. This review analyses the use of HRT and of alternative therapies in such women. Squamous cervical cancer is not estrogen dependent and thus HRT is not contraindicated. While a cautious approach to hormone-dependent cancer is warranted, for women treated for non-hormone-related tumours alternative treatments for menopausal symptoms should be given due consideration, as any reluctance to prescribe HRT for them has neither a biological nor a clinical basis. In studies of HRT for survivors of endometrial and ovarian cancer, for instance, no evidence of increased risk was found, although no definitive conclusions can yet be formulated. The positive effect of HRT on quality of life seems to outweigh the unfounded suspicion of an increased risk of recurrence of non-hormone-related tumours. Effective non-hormonal alternatives for vasomotor symptoms are selective serotonin reuptake inhibitors and selective serotonin-norepinephrine reuptake inhibitors. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Lee, Su Jung; Kim, Nam Cho
Advanced cancer treatments have improved survival from cancer, but the incidence of cardiovascular disease in survivors has recently increased. Sarcopenia and metabolic syndrome (MetS) are related to cancer survival, and sarcopenia is an emerging risk factor for cardiovascular disease. However, evidence of a relationship between sarcopenia and MetS in cancer survivors is lacking. The aims of this study were to determine the prevalence of sarcopenia and MetS in cancer survivors and to investigate independent predictors of MetS in cancer survivors. From the fourth and fifth Korea National Health and Nutritional Exam Survey (2008-2011), 798 consecutive cancer survivors were analyzed. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight less than 1 SD below the sex-specific healthy population aged 20 to 39 years. Metabolic syndrome was defined using the National Cholesterol Education Program definition. Among 798 cancer survivors, the prevalence rates of sarcopenia and MetS were 23.1% and 30.0%, respectively. Survivors with sarcopenia were more likely to have a higher waist circumference, body mass index, triglyceride level, and blood pressure and to have a lower high-density lipoprotein cholesterol level compared with those without sarcopenia. In multivariable analysis, sarcopenia was an independent predictor of MetS (odds ratio, 2.76; 95% confidence interval, 1.92-3.97). In addition, age and type of cancer were independent predictors of MetS. Sarcopenia was associated with an increased prevalence of MetS in cancer survivors. Interventions to prevent sarcopenia may be necessary to improve cardiovascular outcome in cancer survivors.
Klinedinst, N Jennifer; Clark, Patricia C; Dunbar, Sandra B
The purposes of this study were to examine the relationship between the poststroke depressive symptoms, older adult stroke survivors' perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the health care provider with whether or not older stroke survivors discussed their depressive symptoms with a health care provider. A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the health care provider via one time interview. Thirty-seven percent (n = 16) of all older stroke survivors reported depressive symptoms to their health care provider. Of the stroke survivors who had high levels of depressive symptoms (CESD ≥ 16; n = 11), seven reported the depressive symptoms to their health care provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a health care provider. (c) 2013 APA, all rights reserved.
Burton-Chase, Allison M; Parker, Wendy M; Polivka, Katrina M; Gritz, Ellen R; Amos, Christopher I; Lu, Karen H; Lynch, Patrick M; Rodriguez-Bigas, Miguel A; Nancy You, Y; Peterson, Susan K
This study evaluated provider satisfaction in a sample of colorectal cancer (CRC) survivors with and without Lynch syndrome (LS). Participants were case-case-matched CRC survivors with (n = 75) or without (n = 75) LS (mean age of 55; range: 27-93). Participants completed a mailed questionnaire assessing demographics, clinical characteristics, healthcare utilization, psychosocial variables, and provider satisfaction. LS CRC survivors reported lower provider satisfaction scores on three subscales of the Primary Care Assessment Survey: communication (78.14 vs. 83.96; P < 0.05), interpersonal treatment (78.58 vs. 85.30; P < 0.05), and knowledge of the patient (60.34 vs. 69.86; P < 0.01). Among LS CRC survivors, predictors for mean communication and trust subscale scores were location of treatment and socioeconomic status. Higher mean depression scores also were associated with trust, while social support predicted higher satisfaction with communication. Sporadic CRC survivor satisfaction is driven largely by age (communication, interpersonal treatment) and patient anxiety (communication), while seeing a provider more often was associated with increased satisfaction with knowledge of the patient. LS CRC survivors reported lower levels of provider satisfaction than sporadic CRC survivors. LS survivors who received care at The University of Texas MD Anderson Cancer Center, a comprehensive cancer center (CCC), reported higher satisfaction than those receiving care at other institutions. Depressive symptoms and socioeconomic status may impact provider satisfaction ratings. Exploration of other potential predictors of provider satisfaction should be examined in this population. Additionally, further research is needed to examine the potential impact of provider satisfaction on adherence to medical recommendations in LS CRC survivors, particularly those being treated outside of CCCs. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Malhotra, Rahul; Chei, Choy-Lye; Menon, Edward; Chow, Wai Leng; Quah, Stella; Chan, Angelique; Matchar, David Bruce
We utilize group-based trajectory modeling (GBTM) to delineate depressive symptom trajectories among stroke survivor-caregiver dyads, to identify predictors of the delineated trajectories, and to assess the influence of time-varying covariates (stroke survivor depressive symptoms and functional disability, caregiver depressive symptoms, and foreign domestic worker [FDW] assistance) on the level of the depressive symptom trajectories. Data on 172 stroke survivor-caregiver dyads in Singapore, for whom depressive symptoms were assessed thrice (baseline/3 months/6 months), were utilized. GBTM was applied to delineate depressive symptom trajectories, and to identify their predictors and time-varying covariates. Three stroke survivor depressive symptom trajectories (low and decreasing [47.6%], low and increasing [43.1%], and high and increasing [9.3%]) and 2 caregiver depressive symptom trajectories (low and stable [71.5%] and high and decreasing [28.5%]) were delineated. Caregivers with chronic diseases were more likely (odds ratio [95% confidence interval]: 8.09[2.04-32.07]) and those caring for older stroke survivors (0.94[0.90-0.98]) were less likely to follow the high and decreasing than the low and stable depressive symptom trajectory. An increase in stroke survivor functional disability and caregiver depressive symptoms led to a rise (~worsening) in stroke survivor depressive symptom trajectories. Whereas an increase in stroke survivor depressive symptoms led to a rise in caregiver depressive symptom trajectories, FDW assistance led to a decline (~improvement). Care professionals should be mindful of heterogeneity in depressive symptom patterns over time among stroke survivor-caregiver dyads. Reciprocal association of depressive symptoms in the stroke survivor-caregiver dyad suggests that addressing mood problems in 1 member may benefit the other member, and calls for dyadic mental health interventions. Copyright © 2015 National Stroke Association. Published by
Gibson, Todd M; Ehrhardt, Matthew J; Ness, Kirsten K
Treatment-related obesity and the metabolic syndrome in adult survivors of childhood acute lymphoblastic leukemia (ALL) are risk factors for cardiovascular disease. Both conditions often begin during therapy. Preventive measures, including dietary counseling and tailored exercise, should be initiated early in the course of survivorship, with referral to specialists to optimize success. However, among adults who develop obesity or the metabolic syndrome and who do not respond to lifestyle therapy, medical intervention may be indicated to manage underlying pathology, such as growth hormone deficiency, or to mitigate risk factors of cardiovascular disease. Because no specific clinical trials have been done in this population to treat metabolic syndrome or its components, clinicians who follow adult survivors of childhood ALL should use the existing American Heart Association/National Heart Lung and Blood Institute Scientific Statement to guide their approach.
Jae Hoon Chung
Full Text Available Purpose : Long-term survivors of childhood cancer appear to have an increased risk for the metabolic syndrome, subsequent type 2 diabetes and cardiovascular disease in adulthood compared to healthy children. The purpose of this study was to investigate the frequency of the metabolic syndrome and associated factors in childhood cancer survivors at a single center in Korea. Methods : We performed a retrospective review of medical records of 98 childhood cancer survivors who were diagnosed and completed anticancer treatment at Samsung Medical Center, Seoul, Korea between Jan. 1996 and Dec. 2007. Parameters of metabolic syndrome were evaluated between Jan. 2008 and Dec. 2009. Clinical and biochemical findings including body fat percentage were analyzed. Results : A total of 19 (19.4% patients had the metabolic syndrome. The median body fat percentage was 31.5%. The body mass index and waist circumference were positively correlated with the cranial irradiation dose (r=0.38, P<0.001 and r=0.44, P<0.00, respectively. Sixty-one (62.2% patients had at least one abnormal lipid value. The triglyceride showed significant positive correlation with the body fat percentage (r=0.26, P=0.03. The high density lipoprotein cholesterol showed significant negative correlation with the percent body fat (r=- 0.26, P=0.03. Conclusion : Childhood cancer survivors should have thorough metabolic evaluation including measurement of body fat percentage even if they are not obese. A better understanding of the determinants of the metabolic syndrome during adolescence might provide preventive interventions for improving health outcomes in adulthood.
... Down syndrome longer than other children to reach developmental milestones, but they will eventually meet many of these ... identify similarities and differences in the physical and developmental symptoms and milestones of people with Down syndrome and guide future ...
McCarthy, Michael J.; Lyons, Karen S.; Powers, Laurie E.
Depression following stroke is a major problem for survivors and spouses, but few studies have focused on the experiences of couples. This study investigates associations between perceived relationship quality, communication and coping patterns, interpersonal misunderstandings and expectations, and survivors' and spouses' depressive symptoms after…
Berg, B. van den
Most studies after disasters have focused on mental health problems such as post-traumatic stress disorder (PTSD), depression and anxiety among survivors. Besides mental health problems, survivors may develop physical health symptoms that are frequently unexplained such as headache, fatigue and
Rogers, K A
In today's health care environment of merged organizations, downsizing and restructuring, employees can be experiencing a debilitating syndrome called "layoff survivor syndrome." This syndrome can have a crippling effect on workers and organizations as employees struggle to adapt to the changed working environment. This article represents my self-reflection as a nursing unit manager who personally experienced survivor sickness and witnessed its impact on the unit staff that I was leading at the time. The work of Noer (1993) is explored to clarify the syndrome and describe how the nursing staff and I manifested the syndrome. The writings of Bridges (1991), Brockner (1992) and Noer (1993) provide timely and relevant insights into managing the impact of layoffs and downsizing on those left behind to carry on. Noer (1993) sees the adaptation to the change as the ability to make the psychological shift from the old business paradigm that perpetuated codependency to the new business paradigm of fostering empowered employees. Bridges (1991) takes us a step further in making this psychological shift to adapt to the new work environment by providing a three phase process he calls transitions. The works of these three authors hold an important message for organizations and employees working in environments that abound with constant change.
Simonelli, Laura E; Fowler, Jeffrey; Maxwell, G Larry; Andersen, Barbara L
Continuing symptoms and poor health following cancer treatments may alter meaning in life for cancer survivors. Gynecologic cancer survivors are particularly troubled with physical sequelae. In addition, for the most common sites of disease, such as breast and gynecologic cancers, the prevalence of depression is also high. This study tests meaning in life as a mechanism for the relationship between physical symptoms and depressive symptoms. Gynecologic cancer survivors (N = 260) participated. Measures of physical sequelae (nurse rated symptoms/signs, patient-reported gynecologic symptoms), meaning in life (harmony, life purpose, spirituality, and conversely, confusion and loss), and depressive symptoms were obtained at the time of a routine clinical follow-up visit 2-10 years following the completion of treatment. Latent variables were defined, and structural equation modeling tested a mediator model. Analyses support partial mediation. That is, survivors with more physical sequelae also reported lower levels of meaning in life, which was associated with higher levels of depressive symptoms. Gynecologic cancer patients have been neglected in psychosocial research, and findings highlight the importance of existential issues in their lives. While many adjust well, those with persistent physical functioning deficits may experience depressive symptoms. By appreciating the role of meaning in their experience, we may help survivors foster their own growth and perspectives important for their future.
Lim, Jae-Young; Kim, Kyoung-Eun; Choe, Gheeyoung
We describe a 38-yr-old polio survivor with newly developed weakness from myotonic dystrophy. He suffered muscle atrophy and weakness in his legs as a result of poliomyelitis at the age of 3 yrs. After a stable interval of about 30 yrs, he felt new weakness and fatigue in his legs. Electromyography revealed generalized myotonic discharges, early recruitment, and findings of chronic denervation in his left leg. Genetic testing was consistent with myotonic dystrophy type 1. A biopsy from the right gastrocnemius revealed findings of both myotonic dystrophy and chronic denervation. This case report shows the importance of considering other uncommon conditions in the differential diagnoses of postpolio syndrome.
Macartney, Gail; Harrison, Margaret B; VanDenKerkhof, Elizabeth; Stacey, Dawn; McCarthy, Patricia
Little is known about the quality of life of children and youth under the age of 20 who have completed treatment for a pediatric brain tumor. This systematic review was conducted to (a) describe the health-related quality of life (HRQL) outcomes in pediatric brain tumor survivors, (b) identify instruments used to measure HRQL, and (c) determine the relationship between symptoms and HRQL. Using a systematic search and review methodology, databases searched included CINAHL, Medline, Embase, and PsycInfo. No date restrictions were used. Search results elicited 485 articles, of which16 met the inclusion criteria. Compared with their healthy peers, pediatric brain tumor survivors did worse on most measures of physical, psychosocial, social, and cognitive domains of HRQL. Compared with other cancer patients, survivors scored themselves significantly lower on the Pediatric Quality of Life Inventory (PedsQL) social functioning scale, and parents of brain tumor survivors reported lower PedsQL social and total functioning scores for their children. Other variables that were associated with decreased HRQL were degree of hypothalamic tumor involvement, osteopenia, need for special education, older age at diagnosis, greater than 1 year since treatment, and radiation treatment. In these studies, pediatric brain tumor survivors fared worse compared with other cancer survivors or healthy peers on several HRQL domains. Only 3 studies explored the relationship between symptoms, including pain or fatigue, and HRQL in pediatric brain tumor survivors. The relationship between symptoms and HRQL was not well elucidated. More research is needed to explore the multidimensional symptom experience and HRQL outcomes in pediatric brain tumor survivors.
Stubblefield, Michael D
Radiation-induced toxicity is a major cause of long-term disability after cancer treatment. Radiation fibrosis describes the insidious pathologic fibrotic tissue sclerosis that can occur in response to radiation exposure. Radiation fibrosis syndrome describes the myriad clinical manifestations of progressive fibrotic tissue sclerosis resulting from radiation treatment. Radiation-induced damage can include "myelo-radiculo-plexo-neuro-myopathy," causing muscle weakness and dysfunction and contributing to neuromuscular injury. Similarly, radiation damage to neuromuscular structures contributes to radiation-induced trismus and cervical dystonia in head and neck cancer survivors. This narrative review discusses the pathophysiology, anatomy, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders that can result as late effects of radiation treatment. Rehabilitation medicine physicians with extensive training in neuromuscular and musculoskeletal medicine as well as in the principles of functional restoration are uniquely positioned to help lead efforts to improve the quality of life for cancer survivors with radiation fibrosis syndrome. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Loh, Alvona Z; Tan, Julia S; Zhang, Melvyn W; Ho, Roger C
The global prevalence of depressive and anxiety symptoms among caregivers of stroke survivors is unknown. Given the high index of caregiver burden, this meta-analysis aims to evaluate the pooled prevalence of depressive and anxiety symptoms among caregivers of stroke survivors globally and to determine underlying moderators. The authors searched PubMed, Embase, PsychINFO, BIOSIS, Science Direct, and Cochrane CENTRAL databases from inception to June 2016, and relevant articles were selected in accordance to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We calculated the pooled prevalence proportion of depressive and anxiety symptoms among caregivers of stroke survivors. Meta-regression was performed to identify important moderators which contribute to heterogeneity. The literature search generated 1259 records, and 34 full-text articles were reviewed in details. Twelve studies met the inclusion criteria and comprised of 1756 caregivers. The pooled prevalence of depressive symptoms was 40.2% (95% confidence interval 30.1%-51.1%) and anxiety symptoms 21.4% (95% confidence interval 11.6%-35.9%) among caregivers of stroke survivors based on the random-effects model. There was significant heterogeneity. Meta-regression was conducted to account for the heterogeneity of the prevalence. For depressive symptoms, female sex of caregivers and stroke survivors, as well as Caucasian ethnicity of caregivers were associated with high prevalence of depression. Spousal and child relationship of caregivers to stroke survivors were associated with low prevalence of depression. For anxiety symptoms, meta-regression could not be conducted because insufficient number of studies provided information on the moderators. This meta-analysis has identified the high prevalence of depressive and anxiety symptoms among caregivers of stroke survivors, which were 40.2% and 21.4%, respectively. Meta-regression has identified that female sex of caregivers
Rush, Christina L; Lobo, Tania; Serrano, Adriana; Blasini, Maxie; Campos, Claudia; Graves, Kristi D
Complementary and alternative medicine (CAM) is used widely in cancer populations, particularly among women, and has shown promise for addressing symptom and functioning outcomes. Few studies to date have evaluated CAM use and associations over time with symptoms and function among Latina breast cancer survivors. We administered a baseline (N = 136) and follow-up (n = 58) telephone survey in Spanish or English assessing Latina breast cancer survivor demographics, physical function, anxiety, depression, fatigue, satisfaction with social roles, and both CAM activities and devotional and spiritual practices. About one-third of our sample (35% baseline; 36% follow-up) reported using CAM (yoga, meditation, massage, or herbal/dietary supplements). We assessed devotional and spiritual practices separately from CAM (church attendance, prayer, religious groups, and reading devotional and religious texts); the majority of Latina survivors reported devotional and spiritual practices (80% baseline; 81% follow-up). At baseline, CAM demonstrated a positive association with better physical functioning and lower depression. In contrast, CAM use at the time of follow-up appeared to be related to lower levels of satisfaction with social roles and physical function. In longitudinal analyses, devotional and spiritual practices at baseline significantly predicted lower anxiety, depression, and fatigue at follow-up. Findings suggest CAM plays a complex and not always linear role in symptoms and function outcomes for Latina breast cancer survivors. These findings contribute to the literature on longitudinal CAM use and associations with symptom and functioning outcomes among Latina breast cancer survivors.
Carson, James W; Carson, Kimberly M; Porter, Laura S; Keefe, Francis J; Seewaldt, Victoria L
Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.
Khitab, Aaron; Reid, John; Bennett, Vern; Adams, G Camelia; Balbuena, Lloyd
Several recent studies have reported that post-traumatic stress disorder (PTSD) is a frequent occurrence in survivors of an intensive care unit (ICU) admission. To assess the frequency of PTSD symptoms at three and nine months post-ICU admission and examine possible risk factors that predispose to the development of PTSD symptoms. Using the following scales: Davidson Trauma Scale, Impact of Event Scale and the Post-traumatic Symptom Scale, 69 ICU survivors were assessed for PTSD symptoms at three months post-ICU admission. Of the original 69 patients, 37 completed the same questionnaires at the second follow-up at nine months post-ICU admission. Mean symptom levels for avoidance, intrusive thoughts and hyperarousal were calculated, and risk factors for the development of PTSD symptomatology were examined. Depending on which scale was used, 16% to 33% of ICU survivors met the criteria for PTSD at either three or nine months. Younger age and the use of a prescription psychoactive medication at time of ICU admission were both independently associated with a higher risk of developing PTSD symptoms. Interestingly, symptoms of hyperarousal worsened during the follow-up interval for female patients, while they remained constant for males. The frequency of PTSD symptoms was high in patients who survived an admission to the ICU. Depending on sex, symptoms may present and evolve differently. The adoption of screening tools and a multicentre ICU database in Canada is recommended to identify patients who are most at risk.
Klinedinst, N. Jennifer; Clark, Patricia C.; Dunbar, Sandra B.
Purpose The purposes of this study were to examine the relationship between the post-stroke depressive symptoms, older adult stroke survivors’ perceptions of the depressive symptoms, and the congruence with an informal caregiver about the presence of depressive symptoms, and comfort talking to the healthcare provider with whether or not older stroke survivors discussed their depressive symptoms with a healthcare provider. Method A cross-sectional study where 44 caregiver/older adult stroke survivor dyads completed questionnaires including the Center for Epidemiologic Studies Depression Scale, Symptom Perception Questionnaire, and reporting of depressive symptoms to the healthcare provider via one time interview. Results Thirty-seven percent (n=16) of all older stroke survivors reported depressive symptoms to their healthcare provider. Of the stroke survivors who had high levels of depressive symptoms (CESD≥16; n=11), seven reported the depressive symptoms to their healthcare provider. Identifying the symptoms as possible depression and attributing the cause of the depressive symptoms to the stroke were related to stroke survivors reporting the depressive symptoms to a health care provider. Conclusions High functioning, older stroke survivors may benefit from strategies to help them identify when they experience depressive symptoms, in order to be able to play an active role in their recovery by appropriately discussing their symptoms with a healthcare provider. PMID:23855380
Barra, Mathias; Evensen, Gina Sophie Hvidsten; Valeberg, Berit Taraldsen
To investigate to what extent self-reported cues about lack of treatment or concerns about inadequate health care from stroke survivors were associated with symptoms of depression. Stroke survivors are prone to depression, and thus, any easily available cues which may inform healthcare workers about patients' mental well-being are potentially important. This study investigates whether two such cues - Cue 1 the subjectively reported lack of access to rehabilitation, and more generally, Cue 2 an expressed concern that their healthcare needs may not be adequately met - may be clinically relevant to be on the outlook for. A cross-sectional survey of stroke survivors three months after discharge from a stroke unit. Analysis of data on stroke survivors collected at three months after discharge from a hospital's stroke unit, by means of a mailed questionnaire. Descriptive statistics for the sample population were computed, and a binary logistic model fitted to estimate the impact of subjectively perceived lack of rehabilitation and subjectively reported low confidence in the healthcare system on symptoms of depression as measured by the Hospital Anxiety and Depression Scale. The percentage of patients reporting the presence of symptoms of depression three months postdischarge (22·6%) was consistent with the main body of literature on this subject. Both cues investigated had a significant (p symptoms of depression in our population. Healthcare workers who come in contact with stroke survivors who report having missed out on rehabilitation or express concern that their care needs may not be adequately met by their access to health care should ensure that the patients' mental well-being is being duly monitored and should consider further investigation for depression. Healthcare workers who come into contact with stroke survivors should pay attention to patients' remonstrance of access to rehabilitation, or concerns about adequacy of received care, as these might constitute
Choi, JiYeon; Tate, Judith A; Rogers, Mary Alana; Donahoe, Michael P; Hoffman, Leslie A
The association between intensive care unit (ICU) survivors' psychological sequelae, individual care needs, and discharge disposition has not been evaluated. To describe depressive symptoms and anxiety in ICU survivors and explore these symptoms based on individual care needs and discharge disposition for 4 months post-ICU discharge. We analyzed data from 39 ICU survivors who self-reported measures of depressive symptoms (Center for Epidemiologic Studies-Depression 10 items [CESD-10]) and anxiety (Shortened Profile of Mood States-Anxiety subscale [POMS-A]). A majority of patients reported CESD-10 scores above the cut off (≥ 8) indicating risk for clinical depression. POMS-A scores were highest within 2 weeks post-ICU discharge and decreased subsequently. Data trends suggest worse depressive symptoms and anxiety when patients had moderate to high care needs and/or were unable to return home. ICU survivors who need caregiver assistance and extended institutional care reported trends of worse depressive symptoms and anxiety. Copyright © 2016 Elsevier Inc. All rights reserved.
Aviad-Wilchek, Yael; Cohenca-Shiby, Diana; Sasson, Yehuda
This paper examines symptoms of anxiety and depression of Holocaust survivors' (HS) offspring as a function of their parents' age, gender, and survival situation (whether the survivor parent was alone or with a relative during the war). The 180 adults (142 with two parent survivors; 38 with a single parent survivor) who participated in this study completed (a) a measure of state-trait anxiety, (b) a measure of depression symptoms, (c) a sociodemographic questionnaire was divided into three sections: information about the participant, about his mother and about his father. Participants whose mothers were aged 18 or younger during the war and survived alone report more symptoms of anxiety and depression than participants whose mothers were the same age yet survived in the company of relatives. Participants whose mothers were aged 19 or older and survived either alone or in the company of relatives, exhibited fewer symptoms of anxiety and depression. The survival situation was the only predictor related to the fathers. There were no significant differences between participants with one or two HS parents. Although this study is based on a relatively small sample, it highlights the relationship between the parents' survival situation and symptoms of anxiety and depression among their offspring.
Uekusa, Kyoko; Hayashida, Makiko; Saito, Nobuyuki; Mashiko, Kunihiro; Hara, Kenji; Waters, Brian; Ohno, Youkichi
There are few reports from Japan on the analysis of fluids in survivors of body-packer syndrome. We analyzed the concentrations of stimulants in the serum, plasma and urine collected from three patients suspected of being body packers at immigration that were referred to hospitals between 2010 and 2011. The drugs were extracted with solid-phase columns and analyzed by gas chromatography-mass spectrometry (GC-MS). In all cases, wrapped, cylindrical packets of foreign bodies were detected in the intestinal tract on plain X-ray (X-P) and computed tomography (CT), and they were eventually removed surgically. In case 1, the patient presented with convulsions and tachycardia at admission to the hospital and one of the packets was found to have ruptured. In case 2, although the subject appeared to have an intestinal obstruction caused by the packets on the third day, he exhibited no symptoms on arrival and the packets did not appear to have ruptured. In case 3, the patient exhibited restlessness on the first day and one of the removed packets had ruptured. In all cases, methamphetamine (MA) and amphetamine (AP) were detected in serum, plasma and urine. In this study, we report the variation in MA and AP concentrations in survivors of body-packer syndrome. The serum and plasma concentrations of MA were high in subjects that exhibited symptoms of MA intoxication. MA and AP were also detected in the case in which the patient exhibited no symptoms of intoxication and the packets had not ruptured. These results suggest either that the stimulants may have seeped through the wrap of the packets, or that the subject had been abusing the drugs. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Prochwicz, Katarzyna; Sobczyk, Artur
The Jerusalem syndrome is an acute psychotic state observed in tourists and pilgrims who visit Jerusalem. The main symptom of this disorder is identification with a character from the Bible and exhibiting behaviours which seems to be typical for this character. The article presents an overview of cultural and demographic factors associated with the appearance of the Jerusalem syndrome. Three main categories of the syndrome were identified with special focus on the category unconjoined to previous psychopathology which can be described as the 'pure' form of the Jerusalem syndrome. The main diagnostic criteria for the 'pure' type and the sequence of seven clinical stages of the Jerusalem syndrome were described. The article contains a review of the hypothesis about the causes of Jerusalem syndrome with special attention given to the role of places of particular meaning for religious tradition.
Shifren, Kim; Anzaldi, Kristen
The investigation of the relation of positive personality characteristics to mental and physical health among Stroke survivors has been a neglected area of research. The purpose of this study was to examine the relationship between optimism, well-being, depressive symptoms, and perceived physical health among Stroke survivors. It was hypothesized that Stroke survivors' optimism would explain variance in their physical health above and beyond the variance explained by demographic variables, diagnostic variables, and mental health. One hundred seventy-six Stroke survivors (97 females, 79 males) completed the Revised Life Orientation Test, the Center for Epidemiological Studies Depression Scale, two items on perceived physical health from the 36-item Short Form of the Medical Outcomes study, and the Identity scale of the Illness Perception Questionnaire. Pearson correlations, hierarchical regression analyses, and the PROCESS approach to determining mediators were used to assess hypothesized relations between variables. Stroke survivors' level of optimism explained additional variance in overall health in regression models controlling for demographic and diagnostic variables, and mental health. Analyses revealed that optimism played a partial mediator role between mental health (well-being, depressive symptoms and total score on CES-D) variables and overall health.
Hall, Daniel L; Antoni, Michael H; Lattie, Emily G; Jutagir, Devika R; Czaja, Sara J; Perdomo, Dolores; Lechner, Suzanne C; Stagl, Jamie M; Bouchard, Laura C; Gudenkauf, Lisa M; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G
Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one's daily functioning in both patient populations to better understand their relationships with depressed mood. Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants' fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p'sfatigued breast cancer survivors (β=.18, p=.19). CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed.
Hall, Daniel L.; Antoni, Michael H.; Lattie, Emily G.; Jutagir, Devika R.; Czaja, Sara J.; Perdomo, Dolores; Lechner, Suzanne C.; Stagl, Jamie M.; Bouchard, Laura C.; Gudenkauf, Lisa M.; Traeger, Lara; Fletcher, MaryAnn; Klimas, Nancy G.
Objective Persistent fatigue and depressive symptoms are both highly prevalent among patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) as well as breast cancer survivors. This study aimed to assess and directly compare perceptions of fatigue as highly interfering in one’s daily functioning in both patient populations to better understand their relationships with depressed mood. Methods Participants were 95 female CFS/ME patients and 67 females who were approximately 5 years post-treatment for stage 0-III breast cancer presenting with clinically elevated fatigue severity. Self-report measures were obtained on participants’ fatigue-related interference in daily functioning and fatigue severity as well as depressed mood. Hierarchical regression was used to test effects controlling for relevant demographic, psychosocial, and medical covariates. Results CFS/ME patients endorsed greater depressed mood and fatigue interference than did fatigued breast cancer survivors, p’sfatigued breast cancer survivors (β=.18, p=.19). Conclusions CFS/ME patients reported elevated fatigue symptoms and depression relative to fatigued breast cancer survivors. In the former group, greater depressed mood was highly and significantly associated with greater fatigue-related inference in daily activities. Potential targets for cognitive behavioral interventions are discussed. PMID:26180660
Bandak, M; Jørgensen, N; Juul, A
BACKGROUND: Twenty to thirty percent of testicular cancer (TC) survivors have elevated serum levels of luteinising hormone (LH) with or without corresponding low testosterone levels (Leydig cell dysfunction) during clinical follow-up for TC. However, it remains to be clarified if this subgroup...... of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. PATIENTS AND METHODS: TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig...... was higher in TC survivors with uncompensated Leydig cell dysfunction during follow-up, there was no evidence of increased systemic inflammation in patients with Leydig cell dysfunction during clinical follow-up. Total testosterone at follow-up was significantly associated with MetS, whereas...
Kim, Soo Hyun; Lee, Ran; Lee, Keon Suk
The study compared the levels of symptoms and uncertainty, their associated factors, relationships between them and predictors of uncertainty by treatment trajectory among breast cancer survivors. Little is known with regard to how uncertainty and symptoms are related to treatment trajectory among breast cancer survivors. A cross-sectional descriptive design was used. A total of 252 women with breast cancer, receiving cancer therapy, or having completed their therapy were recruited from the National Cancer Center in Korea. Measurements used included symptom subscales of the European Organization of Research and Therapy for Cancer QLQ-C30 and Breast Cancer Module BR23 and the Mishel Uncertainty in Illness Scale. Women in treatment reported more severe symptoms and higher levels of uncertainty than women having completed treatment. During treatment, most symptoms were positively correlated with the level of uncertainty, whereas, in women who had completed treatment, only dyspnoea, insomnia, systemic therapy side effects and arm symptoms positively correlated with uncertainty. There were also differences in predictors of uncertainty by treatment trajectory. Age, marital status and pain were significant predictors of uncertainty during treatment, while monthly income, dyspnoea and insomnia were predictors of uncertainty after treatment. Among breast cancer survivors, levels of symptoms and uncertainty, associated factors, relationships between them and predictors of uncertainty differed depending on treatment trajectory. To provide trajectory-sensitive nursing intervention for uncertainty among breast cancer survivors, age, marital status and pain should be considered during treatment, while factors such as economic status, dyspnoea and insomnia should be taken into account after treatment. © 2011 Blackwell Publishing Ltd.
Acute pain is a symptom enabling us to implement a response when faced with an attack. Chronic pain is complex and multifactorial. The care of the patient by a multidisciplinary team comprises the diagnosis of the pain and the putting in place of a treatment for each of its components. This includes physical reconditioning, adaptation strategies and work on the psychological elements relating to the representation of the pain. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Kamibeppu, Kiyoko; Murayama, Shiho; Ozono, Shuichi; Sakamoto, Naoko; Iwai, Tsuyako; Asami, Keiko; Maeda, Naoko; Inada, Hiroko; Kakee, Naoko; Okamura, Jun; Horibe, Keizo; Ishida, Yasushi
The purpose of this study was to identify factors associated with posttraumatic stress symptoms (PTSS) among Japanese long-term childhood cancer survivors (CCSs). Subjects comprised 185 adolescent and young adult (AYA) CCSs who completed anonymous self-report questionnaires. Attending physicians also completed an anonymous disease/treatment data sheet. Mean age of survivors was approximately 8 years at diagnosis and 23 years at participation. Multiple regression analysis showed that family functioning, satisfaction with social support, being female, and interactions between family functioning and gender and age at the time of diagnosis were associated with PTSS among survivors. This study revealed family functioning as the most predictive factor of PTSS among AYA CCSs in Japan. Even when the survivor may have unchangeable risk factors, family functioning can potentially moderate the effects on PTSS. Thus, it is crucial for health professionals to carefully monitor and attend to survivors' experiences of family functioning to mitigate PTSS. © The Author(s) 2015.
Clayton, Margaret F; Mishel, Merle H; Belyea, Michael
Among older, long-term breast cancer survivors, symptoms from previous treatment can generate uncertainty about whether they represent co-morbid conditions, recurrence, or normal aging. This uncertainty can result in emotional distress and thoughts of recurrence. Communication with health care providers may help women reduce uncertainty and improve both emotional and cognitive well-being. To assess the influence of symptoms, uncertainty, and communication with providers on well-being, data from 203 Caucasian and African American survivors, 5-9 years post treatment, were tested using structural equation modeling. Symptoms, age, and uncertainty had the strongest influence on well-being, regardless of race. There was an unexpected positive association between patient-provider communication and thoughts of recurrence. Descriptive analysis revealed that 52% of women were unable to achieve their desired decision-making role with health care providers. Copyright 2006 Wiley Periodicals, Inc.
Lis-Turlejska, Maja; Szumiał, Szymon; Drapała, Iwona
Background : There is growing evidence of the important role played by socio-interpersonal variables on the maintenance of PTSD. Many World War II survivors in Poland could, as a result of political circumstances during the aftermath of the war, have experienced a lack of social recognition of their war-related trauma. Objective : The main aim of the study was to examine the association between perceived social reactions and the level of posttraumatic stress symptoms (PTSD) and depression. Method : Participants ( N = 120) were aged 71-97 years ( M = 82.44; SD = 6.14). They completed a WWII trauma-related questionnaire, the Posttraumatic Diagnostic Scale (PDS), the Impact of Events Scale (IES) and Beck's Depression Inventory (BDI). The Social Acknowledgement Questionnaire (SAQ) was used to measure participants' perception of others' acknowledgement and disapproval of their war trauma. Results : The rate of probable PTSD, diagnosed according to DSM-IV, was 38.3%. PTSD symptoms and General Disapproval were significantly correlated for all three PTSD symptom groups (Pearson's r ranged from .25 to .41). The structural equation modelling results also demonstrated the importance of General Disapproval with regard to the level of PTSD symptoms. It explained both the intensity of PTSD symptoms (13.4% of variance) and the level of depression (12.0% of variance). Conclusion : In addition to confirming the high rate of PTSD among WWII survivors in Poland, the results indicate the importance of social reactions to survivors' traumatic experiences.
Murthy, Vijayashree; Chamberlain, Ronald S
New breast cancers occur in 25% to 30% of women yoga may be helpful in mild cases of vasomotor symptoms, whereas newer antidepressants are promising in moderate to severe cases, and stellate ganglion block may be used in refractory cases. Local vaginal moisturizers, and in refractory cases low-dose estrogen creams, may ameliorate most urogenital symptoms. Bisphosphonates, vitamin D, and calcium can treat osteoporosis, and weight-bearing exercises decrease bone mineral density loss and help to control weight. Smoking cessation, exercise, and dietary modifications should be recommended to all young patients to decrease cardiac morbidity. At present, there is insufficient evidence to support any natural agent as a viable alternative to hormone replacement therapy to treat these symptoms. No single agent can ameliorate vasomotor, cardiac, skeletal, and sexual concerns of young breast cancer survivors coping with menopausal symptoms. Quality-of-life research involving premenopausal breast cancer survivors is lacking. Further study is needed to identify safe and effective treatments for menopausal symptoms and to confirm their long-term safety in young breast cancer survivors.
Bandak, M.; Jorgensen, N.; Juul, A.
of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart......Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study...... was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular...
Reisi, Nahid; Azhir, Afshin; Hashemipour, Mahin; Raeissi, Pouran; Amini, Abasgholi; Moafi, Alireza
BACKGROUND: To determine the prevalence of metabolic syndrome in survivors of childhood leukemia in Isfahan, Iran. METHODS: During a 4-year period (2003 to 2007), 55 children (33 male and 22 female) diagnosed with ALL at Unit of Hematology/ Oncology, Department of Pediatrics, Isfahan University of Medical Science, were enrolled in this cross-sectional study. Metabolic syndrome was defined using the modified version of Adult Treatment Panel (ATP III) crite-ria. Insulin resistance was defined based on the homeostasis model assessment index (HOMA-IR). RESULTS: The mean age of participates was 10.4 years (range 6-19 years) and the mean interval since completion of chemotherapy was 35 months. Twenty percent (11/55) of survivors (10 male, 1 female) met criteria for diagnosis of metabolic syndrome. Obesity was observed in one forth of patients and nearly 3/4 of obese patients had metabolic syndrome. High serum insulin levels were found in 16% of participants and in 63% of obese survivors. The mean insulin levels in survivors with metabolic syndrome was three-times more than those without (28.3 mu/l vs. 9.57 mu/l, p = 0.004). Insulin resistance was detected in 72.7% of survivors with metabolic syndrome and it was positively correlated with serum triglycerides (0.543, p ≤ 0.001), systolic and diastolic BP (0.348, p = 0.01 and 0.368, p = 006 respectively), insulin levels (0.914, p < 0.001) and blood sugar (0.398, p = 003). CONCLUSIONS: The prevalence of metabolic syndrome in survivors of childhood leukemia in Iran is higher than developed countries. Nearly all of the obese patients had metabolic syndrome. Weight control and regular physical exercise are recommended to the survivors. PMID:21772869
Gold, Sari D; Marx, Brian P; Lexington, Jennifer M
This study explored the relations among internalized homophobia (IH), experiential avoidance, and psychological symptom severity in a community sample of 74 gay male sexual assault survivors. Results indicated that IH is associated with both depressive and posttraumatic stress disorder (PTSD) symptom severity. IH accounted for more variance than assault severity in predicting both PTSD and depression symptom severity. IH and experiential avoidance similarly predicted PTSD symptom severity. In comparison with IH, however, experiential avoidance is a stronger predictor of depression symptom severity. Results also showed that experiential avoidance partially mediated the relation between IH and both depressive and PTSD symptom severity. The implications of these findings are discussed and suggestions for future research are provided.
Cramer, Holger; Rabsilber, Sybille; Lauche, Romy; Kümmel, Sherko; Dobos, Gustav
Breast cancer survivors have only very limited treatment options for menopausal symptoms. The objective of this trial was to evaluate the effects of a 12-week traditional Hatha yoga and meditation intervention on menopausal symptoms in breast cancer survivors. Patients were randomly assigned either to a 12-week yoga and meditation intervention or to usual care. The primary outcome measure was total menopausal symptoms (Menopause Rating Scale [MRS] total score). Secondary outcome measures included MRS subscales, quality of life (Functional Assessment of Cancer Therapy-Breast), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression, and anxiety (Hospital Anxiety and Depression Scale). Outcomes were assessed at week 12 and week 24 after randomization. In total, 40 women (mean age ± standard deviation, 49.2 ± 5.9 years) were randomized to yoga (n = 19) or to usual care (n = 21). Women in the yoga group reported significantly lower total menopausal symptoms compared with the usual care group at week 12 (mean difference, -5.6; 95% confidence interval, -9.2 to -1.9; P = .004) and at week 24 (mean difference, -4.5; 95% confidence interval, -8.3 to -0.7; P = .023). At week 12, the yoga group reported less somatovegetative, psychological, and urogenital menopausal symptoms; less fatigue; and improved quality of life (all P menopausal symptoms. Short-term effects on menopausal symptoms remained significant when only women who were receiving antiestrogen medication (n = 36) were analyzed. Six minor adverse events occurred in each group. Yoga combined with meditation can be considered a safe and effective complementary intervention for menopausal symptoms in breast cancer survivors. The effects seem to persist for at least 3 months. © 2015 American Cancer Society.
Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana
Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Jung, Jung Im; Park, Seog Hee; Lee, Jae Mun; Song, Jeong Sup; Lee, Kyo Young [The Catholic Univ. College of Medicine, Seoul (Korea, Republic of)
The purpose of this report is to describe the high-resolution computed tomography (HRCT) findings of the lung in survivors of acute respiratory distress syndrome (ARDS). Among eleven patients who survived ARDS for one year, chest radiography and HRCT revealed pulmonary fibrosis in four. Causes of ARDS included pneumonia during pregnancy, near drowning, pneumonia during liver cirrhosis, and postoperative sepsis. Thoracoscopic biopsy and histopathologic correlation were available in one patient. HRCT showed diffuse interlobular septal thickening, ground glass opacity, parenchymal distortion, and traction bronchiectasis. Fuzzy centrilobular nodules were seen in two patients and one patient had multiple, large bullae in the left hemithorax. In all patients, lesions affected the upper and anterior zones of the lung more prominently. The distribution of pulmonary fibrosis was characteristic and reflected the pathogenesis of lung injury; fibrosis was largely due to hyperoxia caused by ventilator care. In one patient, histopathologic correlation showed that imaging findings were accounted for by thickening of the alveolar septum along with infiltration of chronic inflammatory cells and fibrosis. Fuzzy centrilobular nodules corresponded with bronchiolitis.
Lucía Del Carmen Quezada Berumen
Full Text Available Facing a severe injury in the children is one of the most devastating experiences that parents may face. The aim of this study was to explore the role of resilience showed by fathers and mothers of children with burns, the TBSA burned, age at the time of the burn and time since the burn in PTSD symptoms in caregivers. It was a cross-sectional study where fathers, mothers and guardians of 51 burn patients were evaluated. Results showed that the higher strength and confidence in caregivers, less severity in PTSD symptoms. The post-burn reactions of parents and guardians can affect the responses and welfare of their children. Therefore, a better understanding of factors related to the adaptation in caregivers, better attention by health services.
Haig, Andrew J; Tong, Henry C; Kendall, Richard
The bent spine syndrome, which mimics spinal stenosis, is thought to be a focal paraspinal myopathy, but because paraspinal fatigue with ambulation is not a feature of more severe myopathies, the cause of symptoms is not clear. To evaluate electromyographic and biomechanical aspects of the bent spine syndrome. University spine clinic. A patient with severe disability from the bent spine syndrome was compared with a fortuitously discovered asymptomatic research subject with the syndrome, in terms of physical examination, magnetic resonance imaging, and electrodiagnostic testing. Both subjects had fatty paraspinal replacement on magnetic resonance imaging and electromyography. More detailed electromyography of the patient showed abnormalities medially and caudally, but changes including apparent myopathic motor units up to the high thoracic region. The research subject had no hip flexion contracture, whereas the patient had severe contracture. Correction of contracture increased ambulation from 20 to 300 meters. Bent spine syndrome is likely a paraspinal myopathy, but symptoms do not occur unless there is also a hip flexion contracture.
Nuver, J; Smit, AJ; Postma, A; Sleijfer, DT; Gietema, JA
With increasing numbers of cancer survivors, attention has been drawn to long-term complications of curative cancer treatment, including a range of metabolic disorders. These metabolic disorders often resemble the components of the so-called metabolic syndrome, or syndrome X, which is an important
Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Kier, M G G; Mortensen, M S; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G
Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers. © 2017 American
Macartney, Gail; Stacey, Dawn; Harrison, Margaret B; VanDenKerkhof, Elizabeth
To explore the symptom experience, coping strategies, and children's descriptions of their quality of life (QOL) after treatment for a brain tumor. An interpretive descriptive qualitative study. A pediatric hospital setting in Ontario, Canada. 12 children aged 9-18 years. Content analysis of semistructured interviews was guided by interpretive description methodology. Children described symptoms including feeling tired, pain, headaches, emotional problems, difficulty thinking and remembering, problems with sleep, physical problems, and weight changes. Symptoms interfered with physical activity, keeping up with school, maintaining appearances, and communication. Coping strategies included reconditioning, taking breaks, taking medication, challenging themselves, volunteering, maintaining friendships, laughing, and using aids. Survivors experienced multiple symptoms that had an effect on their life, but overall, they described good QOL. Caregivers need to understand the complexity of their patient's symptom experience and its impact on his or her daily life. Coping strategies can be identified to help mitigate potentially negative QOL outcomes.
Zhang, Gus; North, Carol S
There is little agreement about the association of somatization with exposure to disaster trauma in the existing literature. Pre-disaster and post-disaster psychiatric disorders, somatization disorder, and individual somatoform (medically unexplained) symptoms were assessed with structured diagnostic interviews in 811 directly exposed survivors of 10 disasters. Only 1 individual met criteria for post-disaster somatization disorder; there were no incident cases. Only 21% of all somatic symptoms reported were somatoform symptoms. Although 29% of the sample had ≥1 post-disaster somatoform symptoms, only 13% of the sample had any incident somatoform symptoms, and only 1.5% of the sample had >1. Somatization disorder is not an observed outcome of disaster. Incidence of individual somatoform symptoms is relatively uncommon and represents a construct that is distinct from somatization disorder. Such symptoms appear to represent nonspecific distress or endemic symptoms in the population and are not necessarily causally related to the disaster. The only studies that have identified somatization symptoms in relation to disaster have used nondiagnostic symptom checklists. As illustrated by the findings from this study, nondiagnostic symptom checklists do not adequately substitute for structured diagnostic instruments in assessment of somatoform psychopathology.
Kjaer, Trille Kristina; Johansen, Christoffer; Ibfelt, Else
Abstract Introduction. Little research has been conducted on the effect of self-reported rating of symptom severity on quality of life (QoL) among cancer survivors. The aim of the study was to examine the prevalence of symptoms and whether information about self-reported symptom severity adds value...
Hargrave, Petrina A; Leathem, Janet M; Long, Nigel R
Although sudden death has been linked to posttraumatic stress disorder (PTSD), its role in complicated grief (CG) and sudden death survivors is unknown. This questionnaire study investigated the role of peritraumatic distress in PTSD and CG symptoms in adults (n = 125) an average of 28.37 months (SD = 3.12) after a loved one's sudden death. The Peritraumatic Distress Inventory, Impact of Event Scale-Revised, and Inventory of Complicated Grief were administered to assess symptoms of peritraumatic distress, PTSD, and CG, respectively. Peritraumatic distress was the strongest correlate of both PTSD (β = .42, p grief reactions. Copyright © 2012 International Society for Traumatic Stress Studies.
Karakurt, Hasan; Sarper, Nazan; Kılıç, Suar Çakı; Gelen, Sema Aylan; Zengin, Emine
Acute lymphoblastic leukemia (ALL) survivors were screened for risk factors of cardiovascular disease. Forty-four ALL survivors in first remission were enrolled. Twenty-six also received 12-18 Gy cranial radiotherapy (RT). Patients' body mass indexes (BMIs) at dignosis and during the study were compared. Metabolic syndrome (MS) evaluation was performed in patients, parents, and siblings older than 6 years. Homeostasis Model Assessment (HOMA) index of the survivors was also calculated. In survivors with impaired fasting glucose levels, oral glucose tolerance test (OGTT) was performed. Thyroid functions and IGF-1 and/or IGFBP-3 levels of the survivors who received cranial RT were evaluated. Median age of the survivors was 11.5 years (6-23). At diagnosis, mean BMI percentile was 46.7 (3-95) and mean z-score was -0.09 ± 1.14; during the study, these values rose to 71.1 ± 25.6 (3-100) and 0.8 ± 0.94, respectively (P obese at diagnosis and during the study, respectively (P = .005). Survivors had significantly higher BMI percentile and BMI z-score compared to their siblings (P = .006 and P = .011, respectively). The study group was small and we could not show a correlation of the patients' obesity with RT, thyroid functions, IGF-1, and IGFBP-3 levels. In three survivors (6.8%), there was MS. Maternal and paternal MS was not found as a risk factor for MS of the survivors (P = .1, P = .5, respectively). The HOMA index revealed insulin resistance (IR) in 12 (27.2%) of the survivors, whereas OGTT revealed abnormal glucose regulation and/or IR in four. As a conclusion, ALL survivors have high risk for obesity and MS.
Zinzow, Heidi M; Rheingold, Alyssa A; Byczkiewicz, Michelle; Saunders, Benjamin E; Kilpatrick, Dean G
The present study examined posttraumatic stress disorder (PTSD) symptoms among friends and family members of homicide victims (homicide survivors). Out of a national sample of 1,753 young adults who completed follow-up interviews after participating in the National Survey of Adolescents, 268 homicide survivors and 653 victims of other interpersonal violence were selected for the study. Participants completed structured telephone interviews that covered the loss of a family member or close friend to homicide, violence exposure, and PTSD symptomatology. Findings indicated that 39% of homicide survivors met criteria for all 3 symptom clusters and 30% of homicide survivors met criteria for 2 PTSD clusters (functional impairment was not assessed). Multivariate logistic regression analyses demonstrated that homicide survivors were more likely than victims of other violence to meet criteria for all 3 PTSD symptom clusters (OR = 1.91, p homicide survivors. Results suggest that homicide survivors are at elevated risk for PTSD symptoms in comparison to victims of other interpersonal violence. Copyright © 2011 International Society for Traumatic Stress Studies.
Saban, Karen L; Mathews, Herbert L; Bryant, Fred B; O'Brien, Timothy E; Janusek, Linda Witek
Informal caregivers of stroke survivors experience elevated chronic stress and are at risk of developing depressive symptoms. The cumulative effects of chronic stress can increase allostatic load and dysregulate biological processes, thus increasing risk of stress-related disease. Stress-induced alterations in the pattern of cortisol secretion vary with respect to stressor onset, intensity, and chronicity. Little is known about the psychoendocrine response to stress in female caregivers of stroke survivors. The purpose of this study was to examine perceived stress, caregiver burden, and the association between caregiver depressive symptoms and diurnal cortisol in 45 females caring for a significant other who experienced a stroke within the past year. Women completed the Center for Epidemiologic Studies Depression Scale (CES-D) and collected saliva for cortisol upon awakening, 30 min postawakening, noon, and bedtime for 2 consecutive days. Results revealed that women had high levels of perceived stress and caregiver burden. In women with CES-D scores ≥ 16, salivary cortisol levels were significantly lower across the day relative to women with CES-D scores caregiving hours per week, perceived social support, and quality of sleep. Younger age was associated with more depressive symptoms as well as lower levels of cortisol at awakening and 30 min postawakening. Results demonstrate that the burden of caregiving increases risk of depressive symptoms and hypocortisolism across the day. Hypocortisolism may contribute to increased risk of depressive symptoms as a result of the loss of glucocorticoid attenuation of stress-induced inflammation.
Glinge, Charlotte; Jabbari, Reza; Risgaard, Bjarke
INTRODUCTION: No studies in an unselected and nationwide setting have characterized the symptoms and medical history of patients with sudden arrhythmic death syndrome (SADS). The aim of this study was to identify and describe the symptoms and medical history of patients before the presentation...... of SADS. METHODS AND RESULTS: We have previously identified all of the autopsied sudden cardiac deaths (SCD; n = 314) in Danes aged 1-35 years between 2000 and 2006. After comprehensive pathological and toxicological investigation did not reveal a cause of SCD, 136 of the patients were identified as SADS....... The National Patient Registry was utilized to obtain information on all in- and outpatient activity in Danish hospitals. All medical records from hospitals and general practitioners, including death certificates and autopsy reports were reviewed. Before death, 48 (35%) SADS patients had cardiac symptoms; among...
Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J.
Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient Introduction . Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method . We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Res...
Park, Boyoung; Kong, Sun-Young; Lee, Eun Kyung; Lee, Moo Hyun; Lee, Eun Sook
This study was conducted to examine the prevalence of and lifestyle factors associated with the metabolic syndrome in breast cancer survivors and to compare those factors with controls without cancer in a community setting. This study included 584 female breast cancer survivors ≥3 years after the initial diagnosis and 2336 age-matched cancer-free female controls from 39 community health examination centers located in 14 urban areas in Korea. The prevalence of the metabolic syndrome is shown. Factors associated with the metabolic syndrome were analyzed as odds ratios (ORs) in cancer survivors and controls; differences between the two groups in the ORs of associated factors were evaluated by calculating p-heterogeneity values. The prevalence of metabolic syndrome in breast cancer survivors and age-matched controls were 26.8% and 26.9%, respectively. Higher percentage of caloric intake from carbohydrates was associated with increased metabolic syndrome only in the breast cancer survivors (OR for the highest vs. lowest quartile for survivors = 2.48 [95% CI = 1.20-5.14]; OR for controls = 1.11 [95% CI = 0.81-1.51]; P-heterogeneity = 0.046). Sweat-inducing exercise for ≥150 min/week was associated with a lower risk of metabolic syndrome only in controls (controls: OR = 0.72 [95% CI = 0.58-0.89]; survivors: OR = 0.88 [95% CI = 0.57-1.36]). Older age, higher body mass index, and a lower education level (≤12 years) was associated with an increased prevalence of metabolic syndrome in both groups. Our results suggest that, in regions with excess carbohydrate intake, the association of the metabolic syndrome with percentage of caloric intake from carbohydrate might be more prominent than exercise in breast cancer survivors, compared with general population. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Hall, Daniel L; Lennes, Inga T; Pirl, William F; Friedman, Emily R; Park, Elyse R
Many cancer survivors report experiencing somatic symptoms as well as elevated stress. Theoretical models have suggested that physical symptoms generate subjective stress via fears of recurrence or progression. To date, this indirect effect has not been established empirically. This study aimed to provide preliminary evidence as to whether fear of recurrence or progression is an intermediary between somatic symptom severity and perceived stress among heterogeneous cancer survivors. Adult cancer survivors (N = 67; median 2.4 years since diagnosis; 34% male) presenting at a hospital survivorship clinic completed measures assessing somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)), perceived stress (four-item Perceived Stress Scale (PSS-4)), and fear of recurrence or progression (Assessment of Survivor Concerns (ASC)). Interrelatedness among variables was assessed using Pearson correlations. Indirect effects were modeled using 5000-iteration bootstrapping. Survivors endorsed a range of somatic symptom severity (29% minimal, 39% low, 18% medium, and 14% high). Somatic symptoms, perceived stress, and fear of recurrence or progression were all significantly positively correlated (rs 0.29 to 0.47). Controlling for time since diagnosis, there was a significant indirect effect of somatic symptom severity on stress via fear of recurrence or progression [B = 0.06, SE = 0.04 (95% CI 0.01-0.16)]. The model accounted for more than one third of the variance in perceived stress [R 2 = 0.35, F(3,54) = 9.59, p stress, due in part to elevated fears of recurrence or progression. Our findings support concerns about recurrence or progression as a mechanism underlying stress states in cancer survivors. Efforts to assist survivors with stress management should teach strategies for managing cancer-related uncertainties stemming from somatic symptoms.
Sabiston, Catherine M; Lacombe, Jason; Faulkner, Guy; Jones, Jennifer; Trinh, Linda
Depression symptoms are prevalent among breast cancer survivors (BCS). Reducing sedentary behavior (SED) may be a non-pharmaceutical strategy for alleviating depression symptoms. However, little is known about SED among BCS. The present study aimed to: (i) describe SED behaviors among BCS and identify unique SED groups based on different SED dimensions; (ii) identify personal and cancer-specific factors that discriminate SED clusters; and (iii) examine the association between SED clusters and depression symptoms. Baseline self-report demographic and medical information was collected from 187 BCS. SED and physical activity were assessed over seven days using an accelerometer. Self-reported depression symptoms were reported three months later. Multiple dimensions of SED were identified and examined in cluster analysis. The clusters were examined for differences using multivariate analysis of variance and chi-square analyses. The difference in depression symptoms among SED groups was assessed using an analysis of covariance. High and low SED groups were identified. Survivors in the high SED cluster were significantly older, heavier, less physically active, reported less education, and were more likely to have undergone lymph/axial node dissection. Women in the high SED cluster reported significantly higher depression symptoms prospectively (M = 9.50, SD = 6.07) compared to women in the low SED group (M = 6.89, SD = 5.18), F(8,179) = 4.97, p = 0.03, R2 = 0.34. The importance of understanding multiple dimensions of SED among BCS was highlighted. Reducing SED during the early survivorship period may alleviate depression symptoms. Copyright © 2017 John Wiley & Sons, Ltd.
Full Text Available
Chung, Misook L; Bakas, Tamilyn; Plue, Laura D; Williams, Linda S
Depressive symptoms are common in stroke survivors and their family caregivers. Given the interdependent relationship between the members of dyads in poststroke management, improving depressive symptoms in dyads may depend on their partner's characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depressive symptoms in an individual, may also contribute to their partner's depressive symptoms. The purpose of this study is to examine actor and partner effects of self-esteem, optimism, and perceived control on depression in stroke survivors and their spousal caregivers. A total of 112 ischemic stroke survivors (78% white, 34% women; mean age, 62.5 ± 12.3 years) and their spouses (mean age, 60.6 ± 12.9 years) completed surveys in which depressive symptoms, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model regression was used to determine influences on depressive symptoms within the dyad. Individuals with lower self-esteem, optimism, and perceived control had higher levels of depressive symptoms. Stroke survivors whose spouses had lower levels of self-esteem (B = -0.338, P optimism (B = -0.361, P optimism on patient's depressive symptoms. These findings suggest that further research is needed to determine if dyadic interventions may help to improve self-esteem, optimism, and depressive symptoms in both patients and their caregivers.
Wang, Xin; Xie, Hong; Cotton, Andrew S.; Duval, Elizabeth R.; Tamburrino, Marijo B.; Brickman, Kristopher R.; Elhai, Jon D.; Ho, S. Shaun; McLean, Samuel A.; Ferguson, Eric J.; Liberzon, Israel
Accumulating evidence suggests traumatic experience can rapidly alter brain activation associated with emotion processing. However, little is known about acute changes in emotion neurocircuits that underlie PTSD symptom development. To examine acute alterations in emotion circuit activation and structure that may be linked to PTSD symptoms, thirty-eight subjects performed a task of appraisal of emotional faces as their brains were functionally and structurally studied with MRI at both two weeks and three months after motor vehicle collision (MVC). As determined by symptoms reported in the PTSD Checklist at three months, sixteen survivors developed probable PTSD, whereas the remaining 22 did not meet criteria for PTSD diagnosis (non-PTSD). The probable PTSD group had greater activation than the non-PTSD group in dorsal and ventral medial prefrontal cortex (dmPFC and vmPFC) while appraising fearful faces within two weeks after MVC and in left insular cortex (IC) three months after MVC. dmPFC activation at two weeks significantly positively correlated with PTSD symptom severity at two weeks (R = 0.462, P = 0.006) and three months (R = 0.418, p = 0.012). Changes over time in dmPFC activation and in PTSD symptom severity were also significantly positively correlated in the probable PTSD group (R = 0.641, P = 0.018). A significant time by group interaction was found for volume changes in left superior frontal gyrus (SFG, F = 6.048, p = 0.019) that partially overlapped dmPFC active region. Between two weeks and three months, left SFG volume decreased in probable PTSD survivors. These findings identify alterations in frontal cortical activity and structure during the early post-trauma period that appear to be associated with development of PTSD symptoms. PMID:27415431
Ullman, Sarah E.; Peter-Hagene, Liana C.
Sexual assault survivors receive various positive and negative social reactions to assault disclosures, yet little is known about the directionality of associations of social reactions to posttraumatic stress disorder (PTSD) symptoms over time. Data from a large, diverse sample of women who had experienced adult sexual assault was analyzed with hierarchical linear modeling (HLM) to examine how negative and positive reactions relate to PTSD symptoms over 3 years and to test the hypothesis that the relationship between negative social reactions and PTSD symptoms is reciprocal. We found that, as predicted, social reactions predicted subsequent PTSD symptoms, and in turn PTSD symptoms predicted subsequent social reactions. We also investigated the role of sexual revictimization by comparing women who suffered (versus not) additional sexual victimization during the course of our study. Revictimized women had greater PTSD symptoms and more negative social reactions, but associations of social reactions with PTSD symptoms did not vary according to revictimization status. Implications for practice and suggestions for future research are discussed. PMID:25538120
Dekel, Sharon; Ein-Dor, Tsachi; Gordon, Kathleen M; Rosen, Jeffrey B; Bonanno, George A
Only a few studies have examined cortisol response to trauma-related stressors in relation to posttraumatic stress disorder (PTSD). We followed a sample of high-exposure survivors of the attacks on September 11, 2001 (9/11; 32 men and 29 women) and examined their cortisol response after recalling the escape from the attack, 7 and 18 months post-9/11. PTSD symptoms and saliva cortisol levels were assessed before and after trauma recollection. Hierarchical regression analyses revealed that PTSD symptoms and male sex predicted increased cortisol response following recollections. For men, elevated cortisol was associated with greater severity of reexperiencing symptoms (p < .001) and lower severity of avoidance symptoms (p < .001). For women, recall-induced cortisol was minimal and unrelated to PTSD symptoms (p = .164 and p = .331, respectively). These findings suggest that augmented cortisol response to trauma-related stressors may be evident in men reporting symptoms of PTSD. Thus, as cortisol abnormalities related to PTSD symptoms appear sex-specific, future research on mechanisms of sex differences in response to trauma is warranted. Copyright © 2013 International Society for Traumatic Stress Studies.
Wahlström, Lars; Michélsen, Hans; Schulman, Abbe; Backheden, Magnus
Negative life events in childhood have an adverse influence on adult psychological health, and increase vulnerability to subsequent potential traumas. It remains unclear whether this is also true in the case of disasters. This study investigates whether the experience of negative life events in childhood and adolescence was associated with psychological symptoms in groups of Swedish survivors with different types of exposure to the tsunami. 1505 survivors from Stockholm responded to a questionnaire on psychological distress, which was sent by post 14 months after the 2004 Indian Ocean tsunami. Psychological distress was measured by General Health Questionnaire-12 and suicidal ideation, and post-traumatic stress was measured by Impact of Event Scale-Revised. Life events prior to age 16 were collected and categorized under the indices accident, violence, loss and interpersonal events. Exposure to the tsunami was categorized in different types, and controlled for in the analyses. With the adjustment for confounders, significant odds ratios were found for all indices on at least one outcome measure, despite the powerful effect of the tsunami. We could not discern any distinct difference in the distribution of the tendency to report the different outcomes depending on types of prior life events. The implication of the study is that, for adult survivors of disaster, the reporting of adverse life events from childhood may influence future decisions regarding therapy.
Glassman, Laura W; Grocott, Olivia R; Kunz, Portia A; Larson, Anna M; Zella, Garrett; Ganguli, Kriston; Thibert, Ronald L
Angelman syndrome (AS) is a neurogenetic disorder characterized by intellectual disability, expressive speech impairment, movement disorder, epilepsy, and a happy demeanor. Children with AS are frequently reported to be poor feeders during infancy and as having gastrointestinal issues such as constipation, reflux, and abnormal food related behaviors throughout their lifetime. To assess the prevalence of gastrointestinal disorders in individuals with AS, we retrospectively analyzed medical records of 120 individuals seen at the Angelman Syndrome Clinic at Massachusetts General Hospital and 43 individuals seen at the University of North Carolina Comprehensive Angelman Clinic. The majority of patients' medical records indicated at least one symptom of gastrointestinal dysfunction, with constipation and gastroesophageal reflux disease (GERD) the most common. Other gastrointestinal issues reported were cyclic vomiting episodes, difficulty swallowing, excessive swallowing, and eosinophilic esophagitis. Upper gastrointestinal symptoms such as GERD, swallowing difficulties, cyclic vomiting, and eosinophilic esophagitis were more common in those with deletions and uniparental disomy, likely related to the involvement of multiple genes and subsequent hypotonia. The frequency of constipation is consistent among all genetic subtypes while early feeding issues appear to mainly affect those with deletions. Caregivers and healthcare providers should be aware of the high prevalence of these issues, as proper treatment may improve not only gastrointestinal dysfunction but also sleep and behavioral issues. © 2017 Wiley Periodicals, Inc.
Otheman, Y; Khalloufi, H; Benhima, I; Ouanass, A
Fahr's syndrome is characterized by the presence of intracerebral, bilateral and symmetrical non-arteriosclerotic calcifications, located in the central grey nuclei. One of its main etiologies is pseudohypoparathyroidism (PHP), due to a resistance to the action of parathormone (PTH) with essentially hypocalcaemia and a normal or a high rate of PTH. Mr B.A. is a 36-year-old man, admitted to hospital because of refractory psychotic symptoms associated with alcohol abuse and fits of convulsion, for diagnostic and therapeutic update. Mr B.A. had presented convulsions since the age of 10, without regular medical treatment. He showed a decrease in his school performances and started using alcohol. Since the age of 17, he began expressing delusions of persecution and of enchantment fed by the persistence of the convulsions. He was administered phenobarbital, and classic antipsychotics (haloperidol and levomepromazine) and developed serious extrapyramidal side effects, treated with an anticholinergic (trihexyphenidyl). Evolution was rather disadvantageous: more epileptic fits, exaggeration of tremors; abuse of alcohol and persistence of psychotic symptoms. On admission, psychiatric examination objectified paranoid delusions of being possessed and persecuted by others. Neurological examination revealed the presence of limb tremors, with a positive Froment's sign on the right, and dysarthria. Other than this, the patient was shorter in comparison with his siblings and exhibited bad dentition. A CT brain scan found bilateral, symmetric basal ganglia calcifications, confirmed by MRI, in favour of Fahr's syndrome. Phosphocalcic investigations revealed a low concentration of serum calcium (65 mg/l) and a hyperphosphataemia (60.1mg/l). The blood level of parathyroid hormone was in the upper limit of normal (66 ng/l), and levels of thyroid hormones and thyroid-stimulating hormone were normal. The diagnosis of Fahr's syndrome, revealing a pseudohypoparathyroidism was posed, and the
Rosen, Galit P; Nguyen, Hoai-Trinh; Shaibi, Gabriel Q
Pediatric cancer survivors have increased risk of obesity, hypertension, dyslipidemia, and type 2 diabetes, leading to premature cardiovascular disease (CVD). Multiple tissues that are involved in glucose homeostasis and lipid metabolism are adversely affected by chemotherapy. This review highlights the relevant tissue and molecular end-organ effects of therapy exposures and synthesizes the current understanding of the mechanisms underlying CVD risk in this vulnerable population. The review also approaches the topic from a developmental perspective, with the goal of providing a translational approach to identifying the antecedents of overt CVD among survivors of pediatric cancer. © 2013 Wiley Periodicals, Inc.
de Haan, Marcel J; Delucchi, Kevin L; Mathews, Carol M; Cath, Danielle C
INTRODUCTION: Gilles de la Tourette's syndrome (TS) is both genotypically and phenotypically heterogeneous. Gene-finding strategies have had limited success, possibly because of symptom heterogeneity. OBJECTIVE: This study aimed at specifically investigating heritabilities of tic symptom factors in
Marroquín, Brett; Czamanski-Cohen, Johanna; Weihs, Karen L; Stanton, Annette L
Among individuals coping with cancer, emotional approach coping-expressing and processing emotions following negative events-has been identified as a potentially adaptive form of emotion regulation. However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinant of emotion regulation associations with depressive symptoms in women with breast cancer. Loneliness was examined as an implicit social-cognitive phenomenon (i.e., automatic views of oneself as lonely), and emotional expression and processing were examined as both explicit and implicit processes. Approximately 11 months after diagnosis, 390 women completed explicit measures of coping through cancer-related emotional expression and processing; an implicit measure of expression and processing (an essay-writing task submitted to linguistic analysis); and an implicit association test measuring loneliness. Depressive symptoms were assessed 3 months later. Regardless of implicit loneliness, self-reported emotional expression (but not emotional processing) predicted fewer depressive symptoms, whereas implicit expression of negative emotion during essay-writing predicted more symptoms. Only among women high in implicit loneliness, less positive emotional expression and more causal processing during the writing task predicted more depressive symptoms. Results suggest that explicit and implicit breast cancer-related emotion regulation have distinct relations with depressive symptoms, and implicit loneliness moderates effects of implicit emotional approach. Findings support implicit processes as influential mechanisms of emotion regulation and suggest targets for intervention among breast cancer survivors.
Full Text Available Background: The structure of trauma narratives is considered to be related to posttraumatic stress symptomatology and thus the capacity to make a coherent narrative after stressful events is crucial for mental health. Objective: The aim of this study is to understand more of the relationship between narrative structure and posttraumatic stress symptoms (PTSS. More specifically, we investigated whether internal and external focus, organization, fragmentation, and length differed between two groups of adolescent survivors of a mass shooting, one group with low levels of PTSS and one group with high levels of PTSS. Method: The sample comprised 30 adolescents who survived the shooting at Utøya Island in Norway in 2011. They were interviewed 4–5 months after the shooting and provided a free narrative of the event. PTSS were assessed using the UCLA Posttraumatic Stress Disorder Reaction Index (PTSD-RI. Results: We found that survivors with high levels of PTSS described more external events and fewer internal events in their narratives compared with survivors with low levels of symptoms. The analysis also showed that especially narratives containing more descriptions of dialogue and fewer organized thoughts were related to higher levels of PTSS. The groups did not differ in levels of narrative fragmentation or in length of the narratives. Conclusion: Specific attributes of narrative structure proved to be related to the level of PTSS. On the basis of our results, we can recommend that practitioners focus especially on two elements of the trauma narratives, namely, the amount of external events, particularly dialogues, within the narrative and the number of organized thoughts. Participants with high levels of PTSS provided trauma narratives with low amount of organized (explanatory thoughts accompanied by detailed descriptions of dialogues and actions, which is indicative for “here and now” quality of recall and a lack of trauma processing.
Spino, Erika; Kameg, Kirstyn M; Cline, Thomas W; Terhorst, Lauren; Mitchell, Ann M
According to the latest statistics from the American Association of Suicidology, there were approximately 41,000 suicides in the United States, accounting for 112 suicides per day or one every 12.8minutes (Drapeau & McIntosh, 2015). Survivors bereaved by suicide often experience complicated grief and feelings of social isolation. The study was a secondary data analysis from a study which involved 44 participants over the age of 18 from Southwestern Pennsylvania. Symptoms of depression and loneliness were assessed in relation to reported social support available to participants. The findings support the notion that increased availability of support can decrease symptoms of depression. Copyright © 2016 Elsevier Inc. All rights reserved.
Arcaya, Mariana C; Lowe, Sarah R; Rhodes, Jean E; Waters, Mary C; Subramanian, S V
The relationship between posttraumatic stress disorder (PTSD) and asthma in the wake of natural disasters is poorly understood. Using pre- and postdisaster data (N = 405) from the Resilience in Survivors of Katrina (RISK) project, we examined associations between PTSD symptoms, measured by the Impact of Event Scale-Revised (IES-R), and self-reported postdisaster asthma attacks. A 1-point increase in the IES-R avoidance score, which corresponded to one standard deviation change in this sample, was associated with double the odds of reporting an asthma attack or episode since the hurricane, 95% CI Revise spacing among characters: [1.22, 4.16]. Association with hyperarousal and intrusion symptoms was null. Further research using objective measures of asthma morbidity is needed; nevertheless, these findings may help inform postdisaster health services delivery and predisaster mitigation planning. Copyright © 2014 International Society for Traumatic Stress Studies.
The ectodermal dysplasia syndromes are underestimated although precise inclusion criteria have been formulated. The purpose is to establish easily detectable ophthalmologic symptoms and signs as reliable criteria for ectodermal dysplasia syndromes. Thirty-six patients with confirmed ectodermal dysplasia syndromes were included in an observational case series: hypohidrotic ectodermal dysplasia (30), EEC syndrome (3), AEC syndrome (2), Gorlin-Goltz syndrome (1). Each patient was examined ophthalmologically. The principal outcome measures were ocular symptoms and signs in patients with different ectodermal dysplasia syndromes of varying severity. Some 94.4% of the patients suffered from dry eye symptoms. Reduction of eyebrows was seen in 94.4%; the lashes were altered in 91.6%. Changes of the meibomian glands were detected in 95.45%. Corneal changes such as pannus occurred later in life. Alterations of the meibomian glands, which were detected by meibomianoscopy, are the most reliable ocular sign of ectodermal dysplasia syndromes.
Bugge, Ingrid; Dyb, Grete; Stensland, Synne Øien; Ekeberg, Øivind; Wentzel-Larsen, Tore; Diseth, Trond H
Physically injured trauma survivors have particularly high risk for later somatic complaints and posttraumatic stress symptoms (PTSS). However, the potential mediating role of PTSS linking injury to later somatic complaints has been poorly investigated. In this study, survivors (N = 255) were interviewed longitudinally at 2 timepoints after the terror attack on Utøya Island, Norway, in 2011. Assessments included injury sustained during the attack, PTSS (after 4-5 months), somatic complaints (after 14-15 months), and background factors. Causal mediation analysis was conducted to evaluate the potential mediating role of PTSS in linking injury to somatic complaints comparing 2 groups of injured survivors with noninjured survivors. For the nonhospitalized injured versus the noninjured survivors, the mediated pathway was significant (average causal mediation effect; ACME = 0.09, p = .028, proportion = 55.8%). For the hospitalized versus the noninjured survivors, the mediated pathway was not significant (ACME = 0.04, p = .453, proportion = 11.6%). PTSS may play a significant mediating role in the development of somatic complaints among nonhospitalized injured trauma survivors. Intervening health professionals should be aware of this possible pathway to somatic complaints. Copyright © 2017 International Society for Traumatic Stress Studies.
Ross, Colin A.
Irritable bowel syndrome is characterized by chronic gastrointestinal symptoms without a demonstrable physical cause. In a subgroup of patients, irritable bowel syndrome may be part of a cluster of psychosomatic symptoms related to childhood sexual abuse. To investigate this possibility, the Dissociative Disorders Interview Schedule (DDIS), the…
Urv, Tiina K.; Zigman, Warren B.; Silverman, Wayne
Changes in psychiatric symptoms related to specific stages of dementia were investigated in 224 adults 45 years of age or older with Down syndrome. Findings indicate that psychiatric symptoms are a prevalent feature of dementia in the population with Down syndrome and that clinical presentation is qualitatively similar to that seen in Alzheimer's…
Meli, Laura; Alcántara, Carmela; Sumner, Jennifer A; Swan, Brendan; Chang, Bernard P; Edmondson, Donald
Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge. In a multiple regression model with adjustment for important covariates, emergency department threat perceptions were associated with higher 1 month post-traumatic stress disorder symptoms only among those with high levels of ongoing cardiac threat.
Brown, Matthew Rd; Ramirez, Juan D; Farquhar-Smith, Paul
Cancer and its treatment exert a heavy psychological and physical toll. Of the myriad symptoms which result, pain is common, encountered in between 30% and 60% of cancer survivors. Pain in cancer survivors is a major and growing problem, impeding the recovery and rehabilitation of patients who have beaten cancer and negatively impacting on cancer patients' quality of life, work prospects and mental health. Persistent pain in cancer survivors remains challenging to treat successfully. Pain can arise both due to the underlying disease and the various treatments the patient has been subjected to. Chemotherapy causes painful chemotherapy-induced peripheral neuropathy (CIPN), radiotherapy can produce late effect radiation toxicity and surgery may lead to the development of persistent post-surgical pain syndromes. This review explores a selection of the common causes of persistent pain in cancer survivors, detailing our current understanding of the pathophysiology and outlining both the clinical manifestations of individual pain states and the treatment options available.
Chiu, Hsiao-Yean; Shyu, Yuh-Kae; Chang, Pi-Chen; Tsai, Pei-Shan
Evidence regarding the effects of acupuncture on hot flashes in breast cancer survivors is conflicting. Little is known about the intermediate-term effects of acupuncture on hot flashes and other menopause-related symptoms in breast cancer survivors. The objective of this study was to evaluate the short-term and intermediate-term effects of acupuncture on menopause-related symptoms and particularly on hot flashes in breast cancer survivors. Electronic databases including EMBASE, PubMed, PsycINFO, Web of Science, CINAHL, Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database from inception until June 15, 2014, were searched. Randomized controlled trials in which acupuncture was compared with sham controls or other interventions according to the reduction of hot flashes or menopause-related symptoms in breast cancer survivors were included. We analyzed 7 studies involving 342 participants. Acupuncture significantly reduced the frequency of hot flashes and severity of menopause-related symptoms (g = -0.23 and -0.36, respectively) immediately after the completion of treatment. In comparison with sham acupuncture, effects of true acupuncture on the frequency and severity of hot flashes were not significantly different. At 1 to 3 months' follow-up, the severity of menopause-related symptoms remained significantly reduced (g = -0.56). Acupuncture yielded small-size effects on reducing hot-flash frequency and the severity of menopause-related symptoms. Acupuncture may be used as a complementary therapy for breast cancer survivors experiencing hot flashes and other menopause-related symptoms; however, whether acupuncture exerts specific treatment effects other than needling or placebo effects needs to be further evaluated.
Bandak, M; Jørgensen, N; Juul, A; Lauritsen, J; Oturai, P S; Mortensen, J; Hojman, P; Helge, J W; Daugaard, G
Twenty to thirty percent of testicular cancer (TC) survivors have elevated serum levels of luteinising hormone (LH) with or without corresponding low testosterone levels (Leydig cell dysfunction) during clinical follow-up for TC. However, it remains to be clarified if this subgroup of TC survivors has an increased long-term risk of systemic inflammation and metabolic syndrome (MetS) when compared with TC survivors with normal Leydig cell function during follow-up. TC survivors with Leydig cell dysfunction and a control group of TC survivors with normal Leydig cell function during follow-up were eligible for participation in the study. Markers of systemic inflammation and prevalence of MetS were compared between TC survivors with Leydig cell dysfunction and the control group. Of 158 included TC survivors, 28 (18%) had uncompensated Leydig cell dysfunction, 59 (37%) had compensated Leydig cell dysfunction and 71 (45%) had normal Leydig cell function during follow-up. MetS and markers of systemic inflammation were evaluated at a median follow-up of 9.7 years (interquartile range 4.1-17.1) after TC treatment. The prevalence of MetS was significantly lower among patients with compensated Leydig cell dysfunction during follow-up (12% versus 27%, p = 0.04), whereas there was no difference between TC survivors with uncompensated Leydig cell dysfunction and controls (33% versus 27%, p = 0.5). Apart from high-sensitivity C-reactive protein which was higher in TC survivors with uncompensated Leydig cell dysfunction during follow-up, there was no evidence of increased systemic inflammation in patients with Leydig cell dysfunction during clinical follow-up. Total testosterone at follow-up was significantly associated with MetS, whereas there was no association between LH and MetS. We did not find evidence that TC survivors with Leydig cell dysfunction during clinical follow-up had increased long-term risk of MetS. Total testosterone at follow-up was significantly associated
Hahn, Erin E; Hays, Ron D; Kahn, Katherine L; Litwin, Mark S; Ganz, Patricia A
The purpose of this study was to determine the prevalence of post-traumatic stress symptoms in a sample of cancer survivors and to investigate their association with the impact of cancer, depressive symptoms, and social support. We administered a survey to participants in a cancer survivor registry. It included: Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Impact of Cancer Scale (IOC) v.2, and measures of social support, income, and long-term effects of cancer. We performed multivariate analyses to estimate associations between PCL-C and other variables. PCL-C score was examined as a continuous dependent variable and categorically. Responses were available from 162 cancer survivors. Mean age was 51 years (standard deviation (SD) 16); mean time since diagnosis was 11 years (SD 10). Mean PCL-C score was 27 (SD 9, range 17-64); 29% of the sample scored 30 and above, 13% scored 38 and above, 7% scored 44 and above. Linear regression indicated that PCL-C scores were significantly associated with the IOC negative impact summary scale (NIS) (p symptoms (p = 0.003), less social support (p = 0.02), and lower income (p = 0.03). NIS subscale analyses showed that two subscales, life interference (LI) and worry (W), were significantly correlated with PCL-C score (LI: p symptoms. Assessing survivors for PTSD symptoms with the PCL-C could detect those individuals in need of psychosocial support. The IOC may be useful for identifying target areas for interventions to reduce these symptoms among cancer survivors. Copyright © 2014 John Wiley & Sons, Ltd.
Prince, Alice; Bernard, Amy L.; Edsall, Patricia A.
Surveyed fibromyalgia syndrome support group members about characteristics of the disease and how it affected their lives. Respondents had symptoms for many years before being diagnosed. Symptoms varied tremendously on a daily and yearly basis, so disease management was in a constant state of flux. Most symptoms significantly impacted quality of…
Edwards, Patrick W.; Donaldson, Mary Ann
A study of the construction and factor validity of the Response to Child Incest Questionnaire, a self-report instrument for assessing commonly reported symptoms of adult survivors of incest, is reported. The instrument's usefulness as a pre- and post-treatment measure and further research needs are discussed. (MSE)
Li, Yawen; Sun, Fei; He, Xusong; Chan, Kin Sun
This study examined the impact of an earthquake as well as the role of sense of community as a protective factor against depressive symptoms among older Chinese adults who survived an 8.0 magnitude earthquake in 2008. A household survey of a random sample was conducted 3 months after the earthquake and 298 older earthquake survivors participated…
Sam Chidi Ibeneme
Full Text Available Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation. Participants. Fifty stroke survivors (22 females and 28 males at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and 54.76±8.79 years, respectively. Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed using Z-test for proportional significance and chi-square test for determining relationship between variables, at p<0.05. Results. Twenty-one (42.0% stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke (χ2 = 21.680, df = 6, and p=0.001, yet none of the participants had a psychiatry review. Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.
style, on knowledge, uptake and adherence of symptom minimization precautions at baseline, 6-, and 12-month follow-up post treatment . Little is known...University 44 42.3 Graduate/Doctoral Degree 25 24.1 Missing/ Refused 1 1 Treatment History* Lumpectomy 73 70.2 Mastectomy 37 35.6 Lymph node dissection...Uptake of, & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors PRINCIPAL INVESTIGATOR: Suzanne M. Miller
Heidrich, Susan M.; Brown, Roger L.; Egan, Judith J.; Perez, Oscar A.; Phelan, Cynthia H.; Yeom, Hyune; Ward, Sandra E.
Purpose/Objectives To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress. Design Two small randomized clinical trials and one pre-experimental study. Setting Oncology clinic and community. Sample 41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3. Methods In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and follow-up (up to four months). Main Research Variables Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life. Findings Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls. Conclusions Preliminary evidence supports the need for and feasibility of an IRIS. Implications for Nursing Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women’s beliefs about their symptoms and their current symptom management strategies. PMID:19403441
Van Buren, Brian R; Weierich, Mariann R
Tonic immobility is a set of involuntary motor responses elicited under conditions of extreme fear and perceived inescapability, and it is one type of peritraumatic distress reported by survivors of child sexual abuse. Experiencing tonic immobility during child sexual abuse is associated with increased risk for developing symptoms of post-traumatic stress disorder, although less is known about relations between tonic immobility and other established risk factors for post-traumatic stress disorder. We investigated posttraumatic cognitions as a potential mediator of the relations between peritraumatic fear, perceptions of inescapability, tonic immobility, and post-traumatic stress disorder symptoms. Specifically, we tested posttraumatic negative beliefs about the self, the world, and self-blame as pathways that might increase risk for post-traumatic stress disorder symptoms in child sexual abuse survivors who had experienced tonic immobility. Forty-six women with a history of unwanted childhood sexual contact completed questionnaires measuring peritraumatic tonic immobility, posttraumatic cognitions, and current posttraumatic stress symptoms. Negative beliefs about the self independently mediated the relation between peritraumatic perceptions of inescapability and post-traumatic stress disorder symptoms, but the data did not support similar path model for the physical symptoms of tonic immobility and post-traumatic stress disorder. We discuss ways in which treatment of survivors and future research on CSA can benefit from attention to the impact of peritraumatic distress on posttraumatic beliefs.
Full Text Available Abstract Background We assessed the quality of life of ICU survivors using SF-36 at 4 months after ICU discharge and investigated any correlation of PCS and MCS with age, illness severity and hospital or ICU length of stay. We examined the relationship between these variables, persisting physical and psychological symptoms and the perceived benefit of individual patients of follow-up. Findings For one year, adult patients admitted for multiple organ or advanced respiratory support for greater than 48 hours to a 16-bedded teaching hospital general intensive care unit were identified. Those surviving to discharge were sent a questionnaire at 4 months following ICU discharge assessing quality of life and persisting symptoms. Demographic, length of stay and illness severity data were recorded. Higher or lower scores were divided at the median value. A two-tailed Students t-test assuming equal variances was used for normally-distributed data and Mann-Whitney tests for non-parametric data. 87 of 175 questionnaires were returned (50%, but only 65 had sufficient data giving a final response rate of 37%. Elderly patients had increased MCS as compared with younger patients. The PCS was inversely related to hospital LOS. There was a significant correlation between the presence of psychological and physical symptoms and desire for follow-up. Conclusion Younger age and prolonged hospital stay are associated with lower mental or physical quality of life and may be targets for rehabilitation. Patients with persisting symptoms at 4 months view follow-up as beneficial and a simple screening questionnaire may identify those likely to attend outpatient services.
Russo, S; Boon, JC; Kema, IP; Willemse, PHB; den Boer, JA; Korf, J; de Vries, EGE
Objective: Carcinoid tumors can produce excessive amounts of biogenic amines, notably serotonin. We assessed psychiatric symptoms in carcinoid patients and peripheral metabolism of tryptophan, the precursor of serotonin. Methods: Twenty consecutive patients with carcinoid syndrome underwent a
Allan, Louise M; Rowan, Elise N; Thomas, Alan J; Polvikoski, Tuomo M; O'Brien, John T; Kalaria, Raj N
Depression is common and an important consequence of stroke but there is limited information on the longer-term relationship between these conditions. To identify the prevalence, incidence and predictors of depression in a secondary-care-based cohort of stroke survivors aged over 75 years, from 3 months to up to 10 years post-stroke. Depression was assessed annually by three methods: major depression by DSM-IV criteria, the self-rated Geriatric Depression Scale (GDS) and the observer-rated Cornell scale. We found the highest rates, 31.7% baseline prevalence, of depressive symptoms with the GDS compared with 9.7% using the Cornell scale and 1.2% using DSM-IV criteria. Incidence rates were 36.9, 5.90 and 4.18 episodes per 100 person years respectively. Baseline GDS score was the most consistent predictor of depressive symptoms at all time points in both univariate and multivariate analyses. Other predictors included cognitive impairment, impaired activities of daily living and in the early period, vascular risk factor burden and dementia. Our results emphasise the importance of psychiatric follow-up for those with early-onset post-stroke depression and long-term monitoring of mood in people who have had a stroke and remain at high risk of depression.
Vaz, Ana F; Pinto-Neto, Aarão M; Conde, Délio M; Costa-Paiva, Lúcia; Morais, Sirlei S; Pedro, Adriana O; Esteves, Sérgio B
The aims of this study were to investigate the frequency of menopausal and sexual symptoms and the proportion of sexually active women and to assess and identify quality of life (QOL) predictors in gynecologic cancer survivors. A prospective case series following a cohort of women under radiation therapy was conducted, including 107 women (aged 21-75 y) with gynecologic cancer (cervical or endometrial cancer) who underwent pelvic radiotherapy in the Radiotherapy Division of the Women's Integral Healthcare Center at the Universidade Estadual de Campinas. Adverse effects of radiotherapy were evaluated using the Common Terminology Criteria Adverse Event Scale. QOL was measured using the abbreviated version of the World Health Organization's Quality of Life instrument before radiotherapy (T0) and at 4 months (T1), 1 year (T2), and 3 years (T3) after radiotherapy. QOL scores were assessed over time using the Wilcoxon signed-rank test. Multiple linear regression analysis was used to identify QOL predictors. A decrease in the frequency of vaginal dryness (26.7% in T0 vs 8.3% in T3; P women (21.5% in T0 vs 44.2% in T3; P health and overall QOL. Dyspareunia negatively affected the physical (P health (P = 0.04). Family income was positively related to environment domain (P health (P gynecologic cancer survivors had a lower frequency of vaginal dryness and a higher proportion of these women were sexually active 3 years after completion of radiotherapy. Furthermore, QOL improved and dyspareunia negatively affected various QOL dimensions.
Quart, Ellen J.; And Others
Twenty-six children (ages 9-18) who had recovered from Reye's syndrome (characterized by lethargy, disorientation, personality changes, and decreased consciousness) were tested for possible memory deficits. In reviewing school histories, an unexpected finding was the disproportionately high number of students who were learning disabled before…
Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J
Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient's symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.
Full Text Available Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient’s symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.
Nuver, J; Smit, AJ; Wolffenbuttel, BHR; Sluiter, WJ; Hoekstra, HJ; Sleifer, DT; Gietema, JA
Purpose The metabolic syndrome may be an important risk factor for cardiovascular disease in long-term survivors of testicular cancer (TC). We investigated the associations between hormone levels and the metabolic syndrome in these men. Patients and Methods We included TC patients cured by
James, Janey; Harris, Yael T; Kronish, Ian M; Wisnivesky, Juan P; Lin, Jenny J
Posttraumatic stress symptoms (PTSS) can be triggered by a diagnosis of a potentially life-threatening illness such as cancer. Little is known about the impact of cancer-related PTSS symptoms on self-management behaviors for comorbid chronic medical conditions such as diabetes mellitus (DM). We recruited patients with DM and a recent diagnosis of early-stage cancer from 2 medical centers in New York City. Cancer-related PTSS were assessed using the Impact of Events Scale (score ≥ 26). DM self-management behaviors (medication adherence, exercise, healthy diet, and glucose testing) were measured 3 months later. Logistic regression was used to assess the association between cancer-related PTSS symptoms and DM self-management behaviors, adjusting for gender, marital status, and anxiety symptoms. Of 56 participants recruited, 33% reported cancer-related PTSS symptoms. Elevated cancer-related PTSS symptoms were associated with lack of healthy diet (odds ratio: 0.08, 95% confidence interval: 0.01-0.62). Early-stage cancer survivors with cancer-related PTSS symptoms were less likely to adhere to some DM self-management behaviors. Providers should recognize the impact of cancer-related PTSS symptoms to better support comorbid disease management in cancer survivors. Copyright © 2017 John Wiley & Sons, Ltd.
Heinsvig Poulsen, Chalotte; Falgaard Eplov, Lene; Hjorthøj, Carsten
Objective Functional gastrointestinal (GI) symptoms can develop into persistent states often categorised as the irritable bowel syndrome (IBS). In the severe end of the GI symptom continuum, other coexisting symptoms are common. We aimed to investigate the GI symptom continuum in relation...... symptom groups and mortality (p = 0.47). IBS and GI symptoms with abdominal pain were significantly associated with development of GI diseases. Only GI symptoms with abdominal pain were associated with development of severe GI diseases (HR: 1.38; 95% CI: [1.06–1.79]). There were no statistically...... significant interactions between symptom groups and coexisting symptoms in relation to the two outcomes. Conclusions GI diseases were seen more frequently, but IBS was not associated with severe GI diseases or increased mortality. Clinicians should be more aware when patients do not fulfil the IBS definition...
Full Text Available Zhuohong Zhu,1 Richu Wang,1 Henry SR Kao,2 Yan Zong,3 Zhengkui Liu,1 Shan Tang,1 Min Xu,4 Ivy CY Liu,5 Stewart PW Lam61Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China; 2Department of Psychology, University of Hong Kong, Hong Kong, 3Sichuan Judicial and Police Officers Professional College, Deyang, Sichuan, People's Republic of China; 4Department of Linguistics, University of Hong Kong, Hong Kong, 5Department of Psychology, Fu Jen Catholic University, New Taipei, Taiwan; 6International Society of Calligraphy Therapy, Hong KongBackground: This study investigated the treatment effects of calligraphy therapy on childhood survivors of the 2008 Sichuan earthquakes in the People's Republic of China.Methods: In experiment 1, 129 children participated in a 30-day calligraphic training, and 81 children were controls. The Children's Revised Impact of Event Scale was adopted to assess behavioral effects. Experiment 2 involved 41 treatment subjects and 39 controls, with the same procedure as in experiment 1 except that salivary cortisol level was also measured as a physiological indicator.Results: After 30 days of calligraphy treatment, the arousal symptoms and salivary cortisol levels in the experimental group decreased from 5.72±0.31 and 13.34±2.88 to 4.98±0.31 and 9.99±2.81, respectively. In the control group, there was not a significant decrease from pretest to post-test. In addition, the arousal scores in posttest (4.98±4.39 were significantly lower than midtest (5.71±4.14 for girls; in contrast, for boys, posttest (4.90±4.24 showed little change compared with midtest (5.04±4.36, but both were significantly lower than pretest (6.42±4.59.Conclusions: Calligraphy therapy was effective in reducing hyperarousal symptoms among child survivors.Keywords: PTSD, calligraphy therapy, salivary cortisol, China earthquakes
Spinhoven, P.; Onstein, E. J.; Sterk, P. J.; Le Haen-Versteijnen, D.
Hyperventilation is assumed to produce a set of somatic and psychological symptoms, the so-called Hyperventilation Syndrome (HVS). Recognition of symptoms during the hyperventilation provocation test (HVPT) is the most widely used criterion for diagnosing HVS, but additional physiological and
Ying, Liu-Hua; Wu, Xin-Chun; Lin, Chong-De
This study aimed to determine the relationships between depressive and posttraumatic stress disorder (PTSD) symptoms in a sample of adolescent survivors following the Wenchuan earthquake in China. Two-hundred adolescent survivors were reviewed at 12, 18 and 24-months post-earthquake. Depression and PTSD were assessed by two self-report…
Wulffaert, Josette; Van Berckelaer-Onnes, Ina A.; Scholte, Evert M.
According to the major classification systems it is not possible to diagnose a comorbid autistic disorder in persons with Rett syndrome. However, this is a controversial issue, and given the level of functioning of persons with Rett syndrome, the autistic disorder is expected to be present in a comparable proportion as in people with the same…
Raghavan, Sumithra S; Rosenfeld, Barry; Rasmussen, Andrew
The United States accepts more refugees than any other industrialized nation. As refugee populations grow, mental health professionals must implement culturally and ethnically appropriate strategies to assess and treat individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, and few structured measures have been demonstrated to have adequate cross-cultural validity for use with diverse and vulnerable populations such as survivors of torture. This study examined the factor structure and equivalency of underlying construct(s) of psychological distress as measured by the Brief Symptom Inventory (BSI) in three samples who had survived torture and other severe trauma from Tibet, West Africa and the Punjab region of India. Confirmatory factor analyses provided support for configural invariance of a two-factor model across the three samples, suggesting that the two latent factors of Complex Dysphoria and Somatic Distress were present in each subgroup. The data provide additional support for the strict invariance model in the West African-Tibetan dyad suggesting that scores are comparable across those two groups. Implications for research and treatment are discussed. © The Author(s) 2015.
... help determine the cause and suggest appropriate action. Causes Although triple X syndrome is genetic, it's usually not inherited — it's due to a random genetic error. Normally, people have 46 chromosomes in each cell, ...
Full Text Available Abstract Background The population of survivors following allogeneic HSCT continues to increase, and yet their experiences of recovery and long-term survivorship have not been fully characterized. This paper presents a study protocol examining over time the functional status, psychosocial adjustment, health-related quality of life, and symptom experience of survivors who have undergone allogeneic transplantation. The aims of the study are to: 1 explore the patterns of change in these health outcomes during the survivorship phase; 2 characterize subgroups of survivors experiencing adverse outcomes; and 3 examine relationships among outcomes and demographic and clinical factors (such as age, graft-versus-host disease (GVHD, and disease relapse. Methods In this longitudinal observational study, adults who survive a minimum of 3 years from date of allogeneic transplantation complete a series of questionnaires annually. Demographic and clinical data are collected along with a series of patient-reported outcome measures, specifically: 1 Medical Outcomes Study SF- 36; 2 Functional Assessment of Chronic Illness Therapy (FACIT - General, 3 FACIT-Fatigue; 4 FACIT- Spiritual; 5 Psychosocial Adjustment to Illness Scale; 6 Rotterdam Symptom Checklist-Revised; and 7 Pittsburgh Sleep Quality Index. Conclusions This study will provide multidimensional patient-reported outcomes data to expand the understanding of the survivorship experience across the trajectory of allogeneic transplantation recovery. There are a number of inherent challenges in recruiting and retaining a diverse and representative sample of long-term transplant survivors. Study results will contribute to an understanding of outcomes experienced by transplant survivors, including those with chronic GVHD, malignant disease relapse, and other late effects following allogeneic transplantation. Trial Registration ClinicalTrials.gov: NCT00128960
Rudzki, E; Romański, B; Dynowska, D; Kaczmarski, M; Olendzka-Rzepecka, E; Kurzawa, R; Obtułowicz, K; Blinowski, J; Korzeniowska-Zuk, E; Piela, Z; Szmurło, A; Stroiński, J; Doniec, Z; Pulka, G
The group of 146 patients suffering from asthma-prurigo syndrome (85 adults and 64 children) have been inquired in many various clinical centers. It was established that in 79.6% of the patients the first symptoms of illness appeared already in infancy and only 28.2% of the patients had negative familiar anamnesis on the allergy. In 73.2% of the patients with asthma-prurigo syndrome the symptoms of atopic dermatitis persisted longer than asthma symptoms and in 89.9% of them asthma-prurigo symptoms accompanied other form of allergic diseases. The most important causal allergens provoking asthma-prurigo symptoms were: house dust (in 64.4% of the patients), chocolate (in 42.2%), cat epithelia (in 40.2%) and cow milk proteins (in 29.5% of the patients).
Bau, V; Deschauer, M; Zierz, S
The term chronic progressive external ophthalmoplegia (CPEO) is not only a symptom but is also used as a syndrome within the group of mitochondrial diseases. However, the symptom CPEO might also occur in other well defined mitochondrial syndromes such as MELAS, MNGIE, SANDO. The molecular bases of the syndrome CPEO are mostly single or multiple deletions of the mtDNA, less frequently point mutations. Multiple deletions are caused by defects of nuclear encoded proteins. In this case, the mode of inheritance might be autosomal dominant or recessive. However, all these types of mtDNA mutations are not only associated with the symptom or syndrome of CPEO but might also cause other well defined mitochondrial syndromes. Thus, the diagnosis of CPEO either as a symptom or as a syndrome requires the subtle characterisation of the complete clinical phenotype as well as the precise genotype. Only on this basis a valid prognosis and information about the mode of inheritance are possible. Georg Thieme Verlag KG Stuttgart.New York.
Warner, Lisa Marie; Gutiérrez-Doña, Benicio; Villegas Angulo, Maricela; Schwarzer, Ralf
Social support and self-efficacy are regarded as coping resources that may facilitate readjustment after traumatic events. The 2009 Cinchona earthquake in Costa Rica serves as an example for such an event to study resources to prevent subsequent severity of posttraumatic stress symptoms. At Time 1 (1-6 months after the earthquake in 2009), N=200 survivors were interviewed, assessing resource loss, received family support, and posttraumatic stress response. At Time 2 in 2012, severity of posttraumatic stress symptoms and general self-efficacy beliefs were assessed. Regression analyses estimated the severity of posttraumatic stress symptoms accounted for by all variables. Moderator and mediator models were examined to understand the interplay of received family support and self-efficacy with posttraumatic stress symptoms. Baseline posttraumatic stress symptoms and resource loss (T1) accounted for significant but small amounts of the variance in the severity of posttraumatic stress symptoms (T2). The main effects of self-efficacy (T2) and social support (T1) were negligible, but social support buffered resource loss, indicating that only less supported survivors were affected by resource loss. Self-efficacy at T2 moderated the support-stress relationship, indicating that low levels of self-efficacy could be compensated by higher levels of family support. Receiving family support at T1 enabled survivors to feel self-efficacious, underlining the enabling hypothesis. Receiving social support from relatives shortly after an earthquake was found to be an important coping resource, as it alleviated the association between resource loss and the severity of posttraumatic stress response, compensated for deficits of self-efficacy, and enabled self-efficacy, which was in turn associated with more adaptive adjustment 3 years after the earthquake.
Koopman, Fieke Sophia; Uegaki, Kimi; Gilhus, Nils Erik; Beelen, Anita; de Visser, Marianne; Nollet, Frans
Background Postpolio syndrome (PPS) may affect survivors of paralytic poliomyelitis and is characterised by a complex of neuromuscular symptoms leading to a decline in physical functioning. The effectiveness of pharmacological treatment and rehabilitation management in PPS is not yet established.
Huang, H-C; Liu, H-H; Yin, L-Y; Yeh, C-H; Tu, C-W; Yang, C-S
Whether upper-limb swelling is associated with axillary web syndrome (AWS) is unknown. We recruited unilateral breast cancer (BC) patients who were scheduled for surgical intervention and lymph node dissection. The pre-operative assessment and post-operative assessment 3-4 weeks after surgery evaluated the upper-limb circumferential measurements, segmental limb volume, pain scores, grasp, shoulder range of motion (ROM), shoulder muscle power and quality-of-life scores. In the control group, the peri-elbow volume and upper-arm volume were significantly higher post-operatively than pre-operatively. In the AWS group, no significant difference was found. In comparison with the control group, the AWS group had significantly more pain, less active ROM in shoulder abduction and a lower upper-limb volume at 0-10 cm proximal to the lateral epicondyle. The incidence of lymphedema was 9.9% and was not associated with AWS. AWS is a common morbidity of lymph node dissection and causes significant pain and restricted shoulder abduction in the affected limb in BC survivors. This study is the first to investigate post-operative upper-limb volumetric changes in BC survivors with and without AWS. Our findings are of great value for the clinical effect of AWS in BC survivors, for patient education, and for developing diagnostic tools for detecting AWS. © 2017 John Wiley & Sons Ltd.
... males need breast-reduction surgery. 6 Language and Learning Symptoms Most males with KS have normal intelligence ... Annales d'endocrinologie (Paris), 71 (6), 494-504. French. [top] Smyth, C.M., & Brenner, W.J. (1998). ...
Kaye-Tzadok, Avital; Davidson-Arad, Bilha
Research suggests that, after a traumatic event, survivors can experience positive change (posttraumatic growth), but the relation of these changes to overall psychological adjustment (resilience) and psychological distress (posttraumatic symptoms; PTS), as well as the relation to possible contributors, is still unclear. The study examines posttraumatic growth (PTG) among women survivors of childhood sexual abuse (CSA), looking at the relation of PTG to the women's cognitive strategies (past self-blame, self-forgiveness, perception of control and hope), resilience and PTS. Self-report questionnaires were completed by 100 women survivors of CSA. Findings show that the main contributors to PTG were demographic-familial variables (birth order and number of siblings) and cognitive strategies (self-blame and hope).The relationship between resilience and PTG was curvilinear: The highest levels of PTG occurred when resilience levels were moderate. Variance in PTG was also explained by an interaction between resilience and PTS. Cognitive strategies and familial variables can contribute to PTG. The complex relations between PTG, resilience and PTS might help professionals better understand different trajectories of adjustment among trauma survivors. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Riegel, Barbara; Hanlon, Alexandra L; McKinley, Sharon; Moser, Debra K; Meischke, Hendrika; Doering, Lynn V; Davidson, Patricia; Pelter, Michele M; Dracup, Kathleen
The timely and accurate identification of symptoms of acute coronary syndrome (ACS) is a challenge for patients and clinicians. It is unknown whether response times and clinical outcomes differ with specific symptoms. We sought to identify which ACS symptoms are related-symptom clusters-and to determine if sample characteristics, response times, and outcomes differ among symptom cluster groups. In a multisite randomized clinical trial, 3522 patients with known cardiovascular disease were followed up for 2 years. During follow-up, 331 (11%) had a confirmed ACS event. In this group, 8 presenting symptoms were analyzed using cluster analysis. Differences in symptom cluster group characteristics, delay times, and outcomes were examined. The sample was predominantly male (67%), older (mean 67.8, S.D. 11.6 years), and white (90%). Four symptom clusters were identified: Classic ACS characterized by chest pain; Pain Symptoms (neck, throat, jaw, back, shoulder, arm pain); Stress Symptoms (shortness of breath, sweating, nausea, indigestion, dread, anxiety); and Diffuse Symptoms, with a low frequency of most symptoms. Those in the Diffuse Symptoms cluster tended to be older (P = .08) and the Pain Symptoms group was most likely to have a history of angina (P = .01). After adjusting for differences, the Diffuse Symptoms cluster demonstrated higher mortality at 2 years (17%) than the other 3 clusters (2%-5%, P symptoms occur in groups or clusters. Uncharacteristic symptom patterns may delay diagnosis and treatment by clinicians even when patients seek care rapidly. Knowledge of common symptom patterns may facilitate rapid identification of ACS.
Fu, Mei R; Axelrod, Deborah; Guth, Amber A; Wang, Yao; Scagliola, Joan; Hiotis, Karen; Rampertaap, Kavita; El-Shammaa, Nardin
The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral health IT system focusing on safe, innovative, and pragmatic self-care strategies for lymphedema symptom management. The purpose of this study was to evaluate usability, feasibility, and acceptability of TOLF among the end-user of breast cancer survivors. Two types of usability testing were completed with 30 breast cancer survivors: heuristic evaluation and end-user testing. Each participant was asked to think aloud while completing a set of specified tasks designed to explicate and freely explore the system features. A heuristic evaluation checklist, the Perceived Ease of Use and Usefulness Questionnaire, and The Post Study System Usability Questionnaire were used to evaluate usability of the system. Open-ended questions were used to gather qualitative data. Quantitative data were analyzed using descriptive statistics and qualitative data were summarized thematically. Breast cancer survivors were very satisfied with the system: 90% (n = 27) rated the system having no usability problems; 10% (n = 3) noted minor cosmetic problems: spelling errors or text font size. The majority of participants 96.6% (n = 29) strongly agreed that the system was easy to use and effective in helping to learn about lymphedema, symptoms and self-care strategies. Themes from the qualitative data included empowerment, high quality information, loving avatar simulation videos, easy accessibility, and user-friendliness. This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.
Full Text Available AbstractPurpose: This study longitudinally investigated the changes of depressive symptoms among adolescent survivors over two years and a half after the 2008 Wenchuan earthquake in China, as well as the predictive effects of demographic characteristics, earthquake exposure, negative life events, social support and dispositional resilience on the risk of depressive symptoms at two time points after the earthquake.Methods: Participants were 1573 adolescent survivors (720 males and 853 females, mean age at initial survey =15 ± 1.26, whose depressive symptoms were assessed at 6 months (T6m and 30 months (T30m post-earthquake. Data on demographics, earthquake exposure and dispositional resilience were collected at T6m. Negative life events and social support were measured at T6m and 24 months (T24m post-earthquake.Results: The prevalence rates of probable depression, 27.5% at T6m and 27.2% at T30m, maintained relatively stable over time. Female gender was related with higher risk of depressive symptoms at both T6m and T30m, while being only-child could only predict higher risk of depressive symptoms at T30m. Negative life events and social support at T6m, as well as earthquake exposure, were concurrently associated with increased risk of depressive symptoms at T6m, but not associated with the risk of depressive symptoms at T30m, while negative life events and social support at T24m could predict depressive symptoms at T30m, all of which suggested that these variables may have strong but short-term effect on adolescents’ depressive symptoms post-earthquake. Besides, dispositional resilience was evidenced as a relatively stable negative predictor for depressive symptoms.Conclusions: These findings could inform mental health professionals regarding how to screen adolescent survivors at high risk for depression, so as to provide them with timely and appropriate mental health services based on the identified risk and protective factors for depressive
Kemp, B J; Adams, B M; Campbell, M L
To compare depressive symptoms and life satisfaction in aging polio survivors with age-matched controls and to relate these outcomes to scores to psychosocial and disability-related variables. A planned medical, functional, and psychosocial study with multivariate analyses. A large, urban rehabilitation center. A volunteer sample of 121 polio survivors and an age-matched control group of 60 people with similar sociodemographic backgrounds. Depression as measured by the Geriatric Depression Scale and an 11-item life satisfaction scale. The prevalence of depressive disorders was not significantly different in the two groups, although the postpolio group tended to have more symptomatology and an overall depressive disorder prevalence of 28%. Some life satisfaction scale scores were significantly lower in the postpolio group, especially those concerned with health. People with postpolio syndrome scored significantly higher on depression scales and lower on some life satisfaction scales than people with a history of polio but without postpolio syndrome. Several psychosocial variables, most notably family functioning and attitude toward disability, helped to mediate this effect. Among people with significant depression, there was little, evidence of adequate treatment in the community. Postpolio by itself does not relate to higher depression scores or lower life satisfaction. Postpolio syndrome has some relation to depression, but family functioning and attitude toward disability are more important. There is a need for better community-based psychological services.
Jensen, J. F.; Thomsen, Thordis; Overgaard, D
/unpublished trials. Randomized controlled trials investigating post-ICU consultations in adults with outcomes such as quality of life (QOL), anxiety, depression, posttraumatic stress disorder (PTSD), physical ability, cognitive function, and return to work were included. Two reviewers extracted data and assessed...... ratio 0.49, 95 % CI 0.26-0.95). There was no effect on other outcomes. CONCLUSIONS: The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3-6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights...
Mumford, D B
The status of the 'Dhat syndrome' is called into question by the results of an epidemiological study of men attending general medical clinics in Lahore. The Dhat complaint was reported by 30% of men attending medical clinics, and to an equal extent by patients with 'functional' and 'organic' diagnoses. It was strongly associated with depressed mood, fatigue symptoms, and a DSM-III-R diagnosis of depression. It is argued that the Dhat complaint should be primarily regarded not as the focus of a culture-bound syndrome, but as a culturally determined symptom associated with depression.
Katz, L H; Burton-Chase, A M; Advani, S; Fellman, B; Polivka, K M; Yuan, Y; Lynch, P M; Peterson, S K
Cancer screening recommendations for patients with Lynch-like syndrome (LLS) are not well defined. We evaluated adherence to Lynch syndrome (LS) screening recommendations, cancer risk perceptions, and communication within the families among colorectal cancer (CRC) survivors with LLS. Thirty-four participants with LLS completed a questionnaire about risk perception, adherence to LS screening recommendations, and communication with relatives. Clinical data were obtained from medical records. Most participants (76%) believed they should undergo colonoscopy every 1-2 years. Only 41% correctly interpreted their genetic tests as uninformative negative or as variant of unknown significance for LS. Less than half had had an upper gastrointestinal endoscopy for screening purpose. Among female participants, 86% had been screened for endometrial cancer (EC) and 71% for ovarian cancer. Most participants had informed relatives about the CRC diagnosis and advised them to undergo CRC screening, but only 50% advised female relatives to be screened for EC and only one-third advised relatives to have genetic counseling. Most CRC survivors with LLS follow the same cancer screening recommended for LS patients but do not understand the meaning of LLS. Greater care must be devoted to communicating the implications of nondiagnostic germline mutation testing among patients with LLS. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Mayr, S; Price, J L
The sexual abuse of women today is analyzed alongside the mythology of Ovid's Metamorphoses. Two thousand years ago, Ovid unfolded a world view of human beliefs and practices that make up today's symptom formation and psychodynamic in victims of sexual abuse. Herewith the mythology of Io. Her rape and subsequent symptom formation is understood as a clinical account of rape-trauma syndrome and post-traumatic stress disorder.
Fink, Per; Toft, Tomas; Hansen, Morten Steen
that they are different manifestations of a common latent phenomenon. Inclusion of a group of five additional general, unspecific symptoms in latent class analysis allowed construction of clinical diagnostic criteria for 'bodily distress disorder' dividing patients into three classes: nonbodily distress (n = 589), modest...... diagnoses. Bodily distress may be triggered by stress rather than being distinct diseases of noncerebral pathology....
Aslam, U; Afzal, S; Syed, Shakir
Hyperventilation causes respiratory alkalosis. The nervous system is more excitable in alkalosis. This phenomenon can be observed as paraesthesia in fingers and toes as well as around the lips in anxious patients breathing rapidly. We wanted to test this phenomenon on already irritable nerves like the median nerve in carpal tunnel syndrome (CTS). We deployed 50 patients who came in to the day case unit for carpal tunnel decompression with electro-physiologically proven diagnosis. We devised a test whereby patients were made to hyperventilate under prescribed conditions and repeated Phalen's test and Tinel's sign for comparison. These were compared with a control group chosen randomly among hospital staff. 86% patients had a positive result which was just behind Phalen's test in sensitivity. It was also 100% specific as there were no false positives. Hyperventilation is a phenomenon which provokes carpal tunnel syndrome. Its clinical value remains to be seen due to cumbersome method and probable patient non-compliance but it is a new discovery. It may be useful in other irritable-nerve-syndromes as a test to add to our available armament. It may be an additional factor or a primary reason for nocturnal paraesthesias in CTS patients.
Data from published studies were combined and analyzed to develop best-fit equations and curves quantifying the change in sick building syndrome (SBS) symptom prevalence in office workers with ventilation rate. For each study, slopes were calculated, representing the fractional...
Roberts, Jane E.; Tonnsen, Bridgette L.; McCary, Lindsay M.; Caravella, Kelly E.; Shinkareva, Svetlana V.
Fragile X syndrome (FXS) is the most common known genetic cause of autism spectrum disorder (ASD). Although 50-75% of children with FXS meet ASD criteria, no studies have compared ASD symptoms in infants with FXS versus other high risk groups, such as siblings of children with ASD (ASIBs). Using the Autism Observation Scale for Infants, our…
Verstappen, Gwenny M.; Kroese, Frans G. M.; Vissink, Arjan; Bootsma, Hendrika
Introduction: Primary Sjogren's syndrome (pSS) is a systemic autoimmune disease, characterized by impaired function of the exocrine glands. Many pSS patients also experience extraglandular symptoms. Effective therapeutic interventions for pSS patients are not yet approved. However, advances in
... leave adolescence and enter adulthood. Treating Language and Learning Symptoms Some, but not all, children with KS ... syndrome. Gynécologie, obstétrique & fertilité , 39 (9), 529-532. French. [top] Plotton I., Brosse A., & Lejeune, H. (2010). ...
Jason, Leonard A.; And Others
The prevalence of chronic fatigue syndrome among 1,474 nurses was addressed through a mailed questionnaire (202 respondents). Demographic characteristics, symptoms, and possible prevalence rates are presented and discussed. Implications of these findings are considered, and the methodology used is analyzed. Suggestions are made for conducting…
Yehuda, R; Schmeidler, J; Labinsky, E; Bell, A; Morris, A; Zemelman, S; Grossman, R A
We performed a longitudinal study of holocaust survivors with and without post-traumatic stress disorder (PTSD) by assessing symptoms and other measures at two intervals, approximately 10 years apart. The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of delayed onset PTSD developed between time 1 and time 2. Self-report ratings at both assessments revealed a worsening of trauma-related symptoms over time in persons without PTSD at time 1, but an improvement in those with PTSD at time 1. The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of delayed onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD.
Schmeidler, James; Labinsky, Ellen; Bell, Amanda; Morris, Adam; Zemelman, Shelly; Grossman, Robert A.
Objective We performed a longitudinal study of Holocaust survivors with and without PTSD by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. Results There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of Delayed Onset PTSD developed between the Time 1 and Time 2. Self-report ratings at both assessments revealed a worsening of trauma related symptoms over time in persons without PTSD at Time 1, but an improvement in those with PTSD at Time 1. Conclusion The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of Delayed Onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD. PMID:18785948
Haley, R W; Kurt, T L; Hom, J
To search for syndromes in Persian Gulf War veterans. Two hundred forty-nine (41%) of the 606 Gulf War veterans of the Twenty-fourth Reserve Naval Mobile Construction Battalion living in 5 southeastern states participated; 145 (58%) had retired from service, and the rest were still serving in the battalion. Participants completed a standardized survey booklet measuring the anatomical distributions or characteristics of each symptom, a booklet measuring wartime exposures, and a standard psychological personality assessment inventory. Two-stage factor analysis was used to disentangle ambiguous symptoms and identify syndromes. Factor analysis-derived syndromes. Of 249 participants, 175 (70%) reported having had serious health problems that most attributed to the war, and 74 (30%) reported no serious health problems. Principal factor analysis yielded 6 syndrome factors, explaining 71% of the variance. Dichotomized syndrome indicators identified the syndromes in 63 veterans (25%). Syndromes 1 ("impaired cognition," characterized by problems with attention, memory, and reasoning, as well as insomnia, depression, daytime sleepiness, and headaches), 2 ("confusion-ataxia," characterized by problems with thinking, disorientation, balance disturbances, vertigo, and impotence), and 3 ("arthro-myo-neuropathy," characterized by joint and muscle pains, muscle fatigue, difficulty lifting, and extremity paresthesias) represented strongly clustered symptoms; whereas, syndromes 4 ("phobia-apraxia"), 5 ("fever-adenopathy"), and 6 ("weakness-incontinence") involved weaker clustering and mostly overlapped syndromes 2 and 3. Veterans with syndrome 2 were 12.5 times (95% confidence interval, 3.5-44.8) more likely to be unemployed than those with no health problems. A psychological profile, found in 48.4% of those with the syndromes, differed from posttraumatic stress disorder, depression, somatoform disorder, and malingering. These findings support the hypothesis that clusters of symptoms
Wang, Bing-Ling; Takigawa, Tomoko; Yamasaki, Yukie; Sakano, Noriko; Wang, Da-Hong; Ogino, Keiki
The potential risk factors for sick building syndrome (SBS) in newly built dwellings were investigated. Two different definitions for SBS were used, a narrow definition (symptoms related to home environment and continuously occurring in the last 3 months were regarded as positive) and another relatively broad definition (symptoms related to home environment and either continuously or sporadically occurring in the last 3 months were regarded as positive). With both definitions indoor air chemicals, especially TVOC, and high stress during work were found to be significantly associated with SBS symptoms. Allergic history was more associated with narrow-sense symptoms and odor perception with broad-sense symptoms. The results indicate that the broad definition be preferred to find more potential risk factors.
Bakke, Kristin A; Howlin, Patricia; Retterstøl, Lars; Kanavin, Øivind J; Heiberg, Arvid; Nærland, Terje
Autism spectrum disorder and epilepsy often co-occur; however, the extent to which the association between autism symptoms and epilepsy is due to shared aetiology or to the direct effects of seizures is a topic of ongoing debate. Angelman syndrome (AS) is presented as a suitable disease model to explore this association. Data from medical records and questionnaires were used to examine the association between age of epilepsy onset, autism symptoms, genetic aberration and communication level. Forty-eight participants had genetically verified AS (median age 14.5 years; range 1-57 years). A measure of autism symptoms (the Social Communication Questionnaire; SCQ) was completed for 38 individuals aged ≥ 4 years. Genetic cause was subgrouped into deletion and other genetic aberrations of the 15q11-q13 area. The number of signs used to communicate (Angelman syndrome may be used to study the relation between epilepsy and autism symptomatology.
Hamilton, Jill B; Worthy, Valarie C; Kurtz, Melissa J; Cudjoe, Joycelyn; Johnstone, Peter A
Acupuncture, acupressure, yoga, meditation, cognitive-behavioral techniques, and, to a lesser extent, music are among those integrative and complementary therapies with known beneficial effects on psychological symptoms. However, noticeably absent from this research is the use of religious song as a type of integrative and complementary therapy. The aim of this study was to explore how religious songs were used to alleviate psychological symptoms associated with a cancer diagnosis among a sample of older African American cancer survivors. Thirty-one older African American cancer survivors residing in the Southeastern US participated in a qualitative descriptive study involving criterion sampling, open-ended semistructured interviews, and qualitative content analysis. Participants used religious songs in response to feeling depressed, low, or sad; feeling weak and seeking strength to endure treatment; and feeling worried, anxious, or fearful. Religious songs were also a source of support and hope. Types of religious songs included instructive, thanksgiving and praise, memory of forefathers, communication with God, and life after death. Religious songs appear to be an important form of religious expression in this population and used to manage psychological symptoms. Integrative and complementary oncology therapy has generally focused on yoga, meditation, acupuncture, and cognitive-behavioral techniques. However, religious songs are an important strategy used among older African American cancer patients. Religious songs can be readily integrated into cancer care. The incorporation of religious songs into spiritually based support groups and other integrative and complementary therapies might enhance health outcomes among this medically underserved cancer population.
Bryant-Davis, Thema; Ullman, Sarah; Tsong, Yuying; Anderson, Gera; Counts, Pamela; Tillman, Shaquita; Bhang, Cecile; Gray, Anthea
African American women are at a slightly increased risk for sexual assault (A. Abbey, A. Jacques-Tiaura, & M. Parkhill, 2010). However, because of stigma, experiences of racism, and historical oppression, African American women are less likely to seek help from formal agencies compared to White women (Lewis et al., 2005; S. E. Ullman & H. H. Filipas, 2001) and/or women of other ethnic backgrounds (C. Ahrens, S. Abeling, S. Ahmad, & J. Himman, 2010). Therefore, the provision of culturally appropriate services, such as the inclusion of religion and spiritual coping, may be necessary when working with African American women survivors of sexual assault. Controlling for age and education, the current study explores the impact of religious coping and social support over 1 year for 252 African American adult female sexual assault survivors recruited from the Chicago metropolitan area. Results from hierarchical linear regression analyses reveal that high endorsement of religious coping and social support at Time 1 does not predict a reduction in posttraumatic stress disorder (PTSD) symptoms at Time 2. However, high social support at Time 2 does predict lower PTSD at Time 2. Also, it is significant to note that survivors with high PTSD at Time 1 and Time 2 endorse greater use of social support and religious coping. Clinical and research implications are explored.
Full Text Available With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder (PTSD in young adult survivors of childhood cancer ranges from 6.2% to 22%; associated risk factors are young age at the assessment, female gender, low education level and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSS, and to identify the risk factors and the associated post-traumatic growth (PTG index.Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15-25, 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD=4.17. Most (52.5% had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD=4.40.The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4% and sub-clinical PTSS (6-8 symptoms: 11.2%, with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r=0.24 p=0.0001. A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05 identified female gender (β = 0.16; p = 0.05 and less perceived social support (β = -0.43; p = 0.05 as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001, with
Tremolada, Marta; Bonichini, Sabrina; Basso, Giuseppe; Pillon, Marta
With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder in young adult survivors of childhood cancer ranges from 6.2 to 22%; associated risk factors are young age at the assessment, female gender, low education level, and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA) survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSSs), and to identify the risk factors and the associated post-traumatic growth (PTG) index. Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman's Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients' mean age at the assessment was 19.33 years (SD = 3.01, 15-25), 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD = 4.17). Most (52.5%) had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD = 4.40). The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4%) and sub-clinical PTSS (6-8 symptoms: 11.2%), with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r = 0.24; p = 0.0001). A hierarchical regression model (R (2) = 0.08; F = 1.46; p = 0.05) identified female gender (β = 0.16; p = 0.05) and less perceived social support (β = -0.43; p = 0.05) as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R (2) = 0.36; F = 9.1; p = 0.0001), with
Full Text Available Marco Carotenuto,1 Maria Esposito,1 Lucia Parisi,2 Beatrice Gallai,3 Rosa Marotta,4 Antonio Pascotto,1 Michele Roccella21Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples, Italy; 2Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 3Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, 4Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, ItalyBackground: The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children.Methods: The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI to screen for the presence of depressive symptoms.Results: The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19 was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our
Adriana Aparecida Siviero-Miachon
Full Text Available Adriana Aparecida Siviero-Miachon1, Angela Maria Spinola-Castro1, Gil Guerra-Junior21Division of Pediatric Endocrinology, Department of Pediatrics, Federal University of Sao Paulo – UNIFESP/EPM, Brazil; 2Division of Pediatric Endocrinology, Department of Pediatrics, State University of Campinas – FCM/UNICAMP, BrazilAbstract: Along with the growing epidemic of obesity, the risk of atherosclerosis, cardiovascular disease morbidity, and mortality are increasing markedly. Several risk factors for cardiovascular disease, such as visceral obesity, glucose intolerance, arterial hypertension, and dyslipidemia commonly cluster together as a condition currently known as metabolic syndrome. Thus far, insulin resistance, and endothelial dysfunction are the primary events of the metabolic syndrome. Several groups have recommended clinical criteria for the diagnosis of metabolic syndrome in adults. Nonetheless, in what concerns children and adolescents, there are no unified definitions, and modified adult criteria have been suggested by many authors, despite major problems. Some pediatric disease states are at risk for premature cardiovascular disease, with clinical coronary events occurring very early in adult life. Survivors of specific pediatric cancer groups, particularly acute lymphocytic leukemia, central nervous system tumors, sarcomas, lymphomas, testicular cancer, and following bone marrow transplantation, may develop metabolic syndrome traits due to: hormonal deficiencies (growth hormone deficiency, thyroid dysfunction, and gonadal failure, drug or radiotherapy damage, endothelial impairment, physical inactivity, adipose tissue dysfunction, and/or drug-induced magnesium deficiency. In conclusion, some primary and secondary prevention remarks are proposed in order to reduce premature cardiovascular disease risk in this particular group of patients.Keywords: metabolic syndrome X, cardiovascular diseases, insulin resistance, obesity, growth hormone
Chen, Hong; Chen, Yanling; Au, Maylan; Feng, Ling; Chen, Qian; Guo, Hongxia; Li, Yun; Yang, Xiaoling
The psychological impact of a mudslide on survivors of the Wenchuan earthquake in China and the risk factors for development of disaster-related post-traumatic stress disorder (PTSD) were investigated. The study design was cross-sectional and included 1321 survivors who had endured both an earthquake and a mudslide. Participants filled out a self-report questionnaire. One month after the mudslide, the rate of PTSD symptoms was 18.7%. Females, the elderly, those with lower educational levels, those that lacked social support, those who did not take precautionary measures, those living with children below 6 years of age, and those who had higher exposure to traumatic events experienced a higher level of PTSD symptoms. Results indicated that timely rescue, abundant material help, and mental rehabilitation after a disaster play important roles in recovery, and that there are still some high-risk groups that need attention, care, and effective intervention from healthcare professionals and society. © 2014 Wiley Publishing Asia Pty Ltd.
Krönauer, T; Friederich, P
The long QT syndrome is caused by a change in cardiac repolarization due to functional ion channel defects. A differentiation is made between a congenital (cLQTS) and an acquired (aLQTS) form of the disease. The disease results in the name-giving prolongation of the QT interval in the electrocardiogram and represents a predisposition for cardiac arrhythmia and sudden cardiac death. This article summarizes the current knowledge on the history, pathophysiology, clinical symptoms and therapy of cLQTS and aLQTS. This knowledge of pathophysiological features of the symptoms allows the underlying anesthesiological approach for individualized perioperative concepts for patients suffering from LQTS to be derived.
Tuisku, K; Holi, M M; Wahlbeck, K; Ahlgren, A J; Lauerma, H
In a previous, controlled study we demonstrated that the general lower limb activity measured by three-channel actometry is a promising objective measure of restless legs syndrome (RLS) severity. In the present study we have further evaluated the method in measuring RLS symptom severity in an open, single-day pramipexole intervention with 15 RLS patients. Both our standardized actometric parameters (nocturnal lower limb activity and controlled rest activity) decreased significantly during the intervention in parallel with the subjectively reported relief of RLS symptoms.
Jaakkola, Maritta S; Yang, Liyan; Ieromnimon, Antonia; Jaakkola, Jouni J K
Objectives To assess the relation between exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers (FPP), and the occurrence of sick building syndrome (SBS)‐related symptoms, chronic respiratory symptoms and respiratory infections. Methods A population‐based cross‐sectional study with a random sample of 1016 adults, 21–63 years old, living in Pirkanmaa District in South Finland was conducted. This study focused on 342 office workers classified as professionals, clerks or administrative personnel according to their current occupation by the International Standard Classification of Occupations‐88. They answered a questionnaire about personal information, health, smoking, occupation, and exposures in the work environment and at home. Results In logistic regression analyses adjusting for age, sex and a set of other confounders, all three exposures were related to a significantly increased risk of general symptoms (headache and fatigue). Exposure to paper dust and to FPP was associated with upper respiratory and skin symptoms, breathlessness, tonsillitis and middle ear infections. Exposure to CCP increased the risk of eye symptoms, chronic bronchitis and breathlessness. It was also associated with increased occurrence of sinus and middle ear infections and diarrhoea. A dose–response relations was observed between the number of exposures and occurrence of headache. The risk of tonsillitis and sinus infections also increased with increasing number of exposures. All chronic respiratory symptoms, apart from cough, were increased in the highest exposure category (including all three exposures). Conclusions This study provides new evidence that exposure to paper dust and to FPP is related to the risk of SBS symptoms, breathlessness and upper respiratory infections. It strengthens the evidence that exposure to CCP increases the risk of eye symptoms, general symptoms, chronic respiratory symptoms and some respiratory infections
Theadom, Alice; Cropley, Mark; Kantermann, Thomas
Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The purpose of this study was to explore how people use daytime naps and to determine the links between daytime napping and symptom severity in fibromyalgia syndrome. A community based sample of 1044 adults who had been diagnosed with fibromyalgia syndrome by a clinician completed an online questionnaire. Associations between napping behavior, sleep quality and fibromyalgia symptoms were explored using Spearman correlations, with possible predictors of napping behaviour entered into a logistic regression model. Differences between participants who napped on a daily basis and those who napped less regularly, as well as nap duration were explored. Daytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems. Sleep problems and fatigue explained the greatest amount of variance in napping behaviour, p naps for >30 minutes had higher memory difficulties (t = -3.45) and levels of depression (t = -2.50) than those who napped for shorter periods (napping was linked with greater symptom severity in people with fibromyalgia. Given the common use of daytime napping in people with fibromyalgia evidence based guidelines on the use of daytime napping in people with chronic pain are urgently needed.
Haraldsson, P O; Carenfelt, C; Diderichsen, Finn
Patients with clinical features of sleep apnea syndrome (SAS) and self-reported sleep spells at the wheel do poorly in simulated monotonous driving. To evaluate whether drivers with defined symptoms of SAS (heavy snoring, sleep disturbances and daytime sleepiness) compensate in real traffic...... by careful driving or not, the rate of car accidents over a 5-year period was investigated. A questionnaire was addressed to 140 patients with and 142 controls without symptoms associated to SAS. Seventy-three of the patients had a complete triad of SAS-associated symptoms. Fifty-two percent...... of these patients reported habitual sleep spells at the wheel, as opposed to less than one percent by the controls. The ratio of drivers being involved in one or more combined-car accident was similar for patients and control drivers, but for single-car accidents the ratio was about 7 times higher for patients...
Fisk, William J.; Mirer, Anna G.; Mendell, Mark J.
Data from published studies were combined and analyzed to develop best-fit equations and curves quantifying the change in sick building syndrome (SBS) symptom prevalence in office workers with ventilation rate. For each study, slopes were calculated, representing the fractional change in SBS symptom prevalence per unit change in ventilation rate per person. Values of ventilation rate, associated with each value of slope, were also calculated. Linear regression equations were fitted to the resulting data points, after weighting by study size. Integration of the slope-ventilation rate equations yielded curves of relative SBS symptom prevalence versus ventilation rate. Based on these analyses, as the ventilation rate drops from 10 to 5 L/s-person, relative SBS symptom prevalence increases approximately 23percent (12percent to 32percent), and as ventilation rate increases from 10 to 25 L/s-person, relative prevalence decreases approximately 29percent (15percent to 42percent). Variations in SBS symptom types, building features, and outdoor air quality may cause the relationship ofSBS symptom prevalence with ventilation rate in specific situations to differ from the average relationship predicted in this paper.
Zhang, Jun; Zhu, Shenyue; Du, Changhui; Zhang, Ye
To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms. The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake. Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months. PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere. Copyright © 2015 Elsevier Inc. All rights reserved.
Adams, Rebecca N; Mosher, Catherine E; Cohee, Andrea A; Stump, Timothy E; Monahan, Patrick O; Sledge, George W; Cella, David; Champion, Victoria L
Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships. Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs. Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management. Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Rens van de Schoot
Full Text Available Background: The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. Methods: First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis- specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Results: Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. Conclusion: We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.
Full Text Available Abstract Background An earlier study showed that a week of yoga practice was useful in stress management after a natural calamity. Due to heavy rain and a rift on the banks of the Kosi river, in the state of Bihar in north India, there were floods with loss of life and property. A week of yoga practice was given to the survivors a month after the event and the effect was assessed. Methods Twenty-two volunteers (group average age ± S.D, 31.5 ± 7.5 years; all of them were males were randomly assigned to two groups, yoga and a non-yoga wait-list control group. The yoga group practiced yoga for an hour daily while the control group continued with their routine activities. Both groups' heart rate variability, breath rate, and four symptoms of emotional distress using visual analog scales, were assessed on the first and eighth day of the program. Results There was a significant decrease in sadness in the yoga group (p Conclusions A week of yoga can reduce feelings of sadness and possibly prevent an increase in anxiety in flood survivors a month after the calamity. Trial Registration Clinical Trials Registry of India: CTRI/2009/091/000285
Jasuja, Veena; Purohit, Geetanjali; Mendpara, Sameer; Palan, B M
The mood changes surrounding menstrual cycle mainly during luteal phase, known as premenstrual syndrome, have been described as early as the time of the ancient Greeks. Beck Depression Inventory (BDI-II) and State Trait Anxiety Inventory (STAI) are used to study psychological symptoms of anxiety and depression. To study the psychological parameters and effects of PMR on females with premenstrual syndrome. It was an experimental study. Sixty participants aged between 18 and 40 years, volunteered for this study. Relaxation technique, PMR was given to the study group (Group A, Mean age 24.13±5.69) for one month and control group (Group B, Mean age 28.96±9.42) was evaluated without any intervention. Paired students t test. Alpha error was set at 1% level. PMR Group A showed significant decrease in Both BDI II and STAI scores (p<0.001), showing benefits of relaxation in reducing anxiety and depression. We conclude that PMR helps to alleviate symptoms of premenstrual syndrome and decreases anxiety and depression as shown by changes in scores of both questionnaires.
Najdowski, Cynthia J.; Ullman, Sarah E.
Prior research has demonstrated that self-blame is predictive of more posttraumatic stress disorder (PTSD) symptoms and poorer recovery (Frazier, 2003; Koss, Figueredo, & Prince, 2002), and perceived control over recovery is associated with less distress (Frazier, 2003) in adult sexual assault (ASA) survivors. A structural equation model was…
Nugent, Bethany D; Sereika, Susan M; Rosenzweig, Margaret; McCue, Michael; Merriman, John D; Bender, Catherine M
Previous research has explored occupational activity of breast cancer survivors but has not examined the influence of occupational level on symptoms prospectively. The purpose of this study was to examine the relationship between occupational classification and changes in mood and symptom burden for postmenopausal breast cancer survivors during the first year of anastrozole therapy. This was an exploratory secondary analysis in 49 postmenopausal women receiving anastrozole therapy for early-stage breast cancer. Participants reported their occupation at baseline and completed self-report questionnaires measuring mood and symptom burden at baseline, 6 months, and 12 months. Occupation was classified according to four major skill levels delineated by the International Standard Classification of Occupations (ISCO). Breast cancer survivors employed at occupational skill levels 1 through 3 reported significantly higher depressive symptoms, fatigue, and total symptoms on average than those employed at ISCO skill level 4. After adjusting for multiple comparisons, this pattern remained for the musculoskeletal, vasomotor, and gastrointestinal symptom subscales. Breast cancer survivors employed at lower skill levels (i.e., ISCO 1-3) reported poorer mood and greater symptom burden than breast cancer survivors employed at a higher skill level (i.e., ISCO 4). Assessing baseline occupation of occupationally active breast cancer survivors may improve understanding of the association between types of occupations and mood and symptom trajectories and may inform development of interventions to mitigate symptom severity in order to help breast cancer survivors maintain optimal occupational function and adherence to therapy.
W. Wayne Lautt
Full Text Available We review evidence that the AMIS (Absence of Meal-induced Insulin Sensitization syndrome describes a paradigm fundamental to development of obesity. The hypoglycemic response to a pulse of insulin is doubled after a meal as a result of Hepatic Insulin Sensitizing Substance (HISS, released from the liver to act selectively on muscle, heart and kidney. In the absence of HISS action, the hypoglycemic response to insulin is the same as in the fasted state, and only half of what it should be. Postprandial hyperglycemia ensues, with compensatory hyperinsulinemia, resultant hyperlipidemia and elevated free radical stress. Storage of nutrient energy shifts from glycogen in muscle to fat. Chronic AMIS results in adiposity, occurs with age, is accelerated with sucrose supplement, and prevented by a synergistic antioxidant. Exercise reverses AMIS, as do pharmaceuticals that mimic the “feeding signals”. The AMIS syndrome develops as a sequence of pathologies based on the consequences of absence of HISS action, including adiposity as the earliest symptom. Cardiac dysfunction, hypertension, hypercholesterolemia, and fatty liver are related to lack of HISS action. The AMIS syndrome hypothesis is mechanistic-based and accounts for the major pathologies associated with prediabetes, obesity, diabetes and metabolic syndrome. AMIS can be diagnosed, prevented and treated.
Lautt, W Wayne; Wang, Hui Helen
We review evidence that the AMIS (Absence of Meal-induced Insulin Sensitization) syndrome describes a paradigm fundamental to development of obesity. The hypoglycemic response to a pulse of insulin is doubled after a meal as a result of Hepatic Insulin Sensitizing Substance (HISS), released from the liver to act selectively on muscle, heart and kidney. In the absence of HISS action, the hypoglycemic response to insulin is the same as in the fasted state, and only half of what it should be. Postprandial hyperglycemia ensues, with compensatory hyperinsulinemia, resultant hyperlipidemia and elevated free radical stress. Storage of nutrient energy shifts from glycogen in muscle to fat. Chronic AMIS results in adiposity, occurs with age, is accelerated with sucrose supplement, and prevented by a synergistic antioxidant. Exercise reverses AMIS, as do pharmaceuticals that mimic the "feeding signals". The AMIS syndrome develops as a sequence of pathologies based on the consequences of absence of HISS action, including adiposity as the earliest symptom. Cardiac dysfunction, hypertension, hypercholesterolemia, and fatty liver are related to lack of HISS action. The AMIS syndrome hypothesis is mechanistic-based and accounts for the major pathologies associated with prediabetes, obesity, diabetes and metabolic syndrome. AMIS can be diagnosed, prevented and treated.
Pinky H. Budhrani
Full Text Available Background. Limited research has been conducted on the moderating effect of race/ethnicity on objective sleep disturbances in breast cancer survivors (BCSs. Objective. To explore racial/ethnic differences in objective sleep disturbances among BCSs and their relationship with self-reported symptoms. Intervention/Methods. Sleep disturbance and symptoms were measured using actigraphy for 72 hours and self-reported questionnaires, respectively, among 79 BCSs. Analysis of covariance, Pearson’s correlation, and multivariate regression were used to analyze data. Results. Sixty (75.9% participants listed their ethnicity as white, non-Hispanic and 19 (24.1% as minority. Total sleep time was 395.9 minutes for white BCSs compared to 330.4 minutes for minority BCSs. Significant correlations were seen between sleep onset latency (SOL and depression, SOL and fatigue, and sleep efficiency (SE and fatigue among minority BCSs. Among white BCSs, significant correlations were seen between SE and pain and wake after sleep onset (WASO and pain. The association between depression and SOL and fatigue and SOL appeared to be stronger in minority BCSs than white BCSs. Conclusions. Results indicate that white BCSs slept longer than minority BCSs, and race/ethnicity modified the effect of depression and fatigue on SOL, respectively. Implications for Practice. As part of survivorship care, race/ethnicity should be included as an essential component of comprehensive symptom assessments.
Shenkman, Geva; Shrira, Amit; Ifrah, Kfir; Shmotkin, Dov
The aim of the current study was to examine whether offspring of Holocaust survivors (OHS) gay men report higher interpersonal vulnerability in comparison to non-OHS gay men, and to further assess whether that vulnerability mediates the association between having a Holocaust background and mental health outcomes (depressive symptoms and life satisfaction). For this purpose, a community-dwelling sample of 79 middle-aged and older OHS and 129 non-OHS gay men completed measures of hostile-world scenario (HWS) in the interpersonal domain, satisfaction from current steady relationship, depressive symptoms and life satisfaction. Results indicated that OHS reported higher HWS interpersonal vulnerability and lower satisfaction from current relationship in comparison to non-OHS gay men. Also, having a Holocaust background had an indirect effect on depressive symptoms and life satisfaction through HWS interpersonal vulnerability as well as through satisfaction from current relationship. These findings are the first to suggest interpersonal vulnerability of older OHS, in comparison to non-OHS, gay men, and an association between this vulnerability and adverse psychological outcomes. This interpersonal vulnerability, possibly representing HWS threats of both early family-based trauma and current sexual minority stress, along with its implications, should be addressed by practitioners who work with older gay men having a Holocaust background. Copyright © 2017 Elsevier B.V. All rights reserved.
Lengacher, Cecile A; Reich, Richard R; Paterson, Carly L; Ramesar, Sophia; Park, Jong Y; Alinat, Carissa; Johnson-Mallard, Versie; Moscoso, Manolete; Budhrani-Shani, Pinky; Miladinovic, Branko; Jacobsen, Paul B; Cox, Charles E; Goodman, Matthew; Kip, Kevin E
The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC). The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes. © 2016 by American Society of Clinical Oncology.
Reich, Richard R.; Paterson, Carly L.; Ramesar, Sophia; Park, Jong Y.; Alinat, Carissa; Johnson-Mallard, Versie; Moscoso, Manolete; Budhrani-Shani, Pinky; Miladinovic, Branko; Jacobsen, Paul B.; Cox, Charles E.; Goodman, Matthew; Kip, Kevin E.
Purpose The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. Patients and Methods A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. Results Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC). Conclusion The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes. PMID:27247219
Wong, Angela T T; Lai, Stephen Y; Gunn, G Brandon; Beadle, Beth M; Fuller, Clifton D; Barrow, Martha P; Hofstede, Theresa M; Chambers, Mark S; Sturgis, Erich M; Mohamed, Abdallah Sherif Radwan; Lewin, Jan S; Hutcheson, Katherine A
The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN. Medical records of 349 OPC patients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema. Patients were considered to have chronic dysphagia if they had aspiration pneumonia, stricture or aspiration detected by fluoroscopy or endoscopy, and/or feeding tube dependence in long-term follow-up ⩾1year following radiotherapy. MD Anderson Symptom Inventory - Head and Neck Module (MDASI-HN) scores were analyzed in a nested cross-sectional survey sample of 118 patients. 34 (9.7%, 95% CI: 6.8-13.3%) patients developed ORN and 45 (12.9%, 95% CI: 9.6-16.9%) patients developed chronic dysphagia. Prevalence of chronic dysphagia was significantly higher in ORN cases (12/34, 35%) compared to those who did not develop ORN (33/315, 11%, p<0.001). ORN grade was also significantly associated with prevalence of dysphagia (p<0.001); the majority of patients with grade 4 ORN requiring major surgery (6 patients, 75%) were found to have chronic dysphagia. Summary MDASI-HN symptom scores did not significantly differ by ORN grade. Significantly higher symptom burden was reported, however, among ORN cases compared to those without ORN for MDASI-HN swallowing (p=0.033), problems with teeth and/or gums (p=0.016) and change in activity (p=0.015) item scores. ORN is associated with excess burden of chronic dysphagia and higher symptom severity related to swallowing, dentition and activity limitations. Copyright © 2017 Elsevier Ltd. All rights reserved.
Ciechanowska, Katarzyna; Łukowicz, Małgorzata
Ciechanowska Katarzyna, Łukowicz Małgorzata. Effect of sonotherapy on symptoms of carpal tunnel syndrome. Journal of Education, Health and Sport. 2017;7(4):610-621. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.556821 http://ojs.ukw.edu.pl/index.php/johs/article/view/4417 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 239...
Buonaguro, Elisabetta F; Cimmarosa, Sara; de Bartolomeis, Andrea
Here we report the case of a patient with psychotic symptoms apparently resistant to antipsychotic treatments. Since the last admission in a psychiatric division the patient was diagnosed with Bipolar Disorder type I and then referred to our Outpatients Unit of Treatment Resistant Psychosis, where she was subsequently re-diagnosed with Dandy-Walker Syndrome. The Dandy Walker Complex is a congenital brain malformation involving the fourth ventricle and the cerebellum. We investigated the cognitive impairment of the patient and found deficits prominently in executive functions. This report may add further evidence on the importance of a correct diagnosis prior to defining a patient as treatment resistant and highlights cerebellar dysfunctions that may contribute to neuropsychiatric symptoms and cognitive impairment.
Bond, Suzie; Gourlay, Catherine; Desjardins, Alexandra; Bodson-Clermont, Paule; Boucher, Marie-Ève
The aim of the study was to assess the prevalence of anxiety, depression and PTSD-related symptoms reported by spouses and close relatives of adult burn survivors. Potential associations between these symptoms and variables such as the severity of the burn were also explored. Participants were spouses (n=31) and close relatives (n=25) of hospitalized patients with acute burns. Anxiety and depression symptoms were assessed by the Hospital Distress Anxiety and Depression Scale and PTSD-related symptoms by the Modified PTSD Symptom Scale at both admission to and discharge from the burn unit. At admission, 77% of spouses and 56% of close relatives of burn patients reported anxiety, depression or PTSD-related symptoms in the clinical range. While spouses had higher scores than close relatives on symptom measures, significant differences were only established for anxiety symptoms (panxiety (p=.01) and depression (p=.02) symptoms than men. Results also showed a main effect for time, with anxiety (p<.0001), depression (p<.0001) and PTSD-related (p<.0001) symptoms being higher at admission than at discharge. Variables associated with the index patient, such as total body surface area burned, length of stay, number of ventilated days, facial burns, or level of care at admission, were not associated with outcome measures. Spouses and close relatives of burn survivors showed high levels of psychological distress in the first few days following admission, and more than a quarter still reported symptoms in the clinical range at discharge. Our analysis points to the need to offer psychological support and guidance to family members so that they can in turn provide effective support to the burn survivor. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.
Full Text Available Objective: Premenstrual syndrome is a common disorder experienced by up to 50% of women during reproductive age. The prevalence of severe form of PMS (PMDD is 3 % to 8%. Psychiatric disorders in PMS patients have resulted in significant morbidity and in some cases caused resistance to the treatment process Material and Method: 390 participants (264 with PMS/PMDD, and 126 healthy students of University of Guilan who completed the demographic questionnaire, daily symptom rating (DSR and the checklist 90-revised (SCL-90-R took part in this study. This study was conducted using a cross sectional method. Results: According to repeated measure variance, the mean scores of psychiatric symptoms (Depression, Anxiety, Aggression, Interpersonal sensitivity in the PMS group were significantly higher than the healthy group (p< 0/05, and increase in severity of PMS from mild to severe was accompanied by increase in mean score of these subscales. There was a significant difference in mean score of depression, anxiety, aggression and interpersonal sensitivity between the 3rd and the 13th day of the cycle. Significant effect of the DSR grouping (PMS and Healthy group and time interaction emerged in interpersonal sensitivity and aggression, significant effect on the DSR grouping (Mild, Moderate, Severer and time interaction demonstrated in interpersonal sensitivity. Conclusion: Patients with prospective confirmed PMDD seemed to suffer from psychiatric symptoms. Therefore, recognizing co-morbid psychiatric symptoms in patients with PMDD is of prime importance. All healthcare providers should be sensitive to mental status of women with PMS.
Telles, Shirley; Naveen, K V; Dash, Manoj
A month after the December 2004 tsunami the effect of a 1 week yoga program was evaluated on self rated fear, anxiety, sadness and disturbed sleep in 47 survivors in the Andaman Islands. Polygraph recordings of the heart rate, breath rate and skin resistance were also made. Among the 47 people, 31 were settlers from the mainland (i.e. India, ML group) and 16 were endogenous people (EP group). There was a significant decrease in self rated fear, anxiety, sadness and disturbed sleep in both groups, and in the heart and breath rate in the ML group, and in the breath rate alone in the EP group, following yoga (P < 0.05, t-test). This suggests that yoga practice may be useful in the management of stress following a natural disaster in people with widely differing social, cultural and spiritual beliefs.
Berry, James D; Rowbotham, Michael C; Petersen, Karin Lottrup
Complex Regional Pain Syndrome (CRPS) associated with herpes zoster (HZ) was first reported by Sudeck in 1901 (Sudeck, 1901) and is recognized clinically. However, only 13 cases have been published in the literature, and nothing is known about the incidence, prevalence, or natural history (Chester, 1992; Foster et al., 1989; Grosslight et al., 1986; Ketz and Schliack,1968; Kishimoto et al., 1995; Querol and Cisneros, 2001; Sudeck, 1901; Visitsunthorn and Prete, 1981). The aim of the present study was to determine the prevalence of CRPS-like symptoms in a prospectively gathered cohort of subjects with HZ and to follow the natural history of their pain and sensory disturbance during the first 6 months after onset of HZ. Subjects were evaluated at four time points after HZ: 2-6 weeks, 6-8 weeks, 3 months, and 6 months. Only subjects aged 50 or older with pain VAS ratings of >/=20/100 at 2-6 weeks were eligible. The first (screening) visit included a neurological and physical examination that was updated at each subsequent visit. Assessments included ratings of pain intensity, allodynia severity, and rash severity. The neurological exam included determination of presence or absence of the following CRPS-like symptoms: (1) increased sweating, (2) color changes, (3) skin temperature changes, (4) weakness of the affected area based on physical exam, (5) edema, and (6) extension of CRPS-like symptoms outside the affected dermatome. For subjects with HZ in dermatomes that can include the limbs (C4-T2 and L1-S2), extremity involvement was considered present if allodynia or rash extended beyond the neck of the humerus (upper extremity), the inguinal ligament (anterior lower extremity), or gluteal sulcus (posterior lower extremity). Involvement of the extremity was considered proximal if neither HZ rash nor allodynia extended past the elbow (upper extremity) or knee (lower extremity). Of the first 75 subjects recruited, 25 had HZ outbreaks in dermatomes that extended into the
Full Text Available Nail changes can accompany many systemic diseases and very often indicate the ongoing systemic process of illness. The yellow nail syndrome (YNS is very rare clinical entity characterized by marked thickening and yellow to yellow-green discoloration of the nails. Congenitally hypoplastic lymphostasis plays a major role in the clinical manifestation of that disease. Syndrome includes pleural effusions, lymphedema and yellow dystrophic nails. The pathogenesis stays still unknown.Aim: Presentation the coexistence of YNS with the systemic symptoms by analyzing cases of 3 patients.Material and methods: The analysis involved 3 patients with YNS (2 women and 1 man aged from 43 to 48 years.Results: We confirmed 3 cases of YNS, with the characteristic nails changes (yellow-greenish discoloration, absence of lunula, etc.. None of the patients had a family history of YNS. All suffered from chronic diseases: the first patient suffered from lymphedema and diabetes mellitus, second - from rheumatoid arthritis and the third complained of a chronic caught and sinusitis. All YNS`s symptoms occurred in the patients` forties. We observed fingers and toes involvement on 7-8 nails in each patient.Conclusions: The YNS offen associated with systemic disease, most commonly lymphedema and bronchiectasis. However, the literature describes some connections with carcinoma and autoimmune diseases. Therefore, each patient with YNS should be examined for cancer detection and stay under periodic medical control.
Robinaugh, Donald John; McNally, Richard J.
Theorists have posited that regarding a trauma as central to one's identity leads to greater posttraumatic stress disorder (PTSD) symptom severity. To test this hypothesis, we administered the Centrality of Events Scale (CES) to women reporting a history of childhood sexual abuse (N = 102). The CES scores were correlated with PTSD symptom severity, depression severity, and self-esteem. In addition, we conducted a principal component analysis (PCA) to evaluate factors underlying the CES. The P...
Park, Eun-Young; Kim, Jung-Hee
The rehabilitation of depressed stroke patients is more difficult because poststroke depression is associated with disruption of daily activities, functioning, and quality of life. However, research on depression in stroke patients is limited. The aim of our study was to evaluate the interaction of demographic characteristics including gender, age, education level, the presence of a spouse, and income status on depressive symptoms in stroke patients and to identify groups that may need more attention with respect to depressive symptoms. We completed a secondary data analysis using data from a completed cross-sectional study of people with stroke. Depression was measured using the Center for Epidemiologic Studies Depression Scale. In this study, depressive symptoms in women living with a spouse were less severe than among those without a spouse. For those with insufficient income, depressive symptom scores were higher in the above high school group than in the below high school group, but were lower in patients who were living with a spouse than in those living without a spouse. Assessing depressive symptoms after stroke should consider the interaction of gender, economic status, education level, and the presence/absence of a spouse. These results would help in comprehensive understanding of the importance of screening for and treating depressive symptoms during rehabilitation after stroke.
Beekers, Nienke; Husson, Olga; Mols, Floortje; van Eenbergen, Mies; van de Poll-Franse, Lonneke V
Dissatisfaction with information provided by healthcare providers may be a reason for cancer survivors to seek health information on the Internet and may also result in more symptoms of anxiety and depression among this population. The aim of this study was to investigate whether anxious and depressive symptoms are associated with satisfaction with information provision and Internet use among cancer survivors. All individuals diagnosed with endometrial or colorectal cancer between 1998 and 2007 or lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry were invited for participation. In total, 4 446 survivors received a questionnaire including the 25-item European Organisation for Research and Treatment of Cancer Quality of Life Group Information questionnaire and Hospital Anxiety and Depression Scale; 69% responded (n = 3080). Having anxious (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.5-0.9; P information. Having depressive symptoms or having both depressive and anxious symptoms were negatively associated with satisfaction with information (OR, 0.5; 95% CI, 0.4-0.7; OR, 0.5; 95% CI, 0.4-0.7, respectively; P information provision is suboptimal, either because it is not adjusted to the mental health status of cancer patients or because it is unsatisfactory and thereby causing anxious and depressive symptoms among cancer patients. More attention should be paid to optimally adjust the information provision to the individual needs of the cancer patients for better mental health.
Mihaela Alexandra POP
Full Text Available OSAHS is a chronic, multifactorial disease, accompanied by significant and complex symptoms. The aim of this study was to evaluate the relationship between OSAHS and dorsal AHI in order to improve early diagnosis of dorsal sleep apnea-hypopnea syndrome. There were significant statistical differences between: the dorsal AHI Mean of the group without excessive daytime sleepiness as opposed to the dorsal AHI Mean of the group with excessive daytime sleepiness; the dorsal AHI Mean of the group without snoring as opposed to the dorsal AHI Mean of the group with snoring; the dorsal AHI Mean of the group without restless sleep as opposed to the dorsal AHI Mean of the group with restless sleep; the dorsal AHI Mean of the group without dyspnea as opposed to the dorsal AHI Mean of the group with dyspnea; the dorsal AHI Mean of the group without night sweats as opposed to the dorsal AHI Mean of the group with night sweats; the dorsal AHI Mean of the group without irritability as opposed to the dorsal AHI Mean of the group with irritability and the dorsal AHI Mean of the group without nightmares as opposed to the dorsal AHI Mean of the group with nightmares. Through this study we highlighted that excessive daytime sleepiness and snoring are prevalent symptoms in dorsal OSAHS. The presence of these symptoms in patients with sleep disorders may improve early diagnosis and the choice of an appropriate treatment for dorsal sleep apnea- hypopnea syndrome, thus participating in improving the patient’s life quality
Dekker, Alain D.; Strydom, Andre; Coppus, Antonia M. W.; Nizetic, Dean; Vermeiren, Yannick; Naude, Petrus J. W.; Van Dam, Debby; Potier, Marie-Claude; Fortea, Juan; De Deyn, Peter P.
Behavioural and Psychological Symptoms of Dementia (BPSD) are a core symptom of dementia and are associated with suffering, earlier institutionalization and accelerated cognitive decline for patients and increased caregiver burden. Despite the extremely high risk for Down syndrome (DS) individuals
Kuiken, S. D.; Lindeboom, R.; Tytgat, G. N.; Boeckxstaens, G. E.
Visceral hypersensitivity is considered an important pathophysiological mechanism in irritable bowel syndrome, yet its relationship to symptoms is unclear. Aim: To detect possible associations between symptoms and the presence of hypersensitivity to rectal distension in patients with irritable bowel
Chasens, E R; Umlauf, M; Valappil, T; Singh, K P
Nocturia, generally accepted as an inevitable consequence of aging, is also a symptom of a potentially lethal condition--obstructive sleep apnea (OSA). The descriptive study reported in this article examined nocturia and sleep-related breathing problems in persons with postpolio syndrome (PPS) and tested the Sleep Disordered Breathing--Nocturia Model. This model describes the cascade of events that results in polyuria in persons with sleep-related breathing disorders. Data were analyzed with descriptive and inferential statistics. A 34-item questionnaire was published in the newsletter of a national polio support group, and the 584 respondents constituted a convenience sample. The results showed statistically significant associations between OSA symptoms, nocturia, poor sleep quality, daytime sleepiness, lower urinary tract symptoms, naps, and decreased self-rated health. Study limitations were the use of a convenience sample and possible self-selection of persons with more severe sleep and bladder problems. The results support the model and document how nocturia and sleep disturbances negatively impact persons with PPS.
Robinaugh, Donald J; McNally, Richard J
Theorists have posited that regarding a trauma as central to one's identity leads to greater posttraumatic stress disorder (PTSD) symptom severity. To test this hypothesis, we administered the Centrality of Events Scale (CES) to women reporting a history of childhood sexual abuse (N = 102). The CES scores were correlated with PTSD symptom severity, depression severity, and self-esteem. In addition, we conducted a principal component analysis (PCA) to evaluate factors underlying the CES. The PCA yielded 3 factors reflecting (a) the centrality and integration of the trauma, (b) whether the event is regarded as a turning point in one's life story, and (c) whether the event is a reference point for expectations about the future. Each factor was associated with PTSD symptom severity. Copyright © 2011 International Society for Traumatic Stress Studies.
Stephens-Shields, Alisa J; Clemens, J Quentin; Jemielita, Thomas; Farrar, John; Sutcliffe, Siobhan; Hou, Xiaoling; Landis, J Richard
We examined symptom variability in men and women with urological chronic pelvic pain syndrome. We describe symptom fluctuations as related to early symptom regression and its effect on estimated 1-year symptom change. We also describe a method to quantify patient specific symptom variability. Symptoms were assessed biweekly in 424 subjects with urological chronic pelvic pain syndrome during 1 year. To evaluate the impact of early symptom regression subjects were classified as improved, no change or worse according to the rate of change using 1) all data, 2) excluding week 0 and 3) excluding weeks 0 and 2. Patient specific, time varying variability was calculated at each interval using a sliding window approach. Patients were classified as high, medium or low variability at each time and ultimately as high or low variability overall based on the variability for the majority of contacts. Prior to excluding early weeks to adjust for early symptom regression 25% to 38% and 5% to 6% of patients were classified as improved and worse, respectively. After adjustment the percent of patients who were improved or worse ranged from 15% to 25% and 6% to 9%, respectively. High and low variability phenotypes were each identified in 25% to 30% of participants. Patients with urological chronic pelvic pain syndrome show symptom variability. At study enrollment patients had worse symptoms on average, resulting in a regression effect that influenced the estimated proportion of those who were improved or worse. Prospective studies should include a run-in period to account for regression to the mean and other causes of early symptom regression. Further, symptom variability may be quantified and used to characterize longitudinal symptom profiles of urological chronic pelvic pain syndrome. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Lammerink, Ellen A. G.; de Bock, Geertruida H.; Schroder, Carolien P.; Mourits, Marian J. E.
Introduction: The intensified treatment of breast cancer improves survival but has a price in terms of side-effects. The main side-effects, such as vasomotor symptoms and impaired sexual functioning, are related to premature menopause due to chemotherapy and/or anti-hormonal therapy. Though for some
van Londen, G.J.; Donovan, H.S.; Beckjord, E.B.; Cardy, A.L.; Bovbjerg, D.H.; Davidson, N.E.; Morse, J.Q.; Switzer, G.E.; de Leeuw, I.M.; Dew, M.A.
Purpose/Objectives: To conduct an investigation of women's experiences related to adjuvant endocrine therapy (AET) and managing AET-related symptoms. Research Approach: Qualitative, focus group design. Setting: Main campus of the University of Pittsburgh in Pennsylvania. Participants: 14 breast
Gillihan, Seth J.; Aderka, Idan M.; Conklin, Phoebe H.; Capaldi, Sandra; Foa, Edna B.
Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and…
Karice K. Hyun
Full Text Available Abstract Background Studies of chronic diseases are associated with a financial burden on households. We aimed to determine if survivors of acute coronary syndrome (ACS experience household economic burden and to quantify any potential burden by examining level of economic hardship and factors associated with hardship. Methods Australian patients admitted to hospital with ACS during 2-week period in May 2012, enrolled in SNAPSHOT ACS audit and who were alive at 18 months after index admission were followed-up via telephone/paper survey. Regression models were used to explore factors related to out-of-pocket expenses and economic hardship. Results Of 1833 eligible patients at baseline, 180 died within 18 months, and 702 patients completed the survey. Mean out-of-pocket expenditure (n = 614 in Australian dollars was A$258.06 (median: A$126.50 per month. The average spending for medical services was A$120.18 (SD: A$310.35 and medications was A$66.25 (SD: A$80.78. In total, 350 (51 % of patients reported experiencing economic hardship, 78 (12 % were unable to pay for medical services and 81 (12 % could not pay for medication. Younger age (18–59 vs ≥80 years (OR: 1.89, no private health insurance (OR: 2.04, pensioner concession card (OR: 1.80, residing in more disadvantaged area (group 1 vs 5 (OR: 1.77, history of CVD (OR: 1.47 and higher out-of-pocket expenses (group 4 vs 1 (OR: 4.57 were more likely to experience hardship. Conclusion Subgroups of ACS patients are experiencing considerable economic burden in Australia. These findings provide important considerations for future policy development in terms of the cost of recommended management for patients.
Koleck, Theresa A; Conley, Yvette P
Research is beginning to suggest that the presence and/or severity of symptoms reported by breast cancer survivors may be associated with disease-related factors of cancer. In this article, we present a novel approach to the identification and prioritization of biologically plausible candidate genes to investigate relationships between genomic variation and symptom variability in breast cancer survivors. Cognitive dysfunction is utilized as a representative breast cancer survivor symptom to elucidate the conceptualization of and justification for our cellular, disease-based approach to address symptom variability in cancer survivors. Initial candidate gene identification was based on genes evaluated as part of multigene expression profiles for breast cancer, which are commonly used in the clinical setting to characterize the biology of cancer cells for the purpose of describing overall tumor aggressiveness, prognostication, and individualization of therapy. A list of genes evaluated within five multigene expression profiles for breast cancer was compiled. In order to prioritize candidate genes for investigation, genes used in each profile were compared for duplication. Twenty-one genes (BAG1, BCL2, BIRC5, CCNB1, CENPA, CMC2, DIAPH3, ERBB2, ESR1, GRB7, MELK, MKI67, MMP11, MYBL2, NDC80, ORC6, PGR, RACGAP1, RFC4, RRM2, and SCUBE2) are utilized in two or more profiles, including five genes (CCNB1, CENPA, MELK, MYBL2, and ORC6) used in three profiles. To ensure that the parsimonious 21 gene set is representative of the more global biological hallmarks of cancer, an Ingenuity Pathway Analysis was conducted. Evaluation of genes known to impact pathways involved with cancer development and progression provide a means to evaluate the overlap between the biological underpinnings of cancer and symptom development within the context of cancer.
Shrira, Amit; Ayalon, Liat; Bensimon, Moshe; Bodner, Ehud; Rosenbloom, Tova; Yadid, Gal
A fascinating, yet underexplored, question is whether traumatic events experienced by previous generations affect the aging process of subsequent generations. This question is especially relevant for offspring of Holocaust survivors (OHS), who begin to face the aging process. Some preliminary findings point to greater physical dysfunction among middle-aged OHS, yet the mechanisms behind this dysfunction need further clarification. Therefore, the current studies assess aging OHS using the broad-scoped conceptualization of successful aging, while examining whether offspring successful aging relates to parental post-traumatic stress disorder (PTSD) symptoms and offspring’s secondary traumatization symptoms. In Study 1, 101 adult offspring (mean age = 62.31) completed measures of parental PTSD, secondary traumatization, as well as successful aging indices – objective (medical conditions, disability and somatic symptoms) and subjective (perceptions of one’s aging). Relative to comparisons and OHS who reported that none of their parents suffered from probable PTSD, OHS who reported that their parents suffered from probable PTSD had lower scores in objective and subjective measures of successful aging. Mediation analyses showed that higher level of secondary traumatization mediated the relationship between parental PTSD and less successful aging in the offspring. Study 2 included 154 dyads of parents (mean age = 81.86) and their adult offspring (mean age = 54.48). Parents reported PTSD symptoms and offspring reported secondary traumatization and completed measures of objective successful aging. Relative to comparisons, OHS whose parent had probable PTSD have aged less successfully. Once again, offspring secondary traumatization mediated the effect. The findings suggest that parental post-traumatic reactions assessed both by offspring (Study 1) and by parents themselves (Study 2) take part in shaping the aging of the subsequent generation via reactions of secondary
Full Text Available A fascinating, yet underexplored, question is whether traumatic events experienced by previous generations affect the aging process of subsequent generations. This question is especially relevant for offspring of Holocaust survivors (OHS, who begin to face the aging process. Some preliminary findings point to greater physical dysfunction among middle-aged OHS, yet the mechanisms behind this dysfunction need further clarification. Therefore, the current studies assess aging OHS using the broad-scoped conceptualization of successful aging, while examining whether offspring successful aging relates to parental post-traumatic stress disorder (PTSD symptoms and offspring’s secondary traumatization symptoms. In Study 1, 101 adult offspring (mean age = 62.31 completed measures of parental PTSD, secondary traumatization, as well as successful aging indices – objective (medical conditions, disability and somatic symptoms and subjective (perceptions of one’s aging. Relative to comparisons and OHS who reported that none of their parents suffered from probable PTSD, OHS who reported that their parents suffered from probable PTSD had lower scores in objective and subjective measures of successful aging. Mediation analyses showed that higher level of secondary traumatization mediated the relationship between parental PTSD and less successful aging in the offspring. Study 2 included 154 dyads of parents (mean age = 81.86 and their adult offspring (mean age = 54.48. Parents reported PTSD symptoms and offspring reported secondary traumatization and completed measures of objective successful aging. Relative to comparisons, OHS whose parent had probable PTSD have aged less successfully. Once again, offspring secondary traumatization mediated the effect. The findings suggest that parental post-traumatic reactions assessed both by offspring (Study 1 and by parents themselves (Study 2 take part in shaping the aging of the subsequent generation via reactions of
Howell, Andrew J.; Watson, David C.
The pattern of perceived dysfunction associated with symptoms composing the externalizing childhood disorder syndrome was compared to the pattern characterizing the internalizing syndrome. In Study 1, undergraduate students (N = 205) judged the social impairment, academic/occupational impairment and personal distress associated with symptoms from…
Zerach, Gadi; Solomon, Zahava
There is an ongoing debate regarding the intergenerational transmission of Holocaust trauma to the third generation (TGH). However, due to the rareness of this population, there are no studies that have examined TGH individuals whose fathers were also victims of war-related trauma and captivity. This prospective study aimed to assess the role of parents' Holocaust background, fathers' posttraumatic stress symptoms (PTSS), and adult offspring's anxiety sensitivity (AS) in adult offspring's PTSS and psychiatric symptomatology. A sample of 123 Israeli father-child dyads (42 TGH and 71 non-TGH), that included 80 former prisoners of war (ex-POWs) dyads and a comparison group of 44 veteran dyads, completed AS, PTSS and psychiatric symptomatology self-report measures. Fathers were assessed 17 years following the Yom Kippur War (T1: 2008) while offspring took part in T2 (2013-2014). Surprisingly, results show that TGH participants reported lower levels of PTSS and psychiatric symptomatology than non-TGH participants, regardless of their fathers' captivity status. Interestingly, a moderated mediation analysis indicated that offspring's AS mediated the association between Holocaust background and participants' PTSS and psychiatric symptomatology, only among ex-POWs' offspring. This study provides evidence for relatively lower levels of PTSS and psychiatric symptomatology among TGH individuals whose fathers were war veterans. Ex-POWs' adult offspring who are grandchildren of Holocaust survivors reported lower levels of AS that was related to lower levels of PTSS and psychiatric symptomatology. Copyright © 2015 Elsevier Ltd. All rights reserved.
Restless legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs and usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movement and is exacerbated or occurs mainly in the evening or night. People suffering from RLS are estimated to represent 2-3% of the general Japanese population, which is relatively lower than the estimated prevalence in western countries. Supportive diagnostic critevia include family history, the presence of periodic-leg movements (PLM) when awake or asleep, and a positive response to dopaminergic treatment. RLS phenotypes include an early onset form that is usually idiopathic with frequent familial history and a late onset form that is usually secondary to other somatic conditions that are causative factors in RLS occurrence. In all patients presenting with complaints of insomnia or discomfort in the lower limbs, diagnosis of RLS should be considered. RLS should be differentiated from akathisia, which is an urge to move the whole body in the absence of uncomfortable sensations. Polysomnographic studies and the suggested immobilization test (SIT) can detect PLM in patients that are asleep or awake. RLS may cause severe sleep disturbances, poor quality of life, depressive and anxious symptoms, and may be a risk factor for cardiovascular disease. Secondary RLS may occur due to iron deficiency, end-stage renal disease, pregnancy, peripheral neuropathy and drug use including antipsychotics and antidepressants. Small fiber neuropathy can trigger RLS or mimic its symptoms. RLS is associated with many neurological disorders, including Parkinson disease and multiple system atrophy; althoughit does not predispose to these diseases. A symptom rating scale for RLS authorized by the International RLS Study Group (IRLS) would facilitate accurate diagnosis of this condition.
Campo, Rebecca A; Wu, Lisa M; Austin, Jane; Valdimarsdottir, Heiddis; Rini, Christine
This longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = -0.07, p = 0.005), mediated by reductions in depressive symptoms (b = -0.01, 95% CI: -0.027, -0.003) and in searching for a reason for one's illness (b = -0.01, 95% CI: -0.034, -0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.
Kay, L; Jørgensen, Torben; Schultz-Larsen, K
With the aim to assess the clustering of abdominal symptoms in a random population, data from a cohort study of a 70 year old Danish population were analysed. The cohort comprised 1,119 subjects of which 72% participated in a primary study and 91% of the survivors in a similar study five years la...... symptoms occur in clusters comparable to clusters in younger populations. The clusters, however, does not totally confirm the traditional concept of Upper Dyspepsia and Irritable Bowel Syndrome....... later. The following clusters of symptoms were constantly associated. One group constituted abdominal distension, borborygmi, altering stool consistency and number of bowel movements. Pain relieved by bowel movement was associated with this cluster. Nausea and vomiting comprised another cluster...
Elliott, Doug; Davidson, Judy E; Harvey, Maurene A; Bemis-Dougherty, Anita; Hopkins, Ramona O; Iwashyna, Theodore J; Wagner, Jason; Weinert, Craig; Wunsch, Hannah; Bienvenu, O Joseph; Black, Gary; Brady, Susan; Brodsky, Martin B; Deutschman, Cliff; Doepp, Diana; Flatley, Carl; Fosnight, Sue; Gittler, Michelle; Gomez, Belkys Teresa; Hyzy, Robert; Louis, Deborah; Mandel, Ruth; Maxwell, Carol; Muldoon, Sean R; Perme, Christiane S; Reilly, Cynthia; Robinson, Marla R; Rubin, Eileen; Schmidt, David M; Schuller, Jessica; Scruth, Elizabeth; Siegal, Eric; Spill, Gayle R; Sprenger, Sharon; Straumanis, John P; Sutton, Pat; Swoboda, Sandy M; Twaddle, Martha L; Needham, Dale M
Increasing numbers of survivors of critical illness are at risk for physical, cognitive, and/or mental health impairments that may persist for months or years after hospital discharge. The post-intensive care syndrome framework encompassing these multidimensional morbidities was developed at the 2010 Society of Critical Care Medicine conference on improving long-term outcomes after critical illness for survivors and their families. To report on engagement with non-critical care providers and survivors during the 2012 Society of Critical Care Medicine post-intensive care syndrome stakeholder conference. Task groups developed strategies and resources required for raising awareness and education, understanding and addressing barriers to clinical practice, and identifying research gaps and resources, aimed at improving patient and family outcomes. Representatives from 21 professional associations or health systems involved in the provision of both critical care and rehabilitation of ICU survivors in the United States and ICU survivors and family members. Stakeholder consensus meeting. Researchers presented summaries on morbidities for survivors and their families, whereas survivors presented their own experiences. Future steps were planned regarding 1) recognizing, preventing, and treating post-intensive care syndrome, 2) building strategies for institutional capacity to support and partner with survivors and families, and 3) understanding and addressing barriers to practice. There was recognition of the need for systematic and frequent assessment for post-intensive care syndrome across the continuum of care, including explicit "functional reconciliation" (assessing gaps between a patient's pre-ICU and current functional ability at all intra- and interinstitutional transitions of care). Future post-intensive care syndrome research topic areas were identified across the continuum of recovery: characterization of at-risk patients (including recognizing risk factors
Vincent, A J; Ranasinha, S; Sayakhot, P; Mansfield, D; Teede, H J
Treatment-induced early menopause occurs in > 80% of premenopausal women diagnosed with breast cancer. This study explored the relationship between vasomotor symptoms (VMS), sleep and mood in women aged 40-51 years with non-metastatic breast cancer. Cross-sectional study using validated questionnaires (Greene Climacteric scale and Hospital Anxiety and Depression Scale, HADS). Women (n = 114) were recruited from the community and hospital outpatient clinics. Frequency determination and structural equation modeling (SEMod) were used to examine the relationship between the latent variables: VMS, anxiety, and depression, and the indicator variable: difficulty sleeping. Participants' mean age was 47 years and 94% became menopausal after breast cancer diagnosis. Difficulty sleeping was reported by 82% of women with 46% reporting (Likert scale) 'quite a bit/extremely'. Most women reported night sweats (77% of women: 47% reporting 'quite a bit/extremely') and hot flushes (84% of women: 50% reporting 'quite a bit/extremely'). HADS scores indicated clinically relevant depression and anxiety in 98% and 99% of women, respectively. SEMod revealed that VMS contributed to difficulty sleeping (standardized coefficient = 0.54; p sleeping mediated the relationship between VMS and anxiety (standardized coefficient = 0.34; p = 0.03). However, difficulty sleeping did not have a significant direct impact on depression (standardized coefficient = -0.03; p = 0.8), although anxiety was a strong predictor of depression (standardized coefficient = 0.83; p = 0.015). VMS, sleep and mood disturbance are commonly experienced by younger women with breast cancer. Using SEMod, we demonstrate for the first time that VMS may directly influence sleep in these women. VMS may have an indirect effect on mood, partly mediated by sleep difficulty.
Hauer, Daniela; Weis, Florian; Krauseneck, Till; Vogeser, Michael; Schelling, Gustav; Roozendaal, Benno
Survivors of the acute respiratory distress syndrome (ARDS) often report traumatic memories from the intensive care unit (ICU) and display a high incidence of post-traumatic stress disorder (PTSD). As it is known that subjects with PTSD often show sustained reductions in circulating cortisol
Cheng, Andy S K; Zeng, Yingchun; Feuerstein, Michael
The purpose of this study was to translate the Cognitive Symptom Checklist-Work-21 (CSC-W21), into Chinese, and culturally adapt and validate the Chinese version, a measure of work-related cognitive limitations in occupationally active breast cancer survivors (BCS). The translation of the English version of the CSC-W21 followed a systematic procedure. Exploratory factor analysis was used to identify factor structures. The internal consistency of the factors was assessed by calculating the Cronbach's alpha reliability coefficients. Item- and scale-level content validity was determined. The intra-class correlation coefficient (ICC) was used to analyze test-retest reliability. A total of two hundred and twenty BCS participated in the psychometric testing of the CSC-W21-C. The construct validity of the total score of the CSC-W21-C was determined through convergent validity and an analysis of its relationship with the four subscales of the Work Limitations Questionnaire (WLQ), a measure of four types of job task difficulties. The CSC-W21-C demonstrated item- and scale-level content validity (>.80). The factor structure of the CSC-W21-C was similar to the original English version. The internal consistency of the subscales of the CSC-W21-C ranged from .84 to .95. The ICC was between .80 and .96 indicating good test-retest reliability. The CSC-W21-C was significantly correlated with the WLQ, particularly the mental-interpersonal subscale, where it accounted for 27.3 % of the total variance. The findings indicate that the CSC-W21-C has sound measurement properties that strongly suggest it can be used in future assessment and intervention research to identify cognitive limitations related to specific work tasks in BCS.
Full Text Available Objective: In this study, we aimed to investigate whether a relationship between the presence and severity of trauma symptoms and duration/frequency of abuse and socio-demographic variables exist or not. Methods: Sixty-five children, aged between 5-17 years, who were admitted to Child and Adolescent Psychiatry Department of Akdeniz University Hospital due to sexual abuse have been enrolled to the study with their mothers. Existing psychopathologies of children were evaluated by Kiddie Schedule for Affective Disorders and Schizophrenia-Lifetime version (K-SADS-PL and PTSD were evaluated by Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA. For identifying PTSD in their parents Clinician Administered PTSD Scale (CAPS was used. Results: 84.6% of victims (n = 55 were female and15.4% (n = 10 were male. There was no significant relationship between the frequency and duration of abuse and CAPS B, C, and D scores (P> 0.05. Similarly, no significant relationship was present between the frequency and duration of abuse and CAPS B, C, and D scores of the mothers (P> 0.05. In females, age and education level were positively correlated with the CAPS B, C and D scores. Parents' education level was tending to be lower by decreasing age of victimized children. Conclusion: Multiple factors (personal, familial, and pertaining to abuse may play role in the impact of abuse on mental health of survivors of sexual abuse. Education levels of parents seem to be related with both the abuse risk of children and its impact on the child’s mental health after sexual abuse.
Full Text Available In this study, several mycological analyses made in the houses of the sick people whose sensitivity against allergens was examined in line with the people and their histories who applied to Istanbul University, Istanbul Medical Faculty Department of Pulmonery Disease. Clinically, in the blood serums of three housewives, who have complaints about respiration difficulties, specific lgG antibody against several mold, thermophylic actinomycetes and bird antigens were examined. As a result of the analysis it is found out that there is a 75% direct relation between in-house molds flora and the molds that the sick person gained sensitivity. Findings appeared in housewives who are living in houses surrounded by molds are regarded as sick building syndrome. In this particular work, knowledge is given about real agents that are hidden behind some general symptoms of anemnesia and examination of patients with chronic complaints. [TAF Prev Med Bull 2006; 5(5.000: 352-363
Oudin, Claire; Berbis, Julie; Bertrand, Yves; Vercasson, Camille; Thomas, Frédérique; Chastagner, Pascal; Ducassou, Stéphane; Kanold, Justyna; Tabone, Marie-Dominique; Paillard, Catherine; Poirée, Marilyne; Plantaz, Dominique; Dalle, Jean-Hugues; Gandemer, Virginie; Thouvenin, Sandrine; Sirvent, Nicolas; Saultier, Paul; Béliard, Sophie; Leverger, Guy; Baruchel, André; Auquier, Pascal; Pannier, Bruno; Michel, Gérard
The prevalence of the metabolic syndrome among adults from the French childhood acute leukemia survivors' cohort was prospectively evaluated considering the type of anti-leukemic treatment received, and compared with that of controls. The metabolic profile of those patients was compared with that of controls. 3203 patients from a French volunteer cohort were age- and sex-matched 3:1 to 1025 leukemia survivors (in both cohorts, mean age: 24.4 years, female individuals: 51%). Metabolic syndrome was defined according to the National Cholesterol Education Program's Adult Treatment Panel III criteria. Metabolic syndrome was found in 10.3% of patients (mean follow-up duration: 16.3+/-0.2 years) and 4.5% of controls, (OR=2.49, pmetabolic syndrome displayed a unique profile compared with controls: smaller waist circumference (91 versus 99.6 cm, p=0.01), increased triglyceride levels (3.99 versus 1.5 mmol/l, pmetabolic syndrome had a larger waist circumference (109 versus 99.6 cm, p=0.007) than controls. Regardless of the anti-leukemic treatment, metabolic syndrome risk was higher among childhood leukemia survivors. Its presentation differed depending on the treatment type, thus suggesting divergent pathophysiology. Copyright © 2018, Ferrata Storti Foundation.
Szubert, Sebastian; Wójcicka, Katarzyna; Gaca, Michał; Linke, Krzysztof; Sajdak, Stefan
Jaundice is a rare symptom of the HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) and is diagnosed in only 5% of the patients with this condition. However jaundice is related with sever presentation of the disease and associated with higher mortality The aim of this paper was to present a case of 24-year-old patient with jaundice as the first symptom of severe HELLP syndrome. A review of the literature about symptoms and treatment of HELLP syndrome and differential diagnosis of jaundice in pregnancy was done as well.
Full Text Available Drug reaction with eosinophilia and systemic symptom (DRESS syndrome is a severe adverse drug-induced reaction. Diagnosing DRESS syndrome is also challenging due to the diversity of cutaneous eruption and the organs involved. Here, we described an 88-year-old Chinese woman who developed DRESS syndrome under combined therapy of nonsteroidal anti-inflammatory drugs (NSAIDs and chlormezanone (CM accompanied with cytomegalovirus reactivation. DRESS syndrome should be highly suspected in patients with symptoms, including skin rash, fever, liver involvement, hypereosinophilia, and lymphadenopathy, especially coexisted with reactivation of the cytomegalovirus. Early withdrawal of the culprit drug is necessary once the diagnosis is established.
Wallström, Sara; Ulin, Kerstin; Omerovic, Elmir; Ekman, Inger
Takotsubo syndrome is a form of acute, reversible heart failure that has gained increasing attention. It affects mostly postmenopausal women, and its acute onset and symptoms mimic acute myocardial infarction. The distinct feature of takotsubo syndrome is the ballooning of a ventricle, but the complete pathophysiological mechanisms are not fully understood. Both short-term and long-term survival are affected, but little is known about the illness experience and self-reported residual symptoms after discharge from hospital. To measure and compare self-reported residual symptoms between patients with takotsubo syndrome and those with acute myocardial infarction. Questionnaire data measuring self-reported symptoms were collected from 48 patients with takotsubo syndrome and 79 patients with acute myocardial infarction 8weeks after discharge. A multivariate adjusted complete case regression model was used to compare the frequency and severity of symptoms. Self-reported symptoms 8weeks after discharge differed little between patients with takotsubo syndrome and those with acute myocardial infarction. Both groups reported symptoms, including pain, fatigue, breathlessness, and sleep disturbance. At onset there were significant differences between the groups concerning previous diabetes mellitus, cardiac troponin T, ejection fraction and Killip class. There were no significant between-group differences in frequency or severity of symptoms after adjusting for these differences. Patients with takotsubo syndrome experience residual symptoms after discharge. Symptoms in several cardiovascular diseases predict quality of life, re-admission, and mortality. Symptom management should be integrated into follow-up care for patients with takotsubo syndrome. One way of achieving this is through person-centered care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Shirley S. M. Fong
Full Text Available This study aimed to investigate the effects of Qigong intervention on quality of life (QOL, health-related functioning, and cancer-related symptoms in survivors of nasopharyngeal cancer (NPC. Twenty-five survivors of NPC were included in the experimental group (mean age ± SD: 55.4 ± 7.5 years and 27 in the control group (mean age ± SD: 58.7 ± 9.5 years. The experimental group underwent a weekly 1.5-hour Qigong training program and an identical home program (three times/week for six months. The control group received no training. Global health status/QOL, functioning, and cancer-related symptoms were assessed by the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-H&N35 questionnaires before training began, after three months of Qigong training, at the end of the six-month Qigong intervention (i.e., posttest, and six months posttest. Intention-to-treat analysis revealed no statistically (P>0.05 or clinically significant improvement in global health status/QOL, functioning, or symptoms in either group. The experimental group had 45.8% fewer sense-related (smell and taste problems (P<0.05 but 98.6% more speech-related problems (P<0.05 than the control group after the Qigong intervention. Qigong training resulted in no apparent improvement in health-related QOL, functionality, or cancer-related symptoms in cancer-free survivors of NPC, except for a possible reduction in smell- and taste-related problems.
Dhondt, Veerle; Hofman, Sarah; Dahan, Karin; Beele, Hilde
Blau syndrome is a rare autosomal dominant condition, typically defined by granulomatous polyarthritis, uveitis and skin eruption. Biopsy specimens demonstrate non-caseating granulomas in all lesions. We present a case of Blau syndrome associated with large recalcitrant leg ulcers. Biopsies taken in the leg ulcers of our patient systematically showed granulomas. Although leg ulcers have not previously been described as a part of Blau syndrome, we assume that the ulcerations in this case form part of Blau syndrome.
Koch, Anna K; Rabsilber, Sybille; Lauche, Romy; Kümmel, Sherko; Dobos, Gustav; Langhorst, Jost; Cramer, Holger
Previous research has found that yoga can enhance quality of life and ease menopausal symptoms of breast cancer survivors. The study examined whether self-esteem mediated the effects of yoga on quality of life, fatigue and menopausal symptoms, utilizing validated outcome measures. This is a secondary analysis of a randomized controlled trial comparing the effects of yoga with those of usual care in 40 breast cancer survivors who suffered from menopausal symptoms. All participants completed all 3 assessments (week 0, week 12, and week 24) and provided full data. Outcomes were measured using self-rating instruments. Mediation analyses were performed using SPSS. Self-esteem mediated the effect of yoga on total menopausal symptoms (B=-2.11, 95% BCI [-5.40 to -0.37]), psychological menopausal symptoms (B=-0.94, 95% BCI [-2.30 to -0.01]), and urogenital menopausal symptoms (B=-0.66, 95% BCI [-1.65 to -0.15]), quality of life (B=8.04, 95% BCI [3.15-17.03]), social well-being (B=1.80, 95% BCI [0.54-4.21]), emotional well-being (B=1.62, 95% BCI [0.70-3.34]), functional well-being (B=1.84, 95% BCI [0.59-4.13]), and fatigue (B=4.34, 95% BCI [1.28-9.55]). Self-esteem had no effect on somatovegetative menopausal symptoms (B=-0.50, 95% BCI n.s.) or on physical well-being (B=0.79, 95% BCI n.s.). Findings support the assumption that self-esteem plays a vital role in the beneficial effect of yoga and that yoga can have long-term benefits for women diagnosed with breast cancer and undergoing menopausal transition. Copyright © 2017 Elsevier B.V. All rights reserved.
Søndergaard, Mads Madsen; tursunovic, Amela; Thye-Roenn, Peter
BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012, with Icterohaemo......BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012...
Pfoh, Elizabeth R; Chan, Kitty S; Dinglas, Victor D; Cuthbertson, Brian H; Elliott, Doug; Porter, Richard; Bienvenu, O Joseph; Hopkins, Ramona O; Needham, Dale M
Survivors of acute respiratory failure commonly experience long-term psychological sequelae and impaired quality of life. For researchers interested in general mental health, using multiple condition-specific instruments may be unnecessary and inefficient when using the Medical Outcomes Study Short Form (SF)-36, a recommended outcome measure, may suffice. However, relationships between the SF-36 scores and commonly used measures of psychological symptoms in acute survivors of respiratory failure are unknown. Our objective is to examine the relationship of the SF-36 mental health domain (MH) and mental health component summary (MCS) scores with symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) evaluated using validated psychological instruments. We conducted a cross-sectional analysis of 1,229 participants at 6- and 12-month follow-up assessment using data from five studies from the United States, the United Kingdom, and Australia. Symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), Depression Anxiety Stress Scales, the Davidson Trauma Scale, Impact of Event Scale (IES), and IES-Revised (IES-R). At 6-month assessment there were moderate to strong correlations of the SF-36 MH scores with HADS depression and anxiety symptoms (r = -0.74 and -0.79) and with IES-R PTSD symptoms (r = -0.60) in the pooled analyses. Using the normalized population mean of 50 on the SF-36 MH domain score as a cut-off, positive predictive values were 16 and 55% for substantial depression; 20 and 68% for substantial anxiety (Depression Anxiety Stress Scales and HADS, respectively); and 40, 44, and 67% for substantial PTSD symptoms (IES-R, IES, and Davidson Trauma Scale, respectively). Negative predictive values were high. The area under the receiver operating characteristics curve of the SF-36 MH score was high for depression, anxiety, and PTSD symptoms (0.88, 0.91, and 0.84, respectively). All results were consistent for the MCS
Carbone, Mario; Della Ferrera, Francesco; Carbone, Lucio; Gatti, Gaia; Carrozzo, Marco
.... The authors report a case of a 71-year-old woman in which the numb chin syndrome was the first symptom of the diffuse large B-cell lymphoma, which caused infiltration and reabsorption of the alveolar...
Nijs, J.; Meeus, M.; Heins, M.; Knoop, H.; Moorkens, G.; Bleijenberg, G.
PURPOSE: Kinesiophobia and catastrophizing are frequent among people with chronic fatigue syndrome (CFS). This study was aimed at examining (1) whether kinesiophobia, anticipated symptoms and fatigue catastrophizing are related to stair climbing performance in people with CFS; and (2) whether
Nijs, J.; Meeuw, M.; Heins, M.; Knoop, H.; Moorkens, G.; Bleijenberg, G.
Purpose: Kinesiophobia and catastrophizing are frequent among people with chronic fatigue syndrome (CFS). This study was aimed at examining (1) whether kinesiophobia, anticipated symptoms and fatigue catastrophizing are related to stair climbing performance in people with CFS; and (2) whether
Bao, Ping-Ping; Zheng, Ying; Nechuta, Sarah; Gu, Kai; Cai, Hui; Peng, Peng; Shu, Xiao-Ou; Lu, Wei
Metabolic syndrome (MetS) is an established risk factor for cardiovascular diseases and mortality. Limited data are available on the prevalence of MetS and its association with exercise among breast cancer survivors. The present study included 1696 breast cancer survivors from the Shanghai Breast Cancer Survival Study, a population-based prospective cohort study conducted between April 2002 and October 2011 in Shanghai, China. All women had a physical examination taken at study clinic approximately 60 months post-diagnosis. Exercise was assessed at approximately 6, 18, 36, and 60 months post-diagnosis. Information on medical history, tumor characteristics, cancer treatment, anthropometrics, and lifestyle were collected at study enrollment. Associations between exercise and MetS at 60 months post-diagnosis were evaluated with multivariable logistic regression models. The mean age of the study population was 56.68 at 60-month survey and the mean follow-up since cancer diagnosis was 63.66 months. The prevalence of MetS using NCEP-ATPIII criteria at approximately 60 months after diagnosis was 33.14%. Among overweight and obesity breast cancer survivors (BMI≥25 kg/m2 at baseline), the prevalence was 55.18%. The most common type of exercise in this population was walking (45.40%) at baseline. Exercise participation between 6 and 60 months post-diagnosis was inversely associated with the prevalence of MetS with the adjusted OR for exercise participation of ≥3.5 hours/week (30 minutes/day) being 0.69 (95% CI: 0. 0.48–0.98). In addition consistent exercise participation reduced the prevalence of MetS (adjusted OR 0.70 (95%CI: 0.50–1.00). Associations of exercise with MetS were not modified by baseline WC, BMI, comorbidity, baseline menopausal status, TNM stage, cancer treatment, or ER/PR status (P interactions >0.05). Regular and persistent exercise after cancer diagnosis, even at low-to-moderate intensity level, decrease the prevalence of MetS among long
Full Text Available PURPOSE: To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. METHODS: 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson's Resilience Scale, and the Severity of Exposure to Earthquake Scale. RESULTS: After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others and PTSD and depressive symptoms. CONCLUSIONS: Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others on PTSD and depressive symptoms.
Gard, Tracy L; Hoover, Donald R; Shi, Qiuhu; Cohen, Mardge H; Mutimura, Eugene; Adedimeji, Adebola A; Anastos, Kathryn
We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV-infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. The Rwandan Women's Interassociation Study and Assessment was a longitudinal prospective study of HIV-infected and uninfected women. At study entry, 922 women (705 HIV+ and 217 HIV-) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical, and behavioral characteristics. Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall quality of life (QOL) than did HIV- women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long-term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL.
de Lange, J.; Ybema, A; Baas, E. M.
Lemierre's syndrome, a thrombophlebitis of the internal jugular vein, is a rare disorder, usually caused by the microorganism Fusobacterium necrophorum. Throat ache and swelling of the neck are often the first symptoms. Without adequate treatment, Lemierre's syndrome may result in thrombosis of the
Claro, Anthony; Cornish, Kim; Gruber, Reut
In the current study, the authors examined whether the fatigue level of children diagnosed with cri du chat syndrome was associated with the expression of autistic symptoms. Sixty-nine children with cri du chat syndrome were compared with 47 children with moderate to severe intellectual disabilities who did not differ on intellectual severity.…
Mohammad Javad Jafari; Ali Asghar Khajevandi; Seyed Ali Mousavi Najarkola; Mohammad Amin Pourhoseingholi; Leila Omidi; Esmaeil Zarei
Background and objectives : Research has consistently shown that air quality personal factors and work related factors were the most effective parameters for sick building syndrome. Several epidemiological studies have been carried out to show the prevalence of the sick building syndrome among the office workers but less attention has been paid to the relation of the sick building syndrome and the environmental parameters. In this work, the relationship between sick building symptoms and ind...
Zhao, Changyi; Wu, Zhibin; Xu, Jiuping
To examine the role of the three types of social support as possible moderating factors between post-traumatic stress disorder (PTSD) and its relationship to two domains of the quality of life (QOL). A cross-sectional survey was done in a local area near the epicenter of the severe earthquake in Wenchuan. The Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview a total of 2,080 earthquake survivors in the one-year follow-up period. Multiple regressions were performed to evaluate the moderating role of social support on the relationship between PTSD and QOL. Among survivors one-year after the Wenchuan earthquake, being a woman (p social support positively influenced the QOL (∆R (2) = 0.016). However, the interaction between social support and PTSD weakened the negative effect of PTSD on the QOL (∆R (2) = 0.012). Subjective support and support availability moderated the association between PTSD and the QOL (∆R (2) = 0.010). Subjective support and support availability are more useful strategies to improve the QOL of the earthquake survivors with PTSD symptoms.
Ghaffari Nejad, Alireza; Mehdizadeh Zare Anari, Ali; Pouya, Fatemeh
Objective: Cotard’s syndrome is a rare psychiatric syndrome. Its core symptom is nihilistic ideation or delusion. Case Report: A female patient with Cotard’s syndrome symptoms associated with out of body experience and depersonalization, and complicated grief was referred for evaluation. She believed that she was killed by a creature named "Aal" in the Persian folklore Conclusions: Cultural and superstitious beliefs could affect the forming of the complex constellation of the patient’s symptoms including Cotard’s syndrome symptoms. The resolution of symptoms might be achieved step by step. Declaration of interest: None. PMID:24644515
Ghaffari Nejad, Alireza; Mehdizadeh Zare Anari, Ali; Pouya, Fatemeh
Cotard's syndrome is a rare psychiatric syndrome. Its core symptom is nihilistic ideation or delusion. A female patient with Cotard's syndrome symptoms associated with out of body experience and depersonalization, and complicated grief was referred for evaluation. She believed that she was killed by a creature named "Aal" in the Persian folklore Conclusions: Cultural and superstitious beliefs could affect the forming of the complex constellation of the patient's symptoms including Cotard's syndrome symptoms. The resolution of symptoms might be achieved step by step. None.
Benedict, Catherine; Rodriguez, Vivian M; Carter, Jeanne; Temple, Larissa; Nelson, Christian; DuHamel, Katherine
Treatment for rectal and anal cancer (RACa) can result in persistent bowel and gastrointestinal (GI) dysfunction. Body image problems may develop over time and exacerbate symptom-related distress. RACa survivors are an understudied group, however, and factors contributing to post-treatment well-being are not well understood. This study examined whether poorer body image explained the relation between symptom severity and psychological distress. Participants (N = 70) completed the baseline assessment of a sexual health intervention study. Bootstrap methods tested body image as a mediator between bowel and GI symptom severity and two indicators of psychological distress (depressive and anxiety symptoms), controlling for relevant covariates. Measures included the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-CR38) Diarrhea, GI Symptoms, and Body Image subscales and Brief Symptom Index Depression and Anxiety subscales. Women averaged 55 years old (SD = 11.6), White (79 %), and were 4 years post-treatment. Greater Depression was related to poorer Body Image (r = -.61) and worse Diarrhea (r = .35) and GI Symptoms (r = .48). Greater Anxiety was related to poorer Body Image (r = -.42) and worse GI Symptoms (r = .45), but not Diarrhea (r = .20). Body Image mediated the effects of bowel and GI symptoms on Depression, but not on Anxiety. Long-term bowel and GI dysfunction are distressing and affect how women perceive and relate to their bodies, exacerbating survivorship difficulties. Interventions to improve adjustment post-treatment should address treatment side effects, but also target body image problems to alleviate depressive symptoms. Reducing anxiety may require other strategies. Body image may be a key modifiable factor to improve well-being in this understudied population. Longitudinal research is needed to confirm findings.
Tani, Masayuki; Kanai, Chieko; Ota, Haruhisa; Yamada, Takashi; Watanabe, Hiromi; Yokoi, Hideki; Takayama, Yuko; Ono, Taisei; Hashimoto, Ryuichiro; Kato, Nobumasa; Iwanami, Akira
People with Asperger's syndrome (AS) experience mental comorbidities, and behavioral symptoms that can deepen social isolation and handicaps. We compared the frequency of mental and behavioral symptoms, motor abnormality, and life history between adults with AS and those with no mental disorders but with disturbance of social functions and…
Lagarde, E.; Salmi, L. R.; Holm, L. W.
IMPORTANCE A proportion of patients experience long-lasting symptoms following mild traumatic brain injury (MTBI). The postconcussion syndrome (PCS), included in the DSM-IV, has been proposed to describe this condition. Because these symptoms are subjective and common to other conditions, there i...
Hepburn, Susan; Philofsky, Amy; Fidler, Deborah J.; Rogers, Sally
Background: Research suggests that children with Down syndrome may be at increased risk of having an autism spectrum disorder; however, previous studies have not utilized comprehensive, state-of-the-art diagnostic tools to address the question of comorbid autism and Down syndrome. Method: Comprehensive evaluations for autism were conducted in 20…
Stallard, Paul; Smith, Elisabeth
Background: Comparatively little is known about the cognitive appraisals and coping styles of child road traffic accident (RTA) survivors that are associated with chronic post-traumatic reactions. Methods: Seventy-five children and young people aged 7-18 who were involved in a road traffic accident and attended an accident and emergency department…
Koopman, Fieke Sophia; Beelen, Anita; Gilhus, Nils Erik; de Visser, Marianne; Nollet, Frans
Postpolio syndrome (PPS) may affect survivors of paralytic poliomyelitis and is characterised by a complex of neuromuscular symptoms leading to a decline in physical functioning. The effectiveness of pharmacological treatment and rehabilitation management in PPS is not yet established. This is an
Anderson, G; Berk, M; Maes, M
Somatization is a symptom cluster characterized by 'psychosomatic' symptoms, that is, medically unexplained symptoms, and is a common component of other conditions, including depression and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This article reviews the data regarding the pathophysiological foundations of 'psychosomatic' symptoms and the implications that this has for conceptualization of what may more appropriately be termed physio-somatic symptoms. This narrative review used papers published in PubMed, Scopus, and Google Scholar electronic databases using the keywords: depression and chronic fatigue, depression and somatization, somatization and chronic fatigue syndrome, each combined with inflammation, inflammatory, tryptophan, and cell-mediated immune (CMI). The physio-somatic symptoms of depression, ME/CFS, and somatization are associated with specific biomarkers of inflammation and CMI activation, which are correlated with, and causally linked to, changes in the tryptophan catabolite (TRYCAT) pathway. Oxidative and nitrosative stress induces damage that increases neoepitopes and autoimmunity that contribute to the immuno-inflammatory processes. These pathways are all known to cause physio-somatic symptoms, including fatigue, malaise, autonomic symptoms, hyperalgesia, intestinal hypermotility, peripheral neuropathy, etc. Biological underpinnings, such as immune-inflammatory pathways, may explain, at least in part, the occurrence of physio-somatic symptoms in depression, somatization, or myalgic encephalomyelitis/chronic fatigue syndrome and thus the clinical overlap among these disorders. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Søndergaard, Mads Madsen; tursunovic, Amela; Thye-Roenn, Peter
BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012, with Icterohaemo......BACKGROUND Leptospirosis is a zoonosis transmitted through urine of infected animals. Symptoms range from mild influenza-like symptoms to severe pulmonary hemorrhagic syndrome (SPHS); the latter are often fatal. The serogroup distribution in Denmark has changed from 1988 to 2012...... after admission she died from respiratory failure where severe hemoptysis was observed. Leptospiral DNA was later detected in a urine sample. CONCLUSIONS This case represents leptospirosis with severe pulmonary hemorrhagic syndrome. In spite of immediate treatment with broad-spectrum antibiotics...
Lyons, Tony R.
Global outsourcing of information technology functions has become a major tool used by organizations to increase or maintain competitive market positioning. One often overlooked in determining an organization's level of success from outsourcing is the negative impact on the behavioral and emotional well-being of surviving employees, often referred…
Cieslak, Roman; Benight, Charles; Schmidt, Norine; Luszczynska, Aleksandra; Curtin, Erin; Clark, Rebecca A; Kissinger, Patricia
The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.
Faubion, Stephanie S; MacLaughlin, Kathy L; Long, Margaret E; Pruthi, Sandhya; Casey, Petra M
Care of the gynecologic cancer survivor extends beyond cancer treatment to encompass promotion of sexual, cardiovascular, bone, and brain health; management of fertility, contraception, and vasomotor symptoms; and genetic counseling. This is a narrative review of the data and guidelines regarding care and surveillance of the gynecologic cancer survivor. We searched databases including PubMed, Cochrane, and Scopus using the search terms gynecologic cancer, cancer surveillance, and cancer survivor and reached a consensus for articles chosen for inclusion in the review based on availability in the English language and publication since 2001, as well as key older articles, consensus statements, and practice guidelines from professional societies. However, we did not undertake an extensive systematic search of the literature to identify all potentially relevant studies, nor did we utilize statistical methods to summarize data. We offer clinical recommendations for the management of gynecologic cancer survivors based on review of evidence and our collective clinical experience. Key messages include the limitations of laboratory studies, including CA-125, and imaging in the setting of gynecologic cancer surveillance, hormonal and non-hormonal management of treatment-related vasomotor symptoms and genitourinary syndrome of menopause, as well as recommendations for general health screening, fertility preservation, and contraception. A holistic approach to care extending beyond cancer treatment alone benefits gynecologic cancer survivors. In addition to surveillance for cancer recurrence and late treatment side effects, survivors benefit from guidance on hormonal, contraceptive, and fertility management and promotion of cardiovascular, bone, brain, and sexual health.
... whether you have Marfan syndrome. Medical and Family Histories Your doctor will ask about your medical history ... and football. You also may need to avoid sports that involve physical contact with other players or ...
Silove, D M; Tay, A K; Steel, Z; Tam, N; Soares, Z; Soares, C; Dos Reis, N; Alves, A; Rees, S
Little is known about the mental health of partners of survivors of high levels of trauma in post-conflict countries. We studied 677 spouse dyads (n = 1354) drawn from a community survey (response 82.4%) in post-conflict Timor-Leste. We used culturally adapted measures of post-traumatic stress disorder (PTSD), psychological distress, explosive anger and grief. Latent class analysis identified three classes of couples: class 1, comprising women with higher trauma events (TEs), men with intermediate TEs (19%); class 2, including men with higher TEs, women with lower TEs (23%); and class 3, comprising couples in which men and women had lower TE exposure (58%) (the reference group). Men and women partners of survivors of higher TE exposure (classes 1 and 2) had increased symptoms of explosive anger and grief compared with the reference class (class 3). Women partners of survivors of higher TE exposure (class 2) had a 20-fold increased rate of PTSD symptoms compared with the reference class, a pattern that was not evident for men living with women exposed to higher levels of trauma (class 1). Men and women living with survivors of higher levels of trauma showed an increase in symptoms of grief and explosive anger. The manifold higher rate of PTSD symptoms amongst women living with men exposed to high levels of trauma requires replication. It is important to assess the mental health of partners when treating survivors of high levels of trauma in post-conflict settings.
de Roest, R H; Dobbs, B R; Chapman, B A; Batman, B; O'Brien, L A; Leeper, J A; Hebblethwaite, C R; Gearry, R B
Current treatment for irritable bowel syndrome (IBS) is suboptimal. Fermentable oligo-, di-, mono-saccharides and polyols (FODMAPs) may trigger gastrointestinal symptoms in IBS patients. Our aim was to determine whether a low FODMAP diet improves symptoms in IBS patients. Irritable bowel syndrome patients, who had performed hydrogen/methane breath testing for fructose and lactose malabsorption and had received dietary advice regarding the low FODMAP diet, were included. The effect of low FODMAP diet was prospectively evaluated using a symptom questionnaire. Furthermore, questions about adherence and satisfaction with symptom improvement, dietary advice and diet were assessed. Ninety patients with a mean follow up of 15.7 months were studied. Most symptoms including abdominal pain, bloating, flatulence and diarrhoea significantly improved (p 0.27, p FODMAP diet shows efficacy for IBS patients. The current strategy of breath testing and dietary advice provides a good basis to understand and adhere to the diet. © 2013 John Wiley & Sons Ltd.
Tzovaras, George; Papamargaritis, Dimitris; Sioka, Eleni; Zachari, Eleni; Baloyiannis, Ioannis; Zacharoulis, Dimitris; Koukoulis, George
Dumping syndrome is a well-known complication after upper gastrointestinal (GI) surgery. There are scarce data in the literature about the incidence of dumping after bariatric operations but, certainly no relation between this syndrome and laparoscopic sleeve gastrectomy (LSG) has been attempted. We conducted a prospective clinical study in order to evaluate the potential presence, incidence and severity of Dumping syndrome after LSG. Thirty one non-diabetic morbidly obese patients (eight male, 23 female) eligible for LSG were evaluated. Median age was 38 (22-58 years) and mean body mass index (BMI) was 45.55 (± 5.37). The diagnosis of dumping syndrome was based on clinical provocation of signs and symptoms using an oral glucose challenge before and 6 weeks after the operation. The Sigstad's dumping score was estimated in order to separate dumpers from non-dumpers, and the Arts questionnaire was completed to distinguish between early and late dumping. Moreover, blood glucose levels during the oral glucose challenge were measured. No patient had symptoms of dumping after provocation preoperatively, whereas after LSG 9 patients (29%) experienced definite dumping and other 5 patients (16%) symptoms suggestive of dumping syndrome. Arts' questionnaire demonstrated that dumping occurrence after LSG was associated with early symptoms. Late hypoglycaemia occurred in one patient. A significant proportion of patients after LSG experienced dumping syndrome upon provocation. It seems that LSG should no longer be considered as a pure restrictive procedure, and it might be an option for heavy sweeters by changing their food tolerance patterns.
... ion levels return to normal. The eating disorders anorexia nervosa and bulimia and some thyroid disorders may cause a drop ... or sodium. These conditions include the eating disorders anorexia nervosa and bulimia, as well as some thyroid disorders. Signs, Symptoms, ...
... Deepen the voice Promote growth of facial and body hair Help the reproductive organs to mature Build and ... classes. In adolescence, symptoms such as lack of body hair could make XXY males uncomfortable in school or ...
Venturelli, Cristina; Guerra, Azzurra; Paolucci, Paolo; Iughetti, Lorenzo
"Dancing eye syndrome", also called Kinsbourne syndrome or Opsoclonus-Myoclonus-Ataxia Syndrome (OMS) is a rare neurological disorder that in children is frequently associated to occult, low-grade neuroblastoma (NB) (>50% of the cases). OMS may also be triggered by infections and it is often associated to developmental impairment and disability. We discuss the case of a 16 months old female with acutely onset of OMS associated to occult stage III NB. OMS represents a diagnostic challenge for pediatric clinicians. The suspect of OMS imposes the search for an occult NB in order to promptly treat a life-threatening event like tumor and to prevent the neurological sequels linked to OMS.
Kamdar, Biren B; Sepulveda, Kristin A; Chong, Alexandra; Lord, Robert K; Dinglas, Victor D; Mendez-Tellez, Pedro A; Shanholtz, Carl; Colantuoni, Elizabeth; von Wachter, Till M; Pronovost, Peter J; Needham, Dale M
Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage. Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview. Predictors of time to return to work were evaluated using Fine and Grey regression analysis. Lost earnings were estimated using Bureau of Labor Statistics data. Sixty-seven (49%) of the 138 2-year survivors were employed prior to ARDS. Among 64 5-year survivors, 20 (31%) never returned to work across 5-year follow-up. Predictors of delayed return to work (HR (95% CI)) included baseline Charlson Comorbidity Index (0.77 (0.59 to 0.99) per point; p=0.04), mechanical ventilation duration (0.67 (0.55 to 0.82) per day up to 5 days; plost earnings, with average (SD) losses ranging from US$38 354 (21,533) to US$43 510 (25,753) per person per year. Jobless, non-retired survivors experienced a 33% decrease in private health insurance and concomitant 37% rise in government-funded coverage. Across 5-year follow-up, nearly one-third of previously employed ARDS survivors never returned to work. Delayed return to work was associated with patient-related and intensive care unit/hospital-related factors, substantial lost earnings and a marked rise in government-funded healthcare coverage. These important consequences emphasise the need to design and evaluate vocation-based interventions to assist ARDS survivors return to work. © 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.
Full Text Available Abstract Background It remains unclear whether estrogenic botanical supplement (EBS use influences breast cancer survivors' health-related outcomes. Methods We examined the associations of EBS use with health-related quality of life (HRQOL, with fatigue, and with 15 hormone-related symptoms such as hot flashes and night sweats among 767 breast cancer survivors participating in the Health, Eating, Activity, and Lifestyle (HEAL Study. HRQOL was measured by the Medical Outcomes Study short form-36 physical and mental component scale summary score. Fatigue was measured by the Revised-Piper Fatigue Scale score. Results Neither overall EBS use nor the number of EBS types used was associated with HRQOL, fatigue, or hormone-related symptoms. However, comparisons of those using each specific type of EBS with non-EBS users revealed the following associations. Soy supplements users were more likely to have a better physical health summary score (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.02-2.70. Flaxseed oil users were more likely to have a better mental health summary score (OR = 1.76, 95% CI = 1.05-2.94. Ginseng users were more likely to report severe fatigue and several hormone-related symptoms (all ORs ≥ 1.7 and all 95% CIs exclude 1. Red clover users were less likely to report weight gain, night sweats, and difficulty concentrating (all OR approximately 0.4 and all 95% CIs exclude 1. Alfalfa users were less likely to experience sleep interruption (OR = 0.28, 95% CI = 0.12-0.68. Dehydroepiandrosterone users were less likely to have hot flashes (OR = 0.33, 95% CI = 0.14-0.82. Conclusions Our findings indicate that several specific types of EBS might have important influences on a woman's various aspects of quality of life, but further verification is necessary.
Meyer, Jessica A.; Mundy, Peter C.; Van Hecke, Amy Vaughan; Durocher, Jennifer Stella
The factors that place children with Asperger syndrome at risk for comorbid psychiatric symptoms, such as anxiety and depression, remain poorly understood. We investigated the possibility that the children’s emotional and behavioral difficulties are associated with social information and attribution processing. Participants were children with either Asperger syndrome (n = 31) or typical development (n = 33).To assess social information and attribution processing, children responded to hypothetical social vignettes.They also completed self-report measures of social difficulties and psychological functioning. Their parents provided information on social competence and clinical presentation. Children with Asperger syndrome showed poor psychosocial adjustment, which was related to their social information and attribution processing patterns. Cognitive and social-cognitive abilities were associated with aspects of social information processing tendencies, but not with emotional and behavioral difficulties. Results suggest that the comorbid symptoms of children with Asperger syndrome may be associated with their social perception, understanding, and experience. PMID:16908481
... Pediatrics, 127, 195-204. [top] Gunay-Aygun, M., Schwartz, S., Heger, S., O'Riordan, M. A., & Cassidy S. B. (2001). ... criteria. Pediatrics, 91, 398-402. [top] Cassidy, S.B., & Schwartz S. (2009). Prader-Willi syndrome. NCBI Bookshelf, a Service ...
Nasser, N J; Israelit, S H; Muhammad, M; Basis, F
A 30-year-old nurse presented with abdominal pain and tenderness. Her blood tests, including amylase, were normal. Urinary amylase was extremely high. The source of the increased urinary amylase was found to be the patient’s saliva—she had spat into her urine sample. Subsequent investigation showed that she had Munchausen syndrome. PMID:21686470
Atema, Vera; van Leeuwen, Marieke; Oldenburg, Hester S A; Retèl, Valesca; van Beurden, Marc; Hunter, Myra S; Aaronson, Neil K
Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients. This study is evaluating the efficacy and cost-effectiveness of an Internet-based CBT program, with or without therapist guidance, in alleviating or reducing the severity of menopausal symptoms. In a multicenter, randomized controlled trial we are evaluating the efficacy of two Internet-based CBT programs in alleviating or reducing the impact of menopausal symptoms, and particularly hot flushes and night sweats, in breast cancer survivors who have experienced a treatment-induced menopause. Secondary outcomes include sexual functioning, sleep quality, hot flush frequency, psychological distress, health-related quality of life and cost-effectiveness. We will recruit 248 women who will be randomized to either a therapist guided or a self-management version of the 6-week Internet-based CBT program, or to a usual care, waiting list control group. Self-administered questionnaires are completed at baseline (T0), and at 10 weeks (T1) and 24 weeks (T2) post-randomization. Internet-based CBT is a potentially useful treatment for reducing menopausal symptoms in breast cancer survivors. This study will provide evidence on the efficacy and cost-effectiveness of such an Internet-based CBT program, with or without therapist support. If demonstrated to be efficacious and cost-effective, the availability of such structured supportive intervention programs will be a welcome addition to standard medical treatment offered
Lengacher, Cecile A; Reich, Richard R; Ramesar, Sophia; Alinat, Carissa B; Moscoso, Manolete; Cousin, Lakeshia; Marino, Victoria R; Elias, Maya N; Paterson, Carly L; Pleasant, Michelle L; Rodriguez, Carmen S; Wang, Hsiao-Lan; Kip, Kevin E; Meng, Hongdao; Park, Jong Y
The purpose of this pilot study was to test the feasibility of delivering the mobile mindfulness-based stress reduction for breast cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement. A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan, and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad. The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic black, and 14 were non-Hispanic white. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear of recurrence, sleep quality, fatigue, and quality of life (P's < .05). Effect sizes for improvements of multiple symptoms ranged from medium to large. These results provide preliminary support that the mMBSR(BC) program may be feasible and acceptable, showing a clinical impact on decreasing psychological and physical symptoms. This mobile-based program offers a delivery of a standardized MBSR(BC) intervention to BCS that is convenient for their own schedule while decreasing symptom burden in the survivorship phase after treatment for breast cancer. Copyright © 2017 John Wiley & Sons, Ltd.
Renata Telles Rudge de Aquino
Full Text Available CONTEXT: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms is a type of drug reaction commonly mistaken for a viral infection. It must be recognized promptly due to its high morbidity and 10% mortality rate. Few cases of DRESS syndrome induced by sulfasalazine have been reported in the literature. CASE REPORT: The case of a 47-year-old white Brazilian woman who developed DRESS syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthritis is reported. She presented a skin rash, fever, hepatitis, lymphadenopathy, eosinophilia and atypical lymphocytes. The causative drug was discontinued immediately, but she only improved after treatment with prednisone.
Theadom, Alice; Cropley, Mark; Kantermann, Thomas
Background: Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The
Full Text Available Introduction: Irritable bowel syndrome (IBS is a common gastrointestinal disorder in children that may lead to anxiety, frequent physician visits and school absenteeism. The aim of this study is to reviewe effects of probiotic for irritable bowel syndrome. Materials and Methods: This study review articles about probiotic for irritable bowel syndrome in pubmed and google scholar. Results: Multiple etiologic factors were suggested for IBS, including psychosocial factors, altered gastrointestinal motility, malfermentation of food residues and changes in the intestinal micro flora. It is reported that patients with IBS have a great homogeneity in the fecal flora with a decrease in lactobacilli, coliforms and bifidobacteria in comparison to healthy individuals. The beneficial effects of probiotics in IBS could be explained by increasing the mass of beneficial bacteria such as lactobacilli strains in the digestive tract, decreasing bacterial overgrowth in the small bowel. Recently it was also demonstrated that some lactobacilli strains may modulate intestinal pain attacks by inducing the expression of μ-opioid and cannabinoid receptors in the intestinal epithelial cells. Probiotics can also reinforce the intestinal mucosal barrier and normalize the motility of the digestive tract and its visceral sensitivity and reversing the imbalance between the pro- and anti-inflammatory cytokines so that suggested as a therapeutic option for IBS. Conclusion: Probiotic has been suggested as a therapeutic option for IBS by modulation pathophysiologic events in these patients. Keyword: Probiotic, IBS, Children.
Khurana, Ramesh K
Patients with postural tachycardia syndrome (POTS) might be misdiagnosed with panic disorder due to shared clinical features. The first aim of our study was to investigate the relationship between symptoms of POTS and panic disorder. The second aim was to delineate clinical features distinguishing symptoms of POTS from panic disorder. A total of 11 patients with POTS and 11 control subjects participated in an IRB-approved, prospective, placebo-controlled study. The experimentally induced panic-like symptoms of POTS were systematically studied using the Acute Panic Inventory (API) questionnaire. The participants answered the questionnaire after each placebo infusion and after each of the three provoking stimuli: head-up tilt test (HUT), isoproterenol infusion (ISI), and sodium lactate infusion (SLI). API responses were summed for each subject at each time point of administration. Individual API symptoms and summed responses were analyzed for statistical significance. All patients with POTS developed symptoms of orthostatic intolerance during HUT. Pharmacologically induced symptoms subjectively mimicked spontaneous symptoms in 5 of 11 patients during ISI and in none of 11 patients during SLI. In contrast, API scores in these patients reached panic threshold in 0 of 11 following HUT, in 4 of 11 following ISI and in 4 of 11 following SLI. Individual symptoms analysis revealed that significant increase in scores was limited to the somatic symptoms of palpitations, dyspnea, and twitching or trembling. In conclusion, the symptoms of POTS are phenomenologically different and clinically distinguishable from panic disorder symptoms.
Full Text Available We performed an epidemiological investigation of subjects with premenstrual dysphoric disorder (PMDD to identify the clinical distribution of the major syndromes and symptoms. The pathogenesis of PMDD mainly involves the dysfunction of liver conveyance and dispersion. Excessive liver conveyance and dispersion are associated with liver-qi invasion syndrome, while insufficient liver conveyance and dispersion are expressed as liver-qi depression syndrome. Additionally, a nonconditional logistic regression was performed to analyze the symptomatic features of liver-qi invasion and liver-qi depression. As a result of this analysis, two subtypes of PMDD are proposed, namely, excessive liver conveyance and dispersion (liver-qi invasion syndrome and insufficient liver conveyance and dispersion (liver-qi depression syndrome. Our findings provide an epidemiological foundation for the clinical diagnosis and treatment of PMDD based on the identification of different types.
Drake, Matthew L; Hensley, Dana T; Chen, Wei C; Taylor, Kenneth F
Background: The purpose of this study is to describe the demographics and duration of symptoms of patients with cubital tunnel syndrome who present with muscle atrophy. Methods: We identified 146 patients who presented to the hand surgery clinic at a single institution over a 5-year period with an initial diagnosis of cubital tunnel syndrome based on history and physical examination. Medical records were retrospectively reviewed to determine if there was a difference in demographic data, physical examination findings, and duration of symptoms in patients who presented with muscle atrophy from those with sensory complaints alone. Results: A total of 17/146 (11.6%) of patients presented with muscle atrophy, all of which were men. In all, 17.2% of men presented with atrophy. Age by itself was not a predictor of presentation with atrophy; however, younger patients with atrophy presented with significantly shorter duration of symptoms. Patients under the age of 29 years presenting with muscle atrophy on average had symptoms for 2.4 months compared with 16.2 months of symptoms for those over 55 years of age. Conclusions: Men with cubital tunnel syndrome are more likely to present with muscle atrophy than women. Age is not necessarily a predictor of presentation with atrophy. There is a subset population of younger patients who presents with extremely short duration of symptoms that rapidly develops muscle atrophy.
Ono, Junji; Chishaki, Akiko; Ohkusa, Tomoko; Sawatari, Hiroyuki; Nishizaka, Mari; Ando, Shin-ichi
This study evaluated the prevalence of obstructive sleep apnea-related symptoms and assessed the relationship with obesity or unusual sleep postures in Down syndrome patients in Japan. We obtained the demographic characteristics, sleep postures, and obstructive sleep apnea-related symptoms experienced by 90 people as reported by their caregivers. Although 71% reported snoring and 59% arousals, obstructive sleep apnea-related symptoms were not significantly different between obese and non-obese participants. The youngest age group had the fewest obstructive sleep apnea-related symptoms, especially symptoms of snoring. The odds for arousal, nocturia, and apnea tended to be higher in the unusual sleep-postures group. Unusual sleep postures were most frequent in the group 6-15 years of age. People with Down syndrome might sleep in unusual postures to avoid upper airway obstruction caused by other anatomical factors. For nurses and other health professionals working in mainstream service, it is important to screen all persons with Down syndrome for symptoms suggestive of obstructive sleep apnea, particularly those six years of age and older, and to refer them for further evaluation for sleep disorders. © 2015 Wiley Publishing Asia Pty Ltd.
Sriratanaviriyakul, Narin; Nguyen, Lam-Phuong; Henderson, Mark C; Albertson, Timothy E
Drug reaction with eosinophilia and systemic symptoms syndrome is a potentially life-threatening cutaneous hypersensitivity reaction characterized by extensive mucocutaneous eruption, fever, hematologic abnormalities including eosinophilia and/or atypical lymphocytosis, and extensive organ involvement. The drugs most often responsible for causing drug reaction with eosinophilia and systemic symptoms syndrome are anticonvulsants, antimicrobial agents and antipyretic or anti-inflammatory analgesics. Although azithromycin is widely prescribed in clinical practice, serious cutaneous reactions from this agent have been rarely described. We report the first adult case of drug reaction with eosinophilia and systemic symptoms syndrome associated with azithromycin. A 44-year-old previously healthy Caucasian man with history of tobacco use presented to his primary care physician with fever and productive cough. He was prescribed azithromycin, promethazine hydrochloride and dextromethorphan hydrobromide syrup. One week later, he developed a blistering erythematous rash over both hands, which over the next two weeks spread to involve nearly his entire body surface, sparing only his face. He was admitted to an outside hospital with signs of systemic inflammatory response syndrome and severe sepsis, presumably from a skin infection. Despite aggressive therapy he deteriorated, with worsening diffuse erythema, and was transferred to our institution. He developed multiple organ failure requiring ventilatory and hemodynamic support. Pertinent laboratory studies included a leukocytosis with a white blood cell count of 17.6 × 10(9)/L and 47% eosinophils. A skin biopsy showed evidence of spongiotic lichenoid dermatitis with eosinophils and neutrophils, compatible with a systemic drug-induced hypersensitivity reaction. Our patient was started on high-dose steroids and showed dramatic improvement within 48 hours. We report the first adult case of drug reaction with eosinophilia and
Menezes Filho, Jonas Rodrigues de; Sardinha, José Carlos Gomes; Galbán, Enrique; Saraceni, Valéria; Talhari, Carolina
Urethral discharge syndrome (UDS) is characterized by the presence of purulent or mucopurulent urethral discharge.The main etiological agents of this syndrome are Neisseria gonorrhoeae and Chlamydia trachomatis. To evaluate the effectiveness of the syndromic management to resolve symptoms in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil. Retrospective cohort of male cases of urethral discharge syndrome observed at a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and clinical data, as well as the results of urethral swabs, bacterioscopy, hybrid capture for C.trachomatis, wet-mount examination, and culture for N.gonorrhoeae, were obtained through medical chart reviews. Of the 800 urethral discharge syndrome cases observed at the STD clinic, 785 (98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for follow-up, 579 (91.5%) were considered clinically cured on the first visit, 41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not reach clinical cure after two appointments. Regarding the etiological diagnosis, 42.7% of the patients presented a microbiological diagnosis of N.gonorrhoeae, 39.3% of non-gonococcal and non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3% of co-infection with chlamydia and gonococcus. The odds of being considered cured in the first visit were greater in those who were unmarried, with greater schooling, and with an etiological diagnosis of gonorrhea. The diagnosis of non-gonococcal urethritis reduced the chance of cure in the first visit. A study conducted at a single center of STD treatment. Syndromic management of male urethral discharge syndrome performed in accordance with the Brazilian Ministry of Health STD guidelines was effective in resolving symptoms in the studied population. More studies with microbiological outcomes are needed to ensure the maintenance of the syndromic management.
Kwak, Minyoung; Zebrack, Brad J; Meeske, Kathleen A; Embry, Leanne; Aguilar, Christine; Block, Rebecca; Hayes-Lattin, Brandon; Li, Yun; Butler, Melissa; Cole, Steven
Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended. Copyright © 2012 John Wiley & Sons, Ltd.
Michael J. Mackenzie
Full Text Available Little attention has been paid to the psychological determinants by which benefits are accrued via yoga practice in cancer-related clinical settings. Using a longitudinal multilevel modeling approach, associations between affect, mindfulness, and patient-reported mental health outcomes, including mood disturbance, stress symptoms, and health-related quality of life (HRQL, were examined in an existing seven-week yoga program for cancer survivors. Participants (N=66 were assessed before and after the yoga program and at three- and six-month follow-ups. Decreases in mood disturbance and stress symptoms and improvements in HRQL were observed upon program completion. Improvements in mood disturbance and stress symptoms were maintained at the three- and six-month follow-ups. HRQL exhibited further improvement at the three-month follow-up, which was maintained at the six-month follow-up. Improvements in measures of well-being were predicted by initial positive yoga beliefs and concurrently assessed affective and mindfulness predictor variables. Previous yoga experience, affect, mindfulness, and HRQL were related to yoga practice maintenance over the course of the study.
Galer, B S; Jensen, M
Reflex sympathetic dystrophy (RSD), recently reclassified as a complex regional pain syndrome, type I (CRPS-I), is best known for its disabling sensory symptoms, including pain, allodynia, and abnormal skin temperature. Yet, motor dysfunction is common in CRPS and can result in major disability. In addition to weakness of the involved limb, CRPS patients may develop symptoms akin to a neurological neglect-like syndrome, whereby the limb may feel foreign ("cognitive neglect") and directed mental and visual attention is needed to move the limb ("motor neglect"). Members of the patient support group, the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA), were mailed a questionnaire inserted in their newsletter which inquired about the presence of these neglect-like symptoms; in addition, a separate medical history questionnaire was included to assess adequate documentation for the diagnosis of CRPS. A total of 242 patients returned the questionnaire but only 224 of the questionnaires were analyzed; 15 were excluded due to inadequate documentation of CRPS and 3 were excluded due to non-limb involvement. Eighty-four percent (84%) of these respondents endorsed the presence of at least one neglect symptom and 47% indicated they had both "cognitive" and "motor" neglect symptoms. Of interest, approximately 33% of respondents spontaneously wrote comments regarding the significant disability due to these neglect symptoms and the difficulty explaining these unusual symptoms to their health care providers and family. This patient survey confirms the presence of neglect-like symptoms in a subset of CRPS patients. Neglect-like symptoms need to be addressed and validated by health care providers.
Although the diagnostic criteria for multiple sclerosis (MS) have become more formalized and sensitive in the era of magnetic resonance imaging (MRI) scanning, the assessment of individual relapses may not always be straightforward or easily linked to a particular lesion seen on imaging. In addition, acute episodes often have to be assessed outside of normal working hours or when the individual patients usual medical team is not available. Often the emergency department physicians have little formal neurological training and are under time pressure to get patients through the system as quickly as possible. It is therefore possible to mislabel functional symptoms as being true relapses. To illustrate scenarios of possible pseudo-relapse, three clinical vignettes are described. Misclassification of functional symptoms as relapse carries a number of inherent risks. Functional symptoms can be multifactorial and may cause a burden of disease. A multidisciplinary approach may be useful in minimizing unnecessary harm and identify if there is more than meets the eye to an episode of clinical deterioration.
Ghaffari Nejad, Alireza; Mehdizadeh Zare Anari, Ali; Pouya, Fatemeh
Objective: Cotard’s syndrome is a rare psychiatric syndrome. Its core symptom is nihilistic ideation or delusion. Case Report: A female patient with Cotard’s syndrome symptoms associated with out of body experience and depersonalization, and complicated grief was referred for evaluation. She believed that she was killed by a creature named "Aal" in the Persian folklore Conclusions: Cultural and superstitious beliefs could affect the forming of the complex constellation of the patient’s sympto...
W. Wayne Lautt; Hui Helen Wang
We review evidence that the AMIS (Absence of Meal-induced Insulin Sensitization) syndrome describes a paradigm fundamental to development of obesity. The hypoglycemic response to a pulse of insulin is doubled after a meal as a result of Hepatic Insulin Sensitizing Substance (HISS), released from the liver to act selectively on muscle, heart and kidney. In the absence of HISS action, the hypoglycemic response to insulin is the same as in the fasted state, and only half of what it should be. Po...
Carbone, F; Vandenberghe, A; Holvoet, L; Vanuytsel, T; Van Oudenhove, L; Jones, M; Tack, J
... pain syndrome which is characterised by meal‐unrelated symptoms such as epigastric burning and epigastric pain. A larger proportion is classified as suffering from postprandial distress syndrome, characterised by meal‐related symptoms such as early satiation and postprandial fullness. However, in clinical practice, overlap between postprandi...
Full Text Available Sheehan’s syndrome, which is pituitary necrosis after severe postpartum hemorrhage and hypovolemia, may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. We report an unusual case, in which a 55-year-old woman with Sheehan's syndrome got worse symptoms after spontaneous labor. In 1998, she had severe postpartum hemorrhage and pituitary necrosis during the third delivery, thus it was diagnosed as Sheehan’s syndrome by clinical manifestations, laboratory tests, and magnetic resonance imaging. She was treated by replacement therapy including hydrocortisone and levothyroxine sodium. However, she had the fourth spontaneous pregnancy in 2000 and got worse symptoms after delivery. We carefully concluded that pregnancy provided no evidence against the diagnosis of Sheehan’s syndrome because pregnancy might improve hypopituitarism by stimulating the pituitary remnant to undergo hyperplasia and irritating the placenta to secrete hormone. However, pregnancy might aggravate the symptoms by inducing autoimmunity as well. All in all, early diagnosis and adequate medical treatment are important to provide a good prognosis of Sheehan’s syndrome.
Koy, Anne; Assmann, Birgit; Klepper, Joerg; Mayatepek, Ertan
Glucose transporter type 1 deficiency syndrome (GLUT1-DS) is caused by a defect in glucose transport across the blood-brain barrier. The main symptoms are epilepsy, developmental delay, movement disorders, and deceleration of head circumference. A ketogenic diet has been shown to be effective in controlling epilepsy in GLUT1-DS. We report a female…
Van Hove, JLK; Wevers, RA; Van Cleemput, J; Moerman, P; Sciot, R; Matthijs, G; Schollen, E; de Jong, JGN; Carey, WF; Muller, [No Value; Nicholls, C; Perkins, K; Hopwood, JJ
Sanfilippo A syndrome, mucopolysaccharidosis type IIIA, is caused by a deficiency of heparan sulphamidase activity, and usually presents in childhood with neurodegeneration leading to death in teenage years. Visceral symptoms are limited to coarsening and diarrhea. We now describe an adult patient
Bazelmans, E.; Bleijenberg, G.; Voeten, M.J.M.; Meer, J.W.M. van der; Folgering, H.T.M.
OBJECTIVE: This study examined the effects of exercise on symptoms and activity in chronic fatigue syndrome (CFS). METHODS: Twenty CFS patients and 20 neighborhood controls performed an incremental exercise test until exhaustion. Fatigue, muscle pain, minutes spent resting, and the level of physical
Meems, M.; Truijens, S. E. M.; Spek, V.; Visser, L. H.; Pop, V. J. M.
Objective To investigate the prevalence, severity and relation to fluid retention of self-reported pregnancy-related carpal tunnel syndrome (CTS) symptoms in a large sample of pregnant women. Design A prospective longitudinal cohort study. Setting Dutch women who became pregnant between January 2013
J Gordon Millichap
Full Text Available Four young boys with neonatal onset of encephalopathy, a progressive course, and MECP2 mutations are reported from the University of Alabama, Birmingham, AL Symptoms suggestive of Rett syndrome included failure to thrive, respiratory insufficiency, microcephaly, hypotonia, movement disorder, with myoclonic, dyskinetic, and choreiform patterns, and repetitive face scratching or nose rubbing stereotypies.
Alterations in gastrointestinal (GI) permeability and immune measures are present in some patients with irritable bowel syndrome (IBS) but the relationship to symptoms is poorly defined. In adults with IBS, we compared permeability, unstimulated peripheral blood monocyte (PBMC) interleukin-10 (IL-10...
Full Text Available Background: The way the municipal transport drivers perform their job contributes to varied burdens linked with the body posture at work, stress, shift work, vibration, noise and exposure to chemical agents. The aim of the study was to assess the condition of the nervous system (NS in municipal transport drivers. Material and Methods: The study covered 42 men, aged 43.4 years (standard deviation (SD: 8.3, employed as bus drivers in the municipal transport enterprise. The duration of employment was 11.8 years on average (SD: 8.6. The condition of the nervous system was assessed on the basis of clinical neurological examinations. Results: Chronic lumbosacral syndrome was found in 54.8% of the subjects. A significant relationship between the incidence of lumbosacral syndrome and the duration of employment (p = 0.032 was observed; significantly higher in drivers employed for 11–15 years (90.9% in comparison to the remaining groups. Nervous system functional disorders were niejedcharacterized by the increased emotional irritability (47.6%, sleep disorders manifested by excessive sleepiness (33.3% or insomnia (28.6% and headaches (3%, mostly tension headaches. Excessive daytime sleepiness was significantly age-dependent (p = 0.038. Conclusions: The evidenced NS disorders indicate the need to undertake preventive measures tailored for the occupational group of bus drivers. Med Pr 2015;66(3:333–341
Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.
Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the…
An, Jihyun; Lee, Joo Ho; Lee, Hyojeong; Yu, Eunsil; Lee, Dan Bi; Shim, Ju Hyun; Yoon, Sunyoung; Lee, Yumi; Park, Soeun; Lee, Han Chu
Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
Full Text Available INTRODUCTION: The vast number of psychopathological syndromes that can be observed in clinical practice can be described in terms of a limited number of elementary syndromes that are differentially expressed. Previous attempts to identify elementary syndromes have shown limitations that have slowed progress in the taxonomy of psychiatric disorders. AIM: To examine the ability of network community detection (NCD to identify elementary syndromes of psychopathology and move beyond the limitations of current classification methods in psychiatry. METHODS: 192 patients with unselected mental disorders were tested on the Comprehensive Psychopathological Rating Scale (CPRS. Principal component analysis (PCA was performed on the bootstrapped correlation matrix of symptom scores to extract the principal component structure (PCS. An undirected and weighted network graph was constructed from the same matrix. Network community structure (NCS was optimized using a previously published technique. RESULTS: In the optimal network structure, network clusters showed a 89% match with principal components of psychopathology. Some 6 network clusters were found, including "Depression", "Mania", "Anxiety", "Psychosis", "Retardation", and "Behavioral Disorganization". Network metrics were used to quantify the continuities between the elementary syndromes. CONCLUSION: We present the first comprehensive network graph of psychopathology that is free from the biases of previous classifications: a 'Psychopathology Web'. Clusters within this network represent elementary syndromes that are connected via a limited number of bridge symptoms. Many problems of previous classifications can be overcome by using a network approach to psychopathology.
Goekoop, Rutger; Goekoop, Jaap G
The vast number of psychopathological syndromes that can be observed in clinical practice can be described in terms of a limited number of elementary syndromes that are differentially expressed. Previous attempts to identify elementary syndromes have shown limitations that have slowed progress in the taxonomy of psychiatric disorders. To examine the ability of network community detection (NCD) to identify elementary syndromes of psychopathology and move beyond the limitations of current classification methods in psychiatry. 192 patients with unselected mental disorders were tested on the Comprehensive Psychopathological Rating Scale (CPRS). Principal component analysis (PCA) was performed on the bootstrapped correlation matrix of symptom scores to extract the principal component structure (PCS). An undirected and weighted network graph was constructed from the same matrix. Network community structure (NCS) was optimized using a previously published technique. In the optimal network structure, network clusters showed a 89% match with principal components of psychopathology. Some 6 network clusters were found, including "Depression", "Mania", "Anxiety", "Psychosis", "Retardation", and "Behavioral Disorganization". Network metrics were used to quantify the continuities between the elementary syndromes. We present the first comprehensive network graph of psychopathology that is free from the biases of previous classifications: a 'Psychopathology Web'. Clusters within this network represent elementary syndromes that are connected via a limited number of bridge symptoms. Many problems of previous classifications can be overcome by using a network approach to psychopathology.
Ding, Qinglan; Whittemore, Robin; Redeker, Nancy
Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors' quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946-April; Week 2, 2015), Embase (OvidSP 1974-March; Week 1, 2015), and PsycINFO (OvidSP 1967-April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors. © The Author(s) 2016.
Kazan, V; Qu, W; Al-Natour, M; Abbas, J; Nazzal, M
The aim of the paper is to determine the incidence of celiac artery compression (CAC) based on computed tomography (CT) scan and correlate the findings to the clinical presentation of patients presenting for CT scan in a hospital. Abdominal CT scans of patients were reviewed between September 2010 and November 2010. CAC was diagnosed if the celiac axis appeared to have a hook or U-shaped appearance with stenosis. The medical records of the patients were reviewed for gastrointestinal symptoms (abdominal pain, nausea, vomiting, constipation, diarrhea), as well as food fear and weight loss. Patients with CAC had lower incidence of symptoms compared with those without CAC (42.1 versus 65.3%, P = 0.042). A total of 450 patients were evaluated. In the end, 284 had both complete medical records and CT scans. The mean age for all patients was 51.3 ± 1.2 years. There were 124 men (42.6%) and 160 (57.4%) women. Nineteen (6.7%) patients had radiological evidence of CAC. CAC is not an uncommon CT finding in patients presenting for CT scan. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Heyer, Geoffrey L; Fedak, Erin M; LeGros, Aggie L
To identify symptoms that may predict postural tachycardia syndrome (POTS) among adolescent patients with headache and lightheadedness referred for tilt table testing. Individuals with POTS can have a variety of symptoms that impair quality of life. The specific symptoms that help to distinguish the POTS patient in an adolescent headache population have not been determined. A group of symptoms was compared among 70 adolescent patients with headache and lightheadedness referred to a pediatric headache clinic for tilt table testing. Every patient completed a symptom questionnaire prior to the tilt table test. The chi-square test was used to compare questionnaire responses between patients found to have POTS and those who did not have POTS. Thirteen symptoms were analyzed. Symptoms that differed statistically between groups were further assessed for sensitivity, specificity, and diagnostic predictive values. Thirty-seven (53%) patients met diagnostic criteria for POTS. Several symptoms differed between the patients found to have POTS and those without POTS. Headache type was not predictive. Vertigo and evening exacerbation of headaches had P values headache trigger, and orthostatic headaches had P values headache type reliably establishes the POTS diagnosis, several symptoms can help to distinguish the POTS patient in an adolescent headache population. © 2013 American Headache Society.
Full Text Available This study examined the prevalence of self-reported depressive symptoms and the self reported somatic depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II among patients hospitalized for acute coronary syndrome (ACS, and explored the impact of gender on both. A convenience sample of 789 adults (248 women and 541 men was recruited for the study during hospital admission for ACS and participants were screened for self-reported depressive symptoms. BDI-II scores of ≥14 indicate a moderate level of depressive symptoms and this cut-off score was used to categorize patients into depressed and non-depressed groups. Pearson chi-square tests for independence (categorical variables and t tests for independent samples (continuous variables were used for gender comparisons. Results showed that depressive symptoms during ACS episodes were different between women and men. Women reported greater overall depressive symptoms (BDI-II mean = 11.89, S.D. = 9.68 than men (BDI-II mean = 9.00, S.D. = 7.93 (P<0.000. Significantly more women (7.66% were identified positive for somatic depressive symptoms (sleep and appetite disturbances and fatigue than men (2.22% (P=0.0003. Findings support that there are gender differences in depressive symptoms experienced by patients hospitalized for ACS. Somatic symptoms of depression may be important indicators of depression especially among female ACS patients.
Full Text Available Numb chin syndrome is a rare sensory neuropathy of the mental nerve characterized by numbness, hypoesthesia, paraesthesia, and very rarely pain. Dental causes, especially iatrogenic ones, maxillofacial trauma, or malignant neoplasm are etiologic factors for this rare syndrome. Many malignant and metastatic neoplasms are causing this syndrome, like primary osteosarcoma, squamous cell carcinoma, and mandibular metastasis of primary carcinoma of breast, lung, thyroid, kidney, prostate, and nasopharynx. Haematological malignancies like acute lymphocytic leukaemia, Hodgkin and non-Hodgkin lymphoma, and myeloma can cause this neuropathy. The authors report a case of a 71-year-old woman in which the numb chin syndrome was the first symptom of the diffuse large B-cell lymphoma, which caused infiltration and reabsorption of the alveolar ridge and lower mandibular cortex. A biopsy of the mass was performed on fragments of tissue collected from the mandibular periosteum, medullary and cortical mandibular bone, and inferior alveolar nerve.
Collins, S.; van Hilten, J.J.; Marinus, J.J.; Zuurmond, W.W.A.; de Lange, J.J.; Perez, R.S.G.M.
Collins S, van Hilten JJ, Marinus J, Zuurmond WW, de Lange JJ, Perez RS. Development of a symptoms questionnaire for complex regional pain syndrome and potentially related illnesses: the Trauma Related Neuronal Dysfunction Symptoms Inventory. Objective: To develop a questionnaire to evaluate
van Dijk, H.M.; van de Schoot, A.G.J.|info:eu-repo/dai/nl/304833207; Rijkeboer, M.M.|info:eu-repo/dai/nl/288357957; Mathews, C.A.; Cath, D.C.|info:eu-repo/dai/nl/194111423
Gilles de la Tourette's syndrome (GTS) is a disorder in which obsessive-compulsive (OC), Attention Deficit Hyperactivity Disorder (ADHD) and autism symptoms occur in up to 60% of patients, suggesting shared etiology. We explored the phenotypic structure of tic, OC, ADHD, and autism symptoms as
Savonitto, Stefano; Morici, Nuccia; Nozza, Anna; Cosentino, Francesco; Perrone Filardi, Pasquale; Murena, Ernesto; Morocutti, Giorgio; Ferri, Marco; Cavallini, Claudio; Eijkemans, Marinus Jc; Stähli, Barbara E; Schrieks, Ilse C; Toyama, Tadashi; Lambers Heerspink, H J; Malmberg, Klas; Schwartz, Gregory G; Lincoff, A Michael; Ryden, Lars; Tardif, Jean Claude; Grobbee, Diederick E
To define the predictors of long-term mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome. A total of 7226 patients from a randomized trial, testing the effect on cardiovascular outcomes of the dual peroxisome proliferator-activated receptor agonist aleglitazar in patients with type 2 diabetes mellitus and recent acute coronary syndrome (AleCardio trial), were analysed. Median follow-up was 2 years. The independent mortality predictors were defined using Cox regression analysis. The predictive information provided by each variable was calculated as percent of total chi-square of the model. All-cause mortality was 4.0%, with cardiovascular death contributing for 73% of mortality. The mortality prediction model included N-terminal proB-type natriuretic peptide (adjusted hazard ratio = 1.68; 95% confidence interval = 1.51-1.88; 27% of prediction), lack of coronary revascularization (hazard ratio = 2.28; 95% confidence interval = 1.77-2.93; 18% of prediction), age (hazard ratio = 1.04; 95% confidence interval = 1.02-1.05; 15% of prediction), heart rate (hazard ratio = 1.02; 95% confidence interval = 1.01-1.03; 10% of prediction), glycated haemoglobin (hazard ratio = 1.11; 95% confidence interval = 1.03-1.19; 8% of prediction), haemoglobin (hazard ratio = 1.01; 95% confidence interval = 1.00-1.02; 8% of prediction), prior coronary artery bypass (hazard ratio = 1.61; 95% confidence interval = 1.11-2.32; 7% of prediction) and prior myocardial infarction (hazard ratio = 1.40; 95% confidence interval = 1.05-1.87; 6% of prediction). In patients with type 2 diabetes mellitus and recent acute coronary syndrome, mortality prediction is largely dominated by markers of cardiac, rather than metabolic, dysfunction.
Smith, Webb A; Li, Chenghong; Nottage, Kerri A; Mulrooney, Daniel A; Armstrong, Gregory T; Lanctot, Jennifer Q; Chemaitilly, Wassim; Laver, Joseph H; Srivastava, Deo Kumar; Robison, Leslie L; Hudson, Melissa M; Ness, Kirsten K
Childhood cancer survivors (CCS) are at an increased risk of developing metabolic syndrome (MetSyn), which may be reduced with lifestyle modifications. The purpose of this investigation was to characterize lifestyle habits and associations with MetSyn among CCS. CCS who were ≥ 10 years from diagnosis, aged > 18 years, and participating in the St. Jude Lifetime Cohort Study completed medical and laboratory tests and a food frequency questionnaire. The Third Report of the National Cholesterol Education Program Adult Treatment Panel criteria were used to classify participants with MetSyn. Anthropometric, food frequency questionnaire, and self-reported physical activity data were used to characterize lifestyle habits according to World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations. Those who met ≥ 4 of 7 recommendations were classified as having followed guidelines. Sex-stratified log-binomial regression models were used to evaluate associations between dietary/lifestyle habits and MetSyn, adjusted for age, age at cancer diagnosis, receipt of cranial radiotherapy, education, and household income. Among 1598 CCS (49.2% of whom were male, with a median age of 32.7 years [range, 18.9 years-60.0 years]), 31.8% met criteria for MetSyn and 27.0% followed WCRF/AICR guidelines. Females who did not follow WCRF/AICR guidelines were 2.4 times (95% confidence interval, 1.7-3.3) and males were 2.2 times (95% confidence interval, 1.6-3.0) more likely to have MetSyn than those who followed WCRF/AICR guidelines. Adherence to a heart-healthy lifestyle is associated with a lower risk of MetSyn among CCS. There is a need to determine whether lifestyle interventions prevent or remediate MetSyn in CCS. © 2014 American Cancer Society.
Herati, Amin S; Shorter, Barbara; Srinivasan, Arun K; Tai, Julia; Seideman, Casey; Lesser, Martin; Moldwin, Robert M
To better elucidate the prevalence of perceived food sensitivity and characterize the sensitivity pattern in patients with clinically diagnosed chronic prostatitis/chronic pelvic pain syndrome. A total of 286 men meeting the National Institutes of Health criteria for chronic prostatitis were mailed a validated questionnaire designed to detect the effect of foods, beverages, and/or supplements on pelvic pain symptoms. The questionnaire assessed the effect of 176 individual comestibles on each patient's symptoms. The responses were numerically scored on a scale of -2 to +2, and the mean values were generated for each comestible. In addition, the participants were asked to complete the O'Leary-Sant Symptom and Problem Index and Chronic Prostatitis Symptom Index questionnaires. Of the 286 surveys, 95 were returned, yielding a response rate of 33.2%. Of those subjects who responded, 47.4% reported that the consumption of certain comestibles aggravated their symptoms, with the most aggravating being spicy foods, coffee, hot peppers, alcoholic beverages, tea, and chili. In contrast, the comestibles that alleviated the symptoms the most included docusate, pysllium, water, herbal teas, and polycarbophil. Many patients with chronic prostatitis/chronic pelvic pain syndrome have demonstrable food, beverage, and dietary supplement sensitivities. Dietary changes should be considered in the treatment of these patients. Copyright © 2013 Elsevier Inc. All rights reserved.
Marín, Jorge Alonso; Ortega, Mayra Alexandra; Sánchez, Isaura Pilar; Pacheco, José Armando
Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity reaction associated with a variety of drugs, mainly anticonvulsants, which is characterized by systemic symptoms and erythematous lesions, common to other toxicodermas. It is an uncommon clinical entity that requires a high suspicion by clinical staff given its varied initial presentation, and the fact that symptoms can overlap with those of other adverse cutaneous reactions to drugs. Without early diagnosis and appropriate treatment, mortality increases.We report the case of a 22-year-old patient with impaired neurodevelopment who received treatment with carbamazepine. Two months later he presented with general symptoms and skin erythematous lesions that began on his trunk. The patient received outpatient care with antihistamines and antipyretics without an appropriate response. His case progressed with increased skin lesions and systemic symptoms that met the diagnostic criteria for DRESS syndrome. He was hospitalized and received medical treatment according to recommended guidelines. The patient's condition improved as his symptoms and associated complications resolved. He was discharged with gradual clearing of the steroid therapy.
A. N. Semyachkina
Full Text Available The paper deals with a rare monogenic connective tissue disease from a group of fibrillinopathies with autosomal dominant inheritance — Beals syndrome caused by a mutation in the FBN2 gene. Attention is drawn to the high phenotypic similarity of this disease and Marfan syndrome (FBN1 gene mutation, which is associated with the almost complete identity of two proteins: fibrillin 1 and fibrillin 2.The paper describes a clinical case of a child with Beals syndrome and the typical manifestations of the disease: asthenic constitution, arachnodactyly of the hands and feet, congenital contractures of the large and small joints, chest deformity, kyphoscoliosis, talpes, and crushed ears. The investigators made a differential diagnosis with other connective tissue diseases, such as Marfan syndrome, Stickler syndrome, Ehlers–Danlos syndrome, homocystenuria, and arthrogryposis. DNA diagnosis verified the Beals syndrome in the proband. Exon 28 in the FBN2 gene showed the previously undescribed missense mutation of c.3719G>A, resulting in the amino acid substitution of cysteine for tyrosine (p.Cys1240Tyr in the structure of the protein fibrillin 2. A de novo mutation occurred. There is evidence for its pathogenicity in the development of the clinical symptoms of the disease. The problems of effective medical genetic counseling in this family are discussed.
Canto, John G; Canto, Elizabeth A; Goldberg, Robert J
Early recognition of the signs and symptoms of acute coronary syndromes (ACS) is essential to improving patient management and associated outcomes. It is widely reported that women might have a different ACS symptom presentation than men. Multiple review articles have examined sex differences in symptom presentation of ACS and these studies have yielded inconclusive results and/or inconsistent recommendations. This is largely because these studies have included diverse study populations, different methods of assessing the chief complaint and associated coronary symptoms, relatively small sample sizes of women and men, and lack of adequate adjustment for age or other potentially confounding differences between the sexes. There is a substantial overlap of ACS symptoms that are not mutually exclusive according to sex, and are generally found in women and men. However, there are apparent differences in the frequency and distribution of ACS symptoms among women and men. Women, on average, are also more likely to have a greater number of ACS-related symptoms contributing to the perception that women have more atypical symptoms than men. In this review, we address issues surrounding whether women should have a different ACS symptom presentation message than men, and provide general recommendations from a public policy perspective. In the future, our goal should be to standardize ACS symptom presentation and to elucidate the full range of ACS and myocardial infarction symptoms considering the substantial overlap of symptoms among women and men rather than use conventional terms such as "typical" and "atypical" angina. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Kim, Sang-Ha; Lee, Shun Nyung; Lee, Seok Jeong; Kim, Chong Whan; Lee, Won Yeon; Yong, Suk Joong; Chul Shin, Kye
Background Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is one of severe adverse drug reactions. Aromatic anticonvulsants and sulfonamides are the most common causes of DRESS syndrome. However, there have been only 2 case reports of DRESS syndrome induced by antituberculous medication. This study was aimed to observe the clinical features of patients with DRESS syndrome caused by antituberculous medications. Methods We retrospectively revealed the clinical and laboratory...
Dworkin, Emily R; Ullman, Sarah E; Stappenbeck, Cynthia; Brill, Charlotte D; Kaysen, Debra
In cross-sectional studies, social support and posttraumatic stress disorder (PTSD) symptoms appear related, in that higher severity of PTSD is associated with lower social support and vice versa. Theoretical models of the causal direction of this relationship differ. Most longitudinal studies suggest that PTSD symptoms erode social support over time, although some suggest that higher social support is prospectively associated with decrease in PTSD symptom severity. It is unclear, though, how social support and PTSD affect each other in the short term. The purpose of this study was to test day-to-day relationships between PTSD and social support to elucidate how PTSD and social support influence each other. Using 1173 daily observations from 75 college women who met screening criteria for lifetime sexual assault and past-month PTSD, this study tested same-day and next-day relationships between PTSD and social support using mixed models. Within-person analyses indicated that, when PTSD was higher than usual on a given day, social support was higher the next day. Between-person analyses suggested that people with generally higher social support tended to have lower PTSD symptoms on a given day, but average PTSD symptom severity was not associated with day-to-day fluctuations in social support. Rather than eroding in response to daily symptoms, social support might be sought out following increases in PTSD, and when received consistently, might reduce symptoms of PTSD in the short term. Interventions that increase college women's access to social support after sexual assault may thus be helpful in addressing PTSD. © 2017 Wiley Periodicals, Inc.
McDuffie, Andrea; Thurman, Angela John; Hagerman, Randi J.; Abbeduto, Leonard
Symptoms of autism are frequent in males with fragile X syndrome (FXS), but it is not clear whether symptom profiles differ from those of nonsyndromic ASD. Using individual item scores from the Autism Diagnostic Inventory-Revised, we examined which current symptoms of autism differed in boys with FXS relative to same-aged boys diagnosed with…
Marcello Weynes Barros Silva
Full Text Available ABSTRACT Sundown syndrome is characterized by the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening. Objective: To evaluate the prevalence of sundown syndrome in university hospital wards and its relationship with anxiety/depression symptoms, cognitive decline, and clinical and demographic variables. Methods: We evaluated 70 patients admitted to the Lauro Wanderley University Hospital (HULW, João Pessoa-PB, Brazil. Data collection instruments were the Confusion Assessment Method (CAM, the Mini-Mental State Exam (MMSE and the Hospital Anxiety and Depression Scale (HADS. Results: Mean patient age was 68.4±6.4 years, 55.7% were male, 67.1% were illiterate or had incomplete primary education. It was observed that 14.3% of patients had delirium, 15.7% had cognitive deficits, while 21.4% and 18.6% had anxious and depressive symptoms, respectively. The age of patients with delirium (71.9±8.7 was significantly higher than those without (67.8±5.8. At 95% confidence, there was a significant difference in the groups with and without delirium for the MMSE and HADS-D scales. Conclusion: We verified the occurrence of delirium compatible with the sundown syndrome and associated with depressive symptoms and cognitive deficit, with no apparent relationship with infectious processes or fever, number of drugs used, hospital stay or anxious symptomatology.
Markowska, Urszula Sioma; Zyg, Michalina; Kiełbratowska, Bogumiła
The aim of the study was to assess the occurrence of symptoms associated with the Couvade syndrome in two groups of men of Polish and Finnish nationality, and to perform a comparative analysis. The study was conducted in two groups of men (expectant fathers): 51 Poles and 40 Finns using a self-constructed questionnaire prepared in Polish and English languages. The statistical analysis was performed in Micro-soft Office Excel 2010 and Statistica 12. The Pearson's test was calculated, and the statistical significance level was p Polish men were weight gain (78%) and gastric disorders (80%), whereas the Finns most frequently declared weight gain (60%). As for emotional symptoms, mood swings (p = 0.0001) and sleep disorders (p = 0.00004) were significantly more common in the Poles, whilst the Finns experienced frustration (p = 0.0403) and nervousness (p = 0.01579) significantly more frequently. The Finnish respondents more often used profes-sional forms of preparation for childbirth and parenthood (p = 0.00229). Psychosomatic symptoms of the Couvade syndrome are significantly more common in Polish than in Finnish expectant fathers. Compared with Polish fathers, Finns significantly more frequently attend ante-natal classes. Ante-natal care should encompass education of men as they do experience the symptoms of the Couvade syndrome during their wives'/partners' pregnancies.
Santos, Alicia; Resmini, Eugenia; Pascual, Juan Carlos; Crespo, Iris; Webb, Susan M
Cushing's syndrome (CS) results from chronic exposure to cortisol excess, produced by the adrenal cortex. Hypercortisolism predisposes to psychiatric and neurocognitive disorders, mainly to depression and anxiety disorders. Screening tools to identify psychiatric symptoms are available for clinicians in their daily practice, although a specific diagnosis should be performed by specialists. Even if psychiatric symptoms improve after remission of hypercortisolism, complete recovery may not be achieved. Given the burden of these symptoms, psychiatric or psychological monitoring and treatment should be offered through all phases of CS, with a multidisciplinary approach. The aim of this article is to review data on the prevalence, diagnosis and management of psychiatric symptoms seen in patients with CS and to propose therapeutic approaches that may be followed in clinical practice. The prevalence of different psychiatric disorders has been described in both the active phase and after CS remission. Patients may not talk spontaneously about psychiatric symptoms they present, thus clinicians should ask directly about them. We recommend the use of screening tools in clinical practice to detect and treat these symptoms promptly. Even if reference endocrinologists cannot perform a definite psychiatric diagnosis, it will be important to ask patients directly about the presence of symptoms and refer if necessary to a psychiatrist. Additionally, patient information and educational programmes could be useful to manage psychiatric symptoms and to improve quality of life in patients with CS.
Mohammad Javad Jafari
Full Text Available Background and objectives : Research has consistently shown that air quality personal factors and work related factors were the most effective parameters for sick building syndrome. Several epidemiological studies have been carried out to show the prevalence of the sick building syndrome among the office workers but less attention has been paid to the relation of the sick building syndrome and the environmental parameters. In this work, the relationship between sick building symptoms and indoor environmental factors of two office buildings were studied. Methods: In this cross- sectional study, the sick building symptoms among two office building workers of Petroleum Industry Health Organization were examined. For this purpose, a validated questionnaire was used to determine the prevalence of the sick building syndromes and the relationship between personal and environmental factors. Meantime, indoor environmental factors including noise, light, humidity, air velocity , temperature and CO2 concentration were measured with appropriate calibrated instrumentations. Results: The results revealed that there is a significant relationship between CO2 concentration as an air quality factor and some sick building symptoms including nausea, headache, nasal irritation, shortness of breath and dry throat. A significant relationship (P-Value < 0.05 was determined between the noise exposure and headache as well as dizziness. The light intensity had a significant impact (P-Value < 0.05 on dry skin, eye pain and malaise. Conclusion: Sick building symptoms among the women were higher than men. Environmental factors and indoor air quality had major impact on sick building symptoms in office buildings.
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...... assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90...
Fisk, William J.; Mirer, Anna G.; Mendell, Mark J.
Data from published studies were combined and analyzed to develop best-fit equations and curves quantifying the change in sick building syndrome (SBS) symptom prevalence with ventilation rate. For each study, slopes were calculated, representing the fractional change in SBS symptom prevalence per unit change in ventilation rate per person. Values of ventilation rate, associated with each value of slope, were also calculated. Linear regression equations were fit to the resulting data points, after weighting by study size. Integration of the slope-ventilation rate equations yielded curves of relative SBS symptom prevalence versus ventilation rate. Based on these analyses, relative SBS symptom prevalence increases approximately 23percent (12percent to 32percent) as the ventilation rate drops from 10 to 5 L/s-person and relative prevalence decreases approximately 29percent (15percent to 42percent) as ventilation rate increases from 10 to 25 L/s-person.
Xia, Ling-Xiang; Ding, Cody
This study explores the relationship between interpersonal traits and posttraumatic stress disorder (PTSD) symptoms in a sample of 617 middle and high school students 16 months after the Wenchuan earthquake in China using the Impact of Event Scale-Revised (IES-R) and the Interpersonal Self-Supporting Scale (ISSS). Even when the effects of gender and grade level were controlled for, the results from regression analyses revealed that greater interpersonal independence, interpersonal initiative, interpersonal responsibility, and interpersonal openness are associated with lesser PTSD symptoms 16 months later. Copyright © 2011 International Society for Traumatic Stress Studies.
Rief, Winfried; Burton, Chris; Frostholm, Lisbeth; Henningsen, Peter; Kleinstäuber, Maria; Kop, Willem J; Löwe, Bernd; Martin, Alexandra; Malt, Ulrik; Rosmalen, Judith; Schröder, Andreas; Shedden-Mora, Meike; Toussaint, Anne; van der Feltz-Cornelis, Christina
The harmonization of core outcome domains in clinical trials facilitates comparison and pooling of data, and simplifies the preparation and review of research projects and comparison of risks and benefits of treatments. Therefore, we provide recommendations for the core outcome domains that should be considered in clinical trials on the efficacy and effectiveness of interventions for somatic symptom disorder, bodily distress disorder, and functional somatic syndromes. The European Network on Somatic Symptom Disorders group of more than 20 experts in the field met twice in Hamburg to discuss issues of assessment and intervention research in somatic symptom disorder, bodily distress disorder, and functional somatic syndromes. The consensus meetings identified core outcome domains that should be considered in clinical trials evaluating treatments for somatic symptom disorder and associated functional somatic syndromes. The following core domains should be considered when defining ascertainment methods in clinical trials: a) classification of somatic symptom disorder/bodily distress disorder, associated functional somatic syndromes, and comorbid mental disorders (using structured clinical interviews), duration of symptoms, medical morbidity, and prior treatments; b) location, intensity, and interference of somatic symptoms; c) associated psychobehavioral features and biological markers; d) illness consequences (quality of life, disability, health care utilization, health care costs; e) global improvement and treatment satisfaction; and f) unwanted negative effects. The proposed criteria are intended to improve synergies of clinical trials and to facilitate decision making when comparing different treatment approaches. These recommendations should not result in inflexible guidelines, but increase consistency across investigations in this field.
Runeson, R; Wahlstedt, K; Wieslander, G; Norbäck, D
A random sample of 1000 subjects (20-65 years of age) received a postal questionnaire regarding sick building syndrome (SBS), including the three-dimensional model of demand-control-support (DCS). The response rate was 70% (n = 695), and 532 were occupationally active. Female gender and atopy were the main predictors of symptoms. Eye symptoms were more common at low social support combined with strained work situation [odds ratio (OR) 2.37], and at high social support combined with active work situation (OR 3.00). Throat symptoms were more common at low social support combined with either passive (OR 1.86) or strained situation (OR 2.42). Tiredness was more common at low social support combined with either passive (OR 2.41), strained (OR 2.25), or active situation (OR 1.87), and at high social support combined with active work situation (OR 1.83). Low social support combined with either passive (P = 0.01) or strained job situation (P = 0.01) was associated with a higher symptom score (SC). The lowest SC was found at a relaxed work situation, irrespective of social support. In conclusion, female gender, low age, asthma, atopy and psychosocial work environment are associated with symptoms. The three-dimensional model can predict symptoms compatible with SBS, but in a more complex way than earlier research indicated. Practical Implications A multi-disciplinary approach, including psychosocial stress factors as well as personal factors such as gender, age, atopy and asthma, and indoor exposures, should be applied in studies on symptoms compatible with sick building syndrome (SBS). Males and females perceive psychosocial work conditions differently, and may react differently to job stressors. The psychosocial work environment can be as important as gender and atopy as a predictor of SBS symptoms.
Huisman-van Dijk, Hilde M.; van de Schoot, Rens; Rijkeboer, Marleen M.; Mathews, Carol A; Cath, Dainelle C
Gilles de la Tourette’s syndrome (GTS) is a disorder in which co-morbid obsessive-compulsive (OC), Attention Deficit Hyperactivity Disorder (ADHD) and autism symptoms occur in up to 60% of patients, suggesting shared etiology. We aimed to explore the phenotypic structure underlying GTS, taking tic, OC, ADHD, and autism symptoms into account as measured by various symptom scales (YGTSS, Y-BOCS, CAARS and AQ) in 225 GTS patients and 371 family members. First, Confirmatory Factor Analyses (CFA) were performed on the symptom structure of each separate symptom scale. Second, the symptom dimensions derived from each scale were combined in one model, and correlations between them were calculated. Using the correlation matrix, Exploratory Factor Analyses (EFA) were performed on the symptom dimensions across the scales. EFA revealed a five factor structure: tic/aggression/symmetry; OC symptoms/compulsive tics/numbers and patterns; ADHD symptoms; autism symptoms; and hoarding/inattention symptoms. The symptom factors found in this study are partly in line with the traditional categorical boundaries of the symptom scales used, and partly reveal a symptom structure that cuts through the diagnostic categories. This phenotypic structure might more closely reflect underlying etiologies than a structure that classically describes GTS patients according to absence or presence of comorbid OCD, ADHD and autism, and might inform both future genetic and treatment studies. PMID:26826899
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and gene......Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...... assigned to systemic group psychotherapy. PTSD symptoms and general psychiatric distress were evaluated at baseline, at discharge, 1 year and 5 years after discharge, using the crime-related post-traumatic stress disorder scale (CR-PTSD) and the Global Severity Index (GSI) from the Symptom Checklist- 90...
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
in women with a history of CSA participating in both analytic and systemic specialized incest group psychotherapy. Improvement was maintained for both groups at 5-year-follow-up. The trajectories of PTSD symptoms and GSI for the two groups differed significantly, however. Implications of the difference...
Usami, Masahide; Iwadare, Yoshitaka; Watanabe, Kyota; Kodaira, Masaki; Ushijima, Hirokage; Tanaka, Tetsuya; Harada, Maiko; Tanaka, Hiromi; Sasaki, Yoshinori; Saito, Kazuhiko
On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized several people, including children. The aim of this study was to assess changes in traumatic symptoms 8, 20, and 30 months of the 2011 tsunami. The study comprised three groups. Copies of the Post-Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on traumatic symptoms, were distributed to 12,524 children (8-month period), 12,193 children (20-month period), and 11,819 children (30-month period). An effective response of children 8 months, 20 months, and 30 month after the disaster was obtained in 11,639 (92.9%), 10,597 (86.9%), and 10,812 children (91.4%), respectively. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15. The PTSSC-15 total score and PTSD subscale of children belonging to 1st-9th grade groups who were tested 30 and 20 months after the tsunami significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 total score and PTSD subscale of children in 1st-9th grade groups tested after 30 months did not decrease significantly compared with those of children tested after 20 months. The PTSSC-15 Depression subscale and PTSD subscale of children in 1st-9th grade groups tested after 30 months significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 Depression subscale of children in 1st-9th grade groups evaluated after 30 months significantly decreased compared with those of children evaluated after 20 months. This study demonstrates that the traumatic symptoms of children who survived the massive tsunami improved with time. Nonetheless, the traumatic symptoms, which in some cases did not improve with time.
Mark B. Detweiler
Full Text Available Organophosphates (OPs are ubiquitous in the world as domestic and industrial agricultural insecticides. Intentional poisoning as suicides attempts are clinical phenomena seen in emergency departments and clinics in agricultural areas. Intermediate syndrome with the neurological complication of extra pyramidal symptoms following acute OP ingestion may occur in pediatric and adult cases. While death is the most serious consequence of toxic OP doses, low levels of exposure and nonfatal doses may disrupt the neurobehavioral development of fetuses and children in addition to bring linked to testicular cancer and male and female infertility. These are disturbing. Chronic and acute toxicity from OPs are barriers to the health of our present and future generations. Symptoms and treatment of acute and chronic OP exposure are briefly referenced with inclusion of the intermediate syndrome. Suggestions for local and systemic reduction of the acute and long term consequences of OP ingestion are opined.
Yavuzsen, Tugba; Walsh, Declan; Davis, Mellar P; Kirkova, Jordanka; Jin, Tao; LeGrand, Susan; Lagman, Ruth; Bicanovsky, Lesley; Estfan, Bassam; Cheema, Bushra; Haddad, Abdo
Cancer-related anorexia is traditionally considered part of a complex but ill-defined anorexia-cachexia syndrome in which anorexia is intimately associated with other gastrointestinal (GI) symptoms and weight loss. We surveyed cancer patients with anorexia to learn more about the relationship between anorexia and these symptoms. A 22-item GI questionnaire assessed the severity of anorexia and the prevalence of concurrent GI symptoms, including taste changes, food aversions, altered sense of smell, and diurnal food intake changes. The relationship between anorexia severity and anticancer therapy and prior menstrual or pregnancy-related appetite changes was also assessed. Ninety-five of 101 patients with anorexia surveyed had complete data. Seventy-eight percent of them had moderate or severe anorexia. Abnormal diurnal appetite variation, taste changes, and food aversions were present in over 50% of all those with anorexia. Judged by the numerical rating scale, the worse the anorexia, the more prevalent were early satiety, constipation, vomiting, and food aversions. Those with more severe anorexia had greater weight loss, and worse performance status. Anorexia severity did not correlate with that during prior menses/pregnancy or antitumor therapy. Evaluation of multiple other GI symptoms is important in understanding the total experience of cancer anorexia. Early satiety, taste changes, food aversions, and altered sense of smell are important accompanying GI symptoms. Most validated anorexia tools do not assess these commonly associated GI symptoms. Future research should develop a comprehensive anorexia symptom questionnaire.
Billing-Ross, Paul; Germain, Arnaud; Ye, Kaixiong; Keinan, Alon; Gu, Zhenglong; Hanson, Maureen R
Mitochondrial dysfunction has been hypothesized to occur in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), a disease characterized by fatigue, cognitive difficulties, pain, malaise, and exercise intolerance. We investigated whether haplogroup, single nucleotide polymorphisms (SNPs), or heteroplasmy of mitochondrial DNA (mtDNA) were associated with health status and/or symptoms. Illumina sequencing of PCR-amplified mtDNA was performed to analyze sequence and extent of heteroplasmy of mtDNAs of 193 cases and 196 age- and gender-matched controls from DNA samples collected by the Chronic Fatigue Initiative. Association testing was carried out to examine possible correlations of mitochondrial sequences with case/control status and symptom constellation and severity as reported by subjects on Short Form-36 and DePaul Symptom Questionnaires. No ME/CFS subject exhibited known disease-causing mtDNA mutations. Extent of heteroplasmy was low in all subjects. Although no association between mtDNA SNPs and ME/CFS vs. healthy status was observed, haplogroups J, U and H as well as eight SNPs in ME/CFS cases were significantly associated with individual symptoms, symptom clusters, or symptom severity. Analysis of mitochondrial genomes in ME/CFS cases indicates that individuals of a certain haplogroup or carrying specific SNPs are more likely to exhibit certain neurological, inflammatory, and/or gastrointestinal symptoms. No increase in susceptibility to ME/CFS of individuals carrying particular mitochondrial genomes or SNPs was observed.
Janda, Carolyn; Kues, Johanna N; Andersson, Gerhard; Kleinstäuber, Maria; Weise, Cornelia
The differentiation between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) has been widely discussed. PMDD is listed as a mental disorder in the DSM-5, whereas PMS is not considered as a mental disorder in any diagnostic manual. Consequently, PMS is operationalized in different ways. Keeping a symptom diary is required to diagnose PMDD but is also recommended for PMS. The aim of our study was, therefore, to operationalize PMS and PMDD within a DSM-5-based symptom diary. We developed a symptom-intensity-score (SI-score) and an interference-score (INT-score) to evaluate the symptom diary. Ninety-eight women (aged 20-45 years) completed a symptom diary over two menstrual cycles, a retrospective screening for premenstrual symptoms, and answered additional impairment questionnaires from August 2013 to August 2015. The scores revealed moderate to good reliability (Cronbach's α = 0.83-0.96). Convergent validity was shown by significant correlations with a retrospective screening, the Pain Disability Index, and the German PMS-Impact Questionnaire. Discriminant validity was indicated by low correlations with the Big Five Inventory-10. These scores may facilitate the evaluation of prospective symptom ratings in research and clinical practice. Future research should focus on continuing to validate the scores (e.g., in an ambulatory setting).
Wagner, Mary L; Walters, Arthur S; Fisher, Barbara C
To determine the occurrence of symptoms of attention-deficit/hyperactivity disorder (ADHD) in adults with restless legs syndrome (RLS), normal controls, and controls with insomnia. University-based hospital. The occurrence and severity of current ADHD symptoms were determined in a prospective study of sequential adult patients with RLS (n = 62) or insomnia (n = 32) and adult controls (n = 77) using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) ADHD criteria, the Brown Attention-Deficit Disorder (ADD) Scale for adults, and a structured psychological interview. RLS severity was assessed using the International RLS Study Group Rating Scale (IRLS). Only 1 experimental subject had previously been diagnosed with ADHD. More RLS patients (26%) than insomnia patients (6%) or controls (5%) had ADHD symptoms using age-adjusted total DSM-IV ADHD scores (P 40, all reported ADD symptoms in 2 settings, and the majority had had ADHD symptoms since childhood. For subjects with a Brown ADD score > 40, there were no differences between the RLS, insomnia control, and normal control groups in quality of life or the level of anxiety or depression. ADHD symptoms are more common in RLS patients than in patients with insomnia or controls. RLS leg discomfort or poor quality of sleep may theoretically lead to hyperactivity and lack of concentration. Alternatively, RLS and ADHD may be part of a single symptom complex, and dopaminergic deficiency may play a role in both disorders.
David J. Levinthal
Full Text Available Background. Multiple sclerosis (MS patients often suffer from gastrointestinal (GI symptoms. However, the full extent and prevalence of such symptoms are not clearly established. Thus, we sought to define the prevalence of GI symptoms and syndromes in those with MS. Methods. 218 MS patients completed self-reported demographic and clinical data questionnaires as well as several standardized surveys probing MS severity and GI health. Results. Nearly two thirds (65.6% of patients endorsed at least one persistent GI symptom. Constipation (36.6%, dysphagia (21.1%, and fecal incontinence (15.1% were common. Surprisingly, nearly 30% (28.4% of the patients reported dyspeptic symptoms. Using validated diagnostic algorithms, patients met criteria for functional dysphagia (14.7%, functional dyspepsia (16.5%, functional constipation (31.7%, and IBS (19.3%, among others. Functional dysphagia, functional dyspepsia, and IBS were significantly more common in those with self-identified mood disorders. Conclusions. Constipation, fecal incontinence, and dysphagia are indeed frequent symptoms seen in MS patients. We also noted a ~30% prevalence of dyspepsia in this population. The mechanisms driving this association are not clear and require further study. However, due to this high prevalence, dyspeptic symptoms should be incorporated into the routine assessment of MS patients and, if found, may warrant collaborative referral with a GI specialist.
Jaakkola, Maritta S; Yang, Liyan; Ieromnimon, Antonia; Jaakkola, Jouni J K
To assess the relation between exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers (FPP), and the occurrence of sick building syndrome (SBS)-related symptoms, chronic respiratory symptoms and respiratory infections. A population-based cross-sectional study with a random sample of 1016 adults, 21-63 years old, living in Pirkanmaa District in South Finland was conducted. This study focused on 342 office workers classified as professionals, clerks or administrative personnel according to their current occupation by the International Standard Classification of Occupations-88. They answered a questionnaire about personal information, health, smoking, occupation, and exposures in the work environment and at home. In logistic regression analyses adjusting for age, sex and a set of other confounders, all three exposures were related to a significantly increased risk of general symptoms (headache and fatigue). Exposure to paper dust and to FPP was associated with upper respiratory and skin symptoms, breathlessness, tonsillitis and middle ear infections. Exposure to CCP increased the risk of eye symptoms, chronic bronchitis and breathlessness. It was also associated with increased occurrence of sinus and middle ear infections and diarrhoea. A dose-response relations was observed between the number of exposures and occurrence of headache. The risk of tonsillitis and sinus infections also increased with increasing number of exposures. All chronic respiratory symptoms, apart from cough, were increased in the highest exposure category (including all three exposures). This study provides new evidence that exposure to paper dust and to FPP is related to the risk of SBS symptoms, breathlessness and upper respiratory infections. It strengthens the evidence that exposure to CCP increases the risk of eye symptoms, general symptoms, chronic respiratory symptoms and some respiratory infections. Reduction of these exposures could improve the
Hartley, Sigan L.; Wheeler, Anne C.; Mailick, Marsha R.; Raspa, Melissa; Mihaila, Iulia; Bishop, Ellen; Bailey, Donald B.
A cross-sectional analysis was used to examine age-related differences in ASD symptoms and corresponding differences in disruptive behavior and social skills in 281 adult men with fragile X syndrome. Four age groups were created: 18-21, 22-29, 30-39, and 40-49 years. The 18-21 year-old group was reported to have more impairments in verbal…
't Hoen, Lisette A; Korfage, Ida J; Verhallen, Jacintha T C M; van Ledden-Klok, Marjan J; van den Hoek, Joop; Blok, Bertil F M; Scheepe, Jeroen R
We sought to establish the reliability and validity of the Dutch version of the Vancouver Symptom Score for Dysfunctional Elimination Syndrome for children with dysfunctional voiding and their parents. For this cross-sectional multicenter study the Vancouver Symptom Score for Dysfunctional Elimination Syndrome was translated and cross-culturally adapted to Dutch following a standardized process. Patients 16 years or younger with dysfunctional voiding and their parents were recruited at pediatric, pediatric urology and pelvic floor physical therapy outpatient clinics. The reference group consisted of children 6 to 16 years old without dysfunctional voiding and their parents. All groups completed questionnaires. The evaluated measurement properties included discriminative ability, internal consistency, test-retest reliability, interrater agreement, criterion validity using the Pediatric Incontinence Questionnaire and construct validity. A cutoff value for diagnosis of dysfunctional voiding was determined. A total of 50 patients and 60 references and their parents were included in the study. The Vancouver Symptom Score for Dysfunctional Elimination Syndrome showed good discriminative ability. A moderate internal consistency was found (Cronbach alpha 0.37-0.55). Test-retest reliability was moderate to good, and interrater agreement demonstrated good correlation between children and parents (ICC 0.85, 95% CI 0.79-0.89). A weak correlation with the Pediatric Incontinence Questionnaire was found in patients and construct validity was confirmed. Cutoff scores for dysfunctional voiding were 11 and 9 for patients and parents, respectively. The Dutch Vancouver Symptom Score for Dysfunctional Elimination Syndrome displayed moderate to good reliability and validity properties for the patient and parent versions. Use of this instrument in clinical practice will support the assessment of dysfunctional voiding and facilitate international reporting of research results. Copyright
Burnout Maslach and Pines (1978) conducted a survey to determine characteristics of burnout and ways of coping with it in mental health settings. They...AD-A158 128 UNCLASSIFIED REEATIONSHIP BETWEEN BURNOUT SVNDROHE SVHPTOHS AND SEEF-ACTUALIZATION SCO. . (U) AIR FORCE INST OF TECH MRIGHT-PATTERSON...RELATIONSHIP BETWEEN BURNOUT SYNDROME SYMPTOMS AND SELF-ACTUALIZATION SCORES IN CRITICAL-CARE NURSES Pamela L. Smith, B.A., B.S.N. A Thesis Presented to
Nijs, J.; Meeuw, M.; Heins, M.; Knoop, H; Moorkens, G.; Bleijenberg, G
Purpose: Kinesiophobia and catastrophizing are frequent among people with chronic fatigue syndrome (CFS). This study was aimed at examining (1) whether kinesiophobia, anticipated symptoms and fatigue catastrophizing are related to stair climbing performance in people with CFS; and (2) whether kinesiophobia and fatigue catastrophizing are related to daily physical activity in CFS. Method: Patients with CFS filled in a set of questionnaires, performed a physical demanding task (two floors stair...
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and gene......Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch....
Iverson, Katherine M; King, Matthew W; Cunningham, Katherine C; Resick, Patricia A
This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT. Published by Elsevier Ltd.
Full Text Available On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized several people, including children. The aim of this study was to assess changes in traumatic symptoms 8, 20, and 30 months of the 2011 tsunami.The study comprised three groups. Copies of the Post-Traumatic Stress Symptoms for Children 15 items (PTSSC-15, a self-rating questionnaire on traumatic symptoms, were distributed to 12,524 children (8-month period, 12,193 children (20-month period, and 11,819 children (30-month period. An effective response of children 8 months, 20 months, and 30 month after the disaster was obtained in 11,639 (92.9%, 10,597 (86.9%, and 10,812 children (91.4%, respectively. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15. We calculated the total score, PTSD subscale, and Depression subscale of PTSSC-15.The PTSSC-15 total score and PTSD subscale of children belonging to 1st-9th grade groups who were tested 30 and 20 months after the tsunami significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 total score and PTSD subscale of children in 1st-9th grade groups tested after 30 months did not decrease significantly compared with those of children tested after 20 months. The PTSSC-15 Depression subscale and PTSD subscale of children in 1st-9th grade groups tested after 30 months significantly decreased compared with those of children tested 8 months after the tsunami. The PTSSC-15 Depression subscale of children in 1st-9th grade groups evaluated after 30 months significantly decreased compared with those of children evaluated after 20 months.This study demonstrates that the traumatic symptoms of children who survived the massive tsunami improved with time. Nonetheless, the traumatic symptoms, which in some cases did not improve with time.
McMonnies, Charles W
: Valid assessment of dry eye syndrome symptoms is essential for diagnosis and for making treatment decisions and monitoring responses to treatment. Notwithstanding the desirability of being able to measure across several assessment domains to gauge the influence of symptom burden on the quality of life, the time-consuming nature of such assessments may make them unsuitable for routine clinical use. This review of symptom assessment methods examines the relative merits of visual analogue and Likert scales. Also examined are ways in which symptoms can be influenced by comorbid diseases and associated medications, and how the validity of assessing treatment efficacy could be compounded by natural progression of a dry eye syndrome apart from either favorable, neutral, or adverse responses to treatment. Follow-up assessments may also be biased by patient expectations. How validity of responses could be improved by the instructional use of a demonstration scale is described and illustrated. Personal instruction is suggested for patients anticipated to have age- or language-related difficulties but for some patients instruction could be successfully self-directed. A comparison of methods used to monitor dry eye syndrome treatment has allowed recommendations to be made for a method of using visual analogue scales which incorporates features which have been demonstrated to be advantageous in previous studies. The continuous nature of a visual analogue scale allows for smaller changes to be recorded with associated better discriminating capacity. More powerful statistical analysis of findings is possible when using visual analogue scales. Reference to previous assessment scores and exactly the same scale anchors improve the reliability of measurements of change in symptoms over time.
Kingma, Eva M.; Rosmalen, Judith G. M.; White, Peter D.; Stansfeld, Stephen A.; Clark, Charlotte
BACKGROUND: Cognitive ability is negatively associated with functional somatic symptoms (FSS) in childhood. Lower childhood cognitive ability might also predict FSS and functional somatic syndromes in adulthood. However, it is unknown whether this association would be modified by subjective and
Zubor, Pavol; Gondova, Alexandra; Polivka, Jiri; Kasajova, Petra; Konieczka, Katarzyna; Danko, Jan; Golubnitschaja, Olga
An epidemic scale of the breast cancer (BC) prevalence is actually recognised as the reality of the early twenty-first century. Particularly alarming is that the sporadic BC (about 90% of all patients) creates currently unpredictable subpopulations in terms of disease predisposition, development and progression. Despite broad discussions run since years in BC area, no any plausible approach has been suggested so far to get the overall situation better controlled in the populations. Here, we present highly innovative concepts considering investigation of specific syndromes and symptoms underestimated till now in relationship with BC predisposition and development. Consequently, the purpose of our pilot project was to evaluate the prevalence of Flammer Syndrome (FS) in BC patient cohort. The results achieved here support the main hypothesis of the project clearly demonstrating the tendency of BC patients to the increased prevalence of FS symptoms compared to the disease-free individuals. Our study strongly indicates the relevance of FS symptoms for BC pathology such as feeling inadequately cold, deficient thermoregulation, altered sensitivity to different stimuli, potential dehydration, altered sleep patterns, tendency towards headache, migraine attacks and dizziness. Moreover, the symptoms' appearance is specifically linked to the individual BC subtypes. Potential mechanisms interconnecting FS with BC pathology are discussed.
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...
Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke
Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...
Maddali Bongi, Susanna; Del Rosso, Angela; Orlandi, Martina; Matucci-Cerinic, Marco
This paper aims to investigate women with primary Sjögren's syndrome (pSS) and sicca syndrome (SS), focusing on the prevalence of disease-related symptoms and their impact on sexual ability, relationship, communication about sexuality with partner and health professionals (HP). Sixty-two women with pSS and 33 with SS were assessed for sexual activity, relationship with partner, communication about sex; for physical disability and body esteem, fatigue, disability, quality of life (QoL), anxiety and depression. Around 55% patients had a relationship; >79% and around 70% at least 1 gynaecological (especially dryness), and 1 muscle-skeletal symptom, respectively; around 60% sex disability for disease-related symptoms, mainly dryness (p=NS for all comparisons between pSS and SS). In both groups, disease changed sexual activity (around 50%), causing limitation (around 50%) and reduced frequency (>80%) in sexual intercourses; sex pleasure and satisfaction were around 30% and 25% (p=NS for pSS vs. SS). Around 55% patients discussed with partner disease-effects on relationship; despite in around 70% partner understood difficulties, in around 34% disease altered relationship (p=NS for pSS vs. SS). Around 16% patients were asked by HP if disease affected sexuality, around 30% never approached anyone to discuss about sex (p=NS for pSS vs. SS). Disability, QOL, mood, fatigue, similar in pSS versus SS (p=NS), were not affected by xerostomia and xeroftalmia, but by sex concerns and sex disability. Patients with pSS and SS present, often and at the same extent, gynaecological symptoms, leading to impaired sexual intercourse, affecting pleasure, satisfaction, sexual ability.
Full Text Available Burning mouth syndrome (BMS is a chronic and spontaneous oral pain with burning quality in the tongue or other oral mucosa without any identifiable oral lesion or laboratory finding. Pathogenesis and etiology of BMS are still unknown. However, BMS has been associated with other chronic pain syndromes including other idiopathic orofacial pain, the dynias group and the family of central sensitivity syndromes. This would imply that BMS shares common mechanisms with other cephalic and/or extracephalic chronic pains. The primary aim of this systematic review was to determine whether BMS is actually associated with other pain syndromes, and to analyze cephalic and extracephalic somatosensory sensitivity in these patients.This report followed the PRISMA Statement. An electronic search was performed until January 2015 in PubMed, Cochrane library, Wiley and ScienceDirect. Searched terms included "burning mouth syndrome OR stomatodynia OR glossodynia OR burning tongue OR oral burning". Studies were selected according to predefined inclusion criteria (report of an association between BMS and other pain(s symptoms or of cutaneous cephalic and/or extracephalic quantitative sensory testing in BMS patients, and a descriptive analysis conducted.The search retrieved 1512 reports. Out of these, twelve articles met criteria for co-occurring pain symptoms and nine studies for quantitative sensory testing (QST in BMS patients. The analysis reveals that in BMS patients co-occurring pain symptoms are rare, assessed by only 0.8% (12 of 1512 of the retrieved studies. BMS was associated with headaches, TMD, atypical facial pain, trigeminal neuralgia, post-herpetic facial pain, back pain, fibromyalgia, joint pain, abdominal pain, rectal pain or vulvodynia. However, the prevalence of pain symptoms in BMS patients is not different from that in the age-matched general population. QST studies reveal no or inconsistent evidence of abnormal cutaneous cephalic and extracephalic
Effat, K G
Otological symptoms (otalgia, subjective hearing loss, blocked ear sensation, tinnitus and vertigo) associated with temporomandibular disorders are documented features of Costen's syndrome. However, the origin of these symptoms and the causes of hearing loss are unknown. This study aimed to characterise hearing loss in a large number of patients with temporomandibular disorders. The causes of these symptoms were explored in patients with otological symptoms and normal audiometric findings. A prospective case study and literature review were performed. The audiometric features of 104 temporomandibular disorder patients were compared with those of 110 control participants. A large proportion of temporomandibular disorder patients had several otological symptoms. Twenty-five per cent of unilateral or bilateral temporomandibular disorder patients had either unilateral (ipsilateral) or bilateral hearing loss; respectively, which was usually mild (p = 0.001). Hearing loss was predominantly sensorineural. The main cause of otological symptoms (apart from otalgia) and of audiometric findings in temporomandibular disorder patients is postulated to be an altered middle-ear to inner-ear pressure equilibrium.
Huisman-van Dijk, Hilde M; Schoot, Rens van de; Rijkeboer, Marleen M; Mathews, Carol A; Cath, Daniëlle C
Gilles de la Tourette's syndrome (GTS) is a disorder in which obsessive-compulsive (OC), Attention Deficit Hyperactivity Disorder (ADHD) and autism symptoms occur in up to 60% of patients, suggesting shared etiology. We explored the phenotypic structure of tic, OC, ADHD, and autism symptoms as measured by the YGTSS,Y-BOCS,CAARS and AQ, in 225 GTS patients and 371 family members. First, Confirmatory Factor Analyses (CFA) were performed on the symptom structure of each separate symptom scale. Second, the symptom dimensions derived from each scale were combined in one model, and correlations between them were calculated. Using the correlation matrix, Exploratory Factor Analyses (EFA) were performed on the symptom dimensions across the scales. EFA revealed a five factor structure: tic/aggression/symmetry; OC symptoms/compulsive tics/ numbers and patterns; ADHD symptoms; autism symptoms; and hoarding/inattention symptoms. The results are partly in line with the traditional categorical boundaries of the symptom scales used, and partly reveal a symptom structure that cuts through the diagnostic categories. This phenotypic structure might more closely reflect underlying etiologies than a structure that classically describes GTS patients according to absence or presence of comorbid OCD, ADHD and autism, and might inform both future genetic and treatment studies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Hauer, Daniela; Kaufmann, Ines; Strewe, Claudia; Briegel, Isabel; Campolongo, Patrizia; Schelling, Gustav
Critically ill patients are at an increased risk for traumatic memories and post-traumatic stress disorder (PTSD). Memories of one or more traumatic events play an important part in the symptom pattern of PTSD. Studies in long-term survivors of intensive care unit (ICU) treatment demonstrated a clear and vivid recall of traumatic experiences and the incidence and intensity of PTSD symptoms increased with the number of traumatic memories present. Preclinical evidence has clearly shown that the consolidation and retrieval of traumatic memories is regulated by an interaction between the noradrenergic, the glucocorticoid and the endocannabinoid system. Critically ill patients in the ICU frequently require treatment with adrenenergic or glucocorticoid drugs and often receive sedative medications; among them propofol is known to influence endocannabinoid signaling. Critical illness could therefore represent a useful model for investigating adrenergic, glucocorticoid as well as endocannabinoid effects on traumatic memory and PTSD development in stressed humans. The endocannabinoid system is an important regulator of HPA-axis activity during stress, an effect which has also been demonstrated in humans. Likewise, a single nucleotide polymorphism (SNP) of the glucocorticoid receptor (GR) gene (the BclI-SNP), which enhances the sensitivity of the glucocorticoid receptors to cortisol and possibly HPA-axis feedback function, was associated with enhanced emotional memory performance in healthy volunteers. The presence of the BclI-SNP increased the risk for traumatic memories and PTSD symptoms in patients after ICU therapy and was linked to lower basal cortisol levels. A number of small studies have demonstrated that the administration of cortisol to critically ill or injured patients results in a significant reduction of PTSD symptoms after recovery without influencing the number of traumatic memories. These glucocorticoid effects can possibly be explained by a cortisol
Full Text Available Context : Excess prevalence of irritable bowel syndrome in asthma has been reported, suggesting a link between these two conditions. Aims: To investigate the association between irritable bowel syndrome (IBS and asthma, and explore the symptoms of IBS among asthma patients in Kuwait. Settings and Design: Case control study. Methods: In a tertiary center, for allergy and asthma, 138 patients aged 20-65 years, with asthma, diagnosed clinically and by spirometry,were compared with 145 healthy, non-asthmatic controls matched for age, gender and nationality. Cases and controls completed a self-administered questionnaire of irritable bowel syndrome diagnosis (ROME II criteria. Statistical Analysis Used: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher′s test. Odds ratio (OR with 95% Confidence Interval (CI were calculated to identify the associated risk factors. The demographic variables were selected for logistic regression analysis. Results : A significantly large proportion (39.13% of asthmatics had IBS as compared to 7.93% controls (P < 0.001. A higher proportion of females with IBS were observed in cases and controls (74%, 61.54%. IBS was seen in 87% cases using inhalers, and in 13% with additional oral theophylline (P < 0.001. As many as 66.6% cases, had IBS with relatively short duration of asthma (1-5 years, P < 000. Predominant symptoms of IBS in asthmatics were abdominal discomfort or distension (64.8% vs. 11.5%, (P < 0.000, OR = 14.1; 95%CI: 3.748-53.209, bloated feeling of abdomen (74.1% vs. 34.62% (P < 0.001, OR = 5.38; 95%CI:1.96-14.84, increased frequency of stools (63%, P < 0.006. Conclusions: Irritable bowel syndrome in asthmatics was significantly high, more in the female asthmatics. Abdominal discomfort, persistent bloated feeling, increased frequency of passing stools were the most common IBS symptoms observed.
Boer, Hink; Westerink, Nico-Derk L.; Altena, Renske; Nuver, Janine; Dijck-Brouwer, D. A. Janneke; van Faassen, Martijn; Klont, Frank; Kema, Ido P.; Lefrandt, Joop D.; Zwart, Nynke; Boezen, H. Marike; Smit, Andries J.; Meijer, Coby; Gietema, Jourik A.
Purpose: Chemotherapy-treated testicular cancer survivors are at risk for development of the metabolic syndrome, especially in case of decreased androgen levels. Polymorphisms in the gene encoding steroid 5-alpha-reductase type II (SRD5A2) are involved in altered androgen metabolism. We investigated
Boyle, Chloe C; Stanton, Annette L; Ganz, Patricia A; Crespi, Catherine M; Bower, Julienne E
Mindfulness meditation reduces psychological distress among individuals with cancer. However, mechanisms for intervention effects have not been fully determined. This study tested emotion regulation strategies as mediators of intervention effects in a sample of younger women treated for breast cancer, a group at risk for psychological distress. We focused on two distinct strategies targeted by the intervention-rumination and self-kindness-and further examined the broader construct of mindfulness as a potential mediator. Women (n = 71) with Stage 0-III breast cancer diagnosed at or before age 50 who had completed cancer treatment were randomly assigned to a 6-week mindfulness intervention or wait-list control group. Assessments occurred at study entry, postintervention, and a 3-month follow-up. In single mediator analyses, increases in self-kindness (CIB [-7.83, -1.93]), decreases in rumination (CIB [-5.05, -.31]), and increases in mindfulness (CIB [-6.58, -.82]) each mediated reductions in depressive symptoms from pre- to postintervention. Increases in self-kindness also mediated reductions in perceived stress (CIB [-5.37, -.62]) from pre- to postintervention, and increases in self-kindness (CIB [-5.67, -.22]) and in mindfulness (CIB [-5.51, -.16]) each mediated intervention effects on perceived stress from preintervention to 3-month follow-up. In multiple mediator analysis, only self-kindness mediated intervention effects on depressive symptoms from pre- to postintervention (CIB [-6.41, -.61]), and self-kindness and mindfulness together mediated intervention effects on perceived stress from preintervention to follow-up (CIB [-6.77, -.35]). Self-kindness played a consistent role in reducing distress in younger women with breast cancer. The efficacy of this understudied emotion regulation strategy should be evaluated in other clinical populations. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Full Text Available present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS.Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system (IBSSS, extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel SyndromeQuality of Life (IBS-QOL Questionnaire. Univariate and multivariate analyses were conducted.Results: The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10. Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531, IBS severity (r = 0.373 to 0.505, and quality of life (r = -0.317 to -0.398. Severity of IBS was independently associated with extraintestinal digestive symptoms’ frequency (β = 0.248. Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms’ frequency (β = -0.225 to 0.260. Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (β = -0.494 and -0.218. After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (β = -0.435 and -0.318.Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.
Segar, David J; Chodakiewitz, Yosef G; Torabi, Radmehr; Cosgrove, G Rees
Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rare genetic disorder characterized by childhood hypotonia, intellectual disability, distinctive facial features, and myriad psychiatric and behavioral disturbances. A 24-year-old female patient with childhood hypotonia, developmental delay, and diagnoses of autism spectrum disorder, OCD, and TS refractory to medical management underwent the placement of bilateral ventral capsule/ventral striatum (VC/VS) DBS leads, with clinical improvement. Medical providers and family observed gradual and progressive improvement in the patient's compulsive behaviors, coprolalia, speech, and social interaction. Symptoms recurred when both DBS electrodes failed because of lead fracture and dislodgement, although the clinical benefits were restored by lead replacement. The symptomatic and functional improvements observed in this case of VC/VS DBS for Kleefstra syndrome suggest a novel indication for DBS worthy of further investigation.
Park, Subin; Park, Min-Hyeon; Kim, Hyo Jin; Yoo, Hee Jeong
The objective of this study was to examine (a) anxiety and depression symptoms in children with Asperger syndrome (AS) compared to children with attention-deficit/hyperactivity disorder (ADHD) and children with depressive disorder; (b) parental anxiety and depressive symptoms in the three groups; and (c) the association between the anxiety and…
Maddineshat, Maryam; Keyvanloo, Sodabe; Lashkardoost, Hossein; Arki, Mina; Tabatabaeichehr, Mahbubeh
Standards of care and treatment of premenstrual syndrome (PMS) vary. Non-drug psychosocial intervention therapy is recommended for women with any kind of discomfort or distress caused by PMS. The current study examined the effectiveness of group cognitive-behavioral therapy on the symptoms of PMS at a girls' dormitory of North Khorasan University of Medical Sciences. In this quasi-experimental study, 32 female students with PMS who were majoring in nursing and midwifery and residing in the dormitory were selected using the convenience sampling method and were assigned to experimental and control groups. The Standardized Premenstrual Symptoms Screening Tool was used as the research tool. Eight sessions of cognitive-behavioral group therapy were held for the students Results: There was a significant difference in psychological symptoms before and after cognitive-behavioral therapy (p=0.012). Furthermore, cognitive-behavioral therapy was effective on social interferences caused by PMS symptoms (p=0.012). Group cognitive-behavioral therapy effectively alleviates PMS symptoms in female college students..
Guyonnet, Denis; Donazzolo, Yves; Gendre, David; Tanguy, Jérôme; Guarner, Francisco
Goals: The aim of this study was to validate the ability of symptom frequency questionnaire to differentiate between irritable bowel syndrome (IBS) patients and healthy subjects. Background: A digestive symptom frequency questionnaire (DSFQ) was previously used in a food efficacy trial in a non-IBS population with mild gastrointestinal symptoms. Study: We compared 2 well-defined populations: 100 IBS patients fulfilling Rome III criteria (mean age 32 y; range, 18 to 59 y), and 100 sex-matched and age-matched healthy subjects. Frequency of individual digestive symptoms (abdominal pain/discomfort, bloating, flatulence, borborygmi) was assessed using a 5-point Likert scale (from none to everyday of the week) and the IBS severity with the IBS-SSS questionnaire. Health-Related Quality of life (HRQoL) was assessed with the Food and Benefits Assessment (FBA) and Functional Digestive Disorders Quality of Life (FDDQL) questionnaires. The digestive (dis)comfort dimension of these questionnaires was considered as the main dimension for HRQoL. Results: The DSFQ discriminated IBS from healthy subjects with a significant difference (Pdigestive discomfort measured by FDDQL (−0.816), digestive comfort measured by FBA (−0.789), and the IBS-SSS score (0.762). Conclusions: Measurement of digestive symptom frequency by means of the DSFQ can differentiate IBS from healthy subjects, and shows a good correlation with other validated questionnaires (clinical trial #NCT01457378). PMID:25014236
Eiko I Fried
Full Text Available Major Depression (MD is a highly heterogeneous diagnostic category. Diverse symptoms such as sad mood, anhedonia, and fatigue are routinely added to an unweighted sum-score, and cutoffs are used to distinguish between depressed participants and healthy controls. Researchers then investigate outcome variables like MD risk factors, biomarkers, and treatment response in such samples. These practices presuppose that (1 depression is a discrete condition, and that (2 symptoms are interchangeable indicators of this latent disorder. Here I review these two assumptions, elucidate their historical roots, show how deeply engrained they are in psychological and psychiatric research, and document that they contrast with evidence. Depression is not a consistent syndrome with clearly demarcated boundaries, and depression symptoms are not interchangeable indicators of an underlying disorder. Current research practices lump individuals with very different problems into one category, which has contributed to the remarkably slow progress in key research domains such as the development of efficacious antidepressants or the identification of biomarkers for depression.The recently proposed network framework offers an alternative to the problematic assumptions. MD is not understood as a distinct condition, but as heterogeneous symptom cluster that substantially overlaps with other syndromes such as anxiety disorders. MD is not framed as an underlying disease with a number of equivalent indicators, but as a network of symptoms that have direct causal influence on each other: insomnia can cause fatigue which then triggers concentration and psychomotor problems. This approach offers new opportunities for constructing an empirically based classification system and has broad implications for future research.
Acikgoz, Ayla; Dayi, Ayfer; Binbay, Tolga
To determine the prevalence of and factors influencing premenstrual syndrome (PMS) in first-year students at a university health campus and to evaluate the relationship between depression and PMS. Methods: This cross-sectional study was conducted on a population of 618 university students from March to June 2016 at Dokuz Eylül University, Izmir, Turkey. Data were collected using the Premenstrual Syndrome Scale (PMSS), Beck Depression Inventory and Student Identification Form. The data were analyzed with Version 20.0 of the Statistical Package for the Social Science. Descriptive statistics, Pearson's chi-square test, and Chi-square test for trend, and independent samples t test and logistic regression analysis were used. Results: The prevalence of PMS in the university students was 58.1%. Premenstrual syndrome was significantly higher in students who smoked, drink alcohol, and consumed a large amount of fatty and high-calorie foods, in students who had a bad to very bad perception of their economic situation, and those who had any chronic disease or anemia (p less than 0.05). Premenstrual syndrome was significantly higher in students who had a risk of depression (p less than 0.01). A statistically significant relationship was determined between the risk of depression and PMSS total score and all PMSS subscale scores except for appetite changes (p less than 0.01). Conclusion: Premenstrual syndrome was found in more than half of the students who participated in the study. Premenstrual syndrome was higher in students who had a chronic disease and/or an unhealthy lifestyle. There was a statistically significant relationship between PMS and risk of depression. Students who have PMS symptoms should be evaluated for the risk of depression.
Laurenius, Anna; Olbers, Torsten; Näslund, Ingmar; Karlsson, Jan
There is a lack of prevalent data for dumping syndrome (DS) and methods discriminating between different symptoms of the DS. A self-assessment questionnaire, the Dumping Symptom Rating Scale (DSRS), was developed. The aim was to measure the severity and frequency of nine dumping symptoms and to evaluate the construct validity of the DSRS. Pre- and 1 and 2 years after Roux-en-Y gastric bypass surgery, 47 adults and 82 adolescents completed the DSRS. Cognitive interview was performed. Reliability and construct validity were tested. Effect sizes (ES) of changes were calculated. Patients found the questionnaire relevant. A high proportion of the respondents reported no symptoms affecting them negatively at all (floor effects). However, 12 % stated, quite severe, severe, or very severe problems regarding fatigue after meal and half of them were so tired that they needed to lie down. Nearly 7 % reported quite severe, severe, or very severe problems dominated by nausea and 6 % dominated by fainting esteem. The internal consistency reliability was adequate for both severity (0.81-0.86) and frequency (0.76-0.84) scales. ES were small, since some subjects experienced symptoms already preoperatively. Although most patients reported no or mild dumping symptoms 1 and 2 years after gastric bypass surgery, around 12 % had persistent symptoms, in particular, postprandial fatigue, and needed to lie down. Another 7 % had problems with nausea and 6 % had problems with fainting esteem. The DSRS is a reliable screening tool to identify these patients.
Su, Andrew; Shih, Wendy; Presson, Angela P.; Chang, Lin
Background Irritable bowel syndrome (IBS) with mixed bowel habits (IBS-M) is a heterogeneous subtype with varying symptoms of constipation and diarrhea, and has not been well characterized. We aimed to characterize gastrointestinal (GI) and non-GI symptoms in IBS-M patients from a U.S. community, and to compare them with IBS with constipation (IBS-C) and diarrhea (IBS-D). Methods Subjects answering community advertisements and meeting Rome III criteria for IBS completed symptom questionnaires. Key Results Of the initial 289 IBS patients identified, one-third (n=51, 32.5%) who met Rome III criteria for IBS-M endorsed having either loose stools or hard stools due to medication. These patients had more severe symptoms and longer duration of flares compared to the rest of the IBS-M group (p = 0.014, p = 0.005). Excluding IBS-M patients with medication-related extremes in stool form who could not be reclassified by medical history, 247 IBS patients were assessed. IBS-M was the most common (44.1%), followed by IBS-C (27.9%), IBS-D (26.3%), and IBS-U (unsubtyped, 1.6%). IBS-M shared symptoms with both IBS-C and IBS-D (p-value range: habits (27.5%), bloating (26.6%), and abdominal pain (20.2%). There were no differences in non-GI symptoms between subtypes. Conclusions & Inferences IBS-M is a heterogeneous symptom group and thus requires that subclassification criteria be better defined. Use of laxative/anti-diarrheal medications adds to the diagnostic complexity in a potentially more severe subset of IBS-M and should be assessed for accurate subclassification. PMID:23991913
Hall David Jeffrey
Full Text Available Abstract Introduction Drug reaction with eosinophilia and systemic symptoms syndrome is a potentially life-threatening hypersensitivity reaction with rash, fever, and internal organ involvement, often hepatitis, occurring most commonly two to eight weeks after initiation of a medication. The present case is an example of severe and potentially life-threatening hepatitis as a manifestation of drug reaction with eosinophilia and systemic symptoms syndrome. Case presentation We report a case of anti-epileptic-induced drug reaction with eosinophilia and systemic symptoms syndrome in an 18-year-old African-American man who presented with a five-day history of rash, periorbital and upper extremity edema, hepatitis and fever. Laboratory findings revealed an atypical lymphocytosis, eosinophilia, and elevated serum transaminases. No drug allergies were reported at the time of presentation, but phenytoin and levetiracetam therapy had been initiated five weeks prior to hospital admission for new-onset seizures. Both medications were discontinued on hospital admission, and after three days of high-dose corticosteroid therapy the patient experienced resolution of both his symptoms and laboratory markers of inflammation. Conclusion Given the significant mortality attributed to drug reaction with eosinophilia and systemic symptoms syndrome, medical personnel should be aware of the potential for this severe hypersensitivity reaction and should ensure close follow-up and offer anticipatory guidance when beginning any new medication, particularly anti-epileptic therapy. Early recognition of drug reaction with eosinophilia and systemic symptoms syndrome and initiation of appropriate therapy are imperative in limiting morbidity.
Yang, Teng-Kai; Hsieh, Ju-Tong; Chen, Shyh-Chyan; Chang, Hong-Chiang; Yang, Hung-Ju; Huang, Kuo-How
To investigate the impact of metabolic syndrome on lower urinary tract symptoms in a sample of middle-aged men receiving a health checkup. Subjects aged 45 years or older who voluntarily underwent a medical checkup were enrolled. Participant demographics and health history were collected by a self-administered questionnaire. All participants were stratified into 2 groups by the presence of metabolic syndrome, as defined according to the updated National Cholesterol Education Program's Adult Treatment Panel III. Prostate volume and prostate-specific antigen levels were used for subgroup analysis. During January through December of 2010, 708 subjects with a mean age of 55.6 ± 9.72 years were enrolled into the study. Compared to the nonmetabolic syndrome group, the metabolic syndrome group had lower total international prostatic symptoms score (7.89 ± 6.63 vs 6.85 ± 6.52, P = .05) and lower severity of weak urinary stream (1.24 ± 1.60 vs 0.95 ± 1.50, P = .021). In the higher prostate volume group (prostate volume ≥ 30 mL), total international prostatic symptoms score, storage score, and urinary frequency, urgency and incomplete emptying were lower in men vs those without metabolic syndrome (all P < .05). The negative association between voiding score, severity of lower urinary tract symptoms, and metabolic syndrome became particularly pronounced as the number of metabolic syndrome factors increased (P for trend < .01). We confirmed that metabolic syndrome had favorable effects on lower urinary tract symptoms, including voiding and storage symptoms in healthy middle-aged men. This beneficial effect was most significant in men with enlarged prostate and/or high prostate specific antigen levels. Copyright © 2012 Elsevier Inc. All rights reserved.
Frazier, Lorraine; Sanner, Jennifer; Yu, Erica; Cron, Stanley G; Moeller, F Gerard
Despite the prevalence of depressive symptoms and increased risk for future cardiovascular events, depressive symptoms frequently go underrecognized in patients hospitalized for acute coronary syndrome (ACS). Identifying an effective approach to depressive symptom screening is imperative in this population. The purpose of this cross-sectional study was to explore the agreement between Beck Depression Inventory-II (BDI-II) scores and a single screening question for depressive symptoms in 1122 patients hospitalized for ACS. Independent-samples t tests and χ tests were used to compare the groups with BDI-II scores of 14 or higher and lower than 14. Three separate agreement analyses were conducted using categorized BDI-II scores (≥14, ≥20, and ≥29). Agreement of the BDI-II categories with the responses to the single screening question was assessed with the simple κ statistic. Sensitivity and specificity were calculated using the BDI-II categories as the criterion standards for depressive symptom screening. The agreement analysis revealed a moderate level of agreement (κ coefficient = 0.42) between the BDI-II scores of 14 or higher and the single screening question. Of the participants who reported a BDI-II score of 14 or higher, 61.65% answered yes to the single screening question (sensitivity, 0.62). For those who had BDI-II scores of lower than 14, a total of 82% responded no to the single screening question (specificity, 0.82). When using higher BDI-II scores to define depressive symptoms (≥20 and ≥29), the level of agreement decreased, whereas sensitivity increased to 0.76 and 0.90, with a trade-off in specificity (0.79 and 0.74, respectively). These results suggest that the single screening question for depressive symptoms correctly identifies depressive symptoms 62% of the time but inappropriately identifies depressive symptoms 18% of the time in patients hospitalized for ACS. This suggests that the single screening question for depressive symptoms
Maryam Maddineshat; Sodabe Keyvanloo; Hossein Lashkardoost; Mina Arki; Mahbubeh Tabatabaeichehr
Objective: Standards of care and treatment of premenstrual syndrome (PMS) vary. Non-drug psychosocial intervention therapy is recommended for women with any kind of discomfort or distress caused by PMS. The current study examined the effectiveness of group cognitive-behavioral therapy on the symptoms of PMS at a girls’ dormitory of North Khorasan University of Medical Sciences.Method: In this quasi-experimental study, 32 female students with PMS who were majoring in nursing and midwifery...
Full Text Available Objective: To investigate the relationship between obesity with symptom severity and cognitive functions in Fibromyalgia syndrome (FMS patients. Materials and Methods: The study comprised 33 FMS patients (mean age 41.21±7.6 years. The patients who have hypertension, hypercholesterolaemia or diabetes, chronic inflammatory disorders, cardiovascular-pulmonary diseases, rheumatological/endocrine diseases, using anticoagulant therapy or have thrombotic disorders, malignancies and pregnant women were excluded from the study. Fibromyalgia Impact Questionnaire (FIQ, Perceived Stress Scale (PSS-10 and Mini Mental State Examination tests were used. The data of FMS patients were recorded by the same physician. Results: There were not statistically significant differences between PSS-10 and MMSE with body mass index (BMI levels. There was a statistically significant difference between FIQ and BMI values. Conclusion: In conclusion, the result of this study showed a statistical relationship between the increased BMI levels and FMS symptom severity that could be beneficial in clinical practice.
... an Allergic Reaction to Food Symptoms of an Allergic Reaction to Food Learn about the mild and severe ... the food to which you are allergic. An allergic reaction to food can affect the skin, the gastrointestinal ...
Albrecht, Rebecca; Löwe, Bernd; A Brünahl, Christian; Riegel, Björn
Despite its high prevalence, little is known about the aetiology and maintenance of Chronic Pelvic Pain Syndrome (CPPS). CPPS is is considered to be a multi-causal syndrome with discomfort and pain in the pelvis. Recent literature suggests that psychosocial factors are important for understanding CPPS. For example, CPPS has been associated with deficits in mentalization and bonding experiences. Our study aims to characterize features of personality disorders according to DSM-IV and psychic structure according to OPD-2 in CPPS patients. Furthermore, we examine the association of personality aspects with urological symptoms (NIH Questionnaire) and pain perception (MPQ Questionnaire). Personality aspects were assessed in a total of 109 patients from our CPPS outpatient clinic using standardized questionnaires. To characterize CPPS patients, we compared the sample's scores with reference groups, mostly the general population. In addition, the associations between personality aspects and both the urologic symptoms and pain perception were assessed using correlations. Missing data were replaced using multiple imputation methods. Compared to reference values, we found 'experiencing emotions' and 'creating relationships' as specific deficits in CPPS patients. Furthermore, patients' self-image (more dominant, higher depressive mood) differs from the general population. A higher pain perception was correlated with deficits in most personality aspects we measured. However, this was not the case for the severity of urological symptoms. Compared to the reference values, only a few personality aspects differed in CPPS patients but there was a correlational association between different personality traits and pain perception. Despite the extend of symptoms, pain perception is associated with difficulty (emotional ability) in dealing with emotions, self-management and relationships. These personality aspects should be taken into account when planning therapy. © Georg Thieme
Full Text Available Introduction: Symptoms induced by premenstrual syndrome (PMS adversely affect the women in reproduction period and decrease their quality of life. In literature, it is a common opinion thought that PMS could be associated with both sleep quality and menstrual attitudes. However, there has been no sufficient number of studies to define in what ways the PMS symptoms are correlated with sleep quality and menstrual attitudes. The objective of this study was to examine the relationship of PMS symptoms with menstrual attitude and sleep quality. Methods: The data were collected from 183 nursing students at Health School of Artvin Çoruh University by using a correlational design. Voluntary students completed a questionnaire involving socio-demographic characteristics, Premenstrual Syndrome Scale (PMSS, Menstrual Attitude Questionnaire (MAQ, and Pittsburgh Sleep Quality Index (PSQI. Results: Average age was 19.9 (1.8. The study determined a positively significant correlation between score of PMSS and mean scores of PSQI (r=0.306; P<0.001, and a negatively significant correlation between score of PMSS and total mean score of MAQ (r=-0.317; P<0.01. Similarly, multiple linear regression analysis showed that PSQI total score (b=5.412; P<0.001 and MAQ total score ( b=-27.455; P=0.001 significantly affected total score of PMSS.Conclusion: The intensity of PMS symptoms is associated with poor sleep quality and negative menstrual attitudes. Determining the methods of coping with PMS and strengthening the young girls on this subject may enhance their quality of future life.
Full Text Available Parents report psychological distress in association with their child's cancer. Reliable tools are needed to screen parental distress over the cancer trajectory. This study aimed to estimate the stability and repeatability of the Distress Thermometer (DT and the Depression and Anxiety items of the Edmonton Symptom Assessment System-revised (ESAS-r-D; -A in parents of children diagnosed with cancer.Fifty parents (28 mothers, median age = 44 of clinically stable survivors of childhood solid and brain tumours completed questionnaires about their own distress (DT, ESAS-r-D; -A, Brief Symptom Inventory-18: BSI-18, Patient Health Questionnaire-9: PHQ-9, Generalized Anxiety Disorder-7: GAD-7 and their children's quality of life (QoL; Peds Quality of Life: PedsQL twice, with a month interval between the two assessments. At retest, parents also evaluated life events that occurred between the two time points. Hierarchical regressions explored moderators for the temporal stability of test measures.Stability estimates were ICC = .78 for the DT, .55 for the ESAS-r-D, and .47 for the ESAS-r-A. Caseness agreement between test and retest was substantial for the DT, fair for the ESAS-r-D, and slight for the ESAS-r-A. Repeatability analyses indicated that the error range for the DT was more than 2 pts below/above actual measurement, whereas it was more than 3 pts for the ESAS-r-A, and 2.5 for the ESAS-r-D. Instability of the DT could be explained by changes in children's physical QoL, but not by other components of QoL or life events. No moderators of stability could be identified for the ESAS-r items.The DT appears to be a fairly stable measure when the respondent's condition is stable yet with a relatively wide error range. Fluctuations in distress-related constructs may affect the temporal stability of the DT. The lower stability of ESAS-r items may result from shorter time-lapse instructions resulting in a greater sensitivity to change. Findings support
Full Text Available Background & Aim: IBS is a gastrointestinal disease with chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. This study was done to assess the effectiveness of cognitive - behavioral stress management courses on the symptoms of the disease in patients referring to Yasouj gastrointestinal diseases clinic. Methods: A controlled randomized clinical trial was conducted on 42 patients with irritable bowel syndrome referring to Yasouj gastrointestinal diseases clinic in 2010. The participants were randomly assigned to intervention (21 patients and control (n=21 groups. After performing a pre-test, using frequency and intensity of intestinal symptoms, the required data were gathered using BSS-FS, quality of life in irritable bowel patients (IBS-QOL-34 and Beck Depression and Anxiety Questionnaires. Conventional treatment along with cognitive-behavioral stress management was conducted within 8 weeks in the intervention group. The control group received only routine treatment regimes. After two months, a post- test was taken with the same measures. Covariance analysis and dependent t-test was conducted to analyze the data. Results: cognitive-behavioral stress management significantly reduced IBS symptoms in patients in the intervention group (p=0.001. Conclusion: This study showed that combination of drug therapy along with psychological interventions can reduce severity and frequency of symptoms in IBD patients and effectively helps them to improve their quality of life. :
Sugaya, Nagisa; Kaiya, Hisanobu; Kumano, Hiroaki; Nomura, Shinobu
To investigate the relationship between subtypes of irritable bowel syndrome (IBS) and severity of symptoms associated with panic disorder (PD). The study comprised 178 consecutive new PD outpatients. Sixty-four patients met the Rome-II criteria for IBS (IBS[+]; 29 diarrhea-predominant IBS (IBSD), 14 constipation-predominant IBS (IBSC), 21 other types of IBS). IBSD patients with agoraphobia avoided a greater number of scenes owing to fear of panic attack than did PD patients without IBS (IBS[-]) and with agoraphobia. IBS[+] patients with avoidant behavior due to fear of IBS symptoms had significantly higher Beck Depression Inventory (BDI) scores and avoided a larger number of scenes owing to fear of panic attack than IBS[+] patients with agoraphobia and without avoidant behavior due to fear of IBS symptoms or IBS[-] patients with agoraphobia. The results suggest that the presence of IBSD or avoidant behavior because of fear of IBS symptoms may be associated with a more severe form of agoraphobia, and the latter may also be associated with depression.
Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako
The purpose of the present paper was to investigate differing characteristics of Munchausen syndrome by proxy (MSBP) between subjects with predominantly physical symptoms and those with predominantly psychological symptoms. A questionnaire survey was sent to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors answered questions regarding the characteristics of MSBP subjects for whom they had helped care. The differences of characteristics between groups were analyzed using Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables. Among 21 reported MSBP subjects, 16 MSBP subjects with predominantly physical symptoms (PHY) and five MSBP subjects with predominantly psychological symptoms (PSY) were found. PHY were more likely to be produced, whereas PSY cases were more often simulated. PHY cases were more often life-threatening than PSY cases, but decisions made by the Child Guidance Center surrounding the custodial outcome of MSBP victims did not differ between PHY and PSY cases. Social welfare services that need to decide on custody for MSBP victims should recognize the relatively high risk of life-threatening danger of PHY cases in their family of origin.
Bailey, Donald B; Raspa, Melissa; Bishop, Ellen; Olmsted, Murrey; Mallya, Usha G; Berry-Kravis, Elizabeth
To identify the most common neurological and behavioral symptoms treated by medications in individuals with fragile X syndrome (FXS), factors associated with treatment variability, and difficulty in swallowing a pill. A total of 1019 caregivers provided information about 1064 sons and 299 daughters with FXS in a US national survey. Caregivers reported (a) current use of medications for attention, anxiety, hyperactivity, mood swings, anger, depression, seizures, self-injury, or sleep; (b) perceived efficacy; and (c) difficulty in swallowing a pill. Sixty-one percent of males and 38% of females were currently taking medication for at least 1 symptom. The most common symptoms were anxiety, attention, and hyperactivity. Treatments for attention and hyperactivity were common in childhood but declined substantially after the age of 18 years; anxiety treatment remained high in adults. Children perceived to be more impaired and children diagnosed or treated for autism were more likely to be taking medications. Caregivers considered most medications somewhat effective, but less than one-third rated current medication as "a lot" effective. Many children had difficulty swallowing a pill, but only 11% of adult males and 2% of adult females had a lot of difficulty. Symptom-based medication use is common in FXS, although response is incomplete and there is clearly an unmet need for medications with improved efficacy. The persistent use of medications to treat anxiety, mood, and behavior problems throughout adolescence and into the adult years suggests important outcomes when evaluating the efficacy of new medications.
Hergüner, Sabri; Harmancı, Hatice; Toy, Harun
Several studies suggest that androgens are involved in the etiology of attention deficit-hyperactivity disorder (ADHD). In this study, we investigated the ADHD symptoms in women with polycystic ovary syndrome (PCOS), a complex endocrine, hormonal, and metabolic condition associated with hyperandrogenism. Forty women between the ages of 18 and 35 years with PCOS were recruited for the study group. For comparison, 40 healthy women who had regular menses were included. Current and childhood ADHD symptoms were assessed by using the Adult ADHD Self-Report Scale and Wender-Utah Rating Scale, respectively. Women with PCOS had higher total Adult ADHD Self-Report Scale and total Wender-Utah Rating Scale scores than controls. According to the Wender-Utah Rating Scale, the frequency of childhood ADHD was significantly higher in PCOS group than the control. Adult ADHD Self-Report Scale: Hyperactivity-Impulsivity and Wender-Utah Rating Scale: Behavioral Problems/Impulsivity scores were significantly higher in women with PCOS. However, there were no significant differences between groups in both current and childhood inattention scores. We found no correlations between ADHD symptoms and serum hormone levels including testosterone in women with PCOS. These results suggest that women with PCOS have higher ADHD symptoms. Further studies are needed to investigate the association between PCOS and ADHD. © The Author(s) 2015.
Lattanzio, Silvia Maria
Fibromyalgia syndrome (FMS) is a chronic, complex, and heterogeneous disorder of still poorly understood etiopathophysiology associated with important musculoskeletal widespread pain, fatigue, non-restorative sleep, and mood disturbances. It is estimated to afflict 2-3% of the worldwide population, with clean prevalence among women. The objective of this paper is to propose a novel treatment for symptomatic remission of FMS, grounded in biochemistry and consisting in the withdrawal from the diet of molecules that can indirectly trigger the symptoms. The hypothesis develops from the evidence that low serotonin levels are involved in FMS. Serotonin is synthesized starting from the essential amino acid tryptophan. The presence of non-absorbed molecules in the gut, primarily fructose, reduces tryptophan absorption. Low tryptophan absorption leads to low serotonin synthesis that triggers FMS symptoms. Moreover not-absorbed sugars could also produce a microbiota deterioration activating a positive feedback loop: the increasing microbiota deterioration reduces the functionality of absorption both of fructose and tryptophan in the gut, entering a vicious circle. The therapeutic idea is to sustain serotonin synthesis allowing the proper tryptophan absorption. The core of the cure treatment is the exclusion from the diet of some carbohydrates and the marked reduction of some others. The main target is the limitation of total dietary fructose as marked as possible. It could be an effective strategy to get the remission of symptoms acting on the impaired biochemical pathways. The straying from the treatment is expected to cause the reappear of the symptoms.
Full Text Available Background: Irritable bowel syndrome (IBS is a functional disorder of the lower gastrointestinal (GI tract caused by stress, which may benefit from a biopsychosocial treatment such as mindfulness-based cognitive therapy (MBCT. The thrust of the study was to examine the efficacy of MBCT on physical and psychological symptoms of women who suffered from IBS. It was hypothesized that MBCT patients would experience greater reduction in overall IBS symptoms in comparison to control patients. Methods: This survey was conducted in Isfahan, Iran, to investigate the impact of MBCT on a group of Iranian women diagnosed with IBS. In this quasi-experimental study 20 women with the diagnosis of IBS were randomly and equally assigned to experimental and control groups. Severity of IBS was measured by the IBS Severity Scoring System (IBS-SSS while the patients’ psychopathology was assessed by Symptom Checklist 90-R (SCL-90-R. The experimental group was exposed to 8 sessions of MBCT on a weekly basis; each session lasting 90 minutes. Data were analyzed using SPSS software and MANCOVA. Results: A significant reduction was noted in anxiety, depression, and somatization symptoms after the intervention and in anxiety and obsessive–compulsive disorder (OCD at follow-up (p < 0.05. However, during the follow-up there was no significant progress in the level of somatization and depression. Apparently our treatment modality did not have any impact on the severity of physical symptoms. Conclusion: Psychological symptoms of IBS can be managed largely with the help of MBCT, resulting in the promotion of mental health in women afflicted by this disorder.
Background Metabolic syndrome (MetS) is increasingly present in breast cancer survivors, possibly worsened by cancer-related treatments, such as chemotherapy. MetS greatly increases risk of cardiovascular disease and diabetes, co-morbidities that could impair the survivorship experience, and possibly lead to cancer recurrence. Exercise has been shown to positively influence quality of life (QOL), physical function, muscular strength and endurance, reduce fatigue, and improve emotional well-being; however, the impact on MetS components (visceral adiposity, hyperglycemia, low serum high-density lipoprotein cholesterol, hypertriglyceridemia, and hypertension) remains largely unknown. In this trial, we aim to assess the effects of combined (aerobic and resistance) exercise on components of MetS, as well as on physical fitness and QOL, in breast cancer survivors soon after completing cancer-related treatments. Methods/Design This study is a prospective randomized controlled trial (RCT) investigating the effects of a 16-week supervised progressive aerobic and resistance exercise training intervention on MetS in 100 breast cancer survivors. Main inclusion criteria are histologically-confirmed breast cancer stage I-III, completion of chemotherapy and/or radiation within 6 months prior to initiation of the study, sedentary, and free from musculoskeletal disorders. The primary endpoint is MetS; secondary endpoints include: muscle strength, shoulder function, cardiorespiratory fitness, body composition, bone mineral density, and QOL. Participants randomized to the Exercise group participate in 3 supervised weekly exercise sessions for 16 weeks. Participants randomized to the Control group are offered the same intervention after the 16-week period of observation. Discussion This is the one of few RCTs examining the effects of exercise on MetS in breast cancer survivors. Results will contribute a better understanding of metabolic disease-related effects of resistance and
Full Text Available Ryohei Itagaki, Keiji Koda, Masato Yamazaki, Kiyohiko Shuto, Chihiro Kosugi, Atsushi Hirano, Hidehito Arimitsu, Risa Shiragami, Yukino Yoshimura, Masato Suzuki Department of Surgery, Teikyo University Chiba Medical Center, Anesaki, Ichihara, Chiba, Japan Purpose: Serotonin (5-hydroxytryptamine [5-HT]3 receptor antagonists are effective for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D, in which exaggerated intestinal/colonic hypermotility is often observed. Recent studies have suggested that the motility disorder, especially spastic hypermotility, seen in the neorectum following sphincter-preserving operations for rectal cancer may be the basis of the postoperative defecatory malfunction seen in these patients. We investigated the efficacy of 5-HT3 receptor antagonists in patients suffering from severe low anterior resection syndrome. Patients and methods: A total of 25 male patients with complaints of uncontrollable urgency or fecal incontinence following sphincter-preserving operations were enrolled in this study. Defecatory status, assessed on the basis of incontinence score (0–20, urgency grade (0–3, and number of toilet visits per day, was evaluated using a questionnaire before and 1 month after the administration of the 5-HT3 antagonist ramosetron. Results: All the parameters assessed improved significantly after taking ramosetron for 1 month. The effect was more prominent in cases whose anastomotic line was lower, ie, inside the anal canal. Defecatory function was better in patients who commenced ramosetron therapy within 6 months postoperatively, as compared to those who were not prescribed ramosetron for more than 7 months postoperatively. Conclusion: These results suggest that 5-HT3 antagonists are effective for the treatment of low anterior resection syndrome, as in diarrhea-predominant irritable bowel syndrome. The improvement in symptoms is not merely time dependent, but it is related to treatment with 5
Shrivastava, Amresh; McGorry, P D; Tsuang, Ming; Woods, Scott W; Cornblatt, Barbara A; Corcoran, Cheryl; Carpenter, William
Schizophrenia is a common disorder, affecting approximately 1 out of every 100 people, with a typical onset during adolescence and early adulthood. The personal and societal costs of schizophrenia are extremely high. Prevention of schizophrenia, would offer substantial benefits to patients, their family members, and the community at large. The prodromal phase of schizophrenia has been recognized since the 19th century. At-risk individuals for psychosis and schizophrenia are the subjects who can provide information for intervention prior to development of frank psychosis. This approach is currently being investigated. The question remains, however, whether it can be a diagnostic category by itself. The proposal for including the risk syndrome is one of the recommendations by the working group on schizophrenia and psychotic disorders for the forthcoming DSM-V. There are differing views in academia regarding this proposal. Prior to becoming fully psychotic, a consistent literature demonstrates that patients generally had suffered from accelerating attenuated symptoms and distress. It is important that the prodromal phase be accurately recognized in order to accomplish the goal of prevention. We can then purposefully engage in early intervention aiming toward prevention. A recent strong resurgent interest in this area stems largely from two developments: First, the identification of the neurobiological deficit processes associated with the severity and chronicity of schizophrenia, and second, the development of reliable criteria for diagnosis. Although the general at-risk construct appears to offer great potential to advance both the treatment and research dealing with psychotic illnesses, it seems premature to many researchers to include the syndrome as an established entity in the text of the new DSM-V. It would be far more appropriate to include this proposed syndrome in the appendix and evaluate the many contemporary issues in future studies. The main issues
Lambert, David A; Giannouli, Eleni; Schmidt, Brian J
The development of polio vaccines 50 yr ago essentially halted childhood polio epidemics in the industrialized world. During the past quarter century, a constellation of delayed neuromuscular symptoms, called postpolio syndrome, became recognized among the aging polio survivors. The prevalence of postpolio syndrome in the U.S. population is estimated to be in the hundreds of thousands. The most common symptoms are fatigue, pain, and new onset weakness thought to be related to delayed deterioration of motor neuron function. When a patient with postpolio syndrome presents for surgery, special precautions are warranted, because these patients may have respiratory impairment, sleep apnea, swallowing difficulties, and cold intolerance. This article first reviews clinical features and some pathoetiologic theories of postpolio syndrome and then focuses on anesthetic considerations including the use of common anesthetics, neuromuscular blockade, regional anesthesia, and general anesthetic management strategies.
Barbosa-Cortés, Lourdes; López-Alarcón, Mardia; Mejía-Aranguré, Juan Manuel; Klünder-Klünder, Miguel; Del Carmen Rodríguez-Zepeda, María; Rivera-Márquez, Hugo; de la Vega-Martínez, Alan; Martin-Trejo, Jorge; Shum-Luis, Juan; Solis-Labastida, Karina; López-Aguilar, Enrique; Matute-González, Guadalupe; Bernaldez-Rios, Roberto
There is a growing body of evidence indicating that pediatric survivors of cancer are at a greater risk of developing metabolic syndrome. This study evaluated some probable predictors of metabolic syndrome (MS), such as leptin and adiponectin concentrations, the leptin/adiponectin ratio, insulin resistance, and adiposity, in a sample of child survivors of lymphoma and leukemia in Mexico City. Fifty two children (leukemia n = 26, lymphoma n = 26), who were within the first 5 years after cessation of therapy, were considered as eligible to participate in the study. Testing included fasting insulin, glucose, adipokines and lipids; body fat mass was measured by DXA. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. Comparisons between continuous variables were performed according to the data distribution. The MS components were analyzed according to tertiles of adipokines, insulin resistance, and adiposity. With the purpose of assessing the risk of a present MS diagnosis, odds ratios (OR) with a 95% confidence interval (95% IC) were obtained using logistic regression analysis according to the various metabolic markers. The median children age was 12.1 years, and the interval time from the completion of therapy to study enrollment was 4 years. Among the MS components, the prevalence of HDL-C low was most common (42%), followed by central obesity (29%). The HOMA-IR (OR 9.0, 95% CI 2.0; 41.1), body fat (OR 5.5, 95% CI 1.6; 19.3), leptin level (OR 5.7, 95% CI 1.6; 20.2) and leptin/adiponectin ratio (OR 9.4, 95% CI 2.0; 49.8) in the highest tertile, were predictive factors of developing MS; whereas the lowest tertile of adiponectin was associated with a protective effect but not significant. Biomarkers such as HOMA-IR, leptin and leptin/adiponectin are associated with each of the components of the MS and with a heightened risk of suffering MS among children survivors of cancer. Given the close relationship
He, Q; Wang, Z; Liu, G; Daneshgari, F; MacLennan, G T; Gupta, S
Epidemiological data suggest that lower urinary tract symptoms (LUTSs) may be associated with metabolic syndrome (MetS). Inflammation has been proposed as a candidate mechanism at the crossroad between these two clinical entities. The aim of this review article is to evaluate the role of MetS-induced inflammation in the pathogenesis and progression of LUTS. A systematic review was conducted using the keywords 'metabolic syndrome and lower urinary tract symptoms' within the title search engines including PubMed, Web of Science and the Cochrane Library for relevant research work published between 2000 and January 2015. The obtained literature was reviewed by the primary author (QH) and was assessed for eligibility and standard level of evidence. Total of 52 articles met the eligibility criteria. On the basis of database search during the past 15 years and our systematic review of prospective and retrospective cohorts, case-control trials, observational studies and animal data identified a possible link between MetS-induced inflammation and LUTS including BPH, bladder outlet obstruction, overactive bladder, urinary incontinence and other possible urinary tract abnormalities. There is convincing evidence to suggest that MetS and inflammation could be important contributors to LUTS in men, particularly in the development of BPH. However, the role of MetS-induced inflammation remains unclear in overactive bladder, urinary incontinence and etiology of LUTS progression.
Seyedeh Zahra Masoumi
Full Text Available Introduction: Premenstrual syndrome is one of the most common disorders in women, which includes a group of psychological and physical symptoms. The aim of this study was to examine the impact of combined use of calcium and vitamin B6 on premenstrual syndrome symptoms. Methods: This double blind randomized controlled was carried out on 76 students of Hamadan University of Medical Sciences. Students were randomly allocated to two groups. (38 people in each group. Student in intervention groups received calcium tablet (500mg and vitamin B6 (40 mg and student in intervention groups received only vitamin B6 twice a day for two consecutive months. The symptoms were assessed by Beck depression inventory (BDI and daily symptom records (DSR questionnaires. Analyses were carried out by test-retest method, Chi-square, Mann-Whitney, Independent t-test, and paired t-test using SPSS software ver.13. Results: The result showed that although the severity of symptoms decreased in both groups, but this reduction was more significant in the combined calcium and vitamin B6 group. Conclusion: According to the result, using of combination of calcium and vitamin B6 leads to better controlling of the premenstrual syndrome symptoms. Therefore it is recommended for women who suffer from these syndromes.
Hantman, Shira; Solomon, Zahava
The current study aims to determine whether elderly Holocaust survivors are affected differently from non-survivors by the adversity of aging and cancer. Holocaust survivors and non-survivors suffering from cancer, were assessed tapping PTSD, psychiatric symptomatology, psychosocial adjustment to illness and coping with the aftermath of the Holocaust. Findings indicate a significant difference between survivors and non-survivors in post-traumatic symptoms and their intensity, survivors endorsing significantly more PTSD symptoms. Survivors were classified into 3 sub-groups, namely "Victims," "Fighters," and "Those who made it". "Victims" reported the highest percentage of persons who met PTSD, psychiatric symptomatology and difficulty coping with the problems of old age. The diversity of responses points to heterogeneity of long-term adaptation and adjustment among Holocaust survivors and similar response to subsequent adversity.
Galer, B S; Henderson, J; Perander, J; Jensen, M P
Few data have been published regarding the natural history, course of symptoms, and quality of life in Complex Regional Pain Syndrome (CRPS). To obtain preliminary data regarding these important issues in CRPS, a set of patient self-report questionnaires were mailed to patients with the diagnosis of CRPS who had been assessed and/or treated at a tertiary university-based pain center in the United States. Self-reports of demographic information, symptoms, the Neuropathic Pain Scale, and a modified Brief Pain Inventory (mBPI) were received from 31 CRPS patients. Approximately 75% of patients reported initial symptoms of pain, swelling, coldness, and color changes. An additional 71% had weakness and inability to move the extremity as initial symptoms. Weakness at some time during their course of CRPS was described by 97%. A majority reported no overall improvement or worsening of symptoms over time (mean 3.3 years). The pain descriptors with the highest mean values were "deep" (6.4/10), "unpleasant" (6.4), "sensitive" (5.7), "surface" (5.4), and "dull" (5.3) pains. Significant sleep disturbance was reported by 80%. CRPS had a severe impact on quality of life, with substantial interference reported in 9 of 10 mBPI activity items by a majority of these patients. These findings should be viewed with caution and should not be generalized to the entire CRPS population because the cohort was small and select. A large multicenter prospective study needs to be performed to validate these preliminary findings.
Tzonova, D; Larrosa, O; Calvo, E; Granizo, J J; Williams, A-M; de la Llave, Y; García-Borreguero, D
It is often assumed that most patients with restless legs syndrome (RLS) only experience symptoms at night. However, previous studies have estimated the prevalence of daytime symptoms to be 10-60%. This study sought to investigate the prevalence and pattern of daytime symptoms in patients with moderate-to-severe RLS. Observational, cross-sectional investigation. A self-administered questionnaire was sent out, on a random basis, to 310 patients with RLS by the Spanish RLS patient support group. Only individuals with a confirmed diagnosis of RLS were included in the final survey. In total, 224 individuals were included in the survey (response rate 72%). Over 55% of patients reported daytime crises on most (>3) days of the week, and 41% suffered daytime symptoms on a daily basis. These breakthrough crises were characterized by unexpected and sudden symptoms and were frequently precipitated by a reduction in daytime activity. The mean severity of these crises on a visual analogue scale (range 0-10) was 6.8 (standard deviation 2.1), and they had a major impact on quality of life. The prevalence of breakthrough crises was related to duration of illness but not to duration of treatment. This study suggests that breakthrough crises are common in moderate-to-severe RLS and have a negative effect on quality of life. More studies are needed to investigate whether breakthrough crises reflect disease progression or, at least for those patients undergoing dopaminergic treatment, whether they represent an early indication of RLS augmentation. Copyright © 2011 Elsevier B.V. All rights reserved.
Full Text Available Background: Irritable bowel syndrome is a chronic continuous or remittent gastrointestinal illness characterized byfrequent unexplained symptoms that include abdominal pain, bloating, and bowel disturbance, in our country, no studyhas been conducted using the Ispaghula husk and oxyphenonium bromide for the treatment of IBS patients. Objectives:To compare the efficacy of treatment with Ispaghula husk and Oxyphenonium bromide. Methods: Total sixty patientsdiagnosed clinically as irritable bowel syndrome irrespective of subtype who fulfilled the Rome II criteria were includedequally into two groups-Group-I (Ispaghula group & Group-II (Oxyphenonium group. In Group-I patients were given30gm of Ispaghula husk at night daily and in Group-II patients were given 5mg of oxyphenonium bromide. After sixweeks the clinical parameters of both the groups recorded in the case record forms were taken for analysis. Results: Themean age of the patients in the Group- I were 33.4±11.9 yrs and that of the patients in the Group-II were 31.0±17.5 yrs.Male and female ratio in group I was 14:1 and in group II was 23:7. Most of the patients were recorded in the age groupof 26-30 in both groups. Symptom free patients were graded in 16.7% patients in Group-I and in 20% patients in Group-II. No improvement was occurred in 16.7% patients in Group-I and in 10% patients in Group-II. Conclusions: Ispaghulahusk shows the better efficacy to improve the symptoms of IBS like abdominal pain or discomfort and sense of well beingthan Oxyphenonium bromide. Oxephenonium bromide shows the better efficacy to decrease the stool frequency frombase line than Ispaghula husk.DOI: 10.3329/bsmmuj.v3i1.5506BSMMU J 2010; 3(1: 3-8
Full Text Available Premenstrual syndrome and premenstrual dysphoric disorder (PMDD seem to form a severity continuum with no clear-cut boundary. However, since the American Psychiatric Association proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome. The objective of the present study was to establish the core latent structure of PMDD symptoms in a non-clinical sample. Data concerning PMDD symptoms were obtained from 632 regularly menstruating college students (mean age 24.4 years, SD 5.9, range 17 to 49. For the first random half (N = 316, we performed principal component analysis (PCA and for the remaining half (N = 316, we tested three theory-derived competing models of PMDD by confirmatory factor analysis. PCA allowed us to extract two correlated factors, i.e., dysphoric-somatic and behavioral-impairment factors. The two-dimensional latent model derived from PCA showed the best overall fit among three models tested by confirmatory factor analysis (c²53 = 64.39, P = 0.13; goodness-of-fit indices = 0.96; adjusted goodness-of-fit indices = 0.95; root mean square residual = 0.05; root mean square error of approximation = 0.03; 90%CI = 0.00 to 0.05; Akaike's information criterion = -41.61. The items "out of control" and "physical symptoms" loaded conspicuously on the first factor and "interpersonal impairment" loaded higher on the second factor. The construct validity for PMDD was accounted for by two highly correlated dimensions. These results support the argument for focusing on the core psychopathological dimension of PMDD in future studies.
Dharmesh H Kaswala
Full Text Available Drug rash with eosinophilia and systemic symptoms (DRESS syndrome is a severe, idiosyncratic, multi-system reaction characterized by the clinical triad of fever, rash, and internal organ involvement. The mortality rate is estimated to be 8%, especially among patients with liver involvement, so early recognition is imperative. Drugs commonly associated with the development of DRESS syndrome include anticonvulsants, long-acting sulfonamides, and anti-inflammatory medications; however, there are no reported cases implicating anti-tuberculosis (anti-TB medications. We report a case of DRESS syndrome from anti-TB therapy. A 68-year-old male with pulmonary TB presented with pruritic skin eruption and sore throat, 8 weeks after starting Rifampin, Isoniazid, Pyrazinamide, and Ethambutol (RIPE therapy. He takes metformin and glyburide for diabetes. Physical exam was significant for diffuse, exfoliative erythematous macules with target lesions involving the entire skin surface, without mucosal involvement. Laboratory data was significant for mild transaminitis and new onset eosinophilia. Given suspicion of drug eruption, RIPE therapy was discontinued. Skin biopsy confirmed erythema multiforme. Despite discontinuation of the implicated medications, eosinophilia and transaminitis continued to worsen, and so systemic corticosteroids were started. After 4 weeks of discontinuation of RIPE therapy, the cutaneous eruption resolved and laboratory data returned to normal. The patient is finishing course of anti-TB with cycloserine and moxifloxacin. Upon follow up as outpatient, the rash was resolving and disappeared in 1 month. DRESS syndrome is always considered when there is high eosinophil counts and multisystem involvement with skin eruptions. It can be potentially life threatening with certain drugs and infectious agents in predisposed individuals. It is imperative to discontinue the causative medication and avoid re-exposure.
Zubrzycka-Sienkiewicz, Anna; Wagner, Teresa; Zabek, Jakub; Palacz, Agnieszka
Polymyositis (PM) and dermatomyositis (DM) are very rare connective tissue disorders which only in exceptional circumstances affect white men. The present paper describes the case of an obese 55-years-old man in whom no muscular-skeletal system symptoms were found during the period of 2 years before the onset of arthritis, and who was treated because of cardiac involvement (pericarditis, PAF), pleuritis, malaise and fever. Only the occurrence of non erosive arthritis decided on the connective tissue disorder as a cause of his complaints. Previously the diagnostics was based on the exclusion of malignant diseases and bacterial and viral infections. The determination of antinuclear antibodies in high titer without any specific, typical of individual disease entities antinuclear antibodies allowed only the diagnose of undifferentiated connective tissue disease. Glucocorticosteroid treatment was initiated, however six months later despite treatment with metyloprednisolone the symptoms and signs associated with PM accompanied by high level of creatinophosphokinase and elevated transaminase were found. The muscle biopsy revealed myositis, but no specific antibodies, especially anti-Jo-1, were detected. It is very interesting that cyclophosphamide + glucocorticoids pulse therapy failed to prevent the development of antiphospholipide syndrome and interstitial pulmonary fibrosis in the PM patient. Overlapping of immunological tissue disorders is a well-known phenomenon, but in the case of fulminating and distinct symptoms and signs the lack of detection of specific antibodies is quite uncommon.
Agah, Shahram; Taleb, Amir Mehdi; Moeini, Reyhane; Gorji, Narjes; Nikbakht, Hajar
Irritable bowel syndrome is one of the most common gastrointestinal disordersCharacterized by chronic abdominal pain, altered bowel habits or changesin stool consistency. Unfortunately, no specific treatments for relieving IBSsymptoms have been suggested yet. This pilot study was conducted to evaluatethe efficacy of the Cumin extract, a kind of herbal used in the treatment of gastrointestinaldisorders like bloating, and other symptoms of IBS. Fifty seven patients with IBS (according to the ROME II diagnostic criteria)with no nay other accompanying illness enrolled in study. Patients wereadvised to discontinue their other treatments during the study course, then 20drops per day of Cumin essential oil was administered for included patients.IBS-associated symptoms including abdominal pain, nausea, painful defection,presence of mucosa in stool, changes in stool consistency and defecationfrequency were evaluated using a questionnairebefore treatment, 2 and4 weeks after beginning treatment and 2 and 4 weeks after stopping treatment. Abdominal pain, bloating, incomplete defecation, fecal urgency and presenceof mucus discharge in stool were statistically significant decreased duringand after treatment with Cumin extract. Stool consistency and defecation frequencywere also both statistically significant improved in patients with constipationdominant pattern of IBS. Cumin extract can be effective in improving all IBS symptoms. Consideringits low cost and easy availability Cumin administration in patients with IBSmay have economic benefits.
Ford, Jennifer S.; Chou, Joanne F.; Sklar, Charles A.; Oeffinger, Kevin C.; Novetsky Friedman, Danielle; McCabe, Mary; Robison, Leslie L.; Kleinerman, Ruth A.; Li, Yuelin; Marr, Brian P.; Abramson, David H.; Dunkel, Ira J.
Purpose Survival rates for individuals diagnosed with retinoblastoma (RB) exceed 95% in the United States; however, little is known about the long-term psychosocial outcomes of these survivors. Patients and Methods Adult RB survivors, diagnosed from 1932 to 1994 and treated in New York, completed a comprehensive questionnaire adapted from the Childhood Cancer Survivor Study (CCSS), by mail or telephone. Psychosocial outcomes included psychological distress, anxiety, depression, somatization, fear of cancer recurrence, satisfaction with facial appearance, post-traumatic growth, and post-traumatic stress symptoms; noncancer CCSS siblings served as a comparison group. Results A total of 470 RB survivors (53.6% with bilateral RB; 52.1% female) and 2,820 CCSS siblings were 43.3 (standard deviation [SD], 11) years and 33.2 (SD, 8.4) years old at the time of study, respectively. After adjusting for sociodemographic factors, RB survivors did not have significantly higher rates of depression, somatization, distress, or anxiety compared with CCSS siblings. Although RB survivors were more likely to report post-traumatic stress symptoms of avoidance and/or hyperarousal (both P < .01), only five (1.1%) of 470 met criteria for post-traumatic stress disorder. Among survivors, having a chronic medical condition did not increase the likelihood of psychological problems. Bilateral RB survivors were more likely than unilateral RB survivors to experience fears of cancer recurrence (P < .01) and worry about their children being diagnosed with RB (P < .01). However, bilateral RB survivors were no more likely to report depression, anxiety, or somatic complaints than unilateral survivors. Conclusion Most RB survivors do not have poorer psychosocial functioning compared with a noncancer sample. In addition, bilateral and unilateral RB survivors seem similar with respect to their psychological symptoms. PMID:26417002
Cynthia Gayle Wible
A framework is described for understanding the schizophrenic syndrome at the brain systems level. It is hypothesized that over-activation of dynamic gesture and social perceptual processes in the temporal-parietal occipital junction (TPJ), posterior superior temporal sulcus (PSTS) and surrounding regions produce the syndrome (including positive and negative symptoms, their prevalence, prodromal signs, and cognitive deficits). Hippocampal system hyper-activity and atrophy have been consistentl...
Van Oudenhove, Lukas; Vandenberghe, Joris; De Vos, Rita; Holvoet, Lieselot; Tack, Jan
BACKGROUND: It is unclear which factors explain the high co-morbidity between functional dyspepsia (FD) and other functional somatic syndromes. The aim of this study is to investigate the association between gastric sensorimotor function, psychosocial factors and 'somatization' on the one hand, and co-morbid irritable bowel syndrome (IBS) and chronic fatigue (CF)-like symptoms on the other, in FD. METHODS: In 259 tertiary care FD patients, we studied gastric sensorimotor function w...
Full Text Available Objective To explore the neuropsychiatric symptoms and 18F-fluoro-2-deoxy-D-glucose (18F-FDG PET imaging features of Parkinson-plus syndromes. Methods There were 8 patients with probable Parkinson-plus syndromes, including one case of multiple system atrophy-cerebellar predominant (MSA-C, 4 cases of progressive supranuclear palsy (PSP, one case of corticobasal ganglionic degeneration (CBD and 2 cases of dementia with Lewy bodies (DLB. Mini-Mental State Examination (MMSE and Montreal Cognitive Assessment (MoCA were used to evaluate cognitive function, Neuropsychiatric Inventory (NPI was used to evaluate neuropsychiatric behaviors, and Hamilton Depression Rating Scale-21 Items (HAMD-21 was used to evaluate the emotional state of patients. Results One MSA-C patient showed only anxiety. Four PSP patients showed different degrees of cognitive disorders, of whom 3 cases also presented obvious depression, anxiety, irritability and sleep disorders. One case of CBD showed dysfunction in executive function, visual spatial ability, verbal function, attention and orientation, as well as depression, anxiety, irritability and sleep disorders. Two cases of DLB were found unable to copy pentagon in MMSE chart or draw a circle in Clock Drawing Test (CDT, and they also presented hallucination, depression and indifference. As for the result of 18F-FDG PET, one MSA-C patient showed cerebellarglucose hypometabolism; 4 PSP patients showed hypometabolism in bilateral symmetrical frontal lobes, anterior cingulate gyrus and parietal lobe, especially in thalamus, basal ganglia region and brain stem; one case of CBD showed hypometabolism in right lateral fronto-temporo-parieto-occipital lobes, left lateral parietal lobe, bilateral cingulate gyri and precuneus; 2 cases of DLB showed hypometabolism in bilateral temporo-occipital lobes. Conclusions Patients with early Parkinson-plus syndromes are easily misdiagnosed as mental illness and delayed treatment, in addition, their
Wendt, M; Bickhardt, K; Herzog, A; Fischer, A; Martens, H; Richter, T
A review is given about the clinical symptoms, pathogenesis and aetiology of the porcine stress syndrome, furthermore aspects of animal welfare are discussed. The current breeding programmes of pig industry in Germany in many cases include animals with a mutation of the ryanodine-receptor (RYR-1)-gene--homozygous or heterozygous. This situation is the result of an intensive breeding of pigs during the last decades with the intention of increased lean carcass content and corresponding proceeds. The homozygous pigs are more stress susceptible (porcine stress syndrome) and produce meat of poor quality (PSE), which is also the case to some extend in heterozygous animals. The clinical symptoms of this muscle disease are characterised by a deficit of oxygen and a rapid glycolysis accompanied by a production of lactic acid and acidosis primarily in II B white muscle fibres. There is no doubt that a very close causal relation exists between the mutation of the RYR-1 and the porcine stress syndrome as well as the poor meat quality. The present knowledge of this disease, the genetic background, the physiology and pathophysiology of the mutation of the RYR-1 leads to the imperative conclusion to eliminate this mutated RYR-1 by selection of healthy pigs, which has been done successfully in other countries with important pig production. This conclusion is also supported by simple economic reasons because fertility, reproduction and daily weight gain are significantly reduced in stress susceptible pigs. Furthermore, it should be emphasised that regular breeding with the mutated RYR-1 is also a matter of animal welfare. The evident correlation between the mutated RYR-1 and the porcine stress syndrome, which includes degeneration of the muscle, pain and even life threatening malignant hyperthermia, can easily lead to the accusation in the public that diseased animals are used for pig meat production. Consequently, the authors would like to urge the breeding companies and the
Brauer, Charlotte; Kolstad, Henrik; Ørbaek, Palle; Mikkelsen, Sigurd
To examine associations between perceived indoor environment at work and the non-specific symptoms that are often referred to as the sick building syndrome (SBS), using cross-sectional and prospective analyses for a large cohort from the general population. The sample comprised 2,164 adults in employment, who completed a postal questionnaire in April 2001. Of these 1,402, who were still working and living in the same place, completed a second questionnaire a year later. The outcome measures were the prevalence of mucous membrane symptoms and general symptoms at baseline and the incidence and persistence of these symptoms at follow-up. Self-reports of the indoor environment from the baseline questionnaire were used as predictors in the analyses. Inconsistent results were found between the cross-sectional and the longitudinal analyses for the associations between perceived indoor environment factors at work and symptoms. Whereas mucous membrane symptoms in the cross-sectional analysis were significantly associated with self-reported high temperature and dry air, the prospective analyses showed that onset of mucous membrane symptoms was associated with the sensation of draught, dry air, and noise. Persistent mucous membrane symptoms were associated only with stuffy air. General symptoms were associated with self-reported stuffy air and dry air in the cross-sectional analysis, while draught was the only predictor of onset of general symptoms. We found no predictors in the indoor environment for the persistence of general symptoms. The symptoms that are often connected with SBS are very common symptoms in the general population among manual workers as well as non-manual workers. Our study gives only limited support to the hypothesis of causal relationships between the indoor environment and these symptoms. We found no evidence of persistent mucous membrane symptoms and general symptoms related to specific factors in the indoor environment.
Rathbone, Alasdair Timothy Llewelyn; Tharmaradinam, Surejini; Jiang, Shucui; Rathbone, Michel P; Kumbhare, Dinesh A
Post-concussion syndrome is an aggregate of symptoms that commonly present together after head injury. These symptoms, depending on definition, include headaches, dizziness, neuropsychiatric symptoms, and cognitive impairment. However, these symptoms are common, occurring frequently in non-head injured controls, leading some to question the existence of post-concussion syndrome as a unique syndrome. Therefore, some have attempted to explain post-concussion symptoms as post-traumatic stress disorder, as they share many similar symptoms and post-traumatic stress disorder does not require head injury. This explanation falls short as patients with post-concussion syndrome do not necessarily experience many key symptoms of post-traumatic stress disorder. Therefore, other explanations must be sought to explain the prevalence of post-concussion like symptoms in non-head injury patients. Many of the situations in which post-concussion syndrome like symptoms may be experienced such as infection and post-surgery are associated with systemic inflammatory responses, and even neuroinflammation. Post-concussion syndrome itself has a significant neuroinflammatory component. In this review we examine the evidence of neuroinflammation in post-concussion syndrome and the potential role systemic inflammation plays in post-concussion syndrome like symptoms. We conclude that given the overlap between these conditions and the role of inflammation in their etiologies, a new term, post-inflammatory brain syndromes (PIBS), is necessary to describe the common outcomes of many different inflammatory insults. The concept of post-concussion syndrome is in its evolution therefore, the new term post-inflammatory brain syndromes provides a better understanding of etiology of its wide-array of symptoms and the wide array of conditions they can be seen in. Copyright © 2015 Elsevier Inc. All rights reserved.
Lutgendorf, S K; Antoni, M H; Ironson, G; Fletcher, M A; Penedo, F; Baum, A; Schneiderman, N; Klimas, N
This study examined the effects of Hurricane Andrew on physical symptoms and functional impairments in a sample of chronic fatigue syndrome (CFS) patients residing in South Florida. In the months after Hurricane Andrew (September 15-December 31, 1992), 49 CFS patients were assessed for psychosocial and physical functioning with questionnaires, interviews, and physical examinations. This sample was made up of 25 CFS patients living in Dade county, a high impact area, and 24 patients in Broward and Palm Beach counties, areas less affected by the hurricane. Based on our model for stress-related effects on CFS, we tested the hypothesis that the patients who had the greatest exposure to this natural disaster would show the greatest exacerbation in CFS symptoms and related impairments in activities of daily living (illness burden). In support of this hypothesis, we found that the Dade county patients showed significant increases in physician-rated clinical relapses and exacerbations in frequency of several categories of self-reported CFS physical symptoms as compared to the Broward/Palm Beach county patients. Illness burden, as measured on the Sickness Impact Profile, also showed a significant increase in the Dade county patients. Although extent of disruption due to the storm was a significant factor in predicting relapse, the patient's posthurricane distress response was the single strongest predictor of the likelihood and severity of relapse and functional impairment. Additionally, optimism and social support were significantly associated with lower illness burden after the hurricane, above and beyond storm-related disruption and distress responses. These findings provide information on the impact of environmental stressors and psychosocial factors in the exacerbation of CFS symptoms.
Harvey Jeanna M
Full Text Available Abstract Background Chronic fatigue syndrome (CFS is a complex, multi-symptom illness with a multisystem pathogenesis involving alterations in the nervous, endocrine and immune systems. Abnormalities in stress responses have been identified as potential triggers or mediators of CFS symptoms. This study focused on the stress mediator neuropeptide Y (NPY. We hypothesized that NPY would be a useful biomarker for CFS. Methods The CFS patients (n = 93 were from the Chronic Fatigue and Related Disorders Clinic at the University of Miami and met the 1994 case definition of Fukuda and colleagues. Healthy sedentary controls (n = 100 were from NIH or VA funded studies. Another fatiguing, multi-symptom illness, Gulf War Illness (GWI, was also compared to CFS. We measured NPY in plasma using a radioimmunoassay (RIA. Psychometric measures, available for a subset of CFS patients included: Perceived Stress Scale, Profile of Mood States, ATQ Positive & Negative Self-Talk Scores, the COPE, the Beck Depression Inventory, Fatigue Symptom Inventory, Cognitive Capacity Screening Examination, Medical Outcomes Survey Short Form-36, and the Quality of Life Scale. Results Plasma NPY was elevated in CFS subjects, compared to controls (p = .000 and to GWI cases (p = .000. Receiver operating characteristics (ROC curve analyses indicated that the predictive ability of plasma NPY to distinguish CFS patients from healthy controls and from GWI was significantly better than chance alone. In 42 patients with CFS, plasma NPY had significant correlations ( Conclusions This study is the first in the CFS literature to report that plasma NPY is elevated compared to healthy controls and to a fatigued comparison group, GWI patients. The significant correlations of NPY with stress, negative mood, general health, depression and cognitive function strongly suggest that this peptide be considered as a biomarker to distinguish subsets of CFS.
Full Text Available Aim: Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and is one of the most common requests for electrodiagnosis. We aimed to note the relationship of subjective symptom severity of CTS, with objective electrophysiological severity and psychological status of patients. Patients and Methods: One hundred and forty-four consecutive patients of CTS referred to neurophysiology laboratory of a tertiary care hospital over 1 year were prospectively studied. Boston CTS Assessment Questionnaire (BCTSAQ and visual analog scale (VAS were used to assess subjective symptom severity. Psychological status was assessed by Hospital Anxiety and Depression Scale (HADS. Electrophysiological severity of CTS was estimated by median motor distal latency and median to ulnar peak sensory latency difference across the wrist. Each parameter in both hands was scored from 0 to 3 depending on the severity grade, and a composite electrophysiological severity score (CEPSS was calculated for each patient by summing up the scores in both hands. Statistical analysis was done by Spearman's rank correlation test. Results: There was significant correlation of BCTSAQ with VAS (P = 0.001, HADS anxiety score (P < 0.001, and HADS depression score (P = 0.01. CEPSS had no significant correlation with VAS (P = 0.103, HADS anxiety score (P = 0.211, or HADS depression score (P = 0.55. CEPSS had a borderline correlation with BCTSAQ (P = 0.048. Conclusions: While the subjective symptoms of CTS are well correlated with psychological factors, their correlation with objective electrophysiological severity is weak. Hence, prompt treatment of psychological comorbidity is important in symptomatic management of CTS; decision about surgical intervention should be based on electrophysiological severity rather than symptom severity.
Maddali Bongi, Susanna; Signorini, Massimo; Bassetti, Massimo; Del Rosso, Angela; Orlandi, Martina; De Scisciolo, Giuseppe
In carpal tunnel syndrome (CTS), manual therapy interventions (MTI) reduce tissue adhesion and increase wrist mobility. We evaluated the efficacy of a MTI in relieving CTS signs and symptoms. Twenty-two CTS patients (pts) (41 hands) were treated with a MTI, consisting in 6 treatments (2/week for 3 weeks) of soft tissues of wrist and hands and of carpal bones. Pts were assessed for hand sensitivity, paresthesia, hand strength, hand and forearm pain, night awakening; Phalen test, thenar eminence hypotrophy and Boston Carpal Tunnel Questionnaire (BCTQ) Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Median nerve was studied by sensory nerve conduction velocity (SNCV) and distal motor latency (DML). CTS was scored as minimal, mild, medium, severe and extreme. We considered as control group the same pts assessed before treatment: at baseline (T0a) and after 12 weeks (T0b). Pts were evaluated at the end of treatment (T1) and after 24-week (T2) follow-up. At T0b, versus T0a, forearm pain and Phalen test positivity were increased and hand strength reduced (p < 0.05). BCTQ-SSS and BCTQ-FSS scores improved at T1 versus T0b (p < 0.05) with the amelioration maintained at T2. At T1, the number of pts with paresthesia, night awakening, hypoesthesia, Phalen test, hand strength reduction and hand sensitivity was reduced with the lacking of symptoms maintained at T2 (p < 0.05). No changes in SNCV, DML and CTS scoring were shown. MTI improved CTS signs and symptoms, with benefits maintained at follow-up. Thus, it may be valid as a conservative therapy.
van der Schaaf, Marieke E; De Lange, Floris P; Schmits, Iris C; Geurts, Dirk E M; Roelofs, Karin; van der Meer, Jos W M; Toni, Ivan; Knoop, Hans
Chronic fatigue syndrome (CFS) is characterized by severe fatigue persisting for ≥6 months and leading to considerable impairment in daily functioning. Neuroimaging studies of patients with CFS have revealed alterations in prefrontal brain morphology. However, it remains to be determined whether these alterations are specific for fatigue or whether they relate to other common CFS symptoms (e.g., chronic pain, lower psychomotor speed, and reduced physical activity). We used magnetic resonance imaging to quantify gray matter volume (GMV) and the N-acetylaspartate and N-acetylaspartylglutamate/creatine ratio (NAA/Cr) in a group of 89 women with CFS. Building on previous reports, we tested whether GMV and NAA/Cr in the dorsolateral prefrontal cortex are associated with fatigue severity, pain, psychomotor speed, and physical activity, while controlling for depressive symptoms. We also considered GMV and NAA/Cr differences between patients with CFS and 26 sex-, age-, and education-matched healthy controls. The presence of pain symptoms was the main predictor of both GMV and NAA/Cr in the left dorsolateral prefrontal cortex of patients with CFS. More pain was associated with reduced GMVs and NAA/Cr, over and above the effects of fatigue, depressive symptoms, physical activity, and psychomotor speed. In contrast to previous reports and despite a large representative sample, global GMV did not differ between the CFS and healthy control groups. CFS, as diagnosed by Centers for Disease Control and Prevention criteria, is not a clinical entity reliably associated with reduced GMV. Individual variation in the presence of pain, rather than fatigue, is associated with neuronal alterations in the dorsolateral prefrontal cortex of patients with CFS. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Manuel Soria Orozco
Full Text Available Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome is a hypersensitivity reaction with rash, fever and multiorgan dysfunction potentially lethal in up to 10% of cases. It often affects liver function, but it can also affect kidney, lungs, and heart. Severe gastrointestinal involvement is rare. We present a case of a 31-year-old hispanic woman with pseudomembranous colitis associated with lamotrigine-induced DRESS syndrome. To the best of our knowledge, this is the fourth reported case of severe involvement of the gastrointestinal tract and the first to report pseudomembranous colitis in the setting of DRESS syndrome.
Full Text Available Manjit K Sanghera,1 Samantha G Sales,2 Jennifer L Robinson,1 Juhee Song,3 Elmyra V Encarnacion,4 R Malcolm Stewart5 1Department of Neurosurgery, Baylor-Scott and White Hospital, Temple, TX, 2Texas A & M College of Medicine, College Station, TX, 3Department of Biostatistics, Baylor-Scott and White Hospital, Temple, TX, 4Department of Neurology, Baylor-Scott and White Hospital, Temple, TX, 5Human Performance Laboratory, Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA Introduction: Restless legs syndrome (RLS is a chronic sensorimotor disorder characterized by discomfort or pain, predominantly in the legs, resulting in an urge to move during times of rest. These disturbances are often accompanied by sleep fragmentation, which can significantly increase medical comorbidities over time and can have a detrimental effect on a patient's overall quality of life. In this retrospective study, we examined the temporal relationship between the time of RLS diagnosis and the onset of non-motor symptoms (NMS and medical comorbidities. Patients and methods: Thirty-six RLS patients were evaluated for age at: symptom onset, time of diagnosis, time of occurrence of NMS, and medical comorbidities. We used structured interviews, validated questionnaires, and past medical records to aggregate and verify patient data. There was no clinical evidence to suggest secondary RLS in any patient at time of diagnosis. Results: Twenty-five patients were diagnosed as having RLS alone and eleven were diagnosed with RLS and Parkinson's disease (RLS + PD. In the RLS + PD group, irrespective of which disorder presented first, we found that patients exhibited symptoms of RLS at a significantly later age than those patients with RLS alone (P<0.05. The incidence and severity of NMS were significantly higher in the RLS + PD group compared to RLS alone and controls (P<0.001. Increased risk of RLS was identified in patients exhibiting mood changes and sleep deficits, and these
Saijo, Y; Kanazawa, A; Araki, A; Morimoto, K; Nakayama, K; Takigawa, T; Tanaka, M; Shibata, E; Yoshimura, T; Chikara, H; Kishi, R
This study investigated the possible relationships between exposures to mite allergen and airborne fungi with sick building syndrome (SBS) symptoms for residents living in newly built dwellings. We randomly sampled 5709 newly built dwellings in six prefectures from northern to southern Japan. A total of 1479 residents in 425 households participated in the study by completing questionnaire surveys and agreeing to environmental monitoring for mite allergen (Der 1), airborne fungi, aldehydes, and volatile organic compounds. Stepwise logistic regression analyses adjusted for confounders were used to obtain odds ratios (OR) of mite allergen and fungi for SBS symptoms. Der 1 had a significantly high OR for nose symptoms. Rhodotorula had a significantly high OR for any symptoms, and Aspergillus had significantly high OR for eye symptoms. However, the total colony-forming units had a significantly low OR for throat and respiratory symptoms. Eurotium had a significantly low OR for skin symptoms. In conclusion, dust-mite allergen levels and indoor airborne Rhodotorula and Aspergillus concentrations may result in SBS symptoms in newly built dwellings. Various factors can cause sick building syndrome symptoms. This study focused on biologic factors such as dust-mite allergen and airborne fungi in newly built dwellings in Japan. Dust-mite allergen levels were significantly associated with higher rates of nose symptoms, airborne Rhodotorula concentrations were significantly associated with higher rates of any symptoms, and Aspergillus concentrations were significantly associated with higher rates of eye symptoms. Measures should be taken to reduce mite allergen levels and fungal concentrations in these dwellings. © 2010 John Wiley & Sons A/S.
Hiyane, Masato; Saito, Yoshiaki; Saito, Takashi; Komaki, Hirofumi; Nakagawa, Eiji; Sugai, Kenji; Sasaki, Masayuki; Sato, Noriko; Yamamoto, Toshiyuki; Imai, Yoko
In this study, we present the case of a 2-year-old boy who exhibited facial and bulbar paralysis since birth, severe dysphagia, signs of oculomotor disturbance, jaw jerks, pyramidal signs on both toes, intellectual disability, and severe gastroesophageal reflux. His blink reflex and auditory/somatosensory evoked potentials suggested abnormalities in the lower brainstem, and magnetic resonance imaging showed a T2 hyperintense area in the pontine tegmentum. These findings combined with the patient's symptoms suggested "dorsal brainstem syndrome" and indicated a possibility of prenatal asphyxia in this patient. Nosologic issues regarding this subgroup of cerebral palsy are discussed here. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
Treldal, Charlotte; Jacobsen, C B; Mogensen, Stine
OBJECTIVE: Patients with burning mouth syndrome (BMS) often represent a clinical challenge as available agents for symptomatic treatment are few and often ineffective. The aim was to evaluate the effect of a bupivacaine lozenge on oral mucosal pain, xerostomia, and taste alterations in patients....... Assessment of oral mucosal pain, xerostomia, and taste alterations was performed in a patient diary on a visual analog scale (ranging from 0 to 100 mm) before and after the lozenge was dissolved. RESULTS: The bupivacaine lozenge significantly reduced the burning oral pain (P ... of taste disturbances (P xerostomia, when adjusted for the treatment period. CONCLUSIONS: Our results indicate that the bupivacaine lozenge offers a novel therapeutic modality to patients with BMS, although without alleviating effect on the associated symptoms, taste...
Jackson, H; MacLeod, A K
There is growing recognition in psychology that wellness is more than the absence of disease and distress. Well-being has been defined in numerous ways. Two dominant models include Diener, Eunkook, Suh, Lucas and Smith's (1999) model of subjective well-being (SWB) and Ryff's (1989) model of psychological well-being (PWB). In contrast to the abundance of research investigating negative constructs and psychopathology in chronic fatigue syndrome (CFS), there has been a paucity of positive psychology studies. This study had two aims: to examine PWB and SWB and their relationship to symptoms in CFS and to compare PWB scores in a subgroup of the CFS sample to a matched control group. Chronic fatigue syndrome participants (n = 60) completed self-report scales of PWB, SWB, fatigue, anxiety and depression. PWB scores in a subgroup of the CFS sample (n = 42) were compared with those of a matched nonclinical control group (n = 42). Correlations between scales of symptoms and well-being were complex. Well-being dimensions were largely independent of physical components of fatigue but strongly related to psychological components of fatigue and psychological distress. Multiple regression indicated that five dimensions of well-being uniquely predicted symptomatology. Compared with the control group, the CFS group scored significantly lower on five of Ryff's six PWB dimensions, with particularly marked deficits in personal growth, environmental mastery and self-acceptance. This multidimensional assessment of well-being advances our understanding of CFS and offers new treatment targets. Future research must investigate whether interventions targeting theses well-being deficits can boost the efficacy of symptom-focused treatments. Copyright © 2016 John Wiley & Sons, Ltd. Previous psychological research into CFS has largely focused on the identification of negative constructs and CBT, a treatment that targets evidenced-based negative constructs, has demonstrated efficacy
Full Text Available Background Premenstrual syndrome (PMS is characterized by recurrent, moderate-to-severe affective, physical, and behavioral symptoms that develop during the luteal menstrual cycle and disappear within a few days of menstruation. Objectives This article aims to identify the effects of relaxation, positive self-talk, and a combination of relaxation and positive self-talk on premenstrual syndrome. Methods In this quasi-experimental study, 80 women with PMS disorder were selected using a simple random sampling method, in Hamadan, west of Iran. They were randomly divided into four groups. The first and second groups underwent positive self-talk and relaxation, respectively. The third group experienced positive self-talk and relaxation at the same time. The fourth group did not receive any treatment. The duration of treatment was 8 one-hour sessions. Data were collected using a PMS symptom severity questionnaire. All groups were followed up for six months after the intervention. Finally, data analysis was performed using SPSS version 18 for ANCOVA and Bonferroni tests. Results The results showed that compared to the control group, relaxation (23.2 and positive self-talk (21.25 treatment methods alone can reduce PMS (P < 0.001. On the other hand, a combined (relaxation + positive self-talk treatment method (13.75 was more effective in reducing PMS compared to relaxation or positive self-talk alone. Conclusions It seems that psychological therapy based on relaxation and positive self-talk can be significantly effective in reducing PMS.
Anthony James Ocon
Full Text Available Chronic Fatigue Syndrome (CFS is defined as greater than 6 months of persistent fatigue that is experienced physically and cognitively. The cognitive symptoms are generally thought to be a mild cognitive impairment, but individuals with CFS subjectively describe them as brain fog. The impairment is not fully understood and often is described as slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness, or a haziness in thought processes. Causes of brain fog and mild cognitive impairment have been investigated. Possible physiological correlates may be due to the effects of chronic orthostatic intolerance in the form of the Postural Tachycardia Syndrome and decreases in cerebral blood flow. In addition, fMRI studies suggest that individuals with CFS may require increased cortical and subcortical brain activation to complete difficult mental tasks. Furthermore, neurocognitive testing in CFS has demonstrated deficits in speed and efficiency of information processing, attention, concentration, and working memory. The cognitive impairments are then perceived as an exaggerated mental fatigue. As a whole, this is experienced by those with CFS as brain fog and may be viewed as the interaction of physiological, cognitive, and perceptual factors. Thus, the cognitive symptoms of CFS may be due to altered cerebral blood flow activation and regulation that are exacerbated by a stressor, such as orthostasis or a difficult mental task, resulting in the decreased ability to readily process information, which is then perceived as fatiguing and experienced as brain fog. Future research looks to further explore these interactions, how they produce cognitive impairments, and explain the perception of brain fog from a mechanistic standpoint.
Husson, O.; Haak, H.R.; Buffart, L.M.; Nieuwlaat, W.A.; Oranje, W.A.; Mols, F.; Kuijpens, J.L.; Coebergh, J.W.; van de Poll-Franse, L.
Background. Given the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQoL) during the follow-up period is of considerable concern. Therefore, the first aim of this study was to assess (thyroid cancer specific) HRQoL among long-term thyroid cancer survivors
Husson, O.; Haak, H.R.; Buffart, L.M.; Nieuwlaat, W.-A.; Oranje, W.A.; Mols, F.; Kuijpens, J.L.; Coebergh, J.W.W.; van de Poll-Franse, L.V.
Background. Given the longevity of thyroid cancer patients, any impairment in health-related quality of life (HRQoL) during the follow-up period is of considerable concern. Therefore, the first aim of this study was to assess (thyroid cancer specific) HRQoL among long-term thyroid cancer survivors
Morina, N.; Böhme, H.F.; Ajdukovic, D.; Bogic, M.; Franciskovic, T.; Galeazzi, G.M.; Kucukalic, A.; Lecic-Tosevski, D.; Popovski, M.; Schützwohl, M.; Stangier, U.; Priebe, S.
The study aimed at establishing the factor structure of the Impact of Event Scale—Revised (IES-R) in survivors of war. A total sample of 4167 participants with potentially traumatic experiences during the war in Ex-Yugoslavia was split into three samples: two independent samples of people who stayed
Davi Tanajura Costa
Full Text Available OBJECTIVE: To compare neurological symptoms and signs in HTLV-1 asymptomatic carriers and HTLV-1 patients with overactive bladder (OB syndrome. METHODS: We studied 102 HTLV-1 positive individuals without HAM/TSP (HTLV-1 associated myelopathy/tropical spastic paraparesis divided into two groups according to the presence or absence of OB syndrome. Clinical interview, neurological exam and proviral load was performed in all patients. RESULTS AND CONCLUSIONS: Individuals with OB were more commonly female (84.3 vs. 60.8% of asymptomatics, p=0.01. The prevalence of neurological complaints was higher in OB group, especially hand or foot numbness and arm or leg weakness. There was no difference between the groups in neurological strength and reflexes. Weakness complaint remained strongly associated with OB in multivariate logistic regression analysis adjusting for sex and age [adjusted odds ratio and 95%CI 3.59 (1.45-8.88 in arms and 6.68 (2.63-16.93 in legs]. Proviral load was also different between the two groups with higher level on OB individuals.
Full Text Available Objectives: This research was administered with the aim of studying the relationship between retirement syndrome components with general health symptoms in retired adults in Esfahan city. Methods & Materials: This research carried out in descriptive and correlational method. Research statistical population was the retired adults in Esfahan city, among them, 461 persons for participating to research were selected using stratified random sampling, and then retirement syndrome questionnaire (helplessness and failure, older and idleness, trying and new direction and conflict and confusion and general health questionnaire (somatization, anxiety and insomnia, social dysfunction, and depression administered to them. Results: 1 Three components have predictive power for prediction of somatization, consisted of: helplessness and failure, older and idleness, trying and new directions, 2 for prediction of anxiety and insomnia, helplessness and failure, trying and new direction, older and idleness have significant predictive power, 3 For prediction of social dysfunction, helplessness and failure, and trying and new directions have significant predictive power, 4 For prediction of depression also, helplessness and failure and trying and new directions have significant predictive power. Conclusion: The finding of this research revealed that, helplessness and failure along with trying and new direction are the two components which must be considered in retired adults. Therefore, it is essential for this two dimensions established counseling centers related to retirement centers for helping retired adults.
He, Qiqi; Wang, Zhiping; Liu, Guiming; Daneshgari, Firouz; MacLennan, Gregory T.; Gupta, Sanjay
Background Epidemiological data suggest that lower urinary tract symptoms (LUTS) may be associated with metabolic syndrome (MetS). Inflammation has been proposed as a candidate mechanism at the crossroad between these two clinical entities. The aim of this review article is to evaluate the role of MetS-induced inflammation in the pathogenesis and progression of LUTS. Methods A systematic review was conducted using the keywords ‘metabolic syndrome AND lower urinary tract symptoms’ within the title search engines including PubMed, Web of Science, and the Cochrane Library for relevant research work published between 2000 and January 2015. The obtained literature was reviewed by the primary author (QH) and was assessed for eligibility and standard level of evidence. Results Total of 52 articles met the eligibility criteria. Based on database search during the past 15 years and our systematic review of prospective and retrospective cohorts, case-control trials, observational studies and animal data identified a possible link between MetS-induced inflammation and LUTS including benign prostatic hyperplasia, bladder outlet obstruction, overactive bladder, urinary incontinence and others possible urinary tract abnormalities. Conclusions There is convincing evidence to suggest that MetS and inflammation could be important contributors to LUTS in men, particularly in the development of benign prostatic hyperplasia. However, the role of MetS-induced inflammation remains unclear in overactive bladder, urinary incontinence and etiology of LUTS progression. PMID:26391088
Sathyapalan, Thozhukat; Beckett, Stephen; Rigby, Alan S; Mellor, Duane D; Atkin, Stephen L
Chocolate is rich in flavonoids that have been shown to be of benefit in disparate conditions including cardiovascular disease and cancer. The effect of polyphenol rich chocolate in subjects with chronic fatigue syndrome (CFS) has not been studied previously. We conducted a double blinded, randomised, clinical pilot crossover study comparing high cocoa liquor/polyphenol rich chocolate (HCL/PR) in comparison to simulated iso-calorific chocolate (cocoa liquor free/low polyphenols(CLF/LP)) on fatigue and residual function in subjects with chronic fatigue syndrome. Subjects with CFS having severe fatigue of at least 10 out of 11 on the Chalder Fatigue Scale were enrolled. Subjects had either 8 weeks of intervention in the form of HCL/PR or CLF/LP, with a 2 week wash out period followed by 8 weeks of intervention with the other chocolate. Ten subjects were enrolled in the study. The Chalder Fatigue Scale score improved significantly after 8 weeks of the HCL/PR chocolate arm [median (range) Exact Sig. (2-tailed)] [33 (25 - 38) vs. 21.5 (6 - 35) 0.01], but that deteriorated significantly when subjects were given simulated iso-calorific chocolate (CLF/CP) [ 28.5 (17 - 20) vs. 34.5 (13-26) 0.03]. The residual function, as assessed by the London Handicap scale, also improved significantly after the HCL/PR arm [0.49 (0.33 - 0.62) vs. 0.64 (0.44 - 0.83) 0.01] and deteriorated after iso-calorific chocolate [00.44 (0.43 - 0.68) vs. 0.36 (0.33 - 0.62)0.03]. Likewise the Hospital Anxiety and Depression score also improved after the HCL/PR arm, but deteriorated after CLF/CP. Mean weight remained unchanged throughout the trial. This study suggests that HCL/PR chocolate may improve symptoms in subjects with chronic fatigue syndrome.
Ozguven, Halise Devrimci; Oner, Ozgur; Baskak, Bora; Oktem, Ferhunde; Olmez, Senay; Munir, Kerim
Although previous studies have shown that the theory of mind (ToM) ability is impaired in Asperger's Syndrome (AS) and in schizophrenia, few controlled studies compared the ToM performance between the two disorders. Besides, the relationship between the degree of ToM impairment and symptom dimensions is unclear, and presence of ToM impairment in remitted patients with schizophrenia is controversial. Here, we tested the hypothesis that schizophrenia patients with prominent negative symptoms were closer to AS patients and different than schizophrenia patients without prominent negative symptoms and healthy controls in terms of ToM functioning. Fourteen patients with AS, 20 with schizophrenia and 20 healthy controls, matched by age, educational level and IQ scores were enrolled. AS was diagnosed according to the DSM-IV criteria and independently confirmed by two psychiatrists. Schizophrenia patients were diagnosed by the Turkish version of Structured Clinical Interview for DSM-IV Diagnosis (SCID-I) and symptom severity was evaluated with the Scale for the Assessment of Negative and Positive Symptoms. Schizophrenia group consisted of clinically stable patients. The ToM battery included stories to assess first and second order false belief tasks (ToM1 and ToM2). The full-scale IQ, Verbal Comprehension, Freedom from Distractibility and Perceptual Organization scores were assessed by Weschler Adult Intelligence Scale-Revised (WAIS-R). Non-parametric tests were used to compare the neuropsychological performances of the three groups. In order to investigate whether schizophrenia patients with prominent negative symptoms were similar to AS patients, schizophrenia patients were divided into high (Sch-HN) and low (Sch-LN) negative-symptom subgroups by median split. For these four groups (AS, Sch-HN, Sch-LN, and controls) between group comparisons were performed. Correlations between the clinical measures and ToM performance were assessed by Spearman correlation test. AS and
Ozguven, Halise Devrimci; Oner, Ozgur; Baskak, Bora; Oktem, Ferhunde; Olmez, Senay; Munir, Kerim
Objective Although previous studies have shown that the theory of mind (ToM) ability is impaired in Asperger’s Syndrome (AS) and in schizophrenia, few controlled studies compared the ToM performance between the two disorders. Besides, the relationship between the degree of ToM impairment and symptom dimensions is unclear, and presence of ToM impairment in remitted patients with schizophrenia is controversial. Here, we tested the hypothesis that schizophrenia patients with prominent negative symptoms were closer to AS patients and different than schizophrenia patients without prominent negative symptoms and healthy controls in terms of ToM functioning. Method Fourteen patients with AS, 20 with schizophrenia and 20 healthy controls, matched by age, educational level and IQ scores were enrolled. AS was diagnosed according to the DSM-IV criteria and independently confirmed by two psychiatrists. Schizophrenia patients were diagnosed by the Turkish version of Structured Clinical Interview for DSM-IV Diagnosis (SCID-I) and symptom severity was evaluated with the Scale for the Assessment of Negative and Positive Symptoms. Schizophrenia group consisted of clinically stable patients. The ToM battery included stories to assess first and second order false belief tasks (ToM1 and ToM2). The full-scale IQ, Verbal Comprehension, Freedom from Distractibility and Perceptual Organization scores were assessed by Weschler Adult Intelligence Scale–Revised (WAIS-R). Non-parametric tests were used to compare the neuropsychological performances of the three groups. In order to investigate whether schizophrenia patients with prominent negative symptoms were similar to AS patients, schizophrenia patients were divided into high (Sch-HN) and low (Sch-LN) negative-symptom subgroups by median split. For these four groups (AS, Sch-HN, Sch-LN, and controls) between group comparisons were performed. Correlations between the clinical measures and ToM performance were assessed by Spearman
Madsen, Michael Tvilling; Isbrand, Anders; Andersen, Ulla Overgaard
, Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome" trial (MEDACIS) is a multicenter, double-blinded, placebo-controlled, randomized clinical trial. A total of 240 patients with ACS and no depressive symptoms will be included in the trial for treatment with either 25 mg...... melatonin or placebo for a 12-week period. Development and severity of depressive symptoms will be evaluated using Major Depression Inventory every 2 weeks with the purpose of investigating the potential preventive effect of melatonin on depressive symptoms. DISCUSSION: Previously, only selective serotonin...
Peralta, Sergio; Cottone, Claudia; Doveri, Tiziana; Almasio, Piero Luigi; Craxi, Antonio
AIM: To estimate the prevalence of small intestinal bacterial overgrowth (SIBO) in our geographical area (Western Sicily, Italy) by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO. METHODS: Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome (IBS); a total of 97 patients accepted to perform a breath test with lactulose (BTLact), and those who had a positive test, received Rifaximin (Normix®, Alfa Wassermann) 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated. RESULTS: Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS. CONCLUSION: SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a “breath test”. Rifaximin may represent a valid approach to the treatment of SIBO. PMID:19496193
Michal, Matthias; Adler, Julia; Reiner, Iris; Wermke, Andreas; Ackermann, Tatiana; Schlereth, Tanja; Birklein, Frank
Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations. We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires. Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P somatization (rho = 0.616, P somatization, depression, anxiety, and depersonalization, but probably not of pain. Whether these associations are causative must be clarified in longitudinal psychological studies.
Full Text Available Qualitative communication disorders belong to the key symptoms of pervasive developmental disorders (PDD. The severity of the symptoms of communication disorders varies depending on the type of PDD, from the lack of functional speech to overdeveloped verbal competencies measured by standardized scales. In Asperger’s syndrome (AS, observed language abnormalities include: pragmatics (application of language in social context, semantics (identifying different meanings of the same word and prosody (rhythm, intonation and modulation of speech. In the case of AS, the difference between formal language skills, i.e. within morphological, phonological and syntactic functions, and semantic and pragmatic deficits is clearly noticeable and distinctive. This situation arouses some questions about neurobiological conditions of these deficits. The language functions are among the first functions for which locations in the brain have been established. Traditionally they have been ascribed to some regions in the left hemisphere; they undergo lateralization and are accomplished owing to the activity of the primary, secondary and tertiary regions of associative cortex. However, there is also quite a lot of evidence suggesting that the right hemisphere plays an important role in communication processes, especially in some aspects of pragmatics and discourse. The analysis of communication deficits observed in patients with acquired right hemisphere damages and patients with AS as well as abnormal patterns of hemispheric asymmetry in this group of patients, suggest that the right hemisphere is involved in aetiology of PDD.
Despite being one of the most common conditions leading to gastroenterological referral, irritable bowel syndrome (IBS) is poorly understood. However, recent years have seen major advances. These include new understanding of the role of both inflammation and altered microbiota as well as the impact of dietary intolerances as illuminated by magnetic resonance imaging (MRI), which has thrown new light on IBS. This article will review new data on how excessive bile acid secretion mediates diarrhea and evidence from post infectious IBS which has shown how gut inflammation can alter gut microbiota and function. Studies of patients with inflammatory bowel disease (IBD) have also shown that even when inflammation is in remission, the altered enteric nerves and abnormal microbiota can generate IBS-like symptoms. The efficacy of the low FODMAP diet as a treatment for bloating, flatulence, and abdominal discomfort has been demonstrated by randomized controlled trials. MRI studies, which can quantify intestinal volumes, have provided new insights into how FODMAPs cause symptoms. This article will focus on these areas together with recent trials of new agents, which this author believes will alter clinical practice within the foreseeable future. PMID:27158477
Nijs, Jo; Meeus, Mira; Heins, Marianne; Knoop, Hans; Moorkens, Greta; Bleijenberg, Gijs
Kinesiophobia and catastrophizing are frequent among people with chronic fatigue syndrome (CFS). This study was aimed at examining (1) whether kinesiophobia, anticipated symptoms and fatigue catastrophizing are related to stair climbing performance in people with CFS; and (2) whether kinesiophobia and fatigue catastrophizing are related to daily physical activity in CFS. Patients with CFS filled in a set of questionnaires, performed a physical demanding task (two floors stair of climbing and descending) with pre-test and post-test heart rate monitoring and immediate post-stair climbing symptom assessment. Real-time activity monitoring was used between the baseline and second assessment day (7 days later). Kinesiophobia and fatigue catastrophizing were strongly related (ρ = 0.62 and 0.67, respectively) to poorer stair climbing performance (i.e. more time required to complete the threatening activity). Kinesiophobia and fatigue catastrophizing were unrelated to the amount of physical activity on the first day following stair climbing or during the seven subsequent days. These findings underscore the importance of kinesiophobia and fatigue catastrophizing for performing physical demanding tasks in everyday life of people with CFS, but refute a cardinal role for kinesiophobia and fatigue catastrophizing in determining daily physical activity level in these patients.
Hornyak, Magdolna; Sohr, Mandy; Busse, Michael
Although "uncomfortable and unpleasant" limb sensations are a core symptom of restless legs syndrome (RLS), change in sensory symptomatology is usually not evaluated as a treatment outcome. In two double-blind trials, patients with idiopathic RLS (n=357 in trial 615 and 398 in trial 604) were randomized to placebo or pramipexole (optimized at 0.125, 0.25, 0.50, or 0.75 mg/day). For entry, trial 604 also required at least moderate mood disturbance. In both trials, 12-week change in RLS-related limb pain was assessed using a 100-mm visual analogue scale (VAS). At baseline, approximately 75% of patients had limb-pain scores >30. Treatment with pramipexole yielded significant score reduction as early as day 5. At week 12, median score reduction for pramipexole relative to placebo was -33.5 vs. -11.0 (p<0.0001) in trial 615 and -31.0 vs. -11.0 (p<0.0001) in trial 604. Painful sensations may be more frequent in RLS than has previously been appreciated, and their amelioration may be a facet of pramipexole's benefit even in patients with concurrent mood disturbance. Limb pain assessment, e.g., by a VAS, is a useful measure of change in RLS symptom severity. Copyright © 2010 Elsevier B.V. All rights reserved.
Klooker, T.K.; Braak, B.; Koopman, K.E.; Welting, O.; Wouters, M.M.; van der Heide, S.; Schemann, M.; Bischoff, S.C.; van den Wijngaard, R.M.; Boeckxstaens, G.E.
Background Mast cell activation is thought to be involved in visceral hypersensitivity, one of the main characteristics of the irritable bowel syndrome (IBS). A study was therefore undertaken to investigate the effect of the mast cell stabiliser ketotifen on rectal sensitivity and symptoms in
Wheeler, Anne C.; Mussey, Joanna; Villagomez, Adrienne; Bishop, Ellen; Raspa, Melissa; Edwards, Anne; Bodfish, James; Bann, Carla; Bailey, Donald B.
We used survey methodology to assess parent-reported autism symptomology in 758 individuals (639 males; 119 females) with fragile X syndrome (FXS). Caregivers reported whether their child with FXS had been diagnosed with an autism spectrum disorder (ASD) and endorsed symptoms based on a list of observable behaviors related to ASD diagnoses.…
Mason, Gina Marie; Spanó, Goffredina; Edgin, Jamie
This study examined individual differences in ADHD symptoms and executive function (EF) in children with Down syndrome (DS) in relation to the dopamine receptor D4 (DRD4) gene, a gene often linked to ADHD in people without DS. Participants included 68 individuals with DS (7-21 years), assessed through laboratory tasks, caregiver reports, and…
Jellema, P.; Windt, D.A.W.M. van der; Schellevis, F.G.; Horst, H.E. van der
BACKGROUND: Despite the trend towards making a positive diagnosis of irritable bowel syndrome (IBS), many health care providers approach IBS as a diagnosis of exclusion. AIM: To summarize available evidence on the diagnostic performance of symptom-based IBS criteria in excluding organic diseases,
Reisinger, Debra L.; Roberts, Jane E.
Social skills are critical for academic, social, and psychological success of children with both typical and atypical development. Boys with fragile X syndrome (FXS) are at high risk for social skill impairments, given intellectual impairments and secondary conditions. The present study examines the impact of adaptive behavior, autism symptoms,…
Full Text Available <b>Purpose:</b> Chronic day-to-day symptoms of orthostatic intolerance are the most notable features of postural orthostatic tachycardia syndrome (POTS. However, we have encountered patients with such symptoms and excessive tachycardia but with no symptoms during the tilt-table test (TTT. We aimed to investigate whether POTS patients with chronic orthostatic intolerance always present orthostatic symptoms during the TTT and analyze the factors underlying symptom manifestation during this test. <b>Methods:</b> We retrospectively examined patients who presented with POTS at the Gyeongsang Na tional University Hospital between 2008 and 2011. Diagnosis of POTS was based on chronic day-to-day orthostatic intolerance symptoms as well as excessive tachycardia during the TTT. The patients were divided two groups depending on the presentation of orthostatic symptoms during the TTT. Clinical data and the results of the TTT were compared between these groups. <b>Results:</b> In 22 patients, 7 patients (31.8% did not present orthostatic symptoms during the test. Diastolic blood pressure (BP was significantly lower in the symptom-positive group. The head-up tilt resulted in a significant increase in diastolic BP in the symptom-negative group (<i>P</i> =0.04, while systolic BP had a tendency to decrease in the symptom-positive group (<i>P</i> =0.06. <b>Conclusion:</b> Significant patients with POTS did not present orthostatic symptoms during the TTT despite having chronic daily symptoms. This finding may be important for establishing definitive diagnostic criteria for pediatric POTS. Development of symptoms during TTT might be related to low diastolic BP and abnormal compensatory responses to orthostasis.
Kutch, Jason J; Labus, Jennifer S; Harris, Richard E; Martucci, Katherine T; Farmer, Melissa A; Fenske, Sonja; Fling, Connor; Ichesco, Eric; Peltier, Scott; Petre, Bogdan; Guo, Wensheng; Hou, Xiaoling; Stephens, Alisa J; Mullins, Chris; Clauw, Daniel J; Mackey, Sean C; Apkarian, A Vania; Landis, J Richard; Mayer, Emeran A
Chronic pain symptoms often change over time, even in individuals who have had symptoms for years. Studying biological factors that predict trends in symptom change in chronic pain may uncover novel pathophysiological mechanisms and potential therapeutic targets. In this study, we investigated whether brain functional connectivity measures obtained from resting-state functional magnetic resonance imaging at baseline can predict longitudinal symptom change (3, 6, and 12 months after scan) in urologic chronic pelvic pain syndrome. We studied 52 individuals with urologic chronic pelvic pain syndrome (34 women, 18 men) who had baseline neuroimaging followed by symptom tracking every 2 weeks for 1 year as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. We found that brain functional connectivity can make a significant prediction of short-term (3 month) pain reduction with 73.1% accuracy (69.2% sensitivity and 75.0% precision). In addition, we found that the brain regions with greatest contribution to the classification were preferentially aligned with the left frontoparietal network. Resting-state functional magnetic resonance imaging measures seemed to be less informative about 6- or 12-month symptom change. Our study provides the first evidence that future trends in symptom change in patients in a state of chronic pain may be linked to functional connectivity within specific brain networks.
Harvie, Ruth M; Chisholm, Alexandra W; Bisanz, Jordan E; Burton, Jeremy P; Herbison, Peter; Schultz, Kim; Schultz, Michael
To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol (FODMAP) diet on irritable bowel syndrome (IBS) symptoms and quality of life (QoL). Participants with IBS (Rome III) were randomized to two groups. Group I commenced a low FODMAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODMAP diet while group I started re-challenging foods. All patients completed the IBS SSS (IBS symptom severity scoring system, 0-500 points increasing with severity), IBS QoL questionnaire (0-100 increasing with QoL), a FODMAP specific food frequency questionnaire and provided a stool sample at baseline, three and six months for microbiome analysis. Fifty participants were enrolled into group I (n = 23) or group II (n = 27). Participants in both groups were similar in baseline values but with more men in group I. There was a significantly lower IBS SSS (275.6 ± 63.6 to 128.8 ± 82.5 vs 246.8 ± 71.1 to 203.6 ± 70.1) (P FODMAP diet (33 ± 17 g/d to 21 ± 8 g/d) (P FODMAP containing foods increased again to 27 ± 9 g/d. There was no change seen in the intestinal microbiome when participants adopted a low FODMAP diet. This study demonstrated that a reduction in FODMAPs improves symptoms in IBS and this improvement can be maintained while reintroducing FODMAPs.
Body, Richard; Carley, Simon; Wibberley, Christopher; McDowell, Garry; Ferguson, Jamie; Mackway-Jones, Kevin
Patient history and physical examination are widely accepted as cornerstones of diagnosis in modern medicine. We aimed to assess the value of individual historical and examination findings for diagnosing acute myocardial infarction (AMI) and predicting adverse cardiac events in undifferentiated Emergency Department (ED) patients with chest pain. We prospectively recruited patients presenting to the ED with suspected cardiac chest pain. Clinical features were recorded using a custom-designed report form. All patients were followed up for the diagnosis of AMI and the occurrence of adverse events (death, AMI or urgent revascularization) within 6 months. AMI was diagnosed in 148 (18.6%) of the 796 patients recruited. Following adjustment for age, sex and ECG changes, the following characteristics made AMI more likely (adjusted odds ratio, 95% confidence intervals): pain radiating to the right arm (2.23, 1.24-4.00), both arms (2.69, 1.36-5.36), vomiting (3.50, 1.81-6.77), central chest pain (3.29, 1.94-5.61) and sweating observed (5.18, 3.02-8.86). Pain in the left anterior chest made AMI significantly less likely (0.25, 0.14-0.46). The presence of rest pain (0.67, 0.41-1.10) or pain radiating to the left arm (1.36, 0.89-2.09) did not significantly alter the probability of AMI. Our results challenge many widely held assertions about the value of individual symptoms and signs in ED patients with suspected acute coronary syndromes. Several 'atypical' symptoms actually render AMI more likely, whereas many 'typical' symptoms that are often considered to identify high-risk populations have no diagnostic value. Copyright 2009. Published by Elsevier Ireland Ltd.
Park, S H; Naliboff, B D; Shih, W; Presson, A P; Videlock, E J; Ju, T; Kilpatrick, L; Gupta, A; Mayer, E A; Chang, L
Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated with early adverse life events (EALs) and a dysregulated hypothalamic-pituitary-adrenal (HPA) axis. Resilience is the ability to recover and adapt positively to stress but has not been well studied in IBS. The aims of this study are to compare resilience in IBS and healthy controls (HCs) and to assess its relationships with IBS symptom severity, quality of life (QOL), EALs, and HPA axis response. Two hundred fifty-six subjects (154 IBS, 102 HCs) completed questionnaires for resilience (Connor-Davidson Resilience Scale [CD-RISC] and Brief Resilience Scale [BRS]), IBS symptoms, IBS-QOL, and EALs. Ninety-six of these subjects had serial serum adrenocorticotropic hormone (ACTH) and cortisol levels to exogenous corticotrophin-releasing hormone (CRH) and ACTH measured. The relationship between IBS status, resilience, and other variables of interest was assessed by regression analysis after adjusting for demographics and neuroticism, a predictor of resilience. Resilience was significantly lower in IBS compared to HCs (CD-RISC: 72.16±14.97 vs 77.32±12.73, P=.003; BRS: 3.29±0.87 vs 3.93±0.69, Presilience and IBS status for ACTH-stimulated cortisol response (P=.031); more resilient IBS subjects had lower cortisol response, and more resilient HCs had higher cortisol response. Lower resilience is associated with IBS status, worse IBS symptom severity, lower IBS-QOL, greater EALs, and stress hyperresponsiveness. © 2017 John Wiley & Sons Ltd.
Reding-Bernal, Arturo; Sánchez-Pedraza, Valentin; Moreno-Macías, Hortensia; Sobrino-Cossio, Sergio; Tejero-Barrera, María Elizabeth; Burguete-García, Ana Isabel; León-Hernández, Mireya; Serratos-Canales, María Fabiola; Duggirala, Ravindranath; López-Alvarenga, Juan Carlos
The aim of this study was to estimate the heritability (h2) and genetic correlation (ρG) between GERD symptoms severity, metabolic syndrome components, and inflammation markers in Mexican families. Cross-sectional study which included 32 extended families resident in Mexico City. GERD symptoms severity was assessed by the ReQuest in Practice questionnaire. Heritability and genetic correlation were determined using the Sequential Oligogenic Linkage Analysis Routines software. 585 subjects were included, the mean age was 42 (±16.7) years, 57% were women. The heritability of the severity of some GERD symptoms was h2 = 0.27, 0.27, 0.37, and 0.34 (p-value syndrome components ranged from 0.40 for fasting plasma glucose to 0.61 for body mass index and diabetes mellitus. The heritability for fibrinogen and C-reactive protein was 0.64 and 0.38, respectively. Statistically significant genetic correlations were found between acidity complaints and fasting plasma glucose (ρG = 0.40); sleep disturbances and fasting plasma glucose (ρG = 0.36); acidity complaints and diabetes mellitus (ρG = 0.49) and between total ReQuest score and fasting plasma glucose (ρG = 0.43). The rest of metabolic syndrome components did not correlate with GERD symptoms. Genetic factors substantially explain the phenotypic variance of the severity of some GERD symptoms, metabolic syndrome components and inflammation markers. Observed genetic correlations suggest that these phenotypes share common genes. These findings suggest conducting further investigation, as the determination of a linkage analysis in order to identify regions of susceptibility for developing of GERD and metabolic syndrome.
Creutzfeldt, Claire J; Holloway, Robert G; Walker, Melanie
... care needs of stroke survivors. Some of the most common and disabling post-stroke symptoms that are reviewed here include central post-stroke pain, hemiplegic shoulder pain, painful spasticity, fatigue, incontinence, post-stroke...
Mettananda, Sachith; Fernando, Asvini D; Ginige, Nimasari
Posterior reversible encephalopathy syndrome is an extremely rare radiological diagnosis that has not been reported previously in association with acute liver failure. A 6-year-old Sri Lankan girl developed acute liver failure with severe hepatic encephalopathy due to sodium valproate. She was successfully treated medically with N-acetylcysteine and L-carnitine. During recovery she again developed features of encephalopathy and had repeated convulsions associated with moderate hypertension. The diagnosis of posterior reversible encephalopathy syndrome was made on clinical and radiological grounds and she showed a gradual improvement with control of blood pressure. This report adds to the evidence behind treatment of valproate-induced acute liver failure with N-acetylcysteine and L-carnitine and illustrates a rare but interesting association between acute liver failure and posterior reversible encephalopathy syndrome.
Wilpart, Katarina; Törnblom, Hans; Svedlund, Jan; Tack, Jan F; Simrén, Magnus; Van Oudenhove, Lukas
Coping resources and processes are altered in patients with irritable bowel syndrome (IBS). We investigated the relationship between coping resources and gastrointestinal (GI) and extraintestinal symptom severity in patients with IBS and potential mediators of this relationship. We performed a cross-sectional study of 216 patients with IBS attending a secondary/tertiary care specialized outpatient center in Sweden from 2003 through 2007. We collected data on coping resources, levels of anxiety (general and GI specific), depressive symptoms, levels of GI symptoms, and extraintestinal somatic symptoms (somatization) by administering validated self-report questionnaires. General Linear Models were used to assess associations and mediation. GI symptoms: low levels of physical coping resources (practice of activities that are beneficial for health; P = .0016), high levels of general anxiety symptoms (P = .033), and GI-specific anxiety symptoms (P Somatization: low levels of physical coping resources (P = .003), high levels of anxiety (P = .0147), depressive (P = .0005), and GI-specific anxiety symptoms (P = .06) were associated with somatization levels (R2 = 0.35). Levels of general and GI-specific anxiety and depressive symptoms partially mediated this physical coping effect. The effect of psychological coping resources (including optimism, social support, and accepting/expressing emotions) on somatization levels was not significant (P = .98), but was fully mediated by levels of anxiety and depressive symptoms, and partially by levels of GI-specific anxiety symptoms. In a cross-sectional study of patients with IBS in Sweden, we found associations of levels of coping resources with GI and extraintestinal symptom severity; these associations were mediated by levels of anxiety and depressive symptoms. Although confirmation in longitudinal studies is needed, this identifies coping as a potential psychological treatment target in IBS. Copyright © 2017 AGA
Full Text Available Background: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders that affect both genders in different ages, but its prevalence is higher in women. Because of perceived stress are very important factors in development of symptoms, the current study aimed to determine the effectiveness of group mindfulness based stress reduction consultation on severity of physical symptoms in women with irritable bowel syndrome. Methods: This semi-experimental study was conducted on 30 women with irritable bowel syndrome referred to one of the educational hospitals in Zahedan in 2015. 30 patients were selected conveniently and then were randomly allocated into two intervention and control groups. The intervention group was received the 8 sessions (each session 90-minutes educational program. Data were collected through the IBS Symptom Severity Scale before and one week after the intervention. Data analysis was done through using SPSS 20, chi-square, independent T-test, paired T-test and ANCOVA. Results: The mean of physical symptoms severity before the intervention in intervention and control groups was 309.46 ± 32.19 and 304.01 ± 34.01 respectively that after the intervention were changed to 228.60 ± 13.56 in intervention (p = 0.001 and 299.80 ± 15.72 in control group (p = 0.8 The result of ANCOVA test showed that there was significant differences between the two groups after the intervention (p = 0.001. Conclusion: Group mindfulness based stress reduction method can be used to reduce severity of physical symptoms in women with irritable bowel syndrome. The application of this method in order to improve the symptoms of stress in other diseases is recommended.
Full Text Available Background and Objective: Irritable bowel syndrome is one of the most common functional gastrointestinal disorders that affect both genders in different ages, but its prevalence is higher in women. Because of perceived stress are very important factors in development of symptoms, the current study aimed to determine the effectiveness of group mindfulness based stress reduction consultation on severity of physical symptoms in women with irritable bowel syndrome. Materials and Method: This semi-experimental study was conducted on 30 women with irritable bowel syndrome referred to one of the educational hospitals in Zahedan in 2015. 30 patients were selected conveniently and then were randomly allocated into two intervention and control groups. The intervention group was received the 8 sessions (each session 90-minutes educational program. Data were collected through the IBS Symptom Severity Scale before and one week after the intervention. Data analysis was done through using SPSS 20, chi-square, independent T-test, paired T-test and ANCOVA. Results: The mean of physical symptoms severity before the intervention in intervention and control groups was 309.46±32.19 and 304.01±34.01 respectively that after the intervention were changed to 228.6±13.56 in intervention (p=0.001 and 299.8±15.72 in control group (p=0.8 The result of ANCOVA test showed that there was significant differences between the two groups after the intervention (p=0.001 Conclusion: Group mindfulness based stress reduction method can be used to reduce severity of physical symptoms in women with irritable bowel syndrome. The application of this method in order to improve the symptoms of stress in other diseases is recommended
Sullivan, Karen A; Edmed, Shannon L
To investigate the good-old-days bias, a psychosocial factor associated with post-concussion syndrome (PCS). Repeated measures comparison of PCS symptoms reported 6 months prior (retrospectively) and currently. A non-clinical sample was used to determine if this bias is a general recall bias. Fifty-seven university students with no history of brain injury or neurological disease completed the British Columbia Post-concussion Symptom Inventory. Symptoms were reported on two occasions, spaced 1 week apart, commencing with current symptoms. Using PCS symptom frequency by severity product scores, there was no significant difference in the 13 PCS symptoms reported across occasions, nor the relevant summary score (p = 0.199). These data do not support the presence of a general recall bias. However, significant differences emerged when analysed using a simple count of the total number of endorsed symptoms (p = 0.002, d = 0.39, small-to-medium effect) or the sample percentage that endorsed each symptom (four symptoms were endorsed by fewer participants retrospectively than currently). There is only weak evidence of a general recall bias in this non-clinical sample. Further consideration of the methods used to study this bias and its role clinically is needed.
Postpolio syndrome is a disorder related to the recurrence of neuromuscular symptoms in survivors of paralytic poliomyelitis. A comprehensive understanding of the pathophysiology is necessary for the anesthesia provider to develop a safe anesthetic plan. This case report discusses the anesthetic challenges and considerations in patients with postpolio syndrome, focusing on the importance of careful pharmacologic dosing of opioids, and neuromuscular agents as well as perioperative and postoperative issues related to aspiration risks, cold intolerance, and positioning.
Perry, Melissa E O; Almaani, Noor; Desai, Nemesha; Larbalestier, Nick; Fox, Julie; Chilton, Daniella
This case report describes two severe antiretroviral drug adverse reactions that occurred in the same patient. A 55-year-old HIV-positive African woman received a single epidural triamcinolone injection for pain relief of postherpetic neuralgia. Forty-one days later, she developed severe iatrogenic Cushing's syndrome due to the drug-drug interaction between triamcinolone and her boosted protease inhibitor therapy. The patient's antiretroviral regimen was thus changed to replace her protease inhibitor with the integrase inhibitor raltegravir. Shortly after commencing the drug, the patient developed a severe adverse drug reaction manifesting as Drug Reaction (or Rash) with Eosinophilia and Systemic Symptoms (DRESS) syndrome. First described in 1996, this hypersensitivity syndrome presents with severe skin reaction as well as fever, rash, lymphadenopathy and internal organ involvement with marked eosinophilia. Clinicians should be aware of raltegravir-induced DRESS syndrome as well as the potential for drug-drug interactions due to protease inhibitor-based therapy.
Ness, Kirsten K; Jones, Kendra E; Smith, Webb A; Spunt, Sheri L; Wilson, Carmen L; Armstrong, Gregory T; Srivastava, Deo Kumar; Robison, Leslie L; Hudson, Melissa M; Gurney, James G
To ascertain prevalence of peripheral sensory and motor neuropathy, and to evaluate impairments in relation to function. St. Jude Lifetime Cohort Study, a clinical follow-up study designed to evaluate adverse late effects in adult survivors of childhood cancer. A children's research hospital. Eligibility required treatment for an extracranial solid malignancy between 1962 and 2002, age ≥ 18 years, ≥ 10 years postdiagnosis, and no history of cranial radiation. Survivors (N=531) were included in the evaluation with a median age of 32 years and a median time from diagnosis of 25 years. Not applicable. Primary exposure measures were cumulative doses of vinca-alkaloid and platinum-based chemotherapies. Survivors with scores ≥ 1 on the sensory subscale of the Modified Total Neuropathy Score were classified with prevalent sensory impairment. Those with sex-specific z scores of ≤-1.3 for dorsiflexion strength were classified with prevalent motor impairment. Participants completed the 6-minute walk test (endurance), the Timed Up & Go test (mobility), and the Sensory Organization Test (balance). The prevalence of sensory and motor impairment was 20% and 17.5%, respectively. Vinca-alkaloid exposure was associated with an increased risk of motor impairment (adjusted odds ratio [OR]=1.66; 95% confidence interval [CI], 1.04-2.64) without evidence for a dose response. Platinum exposure was associated with increased risk of sensory impairment (adjusted OR=1.62; 95% CI, .97-2.72) without evidence of a dose response. Sensory impairment was associated with poor endurance (OR=1.99; 95% CI, .99-4.0) and mobility (OR=1.65; 95% CI, .96-2.83). Vincristine and cisplatin exposure may increase risk for long-term motor and sensory impairment, respectively. Survivors with sensory impairment are at increased risk for functional performance limitations. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Davidson, Karina W.; Rieckmann, Nina; Clemow, Lynn; Schwartz, Joseph E.; Shimbo, Daichi; Medina, Vivian; Albanese, Gabrielle; Kronish, Ian; Hegel, Mark; Burg, Matthew M.
Background Depressive symptoms are an established predictor of mortality and major adverse cardiac events (defined as nonfatal myocardial infarction or hospitalization for unstable angina or urgent/emergency revascularizations) in patients with acute coronary syndrome (ACS). This study was conducted to determine the acceptability and efficacy of enhanced depression treatment in patients with ACS. Methods A 3-month observation period to identify patients with ACS and persistent depressive symptoms was followed by a 6-month randomized controlled trial. From January 1, 2005, through February 29, 2008, 237 patients with ACS from 5 hospitals were enrolled, including 157 persistently depressed patients randomized to intervention (initial patient preference for problem-solving therapy and/or pharmacotherapy, then a stepped-care approach; 80 patients) or usual care (77 patients) and 80 nondepressed patients who underwent observational evaluation. The primary outcome was patient satisfaction with depression care. Secondary outcomes were depressive symptom changes (assessed with the Beck Depression Inventory), major adverse cardiac events, and death. Results At the end of the trial, the proportion of patients who were satisfied with their depression care was higher in the intervention group (54% of 80) than in the usual care group (19% of 77) (odds ratio, 5.4; 95% confidence interval [CI], 2.2–12.9 [P<.001]). The Beck Depression Inventory score decreased significantly more (t155=2.85 [P=.005]) for intervention patients (change, −5.7; 95% CI, −7.6 to −3.8; df=155) than for usual care patients (change, −1.9; 95% CI, −3.8 to −0.1; df=155); the depression effect size was 0.59 of the standard deviation. At the end of the trial, 3 intervention patients and 10 usual care patients had experienced major adverse cardiac events (4% and 13%, respectively; log-rank test, χ12=3.93 [P=.047]), as well as 5 nondepressed patients (6%) (for the intervention vs nondepressed
Freeman, Lyn W; White, Rebecca; Ratcliff, Chelsea G; Sutton, Sue; Stewart, Mary; Palmer, J Lynn; Link, Judith; Cohen, Lorenzo
This multi-site randomized trial evaluates the quality of life (QOL) benefits of an imagery-based group intervention titled 'Envision the Rhythms of Life'(ERL). Breast cancer survivors >6 weeks post-treatment were randomized to attend five weekly 4-h group sessions at a community center with therapist present (live delivery (LD), n = 48), therapist streamed via telemedicine (telemedicine delivery (TD), n = 23), or to a waitlist control (WL) group (n = 47). Weekly individual phone calls to encourage at-home practice began at session one and continued until the 3-month follow-up. Seven self-report measures of QOL were examined at baseline, 1-month and 3-month post-treatments including health-related and breast cancer-specific QOL, fatigue, cognitive function, spirituality, distress, and sleep. The Bonferroni method was used to correct for multiple comparisons, and alpha was adjusted to 0.01. Linear multilevel modeling analyses revealed less fatigue, cognitive dysfunction, and sleep disturbance for LD and TD compared with WL across the follow-up (p's live and telemedicine delivered ERL intervention resulted in improvements in multiple QOL domains for breast cancer survivors compared with WL. Further, there were no significant differences between LD and TD, suggesting telemedicine delivered ERL intervention may represent an effective and viable option for cancer survivors in remote areas. Copyright © 2014 John Wiley & Sons, Ltd.
Twisk, Frank NM
Although myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) are considered to be synonymous, the definitional criteria for ME and CFS define two distinct, partially overlapping, clinical entities. ME, whether defined by the original criteria or by the recently proposed criteria, is not equivalent to CFS, let alone a severe variant of incapacitating chronic fatigue. Distinctive features of ME are: muscle weakness and easy muscle fatigability, cognitive impairment, circulatory deficits, a marked variability of the symptoms in presence and severity, but above all, post-exertional “malaise”: a (delayed) prolonged aggravation of symptoms after a minor exertion. In contrast, CFS is primarily defined by (unexplained) chronic fatigue, which should be accompanied by four out of a list of 8 symptoms, e.g., headaches. Due to the subjective nature of several symptoms of ME and CFS, researchers and clinicians have questioned the physiological origin of these symptoms and qualified ME and CFS as functional somatic syndromes. However, various characteristic symptoms, e.g., post-exertional “malaise” and muscle weakness, can be assessed objectively using well-accepted methods, e.g., cardiopulmonary exercise tests and cognitive tests. The objective measures acquired by these methods should be used to accurately diagnose patients, to evaluate the severity and impact of the illness objectively and to assess the positive and negative effects of proposed therapies impartially. PMID:26140274
Horton, Jessica; Friedenstab, Steve
This article describes a special third-grade classroom unit based on the reality show "Survivor." The goal of this engaging and interactive unit was to teach students about physical and behavioral adaptations that help animals survive in various desert biomes. The activity combines research, argument, and puppet play over one week of…
Naheed, Bushra; Kuiper, Jan Herman; Uthman, Olalekan A; O'Mahony, Fidelma; O'Brien, Patrick Michael Shaughn
Premenstrual syndrome (PMS) is a psychological and somatic disorder of unknown aetiology, with symptoms typically including irritability, depression, mood swings, bloating, breast tenderness and sleep disturbances. About 3% to 10% of women who experience these symptoms may also meet criteria for premenstrual dysphoric disorder (PMDD). PMS symptoms recur during the luteal phase of the menstrual cycle and reduce by the end of menstruation. PMS results from ovulation and may be due to ovarian steroid interactions relating to neurotransmitter dysfunction. Premenstrual disorders have a devastating effect on women, their families and their work.Several treatment options have been suggested for PMS, including pharmacological and surgical interventions. The treatments thought to be most effective tend to fall into one of two categories: suppressing ovulation or correcting a speculated neuroendocrine anomaly.Transdermal oestradiol by patch, gel or implant effectively stops ovulation and the cyclical hormonal changes which produce the cyclical symptoms. These preparations are normally used for hormone therapy and contain lower doses of oestrogen than found in oral contraceptive pills. A shortened seven-day course of a progestogen is required each month for endometrial protection but can reproduce premenstrual syndrome-type symptoms in these women. To determine the effectiveness and safety of non-contraceptive oestrogen-containing preparations in the management of PMS. On 14 March 2016, we searched the following databases: the Cochrane Gynaecology and Fertility Group (CGF) Specialised Register; Cochrane Central Register of Studies (CRSO); MEDLINE; Embase; PsycINFO; CINAHL; ClinicalTrials.gov; metaRegister of Controlled trials (mRCT); and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) Search Portal. In addition, we checked the reference lists of articles retrieved. We included published and unpublished randomized placebo or active
Carbone, F; Vandenberghe, A; Holvoet, L; Vanuytsel, T; Van Oudenhove, L; Jones, M; Tack, J
A validated patient-reported outcome instrument is lacking for the functional dyspepsia/postprandial distress syndrome. To validate the Leuven Postprandial Distress Scale (LPDS). The LPDS diary, comprising eight symptoms with verbal descriptors rated for severity (0-4), was derived from focus groups and cognitive debriefing. It was used in a 2-week run-in, 8-week double-blind placebo-controlled trial of itopride 100 mg t.d.s. Results in 60 patients, with concealed treatment allocation, were used to analyse LPDS content validity, consistency, reliability and responsiveness. Patients also filled out Patient Assessment of Gastrointestinal Symptoms (PAGI-SYM), Nepean Dyspepsia Index, overall treatment evaluation and overall symptom severity questionnaires. Construct validity was evaluated by known-group analyses and by correlating LPDS with these additional questionnaires. Minimum Clinically Important Difference was determined from threshold changes in anchor questionnaires. Symptom patterns and factor analysis identified three cardinal symptoms of postprandial distress syndrome (early satiation, postprandial fullness, upper abdominal bloating), whose mean intensities generate weekly LPDS scores. Known-groups analysis showed large-effect-size differences in LPDS scores (Cohen's d = 2.16). Strong correlations (r > 0.57) between LPDS scores and relevant anchors at baseline indicate good convergent validity. Internal consistency of LPDS was good (α > 0.85) with high inter-item correlations (0.67-0.76), and test-retest reliability (r = 0.85). Changes in LPDS scores were highly convergent with changes in overall treatment evaluation, overall symptom severity and PAGI-SYM (r > 0.52). minimum clinically important difference analysis generated thresholds of 0.4-0.6. The Leuven Postprandial Distress Scale, which is supported by the European Medicines Agency, is a sensitive and reliable patient-reported outcome instrument to assess symptoms in the functional dyspepsia
Yang, Claire C; Lee, Jay C; Kromm, Brenda G; Ciol, Marcia A; Berger, Richard E
Male chronic pelvic pain syndrome (CPPS) is a chronic and debilitating symptom complex, and inconsistent outcomes of antibiotic and anti-inflammatory treatments have created an interest in investigating the neurological mechanisms of CPPS pain. Because chronic pelvic pain likely results in hyperexcitability of dorsal horn neurons, ie central sensitization, thermal algometry may be useful in the assessment of CPPS. We evaluated men with and without CPPS to determine if there were differences between the 2 groups in their responses to noxious heat stimuli. We recruited 66 healthy men without CPPS and 36 men with a history of CPPS for the study. Mean age of CPPS subjects was 43.1 years (range 18 to 62) and mean age of controls was 35.1 (range 21 to 61). All subjects with pain completed a National Institutes of Health-Chronic Prostatitis Symptom Index. We conducted thermal sensory tests with a small thermode programmed to deliver 2 series of 4 rapid bursts of noxious heat stimuli to the perineum and the anterior thigh. The subjects reported sensation on a computerized visual analog scale (COVAS) with a manual sliding lever. The average peak COVAS values and time to peak values from thigh and perineum of each series of thermal bursts were compared between CPPS and controls. The mean pain score on questionnaires was 9.7 (4 or greater indicating significant pain), mean urinary score was 4.7 (range 0 to 10) and mean quality of life impact score was 7.3 (range 3 to 13). Compared to controls men with CPPS reported higher mean peak COVAS values in the perineum. There was no difference between groups in the peak COVAS value on the thigh. Men with CPPS have altered heat sensation/pain sensitization in the perineum compared to controls. This finding is another that supports the resemblance of CPPS to other chronic pain syndromes and may help explain why CPPS is often refractory to treatment. Further investigations into male CPPS should focus on the mechanisms inducing and
Sonohara, Kazuki; Kozaki, Koichi; Akishita, Masahiro; Nagai, Kumiko; Hasegawa, Hiroshi; Kuzuya, Masafumi; Yokote, Koutaro; Toba, Kenji
White matter lesions (WML) are common findings on magnetic resonance imaging (MRI) in elderly persons. In this study, we analyzed the relation of WML with global cognitive function, depression, vitality/volition, and 19 symptoms of geriatric syndrome in Japanese elderly patients who attended three university geriatric outpatient clinics. Two hundred and eighty-six subjects (103 men and 183 women; mean +/- standard deviation age, 74.5 +/- 7.8 years) were included in this study. MRI scans were performed for the diagnosis of WML, and the severity of periventricular and deep white matter hyperintensities (PVH and DWMH) was rated semiquantitatively. Concurrently, all subjects underwent tests of cognitive function, depressive state and vitality, and were examined for 19 symptoms of geriatric syndrome. The study subjects showed cognitive decline, depression and low vitality, all to a mild extent. Univariate linear regression analysis showed a negative correlation between the severity of WML and cognitive function or vitality. Multiple logistic analysis revealed that the severity of WML was a significant determinant of cognitive impairment and low vitality, after adjustment for confounding factors such as age, sex and concomitant diseases. PVH and/or DWMH score was significantly greater in subjects who exhibited 13 out of 19 symptoms of geriatric syndrome. Logistic regression analysis indicated that WML were associated with psychological disorders, gait disturbance, urinary problems and parkinsonism. WML were associated with various symptoms of functional decline in older persons. Evaluating WML in relation to functional decline would be important for preventing disability in elderly people.
Bennett, Jeffrey A; Hodgetts, Sandra; Mackenzie, Michelle L; Haqq, Andrea M; Zwaigenbaum, Lonnie
Prader-Willi syndrome (PWS), a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD) symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2), the Social Communication Questionnaire (SCQ), Social Responsiveness Scale-2 (SRS-2), Social Skills Improvement System-Rating Scales (SSIS-RS), and the Vineland Adaptive Behavioral Scales-II (VABS-II). General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE) diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL) and eight uniparental disomy (UPD) (with a total of 6 female UPD cases). Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS) and observational assessment (ADOS-2) was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
Andrew H Miller
Full Text Available Reduced basal ganglia function has been associated with fatigue in neurologic disorders, as well as in patients exposed to chronic immune stimulation. Patients with chronic fatigue syndrome (CFS have been shown to exhibit symptoms suggestive of decreased basal ganglia function including psychomotor slowing, which in turn was correlated with fatigue. In addition, CFS patients have been found to exhibit increased markers of immune activation. In order to directly test the hypothesis of decreased basal ganglia function in CFS, we used functional magnetic resonance imaging to examine neural activation in the basal ganglia to a reward-processing (monetary gambling task in a community sample of 59 male and female subjects, including 18 patients diagnosed with CFS according to 1994 CDC criteria and 41 non-fatigued healthy controls. For each subject, the average effect of winning vs. losing during the gambling task in regions of interest (ROI corresponding to the caudate nucleus, putamen, and globus pallidus was extracted for group comparisons and correlational analyses. Compared to non-fatigued controls, patients with CFS exhibited significantly decreased activation in the right caudate (p = 0.01 and right globus pallidus (p = 0.02. Decreased activation in the right globus pallidus was significantly correlated with increased mental fatigue (r2 = 0.49, p = 0.001, general fatigue (r2 = 0.34, p = 0.01 and reduced activity (r2 = 0.29, p = 0.02 as measured by the Multidimensional Fatigue Inventory. No such relationships were found in control subjects. These data suggest that symptoms of fatigue in CFS subjects were associated with reduced responsivity of the basal ganglia, possibly involving the disruption of projections from the globus pallidus to thalamic and cortical networks.
Plata, M; Caicedo, J I; Trujillo, C G; Mariño-Alvarez, Á M; Fernandez, N; Gutierrez, A; Godoy, F; Cabrera, M; Cataño-Cataño, J G; Robledo, D
To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Jeffrey A. Bennett
Full Text Available Prader-Willi syndrome (PWS, a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2, the Social Communication Questionnaire (SCQ, Social Responsiveness Scale-2 (SRS-2, Social Skills Improvement System-Rating Scales (SSIS-RS, and the Vineland Adaptive Behavioral Scales-II (VABS-II. General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL and eight uniparental disomy (UPD (with a total of 6 female UPD cases. Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS and observational assessment (ADOS-2 was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
Altobelli, Emma; Del Negro, Valerio; Angeletti, Paolo Matteo; Latella, Giovanni
Irritable bowel syndrome (IBS) affects 7-15% of the general population. A recently devised dietary approach consists of restricting foods with highly fermentable oligo-, di-, and monosaccharides, and polyols (FODMAPs), which can trigger and/or exacerbate IBS symptoms. The aim of this study is to use meta-analysis to provide an update on the randomised control trials (RCTs) and cohort studies, and examine them separately in relation to diet type. Papers were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. Cohen's d and odds ratios were used as a measure of effect size for RCTs. A random effects model was used to account for different sources of variation among studies. Heterogeneity was assessed using Q statistics, I², Tau, and Tau². Publication bias was analysed and represented by a funnel plot, and funnel plot symmetry was assessed with Egger's test. The results showed that in the RCTs, the patients receiving a low-FODMAP diet experienced a statistically significant pain and bloating reduction compared with those receiving a traditional diet; as regards to stool consistency, there was no significant difference between treatments. A significant reduction in abdominal pain and bloating were described by patients receiving a low-FODMAP diet compared with those receiving a high-FODMAP diet. In cohort studies, pain and bloating were significantly reduced after treatment compared with the baseline diet. We conclude that there is evidence that a low-FODMAP diet could have a favourable impact on IBS symptoms, especially abdominal pain and bloating. However, it remains to be demonstrated whether a low-FODMAP diet is superior to conventional IBS diets, especially in the long term.
Zámecník, L; Hanus, T; Pavlík, I
Interstitial cystitis/Painful Bladder Syndrome (IC) is a chronic abacterial inflammatory disease of the bladder wall. It is accompanied by predominant neuropathic pain. Typical symptoms of IC include: suprapubic pain, bladder pain even between voiding, urgency, short intervals between micturition with frequency and nocturia. The objective of the study was to find a correlation between a symptom score and endoscopy together with histopathologic findings from the detrusor biopsy and a correlation between symptoms before and after the intravesical treatment. We have evaluated a group of 30 patients with newly diagnosed IC prospectively. These patients were in the group 1. Control group 2 consisted of 10 patients with asymptomatic bacteriuria. Group 3 consisted of 15 patients with no voiding symptoms. Validated questionnaire (O'Leary-Sant Symptom (ICSI) and Problem Index (ICPI) was used to objectify subjective symptoms. The diagnosis of IC was based on the clinical assessment of subjective symptoms, urodynamic results, endoscopy and histology. The efficacy of therapy was found statistically significant only in the intravesical therapy. In the patients with immunohistochemically identified increased numbers of mast cells per one microscopic field, the correlation with ICSI and ICPI score was statistically significant. Differences in symptom score in the patients before and after the treatment were found significantly higher after the intravesical (with heparin) treatment then after peroral therapy. Significant differences in the correlations of ICSI and ICPI score values with the histopathologic finding (i.e. number of mast cells) were found.
Robert, Jennifer J T; Orr, William C; Elsenbruch, Sigrid
The objective of this study was to determine how depressive symptoms affect autonomic activity during sleep, objective and subjective sleep, and gastrointestinal symptom severity in women with irritable bowel syndrome (IBS). Seventy women who met the Rome II criteria for IBS and 21 healthy volunteers participated. All participants were recruited from the surrounding community. IBS patients were stratified into two groups based on their Beck Depression Inventory II score and 44 IBS patients with depressive symptoms (IBS+DS) were compared to 26 IBS patients without depressive symptoms (IBS-DS). Autonomic activity was measured by heart rate variability (HRV) analysis. Fifteen-minute segments were selected from a baseline presleep period, stage 2, slow-wave sleep, and rapid-eye movement sleep for heart rate variability spectral analysis. Subjective sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI) and gastrointestinal symptom severity was assessed by an 18-item questionnaire. The IBS+DS group reported significantly (P sleep complaints, measured by the PSQI, than the IBS-DS group and healthy controls. The IBS+DS group took significantly (P activity during the baseline presleep period or sleep stages. The results demonstrated that IBS patients with significant depressive symptoms had increased gastrointestinal symptom severity, increased sleep complaints, and alterations in sleep architecture compared to healthy controls and IBS patients without significant depressive symptoms.
Mettananda, Sachith; Fernando, Asvini D; Ginige, Nimasari
Introduction Posterior reversible encephalopathy syndrome is an extremely rare radiological diagnosis that has not been reported previously in association with acute liver failure. Case presentation A 6-year-old Sri Lankan girl developed acute liver failure with severe hepatic encephalopathy due to sodium valproate. She was successfully treated medically with N-acetylcysteine and L-carnitine. During recovery she again developed features of encephalopathy and had repeated convulsions associate...
Le Guennec, Loïc; Brisset, Marion; Viala, Karine; Essardy, Fatiha; Maisonobe, Thierry; Rohaut, Benjamin; Demeret, Sophie; Bolgert, Francis; Weiss, Nicolas
Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS. © 2014 Peripheral Nerve Society.
Bulat, Evgeny; Maranho, Daniel A; Kalish, Leslie A; Millis, Michael B; Kim, Young-Jo; Novais, Eduardo N
The etiology of hip instability in Down syndrome is not completely understood. We investigated the morphology of the acetabulum and femur in patients with Down syndrome and compared measurements of the hips with those of matched controls. Computed tomography (CT) images of the pelvis of 42 patients with Down syndrome and hip symptoms were compared with those of 42 age and sex-matched subjects without Down syndrome or history of hip disease who had undergone CT for abdominal pain. Each of the cohorts had 23 male and 19 female subjects. The mean age (and standard deviation) in each cohort was 11.3 ± 5.3 years. The lateral center-edge angle (LCEA), acetabular inclination angle (IA), acetabular depth-width ratio (ADR), acetabular version, and anterior and posterior acetabular sector angles (AASA and PASA) were compared. The neck-shaft angle and femoral version were measured in the patients with Down syndrome only. The hips of the patients with Down syndrome were further categorized as stable (n = 21) or unstable (n = 63) for secondary analysis. The hips in the Down syndrome group had a smaller LCEA (mean, 10.8° ± 12.6° compared with 25.6° ± 4.6°; p Down syndrome cohort, the unstable hips showed greater femoral anteversion (mean, 32.7° ± 14.6° compared with 23.6° ± 10.6°; p = 0.002) and worse global acetabular insufficiency compared with the stable hips. No differences between the unstable and stable hips were found with respect to acetabular version (mean AVC, 7.8° ± 5.5° compared with 7.6° ± 3.8°; p = 0.93) and the neck-shaft angle (mean, 133.7° ± 6.7° compared with 133.2° ± 6.4°; p = 0.81). Patients with Down syndrome and hip-related symptoms had more retroverted and shallower acetabula with globally reduced coverage of the femoral head compared with age and sex-matched subjects. Hip instability among those with Down syndrome was associated with worse global acetabular insufficiency and increased femoral anteversion, but not with more severe
Full Text Available Abstract Background The onset and course of irritable bowel syndrome (IBS are strongly influenced by psychological factors, and treatment often includes cognitive-behavioral therapy. We conducted a study of the relationships between cognitive appraisal of IBS symptoms and negative mood for the subtypes of IBS. Method The participants were 1087 college students who completed a set of questionnaires that included the Rome II Modular Questionnaire, Self-reported IBS Questionnaire, Cognitive Appraisal Rating Scale, and the Hospital Anxiety and Depression Scale. Results The participants included 206 individuals with IBS; 61 had diarrhea-predominant IBS (IBSD and 45 had constipation-predominant IBS (IBSC. The overall IBS group scored higher on anxiety and depression than the control group. The IBSD and IBSC groups each had significantly higher scores for anxiety but did not significantly differ from the control group in scores for depression. There were no significant differences between the IBSD and IBSC groups in their cognitive appraisal of IBS symptoms. For the IBSD group, anxiety was significantly, positively correlated with commitment, effect, and threat, and depression was significantly, negatively correlated with controllability. In contrast, there were no significant correlations between mood and cognitive appraisal for the IBSC group. Multiple regression analyses with abdominal symptoms as dependent variables and cognitive appraisals as independent variables showed that for the IBSD group, abdominal pain was significantly, positively correlated with commitment, and abdominal discomfort was significantly, positively correlated with appraisal of effect and threat. For the IBSC group, abdominal pain and hard stool were significantly, positively correlated with commitment, and abdominal discomfort was significantly, positively correlated with appraisal of effect and threat. Conclusion IBS patients as a general group report high levels of anxiety
an individual patient’s genetic vulnerability. Due to a possible clinical endophenotype presenting as comorbidity of ASD and GI disorders, we propose treating this situation as an “overlap syndrome”. Practical use of the concept of an overlap syndrome of ASD and GI disorders may help in identifying those children with ASD who suffer from an alimentary tract disease. Unexplained worsening of nonverbal behaviors (agitation, anxiety, aggression, self-injury, sleep deprivation should alert professionals about this possibility. This may shorten the time to diagnosis and treatment commencement, and thereby alleviate both GI and ASD symptoms through reducing pain, stress, or discomfort. Furthermore, this may also protect children against unnecessary dietary experiments and restrictions that have no medical indications. A personalized approach to each patient is necessary. Our understanding of ASDs has come a long way, but further studies and more systematic research are warranted. Keywords: epigenetics, dysautonomia, food allergy, gluten-related disorders, gut-brain axis, microbiome
Khan, Nadia A; Daskalopoulou, Stella S; Karp, Igor; Eisenberg, Mark J; Pelletier, Roxanne; Tsadok, Meytal Avgil; Dasgupta, Kaberi; Norris, Colleen M; Pilote, Louise
Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients. Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged ≤55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013). Prodromal symptoms were determined using the McSweeney Acute and Prodromal Myocardial Infarction Symptom questionnaire. Health-seeking behaviour and prehospital care were determined by questionnaires. The median age was 49 years. The prevalence of prodromal symptoms was high and more women reported symptoms than men (85% vs 72%, p<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low (≤40%) in all patients and less than half perceived their care provider suspected a cardiac source. Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Hanson, Maureen R; Gu, Zhenglong; Keinan, Alon; Ye, Kaixiong; Germain, Arnaud; Billing-Ross, Paul
Earlier this year, we described an analysis of mitochondrial DNA (mtDNA) variants in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) patients and healthy controls. We reported that there was no significant association of haplogroups or singe nucleotide polymorphisms (SNPs) with disease status. Nevertheless, a commentary about our paper appeared (Finsterer and Zarrouk-Mahjoub. J Transl Med14:182, 2016) that criticized the association of mtDNA haplogroups with ME/CFS, a conclusion that was absent from our paper. The aforementioned commentary also demanded experiments that were outside of the scope of our study, ones that we had suggested as follow-up studies. Because they failed to consult a published and cited report describing the cohorts we studied, the authors also cast aspersions on the method of selection of cases for inclusion. We reiterate that we observed statistically significant association of mtDNA variants with particular symptoms and their severity, though we observed no association with disease status.
Şimşek, Zahide; Tuncer, Nazife Candan; Alagüzlü, Hakan; Karaahmet, Fatih; Çoban, Şahin; Dursun, Ayşe
Irritable bowel syndrome (IBS) is a gastrointestinal condition characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any organic cause. This trial investigated the presence of microscopic colitis (MC) and associated factors related to MC in patients diagnosed with IBS. The study group (group I) consisted of 91 consecutive patients diagnosed with IBS based on the Rome III Criteria for whom colonoscopic examination was requested. The control group (group II) had 41 patients diagnosed with IBS considered as eligible for colonoscopic investigation due to specific conditions, and for whom colonoscopic examination was recommended for screening purposes due to a familial history of colon cancer. Clinical data, endoscopic findings, and the effects of the therapy were evaluated. In the diarrhea-predominant IBS group, nine patients (9.89%) were diagnosed with microscopic colitis, seven with lymphocytic colitis (7.69%), and two with collagenous colitis (CC) (2.19%). None of the patients in group II were found to have MC (P = 0.007). There were no diagnoses of MC in the constipation-predominant and mixed type IBS groups. Clinicians should keep MC in mind for patients presenting with diarrhea-predominant IBS symptoms.
Taisne, Nicolas; Desnuelle, Claude; Juntas Morales, Raul; Ferrer Monasterio, Xavier; Sacconi, Sabrina; Duval, Fanny; Sole, Guilhem; Flipo, René Marc; Lacour, Arnaud; Vermersch, Patrick; Cardon, Thierry
Late-onset Pompe disease (LOPD) is a rare disorder characterized by progressive proximal muscle weakness and early respiratory insufficiency, for which enzyme replacement therapy (ERT) is available. Having diagnosed a case of LOPD presenting with bent spine syndrome, we conducted a brief survey in the French centers involved in management of Pompe disease, from which we collected data on 3 other cases. The patients (3 women and 1 man) had a mean age of 64 years (range 51-77 years) and a delay in diagnosis of approximately 10 years (range 8-42 years). At diagnosis, 3 patients already had respiratory symptoms. All had normal or very mildly raised creatine kinase levels and magnetic resonance imaging abnormalities in the paraspinal muscles. They exhibited the most frequent mutation in Pompe disease (c.-32-13 T>G). Clinicians should be aware of this atypical presentation of LOPD to enable earlier diagnosis and treatment. Muscle Nerve 56: 167-170, 2017. © 2016 Wiley Periodicals, Inc.
Eun Joo Yang
Full Text Available The purpose of this study is to assess health-related quality of life in polio survivors (PS compared with that in the general population in Korea. Polio survivors (n = 120 from outpatient clinics at two hospitals, healthy controls (HC, n = 121 and members of the general population with activity limitations (AL, n = 121 recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions. The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI and Short Physical Performance Battery (SPPB were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.
Pedersen, A.M.; Reibel, J.; Nauntofte, Birgitte
autoantibodies, Sjögren's syndrome, saliva flow, labial salivary gland biopsy, rating scales biopsy, rating scales......autoantibodies, Sjögren's syndrome, saliva flow, labial salivary gland biopsy, rating scales biopsy, rating scales...
Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97
Van Oudenhove, L; Vandenberghe, J; Vos, R; Holvoet, L; Tack, J
It is unclear which factors explain the high co-morbidity between functional dyspepsia (FD) and other functional somatic syndromes. The aim of this study is to investigate the association between gastric sensorimotor function, psychosocial factors and 'somatization' on the one hand, and co-morbid irritable bowel syndrome (IBS) and chronic fatigue (CF)-like symptoms on the other, in FD. In 259 tertiary care FD patients, we studied gastric sensorimotor function with barostat (sensitivity, accommodation). We measured psychosocial factors (abuse history, alexithymia, trait anxiety, depression, panic disorder) and 'somatization' using self-report questionnaires, and presence of IBS and CF-like symptoms. Hierarchical multiple logistic regression was used to determine which of these factors were independently associated with co-morbid IBS and CF-like symptoms, including testing of potential mediator effects. Co-morbid IBS or CF-like symptoms respectively were found in 142 (56.8%) and 102 (39.4%) patients; both co-morbidities were not significantly associated (P=0.27). Gastric accommodation (β=0.003, P=0.04) and 'somatization' (β=0.17, P= 0.0003) were independent risk factors for IBS (c=0.74, Prisk factors for CF-like symptoms (c=0.83, Plifetime abuse were mediated by depression and 'somatization', respectively. 'Somatization' is a common risk factor for co-morbid IBS and CF-like symptoms in FD and mediates the effect of abuse. Gastric sensorimotor function and depression are specific risk factors for co-morbid IBS and CF-like symptoms, respectively. © 2011 Blackwell Publishing Ltd.