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... at increased risk for having type 2 diabetes . Gestational Diabetes Women with gestational diabetes often have no symptoms , which is why it's ... the proper time during pregnancy. Learn more about gestational diabetes. Symptoms of Diabetes Complications Have you already been ...
... Advanced MS Pediatric MS Related Conditions Symptoms In multiple sclerosis , damage to the myelin in the central nervous ... Depression Depression is common during the course of multiple sclerosis. In fact, studies have suggested that clinical depression, ...
Vandforsyning er blevet et vigtigt interventionsområde for staten i udvik- lingslande. 'Sikker' vandforsyning har erstattet 'rørlagt' vandforsyning som begrundelse for interventioner, og overvejelser om et utilstrækkeligt serviceniveau og en utilstrækkelig dækningsgrad for serviceydelser er kom- met i forgrunden. Dette rationale er blevet så centralt for de organer, der er involveret i vand- og sanitetsforsyningen, at det er blevet en selvindlysende
The purpose of the present research was to identify rates of posttraumatic stress and depressive symptoms in soldiers returning from war. During reintegration training, U.S. Army soldiers, who recently returned from a 12-month deployment to either Iraq (Operation Iraqi Freedom, n = 2,275) or Afghanistan (Operation Enduring Freedom, n = 1,814), completed study materials. Surveys assessed self-reported levels of depression,
Coady B. Lapierre; Andria F. Schwegler; Bill J. LaBauve
This clinical report describes symptoms of psychological and physical distress and psychiatric disorders in 24 Army Reservists who served war zone graves registration duty in support of Operation Desert Storm. Troops underwent comprehensive assessment for evidence of psychopathology that might be associated with war zone duty as one component of a debriefing protocol scheduled during regular drill exercises eight months
Patricia B. Sutker; Madeline Uddo; Kevin Brailey; Albert N. Allain; Paul Errera
An epidemiological investigation regarding the ocular symptoms of 213 subjects working in the operating theatres of a hospital of the eastern Sicily was conducted. Information was gathered via a questionnaire designed to identify the ocular symptoms that occurred most frequently during working hours in the operating theatre. The questionnaire was administered by a specialist in Occupational Health, before any decision was made to investigate the indoor air quality. The microclimate parameters (temperature, relative humidity, number of air changes/hour, air velocity, illumination levels) of the operating theatres were also studied. The results of the epidemiological investigation showed that 154 subjects out of 213 (72.3%) reported a lack of eye comfort. The most frequently reported symptoms were fatigue (35.21%) and heaviness (34.27%), followed by burning (25.82%), redness (25.35%), lacrimation (17.84%), itching (2%), blinking (20%), foreign body sensation (19%) and photophobia (10%). The study of the indoor climate of the operating theatres showed that the number of air changes/hour and illumination level were not consistent with those recommended by the Italian Regulatory Authority. Others parameters were considered to be satisfactory. The Authors conclude that the low illumination level may be responsible for the high percentage of subjects suffering from eye fatigue and heaviness. The ineffective rate of room air exchange, possibly interacting with chemicals and aerosols, is thought to be responsible for the other ocular symptoms experienced by the workers. The present study suggests that the operating theatre environment might be a cause of the ocular discomfort often complained of by health care workers. Further studies are needed in this area. PMID:10920620
Fenga, C; Cacciola, A; Grillo, O C; Anzalone, C; Germanò, D
The report describes conditions related to the 30 wood-chip fired district heating plants operating in Denmark at the beginning of 1994. The aim was to produce a survey of the technical installations as an aid to the establishment of future plants and to ...
Carl von Clausewitz deler krigsbegrebet op i abstrakt og virkelig krig. Den abstrakte krig eskalerer eksplosivt og grænseløst og efterlader den ene part værgeløs. Med en række virkelighedsnære modifikationer justerer Clausewitz den abstrakte krig, så der skabes en logisk forbindelse mellem abstrakt og virkelig krig. Således påviser Clausewitz, at virkelige krige standser, inden de når den abstrakte krigs ekstreme sluttilstand.
A cross-sectional study of work-related symptoms and cotton dust exposure was made in 404 man-made fiber and 1,048 cotton operatives in Lancashire spinning mills; 39 cotton-exposed operatives (3.7%) had symptoms of byssinosis. This was associated on regression analysis with cumulative lifetime cotton dust exposure (p < 0.001), total years spent carding (p < 0.001), and currently working in the carding area (p = 0.0041). Smoking habit did not differ significantly between byssinotic and nonbyssinotic workers. Other work-related symptoms were common: chronic bronchitis (CB) and persistent cough. The prevalence of CB correlated positively with dust exposure (r = 0.59). Cotton dust sampling was performed in the work area (SDPRES) and personal breathing zone (PD1). A retrospective estimate of lifetime cotton dust exposure based on SDPRES correlated best with the prevalence of byssinosis (r = 0.797), although correlations with PD1 (r = 0.709) and SDPRES (r = 0.594) were also significant. PMID:8049827
Fishwick, D; Fletcher, A M; Pickering, C A; Niven, R M; Faragher, E B
Burnout symptoms, which are characterized by exhaustion, cynicism, and a reduced sense of professional efficacy, may deleteriously affect cognitive function in military personnel. A total of 32 U.S. Military Special Operations personnel enrolled in Survival School completed measures of trauma history, dissociation, and burnout before training. They then completed the Groton Maze Learning Test (GMLT), a neuropsychological measure of integrative visuospatial executive function during three field-based phases of Survival School-enemy evasion, captivity/interrogation, and escape/release from captivity. Lower pre-training perceptions of professional efficacy were associated with reduced executive function during all of the field-based phases of Survival School, even after adjustment for years of education, cynicism, and baseline GMLT scores. Magnitudes of decrements in executive function in Marines with low efficacy relative to those with high efficacy increased as training progressed and ranged from .58 during enemy evasion to .99 during escape/release from captivity. Pre-training perceptions of burnout may predict visuospatial executive function during naturalistic training-related stress in military personnel. Assessment of burnout symptoms, particularly perceptions of professional efficacy, may help identify military personnel at risk for stress-related executive dysfunction. (JINS, 2011, 17, 1-8). PMID:21466738
Morgan, Charles A; Russell, Bartlett; McNeil, Jeff; Maxwell, Jeff; Snyder, Peter J; Southwick, Steven M; Pietrzak, Robert H
splittelse - dog splittelse uden at sætte navn på, hvad det var for en splittelse. Trods opfattelsen af apartheid som baseret på en racelogisk form for social diff erentiering, efterlod systemet også andre kløfter, herunder klasseforskelle, etniske brudfl ader, marginalisering på grund af køn, uddannelseskløfter, forskelle mellem land og by osv. Den institutionelle løsning på denne forskelsproblematik blev etableringen af
|The present study examined the utility of the anhedonic depression scale from the Mood and Anxiety Symptoms Questionnaire (MASQ-AD scale) as a way to screen for depressive disorders. Using receiver-operating characteristic analysis, we examined the sensitivity and specificity of the full 22-item MASQ-AD scale, as well as the 8- and 14-item…
Bredemeier, Keith; Spielberg, Jeffery M.; Silton, Rebecca Levin; Berenbaum, Howard; Heller, Wendy; Miller, Gregory A.
Background: Post-concussive syndrome (PCS), which includes physical, neurological and cognitive complaints, frequently occurs following mild traumatic brain injury (TBI). Research in civilian populations has demonstrated PCS symptom recovery over the cour...
A. J. MacGregor A. L. Dougherty J. J. Tang M. R. Galarneau
Background Persisting abdominal complaints are common after an episode of diverticulitis treated conservatively. Furthermore, some patients develop frequent recurrences. These two groups of patients suffer greatly from their disease, as shown by impaired health related quality of life and increased costs due to multiple specialist consultations, pain medication and productivity losses. Both conservative and operative management of patients with persisting abdominal complaints after an episode of diverticulitis and/or frequently recurring diverticulitis are applied. However, direct comparison by a randomised controlled trial is necessary to determine which is superior in relieving symptoms, optimising health related quality of life, minimising costs and preventing diverticulitis recurrences against acceptable morbidity and mortality associated with surgery or the occurrence of a complicated recurrence after conservative management. We, therefore, constructed a randomised clinical trial comparing these two treatment strategies. Methods/design The DIRECT trial is a multicenter randomised clinical trial. Patients (18-75 years) presenting themselves with persisting abdominal complaints after an episode of diverticulitis and/or three or more recurrences within 2 years will be included and randomised. Patients randomised for conservative treatment are treated according to the current daily practice (antibiotics, analgetics and/or expectant management). Patients randomised for elective resection will undergo an elective resection of the affected colon segment. Preferably, a laparoscopic approach is used. The primary outcome is health related quality of life measured by the Gastro-intestinal Quality of Life Index, Short-Form 36, EQ-5D and a visual analogue scale for pain quantification. Secondary endpoints are morbidity, mortality and total costs. The total follow-up will be three years. Discussion Considering the high incidence and the multicenter design of this study, it may be assumed that the number of patients needed for this study (n = 214), may be gathered within one and a half year. Depending on the expertise and available equipment, we prefer to perform a laparoscopic resection on patients randomised for elective surgery. Should this be impossible, an open technique may be used as this also reflects the current situation. Trial Registration (Trial register number: NTR1478)
Det norske nordområdeinitiativet overfor USA inneholder i betydelig grad et budskap om Barentshavet som viktig fremtidig energiprovins som kan øke global og amerikansk energisikkerhet og er dermed basert på utenrikspolitiske fremfor energipolitiske hensyn. Dette har brakt til overfl aten interne interessemotsetnin- ger i den norske forvaltningen og gitt seg utslag i uklarhet og inkonsistens i norsk interaksjon med amerikansk utenriks-
Roux-en-Y patients have symptoms that vary from almost none to inability to tolerate oral feedings. This study was designed to determine whether there is a relationship between a patient's symptoms and the function of the gastric remnant or the Roux-limb. Gastric remnant and Roux-limb emptying were studied in eight patients with technetium-99m-labeled oatmeal and Roux-limb motor activity was measured with a water-perfused manometry system. We found that gastric emptying was rarely significantly slowed, but emptying of the Roux-limb was delayed in several patients. We also found that there was a rough correlation between the patient's symptoms and the degree of abnormal motility found in the Roux-limb. There is no known reason for these abnormalities in Roux-limb function in some patients after a Roux-en-Y, but our finding of worse abnormalities in those who had multiple previous gastric surgeries suggests that the symptoms and dysfunction may be related to the number of surgeries, as well as to the type of surgery.
BACKGROUND: Persisting abdominal complaints are common after an episode of diverticulitis treated conservatively. Furthermore, some patients develop frequent recurrences. These two groups of patients suffer greatly from their disease, as shown by impaired health related quality of life and increased costs due to multiple specialist consultations, pain medication and productivity losses. Both conservative and operative management of patients with persisting
Bryan JM van de Wall; Werner A Draaisma; Esther CJ Consten; Yolanda van der Graaf; Marten H Otten; G de Wit; Henk F van Stel; Michael F Gerhards; Marinus J Wiezer; Huib A Cense; Hein BAC Stockmann; Jeroen WA Leijtens; David DE Zimmerman; Eric Belgers; Bart A van Wagensveld; Eric DJA Sonneveld; Hubert A Prins; Peter PLO Coene; Tom M Karsten; Joost M Klaase; Markwin G Statius Muller; Rogier MPH Crolla; Ivo AMJ Broeders
Background In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks). The identified patterns were in accordance with neural afflictions at three specific locations (brachial plexus at chord level, posterior interosseous and median nerve on elbow level). We have introduced an intervention program aiming to mobilize nerves at these locations and tested its efficacy. Methods 125 and 59, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course at least three times during workdays in a six month period. Subjects from the other division served as controls. At the end of the intervention both groups were invited to a second identical evaluation by questionnaire and physical examination. Symptoms and findings were studied in the right upper limb. Perceived changes of pain were recorded and individual and patterns of physical findings assessed for both groups at baseline and at follow-up. In subjects with no or minimal preceding pain we additionally studied the relation of incident pain to the summarized findings for parameters contained in the definition of nerve affliction at the three locations. Results Summarized pain was significantly reduced in the intervention group but unchanged in controls. After the intervention, fewer neurological abnormalities in accordance with nerve affliction were recorded for the whole material but no conclusion could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve affliction. Conclusion A six month course of stretching seems to reduce upper limb symptoms in computer operators but we could not demonstrate an influence on neurological physical findings in this sample. The relation of incident symptoms to identified neurological patterns provides additional support to the construct validity of the employed neurological examination.
An association between a quantitative measure of tactile acuity at the fingertips and symptoms of reduced manipulative function, as established by responses to a questionnaire, was demonstrated in a population of 81 manual workers from the mining industry (62 power-tool operators and 19 nonusers). Mechanoreceptor-specific vibrotactile thresholds were determined for the slowly adapting type I (SAI) and fast-adapting types I and II (FAI and FAII) receptors at the fingertip of the third digit of each hand. Statistically significant threshold shifts in SAI and/or FAII acuity were found in persons responding affirmatively to questions concerning finger/hand numbness, blanching, and difficulty buttoning clothing. The best predictors of a quantitative change in tactile acuity were questions relating to difficulty manipulating small objects and buttoning clothing, yielding positive predictive values of from 90% to 100% and false positive rates of from 0% to 2.8%. The demonstration of an association between a quantitative measure of tactile acuity at the fingertips and some symptom reports, obtained by means of a questionnaire, provides the basis for the development of a screening procedure for persons at risk of such disturbances in hand function. PMID:9330148
En af de forudsigelser, der har domineret mediebilledet og skabt mest debat de senere år, er klimaforandringerne. Klimadebatten har de seneste år for alvor bredt sig fra universiteterne ud i stuerne bl.a. på grund af tidligere vicepræsident Al Gores An Inconvenient Truth (2006), hvor Al Gore tegner en dystopisk forestilling om fremtiden på baggrund af de klimaforandringer, som kloden ifølge
In current military operations in Iraq and Afghanistan, US National Guard (NG) troops are serving longer deployments than ever before. Little is known, however, about how such deployments affect this population of individuals, relative to active component (AC) troops. This study investigated the extent of combat exposure, severity of post-deployment psychological symptoms, and general interpersonal functioning, as well as the
Keith D. Renshaw; Camila S. Rodrigues; David H. Jones
Scientist K.R. Sridhar and a twenty-member research team at the University of Arizona Aerospace and Mechanical Engineering (AME) Department are building an Oxygen Generating Subsystem (OGS). This unit is set to be launched into Martian atmosphere in January 2002. When the system is on Mars, it will "suck in Martian atmospheric gases--predominantly carbon dioxide--and process them to produce pure oxygen." The website is of the Oxygen Generator System at the University of Arizona. This site provides more information about the system as well as the team of scientists.
This paper presents the development and application of methodology used in analytical validation of emergency operating procedures (EOPs) for Kozloduy Nuclear Power Plant (KNPP), VVER-1000\\/V320 units. EOPs provide generic guidance to a reactor plant operator in maneuvering the plant to a safe, stable condition in the event of an unexpected plant transient or emergency. These procedures have been analytically validated
The Centro di Ricerche Sismologiche (CRS, Seismological Research Center) of the Istituto Nazionale di Oceanografia e di Geofisica Sperimentale - OGS (Italian National Institute for Oceanography and Experimental Geophysics) in Udine (Italy) after the strong earthquake of magnitude Mw = 6.4 occurred in 1976 in the Italian Friuli-Venezia Giulia region, started to operate the Northeastern Italy Seismic Network: it currently consists of 12 very sensitive broad band and 21 simpler short period seismic stations, all telemetered to and acquired in real time at the OGS-CRS data centre in Udine. Real time data exchange agreements in place with other Italian, Slovenian, Austrian and Swiss seismological institutes lead to a total number of 93 seismic stations acquired in real time, which makes the OGS the reference institute for seismic monitoring of Northeastern Italy, as shown in Fig. 1 (Bragato et al., 2011; Saraò et al., 2010). Since 2002 OGS-CRS is using the Antelope software suite as the main tool for collecting, analyzing, archiving and exchanging seismic data, initially in the framework of the EU Interreg IIIA project "Trans-national seismological networks in the South-Eastern Alps" (Bragato et al., 2010; Pesaresi et al., 2008). SeisComP is also used as a real time data exchange server tool. In order to improve the seismological monitoring of the Northeastern Italy area, at OGS-CRS we tuned existing programs and created ad hoc ones like: a customized web server named PickServer to manually relocate earthquakes, a script for automatic moment tensor determination, scripts for web publishing of earthquake parametric data, waveforms, state of health parameters and shaking maps, noise characterization by means of automatic spectra analysis, and last but not least scripts for email/SMS/fax alerting. A new OGS-CRS real time seismological website (http://rts.crs.inogs.it/) has also been operative since several years.
Bragato, P. L.; Pesaresi, D.; Saraò, A.; Di Bartolomeo, P.; Durì, G.
Operation Enduring Freedom and Operation Iraqi Freedom combat veterans given definite diagnoses of mild Traumatic Brain Injury (TBI) during the Veteran Health Administration (VHA) Comprehensive TBI evaluation and reporting no post-deployment head injury were examined to assess (a) consistency of self-reported memory impairment and (b) symptom validity test (SVT) performance via a two-part study. Study 1 found that while 49 of 50 veterans reported moderate to very severe memory impairment during the VHA Comprehensive TBI evaluation, only 7 had reported any memory problem at the time of their Department of Defense (DOD) post-deployment health assessment. Study 2 found that of 38 veterans referred for neuropsychological evaluations following a positive VHA Comprehensive TBI evaluation, 68.4% failed the Word Memory Test, a forced choice memory recognition symptom validity task. Together, these studies raise questions concerning the use of veteran symptom self-report for TBI assessments and argue for the inclusion of SVTs and the expanded use of contemporaneous DOD records to improve the diagnostic accuracy of the VHA Comprehensive TBI evaluation. PMID:23059350
Incomplete injuries (grade I or II) to the medial collateral ligament (MCL) of the knee are common and usually self limiting. Some patients complain of chronic medial knee pain following injury. We highlight the importance of anatomical investigation of these patients and evaluate a successful treatment technique. A consecutive case series of 34 patients with chronic pain following grade I/II MCL injury were reviewed. Injury prevented sporting activity, and examination revealed thickening and tenderness of the MCL. The knee was assessed by MRI. All patients had radiological evidence of injury to the superficial and deep MCL, with thickening, scarring and tearing. Patients were treated with ultrasound guided injection of local anaesthetic and steroid into the deep MCL and clinically reassessed. They were allowed to return to sport immediately. They were assessed for recurrence of symptoms with a postal questionnaire. Four were excluded from follow up. Four were lost. All patients reported an immediate and sustained resolution their medial knee pain. At mean follow up of 20.4 months (range 11-38 months) all were back to their pre-injury level of work. Twenty five (96%) had immediate and sustained return to sporting activity. Twenty one (81%) reported no change in level of sporting function. In patients with persistent medial joint pain following grade I/II MCL sprain, pain from the deep MCL must be considered. MRI will confirm the diagnosis, exclude coexistent pathology and localise the lesion within the deep MCL. A single corticosteroid injection provides an excellent clinical outcome 20 months post injection. PMID:18938083
Jones, Luke; Bismil, Quamar; Alyas, Faisal; Connell, David; Bell, Jonathan
To determine whether a standard operating procedure (SOP) for prehospital management of patients with the acute coronary syndrome (ACS) improves the quality of patient care in terms of adherence to treatment guidelines of the European Society of Cardiology. Among a total of 1025 patient medical records collected from a period before and after the introduction of the SOP, 269 records included the working diagnosis of ACS and were then reviewed for guideline adherence. Most aspects of patient evaluation, monitoring, treatment, and hospital allocation were fairly guideline adherent (>70%) before the SOP was introduced and were not affected by the SOP. The percentage of cases in whom sublingual nitrate (55.2 vs. 66.7%) or intravenous morphine (26.9 vs. 43.0%) was administered without contraindications was higher after the SOP had been introduced. Therefore, the use of an SOP in prehospital emergency medicine can partly improve the adherence to guideline recommendations for the treatment of patients with ACS. PMID:23411814
The Centro di Ricerche Sismologiche (CRS, Seismological Research Center) of the Istituto Nazionale di Oceanografia e di Geofisica Sperimentale (OGS, Italian National Institute for Oceanography and Experimental Geophysics) in Udine (Italy) after the strong earthquake of magnitude M=6.4 occurred in 1976 in the Italian Friuli-Venezia Giulia region, started to operate the Northeastern Italy Seismic Network: it currently consists of 15 very sensitive broad band and 21 simpler short period seismic stations, all telemetered to and acquired in real time at the OGS-CRS data center in Udine. Real time data exchange agreements in place with other Italian, Slovenian, Austrian and Swiss seismological institutes lead to a total number of about 100 seismic stations acquired in real time, which makes the OGS the reference institute for seismic monitoring of Northeastern Italy. Since 2002 OGS-CRS is using the Antelope software suite on several workstations plus a SUN Cluster as the main tool for collecting, analyzing, archiving and exchanging seismic data, initially in the framework of the EU Interreg IIIA project "Trans-national seismological networks in the South-Eastern Alps". SeisComP is also used as a real time data exchange server tool. In order to improve the seismological monitoring of the Northeastern Italy area, at OGS-CRS we tuned existing programs and created ad hoc ones like: a customized web server named PickServer to manually relocate earthquakes, a script for automatic moment tensor determination, scripts for web publishing of earthquake parametric data, waveforms, state of health parameters and shaking maps, noise characterization by means of automatic spectra analysis, and last but not least scripts for email/SMS/fax alerting. The OGS-CRS Real Time Seismological website (RTS, http://rts.crs.inogs.it/) operative since several years was initially developed in the framework of the Italian DPC-INGV S3 Project: the RTS website shows classic earthquake locations parametric data plus ShakeMap and moment tensor information. At OGS-CRS we also spent a considerable amount of efforts in improving the long-period performances of broadband seismic stations, either by carrying out full re-installations and/or applying thermal insulations to the seismometers: more examples of PSD plots of the PRED broad band seismic station installation in the cave tunnel of Cave del Predil using a Quanterra Q330HR high resolution digitizer and a Sterckeisen STS-2 broadband seismometer will be illustrated. Efforts in strengthening the reliability of data links, exploring the use of redundant satellite/radio/GPRS links will also be shown.
Bragato, P. L.; Pesaresi, D.; Saraò, A.; Di Bartolomeo, P.; Dur?, G.
The Centro di Ricerche Sismologiche (CRS, Seismological Research Center) of the Istituto Nazionale di Oceanografia e di Geofisica Sperimentale (OGS, Italian National Institute for Oceanography and Experimental Geophysics) in Udine (Italy) after the strong earthquake of magnitude M=6.4 occurred in 1976 in the Italian Friuli-Venezia Giulia region, started to operate the Northeastern Italy Seismic Network: it currently consists of 17 very sensitive broad band and 18 simpler short period seismic stations, all telemetered to and acquired in real time at the OGS-CRS data center in Udine. Real time data exchange agreements in place with other Italian, Slovenian, Austrian and Swiss seismological institutes lead to a total number of about 100 seismic stations acquired in real time, which makes the OGS the reference institute for seismic monitoring of Northeastern Italy. The southwestern edge of the OGS seismic network stands on the Po alluvial basin: earthquake localization and characterization in this area is affected by the presence of soft alluvial deposits. OGS ha already experience in running a local seismic network in high noise conditions making use of borehole installations in the case of the micro-seismicity monitoring of a local gas storage site for a private company. Following the ML=5.9 earthquake that struck the Emilia region around Ferrara in Northern Italy on May 20, 2012 at 02:03:53 UTC, a cooperation of Istituto Nazionale di Geofisica e Vulcanologia, OGS, the Comune di Ferrara and the University of Ferrara lead to the reinstallation of a previously existing very broad band (VBB) borehole seismic station in Ferrara. The aim of the OGS intervention was on one hand to extend its real time seismic monitoring capabilities toward South-West, including Ferrara and its surroundings, and on the other hand to evaluate the seismic response at the site. We will describe improvements in running the Northeastern Italy Seismic Network, including details of the Ferrara VBB borehole station configuration and installation, with first results.
... the infection will move to the next stages. Latent syphilis The latent (hidden) stage of syphilis begins when symptoms of secondary syphilis are over. In early latent syphilis, you might notice that signs and symptoms ...
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... severe Swollen or painful testicles If left untreated, men could experience prostate complications and epididymitis (inflammation of the testicles). Symptoms of rectal infection include discharge, anal itching, and occasional painful bowel movements with fresh blood in the feces. Symptoms typically ...
The Centro di Ricerche Sismologiche (CRS, Seismological Research Center) of the Istituto Nazionale di Oceanografia e di Geofisica Sperimentale (OGS, Italian National Institute for Oceanography and Experimental Geophysics) in Udine (Italy) after the strong earthquake (magnitude M=6.4) occurred in 1976 in the Italian Friuli-Venezia Giulia region, started to operate the North-east Italy (NI) seismic network: it currently consists of 11 very sensitive broad band and 23 more simple short period seismic stations, all telemetered to and acquired in real time at the OGS-CRS data center in Udine. Real time data exchange agreements in place with other Italian, Slovenian, Austrian and Swiss seismological institutes lead to a total number of 89 seismic stations acquired in real time, which makes the OGS the reference institute for seismic monitoring of Northeastern Italy. Since 2002 OGS-CRS is using the Antelope software suite as the main tool for collecting, analyzing, archiving and exchanging seismic data in the framework of the EU Interreg IIIA project "Trans-national seismological networks in the South-Eastern Alps". SeisComP is also used as a real time data exchange server tool. At OGS-CRS we then adapted existing programs and created new ones like: a customized web-accessible server to manually relocate earthquakes, a script for automatic moment tensor determination, scripts for web publishing of earthquake parametric data, waveforms, state of health parameters and shaking maps, noise characterization by means of automatic spectra analysis, plus scripts for email/SMS/fax alerting. A new OGS-CRS real time web site has also been recently designed and made operative in the framework of the DPC-INGV S3 Project.
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Research pertaining to the self-report of symptoms after traumatic brain injury was reviewed. Cognitive, emotional, and motivational factors have more relevance than demographic (except for female sex) and personality factors. Specific neuropsychological deficits in attention and memory have been found in the early stages after head injury of even mild severity. This is unlikely to be the only factor affecting symptom persistence. Exaggeration of cognitive dysfunction occurs in some cases, but appears unrelated to symptom overreport. Increased emotional distress typically accompanies symptom persistence. The psychological reaction of preoccupation with symptoms and emotional distress is not unique to concussion, but also occurs after severe head injury and back injury and relates more to the personal interpretation of the effect of the trauma than to objective indicators of brain injury severity. PMID:9253770
Results are presented of dimensional, thermal expansivity, thermal conductivity, Young's modulus, and tensile strength measurements on specimens of nuclear graphites irradiated in capsule OG-2. About half the irradiation space was allocated to H-451 near-...
The results of dimensional, thermal expansivity, thermal conductivity, Young's modulus, and tensile strength measurements on graphite specimens irradiated in capsule OG-3 are presented. The graphite grades investigated included near-isotropic H-451 (three...
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A collection of over 200 symptoms has been labeled premenstrual syndrome. Common belief is that most women experience a marked increase in symptoms premenses. Cyclic variations in the prevalence of commonly cited perimenstrual symptoms were estimated from daily symptom recording. A community-based, multiethnic sample of 345 women recorded symptom severity from "not present" to "extreme" for 90 days. Maximum total reported symptom score occurred during menses, not during premenses. When individual symptoms are considered, the prevalence of those rated as moderate to extreme during menses is less than 15 percent. A method for identifying symptom severity patterns throughout the menstrual cycle is described. Six symptom severity patterns were identified. Only 13 percent of the women exhibited a pattern of increased symptom severity in the premenses. Another 13 percent had a pattern of decreased symptom severity in the premenses.
Effectiveness of alprazolam in daily dosages of 0.8-1.2 mg was studied in 28 patients who showed psychotic symptoms or autonomic imbalance symptoms after operation for breast cancer. Psychotic symptoms included depression, anxiety, tension, and restlessness, and symptoms of autonomic imbalance included sleep disorder, anorexia, and pains. All of these symptoms were improved at high ratios by alprazolam. The drug was very useful in 16 cases (57.1%), useful in 11 cases (39.3%), and slightly useful in one case (3.6%). The only adverse reaction reported was unsteady gait in one case. PMID:2069404
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... Diseases and treatments U - W Vitiligo Signs, symptoms Vitiligo: Signs and symptoms Vitiligo causes loss of color. ... amount of color loss or type of vitiligo. Vitiligo has types and subtypes If you are diagnosed ...
... Diseases and treatments U - W Warts Signs, symptoms Warts: Signs and symptoms There are a few different ... some of the different types of warts. Common warts (also called vurruca vulgaris) Wart under a child's ...
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Background Enterococcus faecalis has emerged as a major hospital pathogen. To explore its diversity, we sequenced E. faecalis strain OG1RF, which is commonly used for molecular manipulation and virulence studies. Results The 2,739,625 base pair chromosome of OG1RF was found to contain approximately 232 kilobases unique to this strain compared to V583, the only publicly available sequenced strain. Almost no mobile genetic elements were found in OG1RF. The 64 areas of divergence were classified into three categories. First, OG1RF carries 39 unique regions, including 2 CRISPR loci and a new WxL locus. Second, we found nine replacements where a sequence specific to V583 was substituted by a sequence specific to OG1RF. For example, the iol operon of OG1RF replaces a possible prophage and the vanB transposon in V583. Finally, we found 16 regions that were present in V583 but missing from OG1RF, including the proposed pathogenicity island, several probable prophages, and the cpsCDEFGHIJK capsular polysaccharide operon. OG1RF was more rapidly but less frequently lethal than V583 in the mouse peritonitis model and considerably outcompeted V583 in a murine model of urinary tract infections. Conclusion E. faecalis OG1RF carries a number of unique loci compared to V583, but the almost complete lack of mobile genetic elements demonstrates that this is not a defining feature of the species. Additionally, OG1RF's effects in experimental models suggest that mediators of virulence may be diverse between different E. faecalis strains and that virulence is not dependent on the presence of mobile genetic elements.
This study ascertained the presence of musculoskeletal symptoms among electricians, in order to evaluate the prevalence of cumulative trauma disorders (CTD) in this population. We adapted the CTD surveillance questionnaire used by National Institute for Occupational Safety and Health (NIOSH) to assess the prevalence of neck, shoulder, elbow, hand/wrist, back, and knee symptoms in the year prior to the survey. Questionnaires were completed by 308 apprentices and journeymen enrolled in training classes at the local union hall. The participants were relatively young individuals, and 86% of the participants were currently working as electricians. Participants reported a high prevalence of symptoms which occurred more than three times during the past year or which lasted more than 1 week. Back symptoms and hand/wrist symptoms were experienced most frequently, by about half the population, while elbow symptoms were reported by only 15% of participants. Symptom prevalence was lower, but still notable, when defined as symptoms which had occurred at least once a month or lasted more than a week in the past year. Eighty-two percent of participants reported at least one musculoskeletal symptom using the most inclusive definition, while 57% reported two or more symptoms. This survey highlights that: 1) low back discomfort is common in young construction workers, and resulted in medical care, missed work, or light duty for almost 35% of the participants; 2) neck discomfort is also very common and required doctor visits or work modification for almost one quarter of the participants; 3) these construction workers continued to work with symptoms that are classifiable as a CTD; and 4) history of injury is correlated with the subsequent prevalence of musculoskeletal symptoms. PMID:8147388
Hunting, K L; Welch, L S; Cuccherini, B A; Seiger, L A
... trust For Parents Home | LD Basics | Assessment & Evaluation | Early Childhood | Attention Deficit Disorder | Help with Your Child | Special Education | Mental Health For Parents > LD Basics > Symptoms of ...
OG2 is a modified antimicrobial peptide, that is, derived from the frog peptide Palustrin-OG1. It has high antimicrobial activity and low cytotoxicity, and it is therefore promising as a therapeutic agent. Both prokaryotic (Escherichia coli) and eukaryotic (Pichia pastoris) production host systems were used to produce OG2 in our previous study; however, it was difficult to achieve high expression yields and efficient purification. In this study, we achieved high-yield OG2 expression using the intein fusion system. The optimized OG2 gene was cloned into the pTWIN1 vector to generate pTWIN-OG2-intein2 (C-terminal fusion vector) and pTWIN-intein1-OG2 (N-terminal fusion vector). Nearly 70% of the expressed OG2-intein2 was soluble after the IPTG concentration and induction temperature were decreased, whereas only 42% of the expressed of intein1-OG2 was soluble. Up to 75?mg of OG2-intein2 was obtained from a 1?l culture, and 85% of the protein was cleaved by 100?mM DTT. Intein1-OG2 was less amenable to cleavage due to the inhibition of cleavage by the N-terminal amino acid of OG2. The purified OG2 exhibited strong antimicrobial activity against E. coli K88. The intein system is the best currently available system for the cost-effective production of OG2.
OBJECTIVES: This study was designed to evaluate whether detailed symptom analysis would help to identify pathophysiologic subgroups in chronic constipation. METHODS: In 190 patients with chronic constipation (age, 53 (range, 18–88) years; 85 percent of whom were women), symptom evaluation, transit time measurement (radiopaque markers), and functional rectoanal evaluation (proctoscopy, anorectal manometry, defecography) were performed. Patients were classified on the
Alexander Koch; Winfried A. Voderholzer; Andreas G. Klauser; Stefan Müller-Lissner
Certain psychiatric diseases have biological pathomechanisms, and as a result they are accompanied by various neurological symptoms. Neurological examination is a simple method to assess these symptoms. Neurological signs come in two varieties; they are either of the hard or the soft type. Hard symptoms appear primarily in organic psychiatric disorders or as side effects of psychiatric therapy. They can also be encountered during neurological diseases of psychiatric patients. Their use in diagnostics and therapy is widely accepted. In contrast, soft neurological symptoms often stay unnoticed, even though they may contain important pieces of information. For this reason they will form the focus of our discussion. Soft neurological symptoms have been studied in different psychiatric disorder-groups. Up to now most attention has been devoted to schizophrenia. The study suggests that the soft symptoms are trait markers of schizophrenia. Furthermore they also signal disease activity and predict the outcome of the disease. Neurological symptoms are also important pointers for psychiatry. However, more systematic studies may increase the theoretical and practical implications of soft symptoms. PMID:21876223
Spices are widely used for flavouring food and are mostly grown in the tropics. Twenty-eight workers in a store processing cloves, pepper, nutmeg, mace and cardamom for export were studied. They were exposed to the dust of these products for short periods, in rotation. Seventy-six per cent of the workers experienced symptoms such as smarting of the nostrils and eyes, cough, sneezing and running nose while handling cloves. Similar symptoms occurred less frequently with pepper (44%). These symptoms were all temporary and lasted only during exposure. Nutmeg, mace and cardamom did not induce any untoward effects. These symptoms, which were absent in a control group, were attributable to irritation of the mucus membranes by the active principles of the spices. A comparison with two other spices, namely chilli and cinnamon, suggests a spectrum in which the frequency of symptoms is proportional to the pungency of the spice. PMID:1560483
The demand for United States Air Force (USAF) remotely piloted aircraft (RPA) intelligence, surveillance, reconnaissance (ISR) and weapons-strike operations has led to the necessity of sustaining around-the-clock operations across the globe. Because of th...
B. Thompson J. Swearengen K. McDonald W. Chappelle
... Brochures Resources Children and Teens Childhood Anxiety Disorders PTSD Symptoms in Children Age Six and Younger Anxiety and Depression Podcasts About Children and Teens Treatment Choosing a Therapist for Your Child Helping Children and Teens With Anxiety ...
... of the muscles of the jaw, or "lockjaw". Tetanus symptoms include: Headache Jaw cramping Sudden, involuntary muscle ... sweating High blood pressure and fast heart rate Tetanus complications include: Uncontrolled/involuntary muscular contraction of the ...
... form when people get crusted scabies, also called Norwegian scabies. Signs and symptoms of scabies include: Itching, ... crusted scabies. Another name for crusted scabies is Norwegian scabies. These crusts house 100s to 1,000s ...
... recognize and prevent MRSA skin infections Symptoms of MRSA As with all regular staph infections, recognizing the ... buttock, armpit, beard area of men). Photos of MRSA Skin Infections View larger image Photo credit: Major ...
Summary Pregnancy impacts common symptoms of major depressive disorder (MDD), such as energy, appetite, weight change, and sleep and\\u000a somatic complaints. However, it is not known whether the presentation of depression during pregnancy is different from that\\u000a at other times in women’s lives. This study compares the severity of symptoms of depression in 61 pregnant women with MDD\\u000a (PD), 50 nonpregnant
Patients with cancer suffer from a multitude of symptoms. Effective treatment strategies are available for a number of the\\u000a common symptoms. A major reason for inadequate symptom relief is lack of effective symptom assessment. Accurate assessment\\u000a of symptoms is necessary before any treatment can be undertaken. Although there are many complexities involved in the assessment\\u000a of symptoms, simple, effective tools
PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n?=?963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that boys were 2.27 times more likely to be exposed to frequent bullying than girls. A latent variable second-order model demonstrated an association between frequency of bullying exposure and PTSD symptoms (beta?=?0.49). This relationship was not moderated by gender. However, the average levels of PTSD symptoms as well as clinical range symptoms were higher for girls. For all bullied students, 27.6% of the boys and 40.5% of the girls had scores within the clinical range. A mimic model showed that youth who identify as being both a bully and a victim of bullying were more troubled than those who were victims only. Our findings support the idea that exposure to bullying is a potential risk factor for PTSD symptoms among students. Future research could investigate whether the same holds for PTSD through diagnostic procedures, but this will depend on whether or not bullying is decided to comply with the DSM-IV classification of trauma required for diagnosis. Results are discussed with regard to their implications for school interventions. PMID:22391775
Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici
The mixings between Berenstein-Maldacena-Nastase (BMN) operators with two scalar impurities and those with a scalar fermion pair are discussed to the lowest order at planar level. For this purpose, matrix model effective vertices are calculated to O(g3). All the mixing patterns are explicitly obtained.
Frontotemporal dementia (FTD)-a common clinical manifestation of frontotemporal lobar degeneration (FTLD)--is characterized by alterations in personality and social conduct. Its symptoms include inertia, loss of volition, social disinhibition, and distractibility, with relative preservation of memory and visuospatial function. We present the typical case of patient with typical clinical symptoms including "going my way" behavior, inactivity, lack of awareness of illness, stereotypic behavior, perseveration, and environmental dependency syndrome. These clinical symptoms can be interpreted on the basis of extent of damage to the frontal lobes and the interaction between the frontal lobes and other neural systems such as the posterior association cortices, basal ganglia or limbic systems. We also address several complex clinical issues, including the relationship between clinical manifestations and pathological findings, underestimation of FTD in patients with amyotrophic lateral sclerosis (ALS) and/or motor neuron disease (MND), and impairment in a single cognitive domain such as isolated agraphia in ALS/MND and FTD. To address these problems, it is essential to observe the clinical symptoms in patients with FTD and ALS/MND in detail and to compare clinical characteristics with pathological findings. It is also critical to develop clinical tests that minimize the impact of speech and motor dysfunction on performance, particularly on the basis of a longitudinal analysis. PMID:19938679
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|PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed…
Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici
In a survey of outpatients at the Denver Veterans Affairs Medical Center for common leg symptoms--515 questionnaires returned in a 3-week period--56% reported nocturnal leg cramps, 29% reported the restless leg syndrome, and 49% reported symptoms of peripheral neuropathy. Only 33% of patients had no symptoms relating to their legs. Patients often did not report these symptoms to their physician but were more likely to do so if the symptoms were frequent. Conditions especially related to leg symptoms were hypertension, peripheral vascular disease, coronary artery disease, cerebrovascular disease, kidney disease, and hypokalemia. Most patients did not receive effective therapy for these symptoms.
Introduction The subjective experience of cancer survivorship can be assessed by various patient-reported outcome (PRO) methods, including\\u000a measures of symptom burden and health-related quality of life (HRQOL). Symptom burden includes the presence and severity of\\u000a multiple symptoms and the level of distress caused by symptoms that go untreated or unrelieved. The concept of symptom burden\\u000a is more limited in scope than
Adjuvant chemotherapy protocols used to treat women with breast cancer have evolved over the last decade and have dramatically altered the symptoms and symptom experiences of these women. The purpose of this study was to identify symptoms, symptom experiences, and resulting symptom distress encountered by women with breast cancer undergoing surgery and receiving current chemotherapy protocols. Convenience sampling was used to recruit 20 women for this study. Women were asked to tell their story and transcripts were analyzed using Colaizzi's procedural steps. Six themes emerged. The most important theme was that symptom experiences and symptom distress, similar among all 20 women, were congruent with the type of treatment. After surgery, women complained of numbness, pulling, and body image changes; while receiving Adriamycin and Cyclophosphamide, symptoms of intense nausea and hair loss caused distress; while receiving Paclitaxel, symptoms of intense bone pain and peripheral neuropathy caused distress. This study provides oncology nurses with a clear description of the symptoms, symptom experiences, and symptom distress women with breast cancer encounter during present-day treatment protocols. Knowing the symptoms and symptom experiences, as well as when they occur during treatment, provides oncology nurses with an opportunity to share with women about to start treatment for breast cancer the expected "normative" symptom experience. This in turn would allow women to anticipate symptoms, employ management strategies, and empower them to improve their cancer experience. PMID:16192830
Over a period of 3 months a 51-year-old woman developed a depressive syndrome with loss of memory, inability to find words, impaired fine movements and phases of spacial disorientation. Biochemical tests demonstrated occasional slight rises in serum calcium (2.8-2.9 mmol/l) and parathormone (4.6-5.2 pmol/l). She had a grade II nodular goitre with normal thyroid function. Ultrasonography of the thyroid suggested a right cranial parathyroid adenoma, confirmed at a right thyroidectomy with resection of the right upper parathyroid, while the other parathyroid glands were grossly normal. Calcium and parathormone levels returned to normal after the operation, as did the neuropsychiatric symptoms (within two months). This typical case illustrates that even in seemingly isolated neuropsychiatric changes an organic disease, like primary hyperparathyroidism, needs to be thought of. PMID:8055744
Schreiber, W; Kellner, M; Heuser-Link, M; Krieg, J C
In countries where the consumption of chillies is high, the grinding of dried red chillies into a fine powder is a new industry. The majority of workers employed in this process suffer from sneezing, watering of the nose, and cough, all of which are maximal at the beginning of their employment. They develop tolerance within a variable period, after which this triad of symptoms occurs only when the atmosphere becomes heavily contaminated with chilli-powder or on inhalation of the volatilized capsaicin which is liberated when the roasted chillies are being ground. A burning sensation of the skin also occurs in most of the workers, especially when the skin is moist. Loss of weight is another common feature. All these symptoms are temporary, last only during the period of exposure, and do not produce radiological changes.
Studies examining the demographic and clinical features of depressed patients who meet criteria for the atypical features subtype have often yielded conflicting results. The present study sought to evaluate the demographic and clinical correlates associated with each of the five symptoms (mood reactivity, hypersomnia, hyperphagia, leaden paralysis and rejection sensitivity) that constitute the DSM-IV criteria set of atypical depression. Symptom prevalence rates were determined for 661 psychiatric outpatients diagnosed with a major depressive disorder, and were analyzed as a function of age, sex, severity, and episode duration. We found that: (1) younger age was positively associated with hypersomnia and negatively associated with leaden paralysis, while middle age was positively associated with both hyperphagia and rejection sensitivity; (2) female sex was associated with all of the atypical symptoms except rejection sensitivity; (3) a greater severity of illness was positively associated with leaden paralysis and rejection sensitivity, and negatively associated with mood reactivity; and (4) a duration of illness of greater than 3 months was positively associated with hyperphagia, leaden paralysis, and rejection sensitivity. Thus, the five atypical features do not appear to be associated with the same clinical profiles. PMID:11711170
Background \\u000a Enterococcus faecalis has emerged as a major hospital pathogen. To explore its diversity, we sequenced E. faecalis strain OG1RF, which is commonly used for molecular manipulation and virulence studies.\\u000a \\u000a \\u000a \\u000a \\u000a Results The 2,739,625 base pair chromosome of OG1RF was found to contain approximately 232 kilobases unique to this strain compared\\u000a to V583, the only publicly available sequenced strain. Almost no mobile
Agathe Bourgogne; Danielle A Garsin; Xiang Qin; Kavindra V Singh; Jouko Sillanpaa; Shailaja Yerrapragada; Yan Ding; Shannon Dugan-Rocha; Christian Buhay; Hua Shen; Guan Chen; Gabrielle Williams; Donna Muzny; Arash Maadani; Kristina A Fox; Jason Gioia; Lei Chen; Yue Shang; Cesar A Arias; Sreedhar R Nallapareddy; Meng Zhao; Vittal P Prakash; Shahreen Chowdhury; Huaiyang Jiang; Richard A Gibbs; Barbara E Murray; Sarah K Highlander; George M Weinstock
|A study aims to examine attention-deficit/hyperactivity disorder(ADHD) symptoms and subtypes in childhood and adolescence. The results conclude the persistence of ADHD from childhood to adolescence with specific symptoms contributing to persistent ADHD.|
Hurtig, Tuula; Ebeling, Hanna; Taanila, Anja; Miettunen, Jouko; Smalley, Susan L.; McGough, James J.; Loo, Sandra K.; Jarvelin, Marjo-Riitta; Moilanen, Irma K.
OBJECTIVES: To investigate a large population of cotton textile weavers for reported respiratory symptoms relative to occupational factors, smoking, and exposure to dust. Cotton processing is known to produce a respiratory disease known as byssinosis particularly in the early processes of cotton spinning. Relatively little is known about the respiratory health of the cotton weavers who produce cloth from spun cotton. By the time cotton is woven many of the original contaminants have been removed. METHODS: 1295 operatives from a target population of 1428 were given an interviewer led respiratory questionnaire. The presence of upper and lower respiratory tract symptoms were sought and the work relatedness of these symptoms determined by a stem questionnaire design. Also occupational and demographic details were obtained and spirometry and personal dust sampling performed. RESULTS: Byssinosis was present in only four people (0.3%). Chronic bronchitis had a moderate overall prevalence of about 6% and was related predominantly to smoking. There were several other work related respiratory symptoms (persistent cough 3.9%, chronic production of phlegm 3.6%, chest tightness 4.8%, wheezing 5.4%, and breathlessness 2.3%). All of these were predicted predominantly by smoking (either past or present), with no consistent independent effect of exposure to dust. Work related eye and nasal symptoms were more common (10.4% and 16.9% respectively). CONCLUSION: Byssinosis is a rare respiratory symptom in cotton weaving. Other work related respiratory symptoms were reported but their presence was predominantly related to smoking with no consistent effects of exposure to dust.
Raza, S. N.; Fletcher, A. M.; Pickering, C. A.; Niven, R. M.; Faragher, E. B.
... Favorites Delicious Digg Google Bookmarks Symptoms of Coccidioidomycosis (Valley Fever) Skin lesions due to Coccidioides immitis . Most people ... TTY: (888) 232-6348 Contact CDC–INFO Coccidioidomycosis (Valley Fever) Definition Symptoms People at Risk & Prevention Sources of ...
Evaluated the Hopelessness Depression Symptom Questionnaire (HDSQ; Metalsky & Joiner, 1991). The HDSQ is a 32-item self-report measure of eight symptoms posited by L. Abramson, G. Metalsky, and L. Alloy (1989) to comprise a specific subtype of depression—hopelessness depression. Factor analytic results from 435 subjects suggested that: (a) Each of the eight subscales of the HDSQ reflects a distinct symptom
The purpose of this study was to extend available psychometric data on the Patient Health Questionnaire-9-Observation Version (PHQ-9-OV) by comparing it with the Cornell Scale for Depression in Dementia (CSDD) in a new sample of long-term care residents. Data were collected post intervention in a quasi-experimental storytelling study across six communities. The sample (N = 54) was 87% women with mean age of 84.5, mean CSDD score of 3.96, and mean PHQ-9-OV score of 4.22. Prevalence of depressive symptoms by CSDD criteria was 20.4% and by PHQ-9-OV criteria was 40.7%. The CSDD and PHQ-9-OV were well correlated (rs = 0.78, p < 0.0001). Neither scale was significantly correlated with depression diagnosis nor antidepressant agent use. Both measures demonstrated adequate reliability. The PHQ-9-OV item scoring and established cut-off points designate a lower threshold than the CSDD to detect clinically significant depressive symptoms. Further study is needed to determine the sensitivity of the PHQ-9-OV in identifying treatment effects.
Kyvik, G. 2004. Nye undersökelser og nye tolkninger av det danske eikekiste materialet fra bronsealderen. (New investigations and interpretations of the Danish Bronze Age oak log coffins.) Fornvännen gg. Stockholm. Some of Denmark's Bronze Age barrows with oak log cjiffins have remarkable conditions for preservation and have been the subject of much research. A thin iron pan encapsulating the cores
Our previous work identified a cosmid clone containing a 43-kb insert from Enterococcus faecalis OG1RF that produced a nonprotein antigen in Escherichia coli. In the present work, we studied this clone in detail. Periodate treatment of lysates of the clone confirmed that the antigen was carbohydrate in nature. Analysis of DNA sequences and transposon insertion mutants suggested that the insert
Introduction Surgeons are a unique group of healthcare professionals who are at risk for developing work-related musculoskeletal symptoms\\u000a (WMS). The diversity of operating skills for laparoscopic and endovascular procedures impose different physical demands on\\u000a surgeons, who also work under time pressure. The present study aims to examine the physical and psychosocial factors and their\\u000a association with WMS among general surgeons
Grace P. Y. Szeto; Pei Ho; Albert C. W. Ting; Jensen T. C. Poon; Stephen W. K. Cheng; Raymond C. C. Tsang
Transient ischemic attack (TIA) is a cerebrovascular disease with temporary (<24 h) neurological symptoms. The symptoms of TIA patients are largely similar to those of ischemic stroke patients and include unilateral limb weakness, speech disturbances, sensory symptoms, visual disturbances, and gait difficulties. As these symptoms are transient, they are frequently evaluated based on patients' subjective reports, which are less precise than those of patients with stroke whose longer-lasting symptoms and signs can be reliably assessed by physicians. Some symptoms, such as monocular blindness, are much more common in TIA than in stroke, and limb shaking occurs almost exclusively in TIA patients. On the other hand, symptoms like hemivisual field defects or limb ataxia are underappreciated in TIA patients. These transient neurological symptoms are not necessarily caused by cerebrovascular diseases, but can be produced by a variety of non-vascular diseases. Careful history taking, examination, and appropriate imaging tests are needed to differentiate these TIA mimics from TIA. Each TIA symptom has a different specificity and sensitivity, and there has been an effort to assess the outcome of the patients through the use of specific clinical features. On top of this, recent developments in imaging techniques have greatly enhanced our ability to predict the outcomes of TIA patients. Perception or recognition of TIA symptoms may differ according to the race, sex, education, and specialty of physicians. Appropriate education of both the general population and physicians with regard to TIA symptoms is important as TIAs need emergent evaluation and treatment. PMID:24157558
The Third International Symposium on Cough focused on acute and chronic cough, both clinical and basic science. Cough is a defensive and clearing mechanism, and can cause discomfort and nuisance; it is also an important symptom of many chronic airway diseases. In this Symposium, several issues concerning the relationship of cough to disease processes, different types of cough, and the concept of idiopathic cough will be discussed. Characterization of cough receptor(s) and identification of peripheral and central mechanisms for cough sensitization are current areas of investigation for delineating the cause of chronic cough. Peripheral mechanisms may be most important for acute cough such as after viral infections. The role of pathological changes at the level of the airway mucosa and of cortical pathways will be reviewed. Finally, therapeutic inhibition of the cough reflex remains an area of active research. PMID:15564070
The purpose of this study was to determine the prevalence of perimenstrual symptoms (PMS) in a free-living population of US women and to determine if prevalence estimates varied with parity, contraceptive status, characteristics of the menstrual cycle, and selected demographic variables. We identified all households from a census listing for five southeastern city neighborhoods that offered variation in racial composition and socioeconomic status. We ascertained all households in which there was one nonpregnant woman between the ages of 18 and 35 years per household. Of the 241 eligible women, 179 (74 per cent) participated in the study. Trained interviewers administered the Moos Menstrual Distress Questionnaire (MDQ) and other demographic measures to women between March and July 1979. Symptoms with a prevalence greater than 30 per cent included weight gain, headache, skin disorders, cramps, anxiety, backache, fatigue, painful breasts, irritability, mood swings, depression, or tension. Only 2 to 8 per cent of women found most of these severe or disabling. The exceptions were severe cramps reported by 17 per cent of women and severe premenstrual and menstrual irritability by 12 per cent. Cramps, backaches, fatigue, and tension were most prevalent during the menstruum; weight gain, skin disorders, painful breasts, swelling, irritability, mood swings, and depression were more prevalent in the premenstruum. Parity, oral contraceptive use, age, employment, education, and income were negatively associated with selected PMS. Use of an IUD, having long menstrual cycles, long menstrual flow, or heavy menstrual flow, and being able to predict the next period were positively associated with selected PMS. Race had both positive and negative effects on PMS.
Previously, TX5179, a disruption mutant of the enterococcal polysaccharide antigen (epa) gene cluster of Enterococcus faecalis strain OG1RF was shown to be attenuated in translocation, biofilm, mouse peritonitis and was more susceptible to polymorphonuclear leukocyte phagocytic killing. Here, wild-type E. faecalis OG1RF and TX5179 strains were tested in a mixed-infection (inoculum, approximately 1:1) mouse urinary tract infection model. Wild-type OG1RF outnumbered TX5179 in the kidneys (P < .001) and bladder (P < .001). In conclusion, the epa locus of E. faecalis OG1RF contributes to murine urinary tract infection and is the first such enterococcal polysaccharide locus shown to be important in this site. PMID:19545208
Singh, Kavindra V; Lewis, Roshan J; Murray, Barbara E
Previously, TX5179, a disruption mutant of the enterococcal polysaccharide antigen (epa) gene cluster of Enterococcus faecalis strain OG1RF was shown to be attenuated in translocation, biofilm mouse peritonitis and was more susceptible to polymorphonuclear leukocyte phagocytic killing. Here, wild-type E. faecalis OG1RF and TX5179 strains were tested in a mixed-infection (inoculum, ~1:1) mouse urinary tract infection model. Wild-type OG1RF outnumbered TX5179 in the kidneys (P < .001) and bladder (P < .001). In conclusion, the epa locus of E. faecalis OG1RF contributes to murine urinary tract infection and is the firs such enterococcal polysaccharide locus shown to be important in this site.
Singh, Kavindra V.; Lewis, Roshan J.; Murray, Barbara E.
Our purpose in this study was to identify differences in menopausal symptom management among four major ethnic groups in the U.S. This was a secondary analysis of the qualitative data from a larger Internet-based study. We analyzed data from 90 middle-aged women in the U.S using thematic analysis. We extracted four themes during the data analysis process: (a) “seeking formal or informal advice,” (b) “medication as the first or final choice,” (c) “symptom-specific or holistic,” and (d) “avoiding or pursuing specific foods.” Health care providers need to develop menopausal symptom management programs while considering ethnic differences in menopausal symptom management.
The label "sick building syndrome" is often used to imply the absence of a physiologic basis for symptoms in the built environment. Although building-related illness is widely recognized but considered rare, several well-studied mechanisms may be responsible for many symptoms in buildings. These mechanisms do not explain why some individuals perceive disability. Until researchers distinguish physiologic mechanisms from other aspects of disease and study them systematically, poorly defined symptoms will remain poorly understood. The disability associated with such symptoms and syndromes, not the physiology, is the primary interest and generates controversy.
Individuals suffering from intolerable symptoms of the common cold can now be advised of safe and effective products for symptomatic relief. This article describes and discusses four categories of drugs used to treat the common cold. To simplify the product selection process for family physicians, suggestions are included for possible ingredients for treatments of specific cold symptoms.
Objective: To describe a less common initial symptom of nephrolithiasis, its diagnostic pitfalls, risk factors, and mimicry of other conditions. Intervention and long-term management of nephrolithiasis is also discussed.Clinical Features: A Caucasian man aged 25 years had sudden bilateral inguinal and occasional periumbilical pain. The initial symptom suggested an abdominal pathologic condition; however, costovertebral angle pain followed 1 hour later
Background: The prevalence of psychiatric symptoms and hostility factors in patients with scleroderma, although a matter of clinical interest, it is rather poorly studied. Methods: Thirty female patients with scleroderma were investigated. Thirty-three healthy women were used as a comparison group. The applied psychometric instruments were the Hostility and Direction of Hostility Questionnaire (HDHQ), the Delusions Symptoms States Inventory\\/states of
N. V. Angelopoulos; A. A. Drosos; H. M. Moutsopoulos
astroparesis is a disorder that presents with symptoms of gastric reten- tion with objective evidence of delayed gastric emptying in the absence of mechanical obstruction. Diabetic, idiopathic, and postsurgical gas- troparesis are the most common forms; however, many other conditions are associated with symptomatic delayed gastric emptying (Table 1). Its main symptoms include nausea, vomiting, early satiety, postprandial fullness, and
|During menopause and the climacteric, women experience many changes that can affect nearly every organ system and cause psychological symptoms. This article reviews the specific changes and explains how exercise can address each symptom; outlines a practical approach physicians can use to help menopausal patients improve their quality of life.…
OBJECTIVE--To analyse the relation between symptoms regularly reported by hospital personnel and exposure to anaesthetics. SETTING--Personnel of 18 hospitals in Paris from 1987 to 1989. DESIGN--An exposed group that included all operating theatre members except for doctors, and which was divided into three subgroups depending on the degree of exposure--exposure was measured by the frequency of the use of the scavenging system--and a control group that included other hospital personnel matched by hospital, sex, occupation, age, and duration of service. SUBJECTS--557 exposed workers and 566 unexposed workers. MAIN OUTCOME MEASURES--The groups were compared according to the crude rates of regular symptoms. Adjusted odds ratios were calculated to estimate the risks associated with exposure to anaesthetic gas. Liver transaminase activities (alanine aminotransferase, aspartate aminotransferase (s-ASAT, and gamma-glutamyl transpeptidase) were measured and compared between groups of exposure. RESULTS--After controlling for working conditions and matching factors, neuropsychological symptoms and tiredness were reported more by workers in less often scavenged theatres than by controls. No difference was found between workers of the well scavenged theatres and controls. Among the exposed workers, the members of paediatric surgical staffs reported a higher rate of neurological complaints (tingling, numbness, cramps) and tiredness than the members of the other surgical staffs. They had a high value of s-ASAT more frequently than the other exposed workers. CONCLUSION--These results strengthen the hypothesis of a causal relation between exposure to anaesthetics and neuropsychological symptoms, and show a dose-response effect. They suggest that the use of ventilating systems in operating rooms is an effective means of prevention.
Saurel-Cubizolles, M J; Estryn-Behar, M; Maillard, M F; Mugnier, N; Masson, A; Monod, G
Despite the official exclusion criteria for autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) in the DSM-IV and ICD-10, patients with ASD often show ADHD symptoms. We aimed to examine the potential influence of ADHD symptoms on autistic psychopathology in a large sample of patients with ASD. We tested the hypothesis that patients with ASD and an additional ADHD (ASD+) would show a higher severity of autistic symptoms than those with ASD only (ASD-). We measured autistic symptoms using the autism diagnostic observation schedule (ADOS-G), the autism diagnostic interview (ADI-R), and the social responsiveness scale (SRS). To measure overall psychopathology and ADHD symptoms, we used the child behavior checklist (CBCL) and the ADHD rating scale (FBB-ADHS), respectively. Group differences between the ASD+ and the ASD- group (group division was conducted according to the results of the FBB-ADHS) were calculated using a univariate analysis of variance (ANOVA). The ASD+ group showed a greater severity of autistic symptoms than the ASD- group, measured by the SRS and the ADI-R. Especially in the social interaction subscale (ADI-R), a significantly higher symptom severity was found in the ASD+ group. No significant group differences were found regarding autistic symptoms measured by the ADOS-G. Patients with ASD and an additional ADHD expressed a stronger severity of autistic symptoms than patients with ASD only. According to our results, the possibility of a co-diagnosis of ADS and ADHD, as is being planned in the DSM-5, is in line with earlier studies, is highly reasonable, will simplify research, and have therapeutic implications. PMID:23973801
Aims Examine the association of person-specific trajectories of withdrawal symptoms of urge-to-smoke, negative affect, physical symptoms, and hunger during the first 7 days after smoking cessation with abstinence at end of treatment (EOT) and 6 months. Design Hierarchical Linear Modeling (HLM) was used to model person-specific trajectory parameters (level, slope, curvature and volatility) for withdrawal symptoms. Setting University-based smoking cessation trials. Participants Treatment seeking smokers in clinical trials of transdermal nicotine versus nicotine spray (n=514) and bupropion versus placebo (n=421) Measurements Self-reported withdrawal symptoms for 7 days after the planned quit date, and 7 day point prevalence and continuous abstinence at EOT and 6 months. Findings In regressions that included trajectory parameters for one group of withdrawal symptoms, both urge-to-smoke and negative affect were predictive of abstinence while physical symptoms and hunger were generally not predictive. In stepwise regressions that included the complete set of trajectory parameters across withdrawal symptoms (for urge-to-smoke, negative affect, physical symptoms, and hunger), with a single exception, only the trajectory parameters for urge-to-smoke were predictive. Area under the Receiver Operator Characteristic curve was 0.594 for covariates alone, and 0.670 for covariates plus urge-to-smoke trajectory parameters. Conclusion Among a number of different withdrawal symptoms (urge-to-smoke, negative affect, physical symptoms, and hunger) urge-to-smoke trajectory parameters (level, slope, and volatility) over the first 7 days of smoking cessation show the strongest prediction of both short and long term relapse. Other withdrawal symptoms increase the predictive ability by negligible amounts.
The current study explored psychological symptoms, symptom severity, and suicide risk in a national sample (N = 628) of student veterans. We hypothesized that the rates, types, and severity of problems experienced by student veterans on campus would in many ways mirror those reported by active duty service members as well as the Operation Iraqi Freedom\\/Operation Enduring Freedom veteran population.
... Home Current Issue Past Issues Cover Story: Traumatic Brain Injury TBI Symptoms, Diagnosis, Treatment, Prevention Past Issues / Fall ... lucky in my ongoing recovery from the traumatic brain injury I suffered in Iraq." —Bob Woodruff Treatment Immediate ...
... nervousness and irritability are signs that a person's blood sugar is getting dangerously low. A person showing any of these symptoms should check their blood sugar. If the level is low (70 mg/dl), ...
... makes the tiredness better or worse. Is mucus production a symptom of COPD? Excess mucus (phlegm or ... For further information about this series, contact J.Corn at firstname.lastname@example.org. www.thoracic.org
Massage therapy is widely used by patients with fibromyalgia seeking symptom relief. We performed a review of all available\\u000a studies with an emphasis on randomized controlled trials to determine whether massage therapy can be a viable treatment of\\u000a fibromyalgia symptoms. Extensive narrative review. PubMed, PsychInfo, CINAHL, PEDro, ISI Web of Science, and Google Scholar\\u000a databases (inception-December 2009) were searched for
Two surveys of individuals with fibromyalgia were conducted to assess the frequency and prevalence of symptoms (N = 99) as well as healthcare providers, medications, and self-care activities used to manage one's fibromyalgia (N = 54). The pervasiveness of symptoms was striking, with 24 various symptoms ranging from cognitive to intestinal problems occurring in at least 75% of the respondents. Significant correlations were present between health status and both physical (P = .002) and psychological (P =.008) symptoms. There was also a significant correlation between the total number of symptoms and the degree of life disruption attributed to fibromyalgia (P =.015). A variety of healthcare professionals were seen, with internists, family physicians, and rheumatologist most frequently used. Although at least 80% of the respondents reported difficulty with anxiety, confusion, irritability, depression, and cognitive difficulties, less than 10% of the respondents reported seeing a psychiatrist. Most frequently used medications were: amitriptyline, (fluoxetine HCl) Prozac, ibuprofen (Motrin), sertraline HCI (Zoloft), and zolpidem (Ambein). Self-care activities used with the most success were walking, stretching, and exercising. These studies indicate the need for more research and support for healthcare providers as well as patients with fibromyalgia. PMID:11839925
It is estimated that there are 13 million cancer survivors in the United States, and more than 65% of them are 5 or more years beyond their diagnosis. The majority are "cancer-free and free of cancer," although some survivors have late or long-term effects of treatment or develop second or secondary cancers. Late and long-term effects for survivors of childhood cancers have been well studied, but less is known about the "seasons of survivorship" for adult cancer survivors.Symptoms during diagnosis, treatment, and then extending through the first several years of survivorship were reported in more than half of a large and heterogeneous group of cancer survivors. The incidence of late and/or long-term symptoms and health problems of long-term cancer survivors is less well characterized. These persistent symptoms are related to survivors' cancer diagnosis and the treatment they received, as well as age and other comorbidities. Health-related quality of life generally is stable for many years, although some cancer survivors experience a significant drop in health-related quality of life years after treatment, although the etiology is not clear yet.This article provides an overview of the natural history of cancer survivorship ("The seasons of survivorship"), disease-specific toxicities, and changes in symptoms in cancer survivors over time. Several common symptoms are used as examples including pain, fatigue, and cognitive dysfunction. PMID:24051613
The symptoms in family medicine are not signs of disease, but "signs of life"; in the consultation "all patient life comes together with him". Every consultation is primarily a biopsicosocial problem: the person perceives a dysfunction or alteration in relation with himself and his context. To do a diagnosis only with physical symptoms, can be a mistake because these do not identify the real problem. The different types of symptoms are "entangled" or chained some in others: the symptoms can be fitted or inevitable; to be expressions of biochemical alterations, symbols for the patient, group context expressions, or kinds of facing the facts; and they depend on the previous psychological patient performance, the severity of the deficit of the psychological function associated with the disease, the residual skills, the adjustment and the confrontation of the functional limitations, the relation doctor-patient, as well as on the influence of the context. PMID:21782291
Turabián, José Luis; Pérez Franco, Benjamín; Turabián Fernández, José Luis; Pérez Franco, Benjamin
Somatic symptoms are often common causes for medical consultation. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Five principal groups of drugs such as tricyclic antidepressants (TCA), serotonin reuptake inhibitors (SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics and herbal medication are systematically studied. The evidence indicates that all five groups are effective in a wide range of disorders. All classes of antidepressants seem to be effective against somatoform and related disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder (BDD), and SNRIs appear to be more effective than other antidepressants when pain is the predominant symptom. Research leaves many unanswered questions regarding dosing, duration of treatment, sustainability of improvement in the long term and differential response to different class drugs. Further studies need to focus on treatments based on clinical features/psychopathology and collaborative research with other specialists in understanding the relation of somatic symptom disorders and functional somatic syndromes (FSS), and comparing psychotropics and non-psychotropics and combinations treatments. PMID:23383672
This report presents a summary of the military participation in Operation TEAPOT, conducted at the Nevada Test Site during the period 15 February through 28 May 1955. The missions of the military representation within the test organization were: (1) to co...
Ascertaining the symptom experience of chronically critically ill (CCI) patients is difficult because of communication impairment and fluctuations in patient cognition and physiologic conditions. The use of checklist self-report ratings is hampered by the inability of most CCI patients to respond verbally to symptom queries. In addition to the communication problems caused by mechanical ventilation, the apparently diverse idioms of symptom expression add to the potential for miscommunication regarding symptom experience. Although patient communication impairment is a major barrier to symptom identification, symptom assessment and treatment are fundamental components of nursing care for CCI. This article reviews and describes the unique constellation of symptoms experienced by many critically ill patients. We report our observations of symptom communication among CCI patients and nurses and discuss inconsistency in the language of symptom expression among nurses and patients. Clinically applicable strategies to improve nurse-patient symptom communication and suggestions for refinement of symptom assessment in chronic critical illness are provided. PMID:20118706
The altitude threshold for decompression sickness (DCS) symptoms has been variously described as being 18,000 ft (5,487 m) to above 25,000 ft (7,620 m). Safety and efficiency of aerospace operations require more precise determination of the DCS threshold....
In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit\\/hyperactivity\\u000a disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore,\\u000a 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and ASD symptoms. OCD patients showed\\u000a increased ADHD and autism symptom frequencies, OCD + ADHD patients reporting more autism symptoms
Gideon E. Anholt; Danielle C. Cath; Patricia van Oppen; Merijn Eikelenboom; Johannes H. Smit; Harold van Megen
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings
Background: The reproducibility of symptom clusters (SCs) in different populations would support the validity of the cluster concept. Ideal approaches to cluster identification are unknown. The presence of a sentinel (most prevalent) symptom may reduce the number of symptoms in a comprehensive symptom assessment tool. The primary purpose was to assess consistency of SCs between 2 independent data sets. A
Jordanka Kirkova; Aynur Aktas; Declan Walsh; Lisa Rybicki; Mellar P. Davis
The culture supernatant fraction of an Enterococcus faecalis gelE mutant of strain OG1RF contained elevated levels of the secreted antigen SalB. Using differential fluorescence gel electrophoresis (DIGE) the salB mutant was shown to possess a unique complement of exoproteins. Differentially abundant exoproteins were identified using matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Stress-related proteins including DnaK, Dps family protein, SOD, and NADH peroxidase were present in greater quantity in the OG1RF salB mutant culture supernatant. Moreover, several proteins involved in cell wall synthesis and cell division, including d-Ala-d-Lac ligase and EzrA, were present in reduced quantity in OG1RF salB relative to the parent strain. The salB mutant displayed reduced viability and anomalous cell division, and these phenotypes were exacerbated in a gelE salB double mutant. An epistatic relationship between gelE and salB was not identified with respect to increased autolysis and cell morphological changes observed in the salB mutant. SalB was purified as a six-histidine-tagged protein to investigate peptidoglycan hydrolytic activity; however, activity was not evident. High-pressure liquid chromatography (HPLC) analysis of reduced muropeptides from peptidoglycan digested with mutanolysin revealed that the salB mutant and OG1RF were indistinguishable. PMID:22563054
The culture supernatant fraction of an Enterococcus faecalis gelE mutant of strain OG1RF contained elevated levels of the secreted antigen SalB. Using differential fluorescence gel electrophoresis (DIGE) the salB mutant was shown to possess a unique complement of exoproteins. Differentially abundant exoproteins were identified using matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) mass spectrometry. Stress-related proteins including DnaK, Dps family protein, SOD, and NADH peroxidase were present in greater quantity in the OG1RF salB mutant culture supernatant. Moreover, several proteins involved in cell wall synthesis and cell division, including d-Ala-d-Lac ligase and EzrA, were present in reduced quantity in OG1RF salB relative to the parent strain. The salB mutant displayed reduced viability and anomalous cell division, and these phenotypes were exacerbated in a gelE salB double mutant. An epistatic relationship between gelE and salB was not identified with respect to increased autolysis and cell morphological changes observed in the salB mutant. SalB was purified as a six-histidine-tagged protein to investigate peptidoglycan hydrolytic activity; however, activity was not evident. High-pressure liquid chromatography (HPLC) analysis of reduced muropeptides from peptidoglycan digested with mutanolysin revealed that the salB mutant and OG1RF were indistinguishable.
Shankar, Jayendra; Walker, Rachel G.; Wilkinson, Mark C.; Ward, Deborah
It is well recognised that ingestion of food is a trigger for functional bowel symptoms, particularly those associated with irritable bowel syndrome (IBS). Patients often use manipulation of diet as a means of controlling symptoms. Despite description of multiple dietary methods, few have scientific backing or quality evidence of efficacy. One approach is to define how specific food components influence the pathophysiology of IBS and then rationally design dietary approaches. For example, short-chain poorly absorbed carbohydrates (fermentable oligo-, di- and mono-saccharides and polyols (FODMAP)) cause luminal distension, which is a major stimulus for the development of symptoms in patients with visceral hypersensitivity. By determining food content of FODMAP, a diet in which foods low in FODMAP are favoured over those high in FODMAP can be designed. Observational, comparative and randomised controlled treatment and rechallenge studies have shown that such an approach is efficacious in the majority of patients with IBS. The low FODMAP diet is now the primary dietary therapy for such patients. Similar approaches can be applied to other food components, including proteins (such as gluten), fats and natural bioactive food chemicals. Such approaches have suggestions of efficacy, but the evidence base remains underdeveloped. An additional and important consideration for any dietary therapy is its nutritional adequacy and potential adverse health effects. Dietary manipulation is now a key management strategy in patients with functional bowel symptoms. Future well-designed interventional studies will lead to refinement of dietary approaches taken and to a better understanding of their long-term safety. PMID:24134168
The psychological correlates of bulimia include affective disorder and emotional liability. In addition, emotional liability appears to precipitate binge-purge episodes. It has been proposed that emotional liability is a function of irrational beliefs regarding personal performance, interpersonal relationships and self-control. Irrational beliefs and bulimia symptoms were assessed with psychometrically valid self-report measures. Correlational analyses showed that the irrational beliefs of
Although studies on sub-threshold depression in childhood and adolescence havedemonstrated an at risk profile that merits further attention, only few investigators examined the impact of therapy with these children. In this study, twenty elementary schoolchildren (aged 10–12) with moderate depressive symptoms were randomly assigned to an eighteen-session cognitive-behavioural treatment programme or to a waiting list (WL) control group (= Study
Sandy De Cuyper; Benedikte Timbremont; Caroline Braet; Vicky De Backer; Tina Wullaert
We determined the relationship between symptom severity and distress for multiple cancer symptoms, and examined patient demographic influences on severity and distress in advanced cancer. A Cochran-Armitage trend test determined whether symptom distress increased with severity. Chi-square, Fisher's exact test and logistic regression analysis examined moderate/severe ('clinically important') and distressful symptoms by age (65), gender, primary site group, and ECOG performance status. Forty-six symptoms were analyzed in 181 individuals. More than 50% of individuals with clinically important symptoms rated them as distressful. The median percentage of individuals with mild but still distressful symptoms was 25%, with a range of 0% (bad dreams) to 73% (sore mouth). In both univariate and multivariate analysis, younger (symptoms (only anxiety was more frequently distressful to older individuals). Clinically important symptoms and two of those considered distressful varied by primary site group. After control for severity, symptom distress did not differ by primary site group. The prevalence of distress increased with greater symptom severity. Younger individuals, those with poor performance status, and females had greater symptom severity and distress. Mild symptoms were often distressful. After adjustment for severity, age, gender, and performance status all influenced symptom distress. PMID:20015920
In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and ASD symptoms. OCD patients showed increased ADHD and autism symptom frequencies, OCD + ADHD patients reporting more autism symptoms (particularly attention switching and social skills problems) than OCD - ADHD patients. Attention switching problems were most significant predictors of OC symptom dimensions (except hoarding) and of symptom severity. Hoarding was not associated with elevated autism scale scores, but with inattention. In conclusion, attention switching problems may reflect both symptom overlap and a common etiological factor underlying ASD, ADHD and OCD. PMID:20039111
Anholt, Gideon E; Cath, Danielle C; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H; van Megen, Harold; van Balkom, Anton J L M
In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and ASD symptoms. OCD patients showed increased ADHD and autism symptom frequencies, OCD + ADHD patients reporting more autism symptoms (particularly attention switching and social skills problems) than OCD ? ADHD patients. Attention switching problems were most significant predictors of OC symptom dimensions (except hoarding) and of symptom severity. Hoarding was not associated with elevated autism scale scores, but with inattention. In conclusion, attention switching problems may reflect both symptom overlap and a common etiological factor underlying ASD, ADHD and OCD.
Anholt, Gideon E.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.
This study assessed the prevalence of risk for development of post-traumatic stress disorder (PTSD) symptoms among active duty and reserve veterans from Pennsylvania and Hawaii who either deployed (N = 1,524) or did not deploy (N = 2,727) to the Persian Gulf as a result of Operation Desert Storm. All participants anonymously completed a survey questionnaire that included the Impact of Event Scale and the Brief Symptom Inventory. Results indicate the likelihood of PTSD symptoms in approximately 8.0% of active duty veterans and 9.3% of reserve veterans who deployed to the Persian Gulf. PTSD risk comparisons are made with other active duty Army veterans assessed 1 year earlier. Sources of trauma are presented and implications for future military deployments on potential risks for developing PTSD are discussed. PMID:8754714
Stretch, R H; Marlowe, D H; Wright, K M; Bliese, P D; Knudson, K H; Hoover, C H
Purpose Symptoms of urinary bladder detrusor dysfunction have been rarely reported in Lyme disease. The aim was to carry out the first systematic study to compare the prevalence of such symptoms in a group of Lyme disease patients and a group of matched controls. Methods A questionnaire relating to detrusor function was administered to 17 serologically positive Lyme disease patients and to 18 control subjects. Results The two groups were matched in respect of age, sex, body mass, and mean arterial blood pressure. None of the 35 subjects was taking medication which might affect urinary function and none had undergone a previous operative procedure on the lower urinary tract. Six of the Lyme patients (35%) and none of the controls (0%) had symptoms of detrusor dysfunction (P<0.01). Conclusions This first systematic controlled study confirms that Lyme disease is associated with urinary bladder detrusor dysfunction. Further evaluation of detrusor function is warranted in this disease.
Shah, Mussadiq; Julu, Peter O.; Kingston, Michele C.; Monro, Jean A.
Previous studies have demonstrated that the ebp operon and the ace gene of Enterococcus faecalis, encoding endocarditis- and biofilm-associated pili and an adhesin to collagen of E. faecalis, respectively, are both important in experimental urinary tract infections (UTI) and endocarditis. We have also shown that growth of E. faecalis in brain heart infusion (BHI) serum enhances Ebp pilus and Ace production and increases adherence to several host extracellular matrix proteins. Here, we report that deletion of ebpABC almost eliminated serum-elicited adherence to fibrinogen (P < 0.0001), resulted in moderate reduction in adherence to collagen (P < 0.05), and had no effect on fibronectin adherence relative to that of wild-type OG1RF. An OG1RF?ace?ebpABC double mutant showed further reduced collagen adherence versus that of the OG1RF?ace or OG1RF?ebpABC mutants (P < 0.001). These results were corroborated by complementation and/or studies with native pilus-enriched surface extracts and a collagen-secreting 3T6 fibroblast cell line, as well as antibody inhibition. In the UTI model, both the OG1RF?ace and OG1RF?ace?ebpABC mutants were found to be significantly attenuated compared to the wild type; however, no significant differences were observed between individual ace or ebp mutants and the OG1RF?ace?ebpABC mutant. In summary, these data implicate the Ebp pili as having some role in collagen adherence, albeit less than that of Ace, and a very major role in fibrinogen adherence, which may explain in part the importance of these pili in experimental endocarditis. The OG1RF?ace?ebpABC mutant was attenuated in the UTI model, although not significantly more so than the ?ace or ?ebpABC mutants, suggesting involvement of other E. faecalis factors in urinary tract colonization or infection.
Nallapareddy, Sreedhar R.; Singh, Kavindra V.; Sillanpaa, Jouko; Zhao, Meng; Murray, Barbara E.
|Objective: This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. Method: Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience…
Smith, Bruce W.; Ortiz, J. Alexis; Steffen, Laurie E.; Tooley, Erin M.; Wiggins, Kathryn T.; Yeater, Elizabeth A.; Montoya, John D.; Bernard, Michael L.
Objective: This study investigated the association between mindfulness, other resilience resources, and several measures of health in 124 urban firefighters. Method: Participants completed health measures of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, physical symptoms, and alcohol problems and measures of resilience…
Smith, Bruce W.; Ortiz, J. Alexis; Steffen, Laurie E.; Tooley, Erin M.; Wiggins, Kathryn T.; Yeater, Elizabeth A.; Montoya, John D.; Bernard, Michael L.
Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Scale (DTS) across three veteran samples: treatment-seeking Vietnam- era veterans, treatment-seeking post-Vietnam-era veterans, and Operation Enduring Freedom\\/Operation Iraqi Freedom (OEF\\/OIF) veteran research participants. Confirmatory factor analyses of
Scott D. McDonald; Jean C. Beckham; Rajendra Morey; Christine Marx; Larry A. Tupler; Patrick S. Calhoun
... Feature: Glaucoma Glaucoma: Symptoms, Diagnosis, Treatment and Latest Research Past Issues / Fall 2009 Table of Contents Symptoms ... patients may need to keep taking drugs. Latest Research Researchers are studying the causes of glaucoma, looking ...
Menopausal symptoms commonly occur in breast cancer survivors. In this research program we evaluated the efficacy of a comprehensive menopausal assessment (CMA) and intervention program for management of menopausal symptoms (hot flashes, vaginal dryness, ...
... reprinted for personal, noncommercial use only. Carpal tunnel exercises: Can they relieve symptoms? By Mayo Clinic staff ... e-mail address Sign up Question Carpal tunnel exercises: Can they relieve symptoms? I've been diagnosed ...
... Publications What are common symptoms of pheochromocytoma? Page Content Pheochromocytoma causes a variety of signs and symptoms, including (in alphabetical order): Abdominal pain Constipation Chest pain Dizziness Elevated blood sugar Facial flushing (redness) High blood pressure Increased respiratory ...
... Twitter. What Are the Signs and Symptoms of Cystic Fibrosis? The signs and symptoms of cystic fibrosis (CF) ... respiratory, digestive, or reproductive systems of the body. Cystic Fibrosis Figure A shows the organs that cystic fibrosis ...
Although effective treatments for negative symptoms are currently limited, clinicians still need to assess and monitor them because of their impact on patient functioning. Further, documenting patients' negative symptoms provides a complete clinical record that the clinician can use to make systematic and careful treatment decisions. Several tools for assessing negative symptoms in schizophrenia are available, including the Clinical Global Impression scale (CGI), the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS), the 16-item Negative Symptoms Assessment (NSA-16), and the Schedule for Deficit Syndrome (SDS). Additionally, newer instruments are in development-the Clinical Assessment Interview for Negative Symptoms (CAINS) and the Brief Negative Symptoms Scale (BNSS)-and are yielding promising results. This overview outlines these assessment tools so that clinicians can measure negative symptom severity and track treatment response for their patients with schizophrenia. PMID:23842020
The Post-concussive Symptom Questionnaire (PCSQ) and its short forms were evaluated to determine their utility in measuring symptom validity as brief self-report measures in 112 individuals referred for a neuropsychological evaluation. First, the relationships between the PCSQ forms and measures of cognitive performance (Wechsler Adult Intelligence Scale-Fourth Edition Full-Scale IQ, California Verbal Learning Test-Second Edition Trials 1-5 Total T-score, Trails B, FAS), general distress (Minnesota Multiphasic Personality Inventory [MMPI]-2 M8), and self-report symptom validity (MMPI-2 FBS Symptom Validity Scale [FBS] and Response Bias Scale [RBS]) were investigated to determine construct validity. Measures of self-report symptom validity explained the greatest amount of variance. Second, receiver operating characteristics curve analyses were conducted to determine the predictive value of the PCSQ forms in detecting over reporting on the FBS and the RBS in addition to establishing optimal cutoff scores. On the basis of the proposed cutoff scores, sensitivity, specificity, positive predictive power, negative predictive power, and hit rates were calculated. PMID:20710017
Van Dyke, Sarah A; Axelrod, Bradley N; Schutte, Christian
Our previous work identified a cosmid clone containing a 43-kb insert from Enterococcus faecalis OG1RF that produced a nonprotein antigen in Escherichia coli. In the present work, we studied this clone in detail. Periodate treatment of lysates of the clone confirmed that the antigen was carbohydrate in nature. Analysis of DNA sequences and transposon insertion mutants suggested that the insert contained a multicistronic gene cluster. Database comparison showed that the cluster contained genes similar to genes involved in the biosynthesis of dTDP-rhamnose, glycosyltransferases, and ABC transporters involved in the export of sugar polymers from both gram-positive and gram-negative organisms. Insertions in several genes within the cluster abolished the immunoreactivity of the clone. This is the first report on a gene cluster of E. faecalis involved in the biosynthesis of an antigenic polysaccharide.
Depressive symptoms are common among hospitalized patients and can indicate more serious problems. This study examined the level of depressive symptoms among patients in one hospital in Jerusalem, the variables related to depression, and the extent to which social workers provided services to those patients. Over 60% of patients reported high levels of depressive symptoms. Levels were higher among Arabs,
... treatment for you. Not everyone who goes through trauma will get PTSD, but keep in mind that good treatments are available even if you only have some PTSD symptoms. Brief checklist of trauma symptoms Check the symptoms below that you experience. ...
The power of four cardiorespiratory symptoms to predict subsequent mortality has been analysed in data derived from a random sample of the population of Great Britain recruited in 1965 and followed for 12.4 years. The associations of respiratory symptoms with all causes of death (except stroke) and of cardiovascular symptoms with death from coronary heart disease were strong. The trends
Psychological theories on symptom perception have put forward determinants of physical symptom reporting. These determinants concern either attentional strategies, attributional processes or personality factors. In this paper, we bring together five major determinants of symptom reporting (external information, selective attention to body, attributional style, negative affectivity and somatization) in a cognitive-psychological model. Sex differences on these determinants may contribute to
M. T. Cecile; Gijsbers van Wijk; Annemarie M. Kolk
Gender differences in adolescent depressive symptoms are substantially reduced when body image is statistically controlled. The current investigation examines the temporal association (13-month time lag) between body image and depressive symptoms in an ethnically diverse sample of male and female adolescents. It was anticipated that body image would have a stronger impact on the depressive symptoms of girls than of
Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the reexperiencing, avoidance\\/numbing, and
Matthew J. Cordova; Jamie L. Studts; Danette M. Hann; Paul B. Jacobsen; Michael A. Andrykowski
... 5/2013 Symptoms and Signs Cancer.Net Guide Head and Neck Cancer Overview Statistics Risk Factors and Prevention Symptoms and ... or click “Next” at the bottom. People with head and neck cancer often experience the following symptoms or signs. Sometimes, ...
The present study examined the associations among the frequency of negative social interactions, personality traits, and depressive symptoms in university students. Subjects completed measures of negative social interactions, sociotropy, autonomy, perfectionism, and depressive symptoms. It was found in the total sample that higher depression symptoms scores were correlated significantly with the frequency of negative social interactions, sociotropy, autonomy, and socially
GORDON L. FLETT; PAUL L. HEWITT; MARILYN GARSHOWITZ; THOMAS R. MARTIN
|A survey of 110 triathletes was made to identify symptoms experienced during triathlon activities, to determine factors affecting the symptoms, and to find out if symptoms were specific to the athlete or to the event. Results are discussed. (Author/MT)|
Purpose/Objectives To review how gastrointestinal (GI) symptoms are represented within symptom clusters in patients with cancer receiving chemotherapy. Data Sources MedLINE®, PsycINFO, and CINAHL®. Data Synthesis Forty-two symptom clusters containing a GI component emerged. Only four clusters were replicated in different samples; 38 were unique clusters. Thirteen different symptom measurement tools were used across the studies. Nineteen different GI symptoms were measured; however, many chemotherapy- or cancer-related GI symptoms known to be present in this population were missing or underrepresented. Twenty-one of the studies reviewed identified a symptom cluster that was primarily (50% or greater) composed of GI symptoms. Conclusions GI symptoms are prevalent in symptom clusters, but those clusters often are inconsistent. One explanation for this finding may be that current symptom measurement tools do not fully address GI symptoms commonly experienced by patients receiving chemotherapy. Implications for Nursing Future research should focus on using a comprehensive symptom assessment tool in a homogenous sample of participants who are receiving chemotherapy. Improved measurement of GI symptoms will advance symptom cluster research, which could impact assessment of chemotherapy-related symptoms and development of interventions for symptom clusters.
This is program system for long term production and development planning in hydro dominated electric power supply systems, consisting of two or more cooperating subsystems. The report describes how the components of the supply system are represented in th...
A. Haugstad T. Reinertsen A. Johannesen T. Green O. J. Botnen
The relation between life events and psychiatric symptoms among wives of soldiers deployed to the Persian Gulf during Operation Desert Storm (ODS) was examined. Psychiatric symptoms were measured, using the 25-item Hopkins Symptom Checklist (HSCL), at two times, once while the soldiers were away and a second time several months after they returned. In a multiple regression analysis, symptoms at
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. PMID:19932143
Background: Surgical treatment is the most effective method for weight reduction in morbid obesity. The most common operations\\u000a are gastric banding and gastric bypass. The effect of these interventions on esophageal function and gastroesophageal reflux\\u000a symptoms has not been adequately investigated. Methods: Patients undergoing obesity surgery were prospectively included in\\u000a an observational study. Before surgery, each of the 53 patients
Michael Korenkov; Lothar Köhler; Nedim Yücel; Guido Grass; Stefan Troidl; Maria Lempa; Hans Troidl
The review discusses the physiological and pathophysiological mechanisms associated with the symptoms of acute and chronic rhinosinusitis. An understanding of symptom mechanisms is important for the clinical diagnosis of rhinosinusitis and is important in assessing the efficacy of surgical and medical treatments for rhinosinusitis. The review will discuss the four primary symptoms used to diagnose rhinosinusitis: nasal obstruction, nasal discharge, facial pain and loss of sense of smell; and the secondary symptoms, cough, sneezing, sore throat and voice changes, epiphora, fever, and psychological effects and fatigue. The review will highlight that our understanding of a key diagnostic symptoms facial pain is limited, and that the incidence of pain with rhinosinusitis is controversial. Sneezing is a common symptom of acute rhinosinusitis with allergy but is not normally described as symptom in chronic rhinosinusitis and this anomaly is in need of more research. The mechanism of unilateral nasal obstruction with rhinosinusitis is discussed. PMID:21751530
|Objective: The effect of manipulating item positioning on self-reported ADHD symptoms was examined. We assessed whether listing DSM-IV ADHD symptoms serially or interspersed affected (a) the correlation between ADHD symptoms and (b) the rate of symptom endorsement. Method: In Study 1, an undergraduate sample (n = 102) completed a measure that…
Mitchell, John T.; Knouse, Laura E.; Nelson-Gray, Rosemery O.; Kwapil, Thomas R.
Research has shown that elderly patients are especially at risk for the development of psychotic symptoms. A combination of factors contributes to the increased risk for psychosis in this patient population. Various DSM-IV diagnostic categories including delirium, schizophrenia, delusional disorder, mood disorders, dementia, substance abuse, and medical-neurologic conditions can be associated with psychotic symptoms. In general, medications are prescribed for specific target symptoms, started at low doses, and titrated gradually. Although buspirone, trazodone, valproic acid, and carbamazepine have been used with some success, antipsychotic medications have been the primary treatment of psychosis in the elderly. Because the atypical antipsychotics offer effective management of psychotic symptoms combined with low liability of extrapyramidal symptoms, these agents may be the current treatment of choice for psychotic symptoms in the elderly when used cautiously.
Research suggests that Attention Deficit Hyperactivity Disorder (ADHD) and nicotine withdrawal symptoms are related; however, it is unknown how this relationship extends across ADHD symptom gradations, differs between inattention and hyperactivity-impulsivity symptom types, and generalizes to a national sample. This study examined cross-sectional associations between childhood ADHD symptom indexes (total, inattention, and hyperactivity-impulsivity) and lifetime DSM-IV nicotine withdrawal symptoms. Results showed that each ADHD symptom index associated with almost every withdrawal symptom (Ps < .01). After controlling for hyperactivity-impulsivity and inattention symptom overlap, inattention (but not hyperactivity-impulsivity) retained incremental associations with most withdrawal symptoms. These findings are relevant for understanding mechanisms of ADHD and smoking comorbidity.
This prospective 20-year study assessed associations between maternal depressive symptoms in infancy, childhood, and adolescence, and child and adolescent depressive symptoms in a sample of families at high psychosocial risk. Maternal symptomatology was assessed with the Center for Epidemiological Studies Depression Scale (CES-D) when children were infants (12 months), school-aged (age 8), and adolescents (age 19). Children's depressive symptoms were measured at age 8 (Dimensions of Depression Profile for Children and Adolescents) and age 19 (CES-D). Maternal depressive symptoms during infancy contributed to the prediction of child depressive symptoms at age 8, after controlling for concurrent maternal depressive symptoms, clinical risk in infancy, and gender. Clinical risk in infancy marginally contributed to the prediction model. Disorganization of attachment in infancy and maternal hostility were independent predictors of depressive symptoms at age 8 and did not mediate the relation between maternal and child depressive symptoms. Depressive symptoms in adolescence were predicted by gender, children's depressive symptoms at age 8, maternal depressive symptoms in adolescence, and maternal depressive symptoms in infancy. There was no moderating effect of gender. Adding to previous evidence on the importance of early maternal depression, maternal depressive symptoms during infancy were related to the development of depressive symptoms in childhood and adolescence even when other variables of potential relevance were controlled. PMID:19338696
Bureau, Jean-François; Easterbrooks, M Ann; Lyons-Ruth, Karlen
This prospective 20-year study assessed associations between maternal depressive symptoms in infancy, childhood, and adolescence and child and adolescent depressive symptoms in a sample of families at high psychosocial risk. Maternal symptomatology was assessed with the Center for Epidemiological Studies-Depression Scale (CES-D; Radloff, 1977) when children were infants (12 months), school-aged (age 8), and adolescents (age 19). Children’s depressive symptoms were measured at age 8 (Dimensions of Depression Profile for Children and Adolescents, Hatter & Nowakowski, 1987) and age 19 (CES-D). Maternal depressive symptoms during infancy contributed to the prediction of child depressive symptoms at age 8, after controlling for concurrent maternal depressive symptoms, clinical family risk in infancy, and gender. Clinical family risk in infancy marginally contributed to the prediction model. Disorganization of attachment in infancy and maternal hostility were independent predictors of depressive symptoms at age 8 and did not mediate the relation between maternal and child depressive symptoms. Depressive symptoms in adolescence were predicted by gender, children’s depressive symptoms at age 8, maternal depressive symptoms in adolescence, and maternal depressive symptoms in infancy. There was no moderating effect of gender. Adding to previous evidence on the importance of early maternal depression, maternal depressive symptoms during infancy were strongly related to the development of depressive symptoms in childhood and adolescence.
Bureau, Jean-Francois; Easterbrooks, M. Ann; Lyons-Ruth, Karlen
Functional gastrointestinal disorders are the most common problem in gastroenterological practice. They are defined by chronic abdominal symptom complexes that occur in the absence of underlying structural abnormalities. The pathogenesis of these disorders is heterogeneous and involves behavioral, infective, and inflammatory components. Common symptoms are abdominal pain, diarrhea, constipation, and bloating. Mechanisms underlying these symptoms include alterations in gastrointestinal motility, visceral perception, altered epithelial function, and disturbances in fermentation activity by gut commensal bacteria.
OBJECTIVE: The severity of self-reported withdrawal symptoms varies during detoxification of opioid-dependent patients. The aim of this study is to identify subgroups of withdrawal symptoms within the detoxification trajectory and to predict the severity of withdrawal symptoms on the basis of drug-related and sociodemographic characteristics. DESIGN AND SETTING: A prospective study carried out in an in-patient setting in four addiction
B. A. G. Dijkstra; P. F. M. Krabbe; C. A. J. de Jong; C. P. F. van der Staak
Objective: The severity of self-reported withdrawal symptoms varies during detoxification of opioid-dependent patients. The aim of this study is to identify subgroups of withdrawal symptoms within the detoxification trajectory and to predict the severity of withdrawal symptoms on the basis of drug-related and sociodemographic characteristics. Design and setting: A prospective study carried out in an in-patient setting in four addiction
B. A. G. Dijkstra; P. F. M. Krabbe; C. A. J. de Jong; C. P. F. van der Staak
Relieving the suffering associated with cancer and its treatment in the physical, emotional, practical, and spiritual domains is impossible without impeccable symptom control. This review summarizes key features essential to the management of: anorexia/cachexia, bowel obstruction, diarrhea, fatigue, mucositis, and nausea/vomiting. Taken together, these are some of the most vexing symptoms for cancer patients. Well-managed symptoms enable the course of overall cancer care to be unimpeded. PMID:24051612
Summary Objective Although many cancer patients experience multiple concurrent symptoms, most studies have either focused on the analysis of single symptoms, or have used methods such as factor analysis that make a priori assumptions about how the data is structured. This article addresses both limitations by first visually exploring the data to identify patterns in the co-occurrence of multiple symptoms, and then using those insights to select and develop quantitative measures to analyze and validate the results. Methods We used networks to visualize how 665 cancer patients reported 18 symptoms, and then quantitatively analyzed the observed patterns using degree of symptom overlap between patients, degree of symptom clustering using network modularity, clustering of symptoms based on agglomerative hierarchical clustering, and degree of nestedness of the symptoms based on the most frequently co-occurring symptoms for different sizes of symptom sets. These results were validated by assessing the statistical significance of the quantitative measures through comparison with random networks of the same size and distribution. Results The cancer symptoms tended to co-occur in a nested structure, where there was a small set of symptoms that co-occurred in many patients, and progressively larger sets of symptoms that co-occurred among a few patients. Conclusions These results suggest that cancer symptoms co-occur in a nested pattern as opposed to distinct clusters, thereby demonstrating the value of exploratory network analyses to reveal complex relationships between patients and symptoms. The research also extends methods for exploring symptom co-occurrence, including methods for quantifying the degree of symptom overlap and for examining nested co-occurrence in co-occurrence data. Finally, the analysis also suggested implications for the design of systems that assist in symptom assessment and management. The main limitation of the study was that only one dataset was considered, and future studies should attempt to replicate the results in new data.
A survey of 100 professionally supervised bungee jumpers who used an ankle harness in a single leap from a platform reveals that 42 jumpers had a total of 59 minor medical complaints or symptoms after their jumps. Immediate symptoms included musculoskeletal pain in the ankle, neck, back, and chest, neurologic complaints such as dizziness and headache, and blurred vision. Dizziness was the most common symptom, and neurologic complaints outnumbered musculoskeletal symptoms. All complaints resolved within 1 week of the jump except for lacerations sustained by one person who tried to grab the platform as he was jumping. PMID:20086815
Depressive symptoms are common among hospitalized patients and can indicate more serious problems. This study examined the level of depressive symptoms among patients in one hospital in Jerusalem, the variables related to depression, and the extent to which social workers provided services to those patients. Over 60% of patients reported high levels of depressive symptoms. Levels were higher among Arabs, those with lower income, small social networks, stronger locus of control (powerful others), weaker internal locus of control, and low emotional support from staff. Social workers were in contact with 44% of patients who had high levels of depressive symptoms. PMID:22352360
Objective: To provide a critical review and analysis of heart failure (HF)-specific symptom measures Methods: A systematic search using the PubMed and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases and reference lists of relevant papers was undertaken to identify symptom measures that were primarily designed for patients with HF. Results: The systematic search yielded seven instruments that included three or more symptoms. Of the seven instruments, only five had psychometric properties available and these were reviewed. Levels of comprehensiveness of symptom measures varied including the number of symptoms assessed (13-32 symptoms/signs) and symptom dimensions (e.g. frequency and severity). Information about reading levels, time to completion, and completion rates was limited. Psychometric properties of the five measures have not been extensively investigated or reported. Conclusion: The development and use of the HF symptoms instruments is at a relatively early stage. Thus, further investigation of the psychometric characteristics of existing HF-specific symptom instruments is necessary before one can be recommended for research and clinical use. PMID:23303769
Many veterans of Operation Enduring Freedom and Operation Iraqi Freedom have incurred blast related injuries during deployment. One of the most common blast related injuries is mild traumatic brain injury, with the long-term consequences known as postconcussive Syndrome (PCS). Because of frequent combat related injuries and lengthy deployments, many OEF\\/OIF returnees also report ongoing pain problems and symptoms of posttraumatic
Robyn L. Walker; Michael E. Clark; Steven H. Sanders
Objective: A substantial proportion of the more than 2 million service members who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have experienced a traumatic brain injury (TBI). Understanding the long-term impact of TBI is complicated by the nonspecific nature of postconcussive symptoms (PCSs) and the high rates of co-occurrence among TBI, posttraumatic stress disorder (PTSD),
Sandra B. Morissette; Matthew Woodward; Nathan A. Kimbrel; Eric C. Meyer; Marc I. Kruse; Sara Dolan; Suzy Bird Gulliver
In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…
Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.
|In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…
Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.
Rashid Bin Muhammad at Kent State University presents his page of lectures notes and other instructional materials on operating systems. The site is divided into a number of topics about operating systems: history, structure, process, threads, Solaris-2, CPU / process scheduling, schedule algorithm, interprocess communication, deadlock, important UNIX commands, and references. The site is then followed by links to outside resources to help supplement the material presented here. This is a great resource for computer science instructors teaching students about operating systems.
Being chosen as a differential operator of a special form, the metric ? operator has become unitary equivalent to a one-dimensional Hermitian Hamiltonian with a natural supersymmetric structure. We show that fixing the superpartner of this Hamiltonian permits us to determine both the metric operator and the corresponding non-Hermitian Hamiltonian. Moreover, under an additional restriction on the non-Hermitian Hamiltonian, it has become a superpartner of another Hermitian Hamiltonian. This article is part of a special issue of Journal of Physics A: Mathematical and Theoretical devoted to ‘Quantum physics with non-Hermitian operators’.
OBJECTIVE: Dissociation is a mental process with psychological and somatoform manifestations, which is closely related to hypnotic suggestibility and essentially shows the ability to obtain distance from reality. An increased tendency to dissociate is a frequently reported characteristic of patients with functional neurological symptoms and syndromes (FNSS), which account for a substantial part of all neurological admissions. This review aims to investigate what heart rate variability (HRV), EEG and neuroimaging data (MRI) reveal about the nature of dissociation and related conditions. METHODS: Studies reporting HRV, EEG and neuroimaging data related to hypnosis, dissociation and FNSS were identified by searching the electronic databases Pubmed and ScienceDirect. RESULTS: The majority of the identified studies concerned the physiological characteristics of hypnosis; relatively few investigations on dissociation related FNSS were identified. General findings were increased parasympathetic functioning during hypnosis (as measured by HRV), and lower HRV in patients with FNSS. The large variety of EEG and functional MRI investigations with diverse results challenges definite conclusions, but evidence suggests that subcortical as well as (pre)frontal regions serve emotion regulation in dissociative conditions. Functional connectivity analyses suggest the presence of altered brain networks in patients with FNSS, in which limbic areas have an increased influence on motor preparatory regions. CONCLUSIONS: HRV, EEG and (functional) MRI are sensitive methods to detect physiological changes related to dissociation and dissociative disorders such as FNSS, and can possibly provide more information about their aetiology. The use of such measures could eventually provide biomarkers for earlier identification of patients at risk and appropriate treatment of dissociative conditions. PMID:23175855
van der Kruijs, Sylvie J M; Bodde, Nynke M G; Carrette, Evelien; Lazeron, Richard H C; Vonck, Kristl E J; Boon, Paul A J M; Langereis, Geert R; Cluitmans, Pierre J M; Feijs, Loe M G; Hofman, Paul A M; Backes, Walter H; Jansen, Jacobus F A; Aldenkamp, A P
Our research is motivated by 2 methodological problems in assessing diagnostic accuracy of traditional Chinese medicine (TCM) doctors in detecting a particular symptom whose true status has an ordinal scale and is unknown—imperfect gold standard bias and ordinal scale symptom status. In this paper, we proposed a nonparametric maximum likelihood method for estimating and comparing the accuracy of different doctors in detecting a particular symptom without a gold standard when the true symptom status had an ordered multiple class. In addition, we extended the concept of the area under the receiver operating characteristic curve to a hyper-dimensional overall accuracy for diagnostic accuracy and alternative graphs for displaying a visual result. The simulation studies showed that the proposed method had good performance in terms of bias and mean squared error. Finally, we applied our method to our motivating example on assessing the diagnostic abilities of 5 TCM doctors in detecting symptoms related to Chills disease.
Exaggerated startle and PTSD symptoms have been investigated primarily in relation to acute or Type I stressors. The present study examined PTSD symptoms and startle eyeblink response in relation to chronic or Type II stressors. Type II stressors were operationally defined as high levels of childhood corporal punishment and high levels of current partner aggression. This study recruited a sample of 52 women from a metropolitan community and administered several questionnaires assessing experience of corporal punishment in childhood, current intimate partner aggression and level of PTSD symptoms. Following questionnaires, women were presented with eight auditory startle probes (white noise). Results showed that both childhood corporal punishment and intimate partner aggression were associated with women's PTSD symptom scores. However, only PTSD symptom scores were associated with reduced startle. Results are discussed in light of Type I and Type II stressors, and recent suggestions in the PTSD literature that a subgroup of individuals may experience physiological suppression rather than heightened physiological reactivity. PMID:11286819
Medina, A M; Mejia, V Y; Schell, A M; Dawson, M E; Margolin, G
The family stress model posits that contextual stressors, such as neighborhood danger, negatively influence youth adjustment, including internalizing symptoms, via disruptions in parenting and family processes. The current study examined a culturally and contextually modified family stress model in a diverse sample of Mexican origin fathers and their children (N = 463) from the Southwestern U.S. Results supported the hypothesized negative influence of neighborhood danger on youth internalizing symptoms via disruptions in family cohesion. Paternal warmth did not play a role in linking contextual stress to outcomes. The role of harsh parenting was highly nuanced. Results suggest that both culture and context have the potential to moderate putative family stress model associations for specific parenting behaviors and further our understanding of the ways that culture and context may operate in models of family stress and youth outcomes. PMID:22383856
Since the end of the Cold War the role of the armed forces in the operational environment has changed profoundly and continues to change. Long-held views about the roles and attributes of individual services have been challenged by contemporary operations, as have the traditional barriers between the military and their civilian counterparts in conflict zones. All such change is the
This study examined the relationship between obesity and asthma symptom perception in 200 youth with asthma. Repeated subjective and objective peak flow measurements were summarized using the Asthma Risk Grid (Klein et al., 2004), resulting in Accurate, Symptom Magnification and Danger Zone scores. Analyses were stratified by age and included ethnicity.For younger children, obesity was not significantly related to perception
Sheryl J. Kopel; Natalie Walders-Abramson; Elizabeth L. McQuaid; Ronald Seifer; Daphne Koinis-Mitchell; Robert B. Klein; Marianne Z. Wamboldt; Gregory K. Fritz
Researchers examining the relationship of autism "symptomatology" and maternal stress have defined symptomatology in terms of level of severity, frequency of occurrence, or symptom type. In the present study, the relationship of maternal perceptions of these dimensions, along with a fourth, symptom diversity, and negative and positive indices of…
Examined the prevalence of depressive symptoms in an African American female college student sample (n=78) using the Minnesota Multiphasic Personality Inventory (MMPI2) and the Beck Depression Inventory (BDI). MMPI-2 was a more conservative scale than BDI in identifying depressive symptom levels. Discusses stress inoculation methods to assist…
To examine whether harsh winter weather is associated with depressive symptoms, 45 healthy subjects from Minnesota were compared to 42 subjects from California near the end of the winter season. No differences in the prevalence of depressive symptoms were found between the two groups.
Garvey, Michael J.; Goodes, Mike; Furlong, Candy; Tollefson, Gary D.
Extrapyramidal symptoms (EPSs), such as akathisia, dystonia, psuedoparkinsonism, and dyskinesia, are drug-induced side effects that can be problematic for persons who receive antipsychotic medications (APMs) or other dopamine-blocking agents. The clinical manifestations include a number of atypical involuntary muscle contractions that influence gait, movement, and posture. The symptoms can develop acutely, be delayed, or overlap making diagnosing a challenge. Preventive
In this report 50 subjects with multiple sclerosis are compared to 50 subjects with multiple personality disorder. The multiple sclerosis patients endorsed an average (1 3.0 somatic symptoms on structuredinterview, the multiple personality subjects an average of 14.5. The somatic symptoms characteristic of neurological illness were trouble walking, paralysis, and muscle weakness. Those characteristic of psychiatric illness were genitourinary and
Colin A. Ross; Geri Anderson; Anthony Auty; Judy Todd; Cohn A. Ross
Cinnamon, which is the bark of the Cinnamomum zeylanicum tree, contains cinnamic aldehyde, which is an irritant. Workers processing cinnamon before export are exposed to much cinnamon dust. Forty such workers with an average of four years' service in the industry were examined. Thirty five workers (87.5%) had symptoms, nine having had asthma (22.5%). Other symptoms, probably related to the
Bullies, victims and pupils neutral to bullyingwere compared on depressive symptoms and suicidal thoughts.The sample included 2,088 Norwegian boys and girls in grade 8. The results revealed that both bullies and victims had significantly higher mean scores than neutral pupils on both depressive symptoms and suicidal thoughts. Victims had a significantly higher mean score on depressive thoughts than the bullies.
The purpose of this study is to examine the classic psychopathologic notion of depersonalization in the light of the Basic Symptom paradigm. A sample of 57 chronic schizophrenics was cross-sectionally assessed with the Bonn Scale for the Assessment of Basic Symptoms (BSABS) and contextually with specific scales testing positive, negative, depressive and alexithymic dimensions. In order to categorize depersonalized vs.
The current study examined depressive symptoms, concerning the week following autism spectrum diagnosis and an average of 1.4 years later, in mothers (n = 75) of young children diagnosed with an autism spectrum disorder (ASD). Over three-quarters of mothers (78.7%) provided retrospective reports of clinically significant depressive symptoms…
|Childhood exposure to trauma has been associated with increased rates of somatic symptoms (SS), which may contribute to diminished daily functioning. One hundred and sixty-one children residing at a residential treatment home who had experienced neglect and/or abuse were administered the Trauma Symptom Checklist for Children (TSCC), the…
Kugler, Brittany B.; Bloom, Marlene; Kaercher, Lauren B.; Truax, Tatyana V.; Storch, Eric A.
Assessed nature and severity of psychological symptoms of university counseling center clients (N=l,589) with application of Symptom Check List-90-Revised (SCL-90-R) in a university counseling center setting. Found one-fourth of clients had scores indicating presence of psychiatric disorder. Results suggest need for crisis intervention skills and…
|A literature review was conducted to determine the meaning, symptoms, causes, and treatment of dyslexia. The review revealed that dyslexia simply means "distorted words," and is the inability to read either phonetically or visually. Among the symptoms of dyslexia disclosed by the review are motion sickness, retardation in reading of from 6 months…
The purpose of this study was to estimate the prevalence of perimenstrual symptoms in professionally employed women. Questionnaires were administered to all female nurses working at least 32 hr\\/wk in 7 different hospitals on the West Coast between October, 1987 and June, 1988. Of the 760 respondents, 594 were currently menstruating and met inclusion criteria. Symptoms frequently experienced by a
SUMMARY Objectives The main objective was to examine the association between obesity and depressive symptoms among Chinese elderly in Hong Kong. Methods Cross-sectional data on depressive symptoms and body mass index from 56 167 clients aged 65 or over who enrolled as members of Elderly Health Centres from July 1998 to December 2000 were analysed using multiple logistic regression with
Zhi Bin Li; Sai Yin Ho; Wai Man Chan; Kin Sang Ho; Mun Pik Li; Gabriel M Leung; Tai Hing Lam
Discusses the mechanism and interpretation of dreams. Dreams are examined as the causal factors of symptoms. They may be the source of depression in some individuals and these symptoms may persist. The manifest content of dreams is a distortion of a repressed wish of the dreamer. M. Prince (see Journal of Abnormal Psychology, Vol 5, 139-195, PA: 52638) has referred
|Objectives: The main purposes of this study were to determine (1) the prevalence of depressive symptoms among foster caregivers, (2) the social-demographics, risk factors, and social support predicting depressive symptoms, and (3) whether social support buffered the effects of the risk factors in the Illinois Foster Caregivers Study. Method:…
Dyspnea is one of the major clinical symptoms which patients report to general practitioners, internists, cardiologists and hospitals. In this review article we discuss the evidence of medical history, laboratory procedures and diagnostic investigations to approach patients with acute or chronic dyspnea and try to structure this complex symptom dyspnea to reach the etiology of the underlying disease. PMID:23615840
Background Despite known health risks related to the use of powdered latex gloves (PLGs), they are still widely used in hospitals in developing countries due to the high cost of alternatives. Aims To determine the prevalence of dermal and respiratory symptoms associated with latex glove use in nurses in Thailand and evaluate the influence of previously reported occupational risk factors in this population. Methods A cross-sectional study in female nurses working in three Thai hospitals. Participants completed a questionnaire on demographics, occupational and personal history, use of latex products at work and dermal and respiratory symptoms attributed to occupational use of latex gloves. Results Of 899 nurses, 18% reported health effects attributed to the use of latex products. After adjustment for confounding, occupational risk factors associated with increased reporting of dermal symptoms included wearing more than 15 pairs of PLG per day (odds ratio (OR): 2.10, 95% confidence interval (CI): [1.32-3.34]), using chlorhexidine (OR: 2.07, 95% CI: [1.22-3.52]) and being an operating theatre nurse (OR: 2.46, 95% CI: [1.47-4.12]). Being a labour ward nurse (OR: 3.52, 95% CI: [1.26-9.85]) was the only factor associated with increased reporting of respiratory symptoms. Conclusions Continuing use of PLGs in Thai nurses is associated with increased prevalence of dermal symptoms compared with data from developed countries. Measures to reduce such health effects are well established and should be considered. Additionally, replacement of chlorhexidine with an alternative detergent seems advisable. PMID:23749805
Depressive symptoms are common among patients with diabetes and may have a significant impact on self-management and health outcomes. In this study we predicted that: 1) there would be a significant association between depressive symptoms and diabetes symptom burden, physical functioning, diabetes self-care, and HbA1c levels; and, 2) that the association between depressive symptoms and HbA1c levels would be significantly
Paul S Ciechanowski; Wayne J Katon; Joan E Russo; Irl B Hirsch
This study examined differential symptom functioning (DSF) in ADHD symptoms across Malay and Chinese children in Malaysia.\\u000a Malay (N?=?571) and Chinese (N?=?254) parents completed the Disruptive Behavior Rating Scale, which lists the DSM-IV ADHD symptoms. DSF was examined using\\u000a the multiple indicators multiple causes (MIMIC) structural equation modeling procedure. Although DSF was found for a single\\u000a inattention (IA) symptom and
There have been few studies evaluating depressive symptoms in Chinese patients with schizophrenia. Thus, we planned to compare the diagnostic validity of 4 commonly used assessment scales for depression in schizophrenia in China. The association between different depression scales and between depression scales and negative symptoms were also studied. The study population consisted of 101 inpatients meeting the DSM-IV criteria for schizophrenia. Depression in the study subjects was defined by the DSM-IV criteria for a major depressive episode. The negative subscale of the PANSS was used to assess the negative symptoms in schizophrenia. The following 4 depression scales were assessed for their diagnostic validity as measures of depressive disorder in schizophrenia: the Calgary Depression Scale for Schizophrenia (CDSS), the Montgomery-Asberg Depression Rating Scale (MADRS), the Hamilton Rating Scale for Depression (HAM-D), and the depression subscale of the PANSS (PANSS-D). The depression scales were found to be highly intercorrelated with each other. Of the 4 depression scales studied, only CDSS can discriminate between depression and a PANSS negative symptoms subscale score or negative item scores. The areas under the receiver operating characteristic curves of the CDSS, HAM-D, MARDS, and PANSS-D were 0.954, 0.881, 0.828, and 0.897, respectively. The area under the receiver operating characteristic curve of the CDSS was significantly greater than those of the HAM-D, the MARDS, and the PANSS-D. Our study suggests that the CDSS may provide optimal assessment of depression in patients with schizophrenia. PMID:19214051
This study examined associations among several measures of emotion regulation, and their links to depressive symptoms, in a sample of children ages 10-12 years old (N=87). Both temporal features of emotion regulation and regulation processes involved in the evaluation, monitoring, and modification of emotion were assessed through parent and child report and behavioral observation. Children also completed a self-report measure of depressive symptoms. Children with more depressive symptoms were reported by mothers and rated by observers as having higher levels of negative affect intensity. Regarding emotion regulation processes, children with more depressive symptoms reported more biased interpretations of emotionally charged situations, less awareness of their emotions, and their mothers reported that they utilized less problem-focused coping and positive reframing when coping with upsetting events. Findings suggest that children with depressive symptoms experience a wide range of difficulties with emotion regulation. PMID:22160271
The authors present a very rare case of a child with anterior communicating artery aneurysm and symptoms of anorexia nervosa. Because of coexistence of subarachnoid haemorrhage and head trauma false diagnosis of temporal and frontal lobe contusion was initially established. Headaches, anorexia and cachexia occurred with aneurysm enlargement. Computed tomography and cerebral angiography allowed to indicate operation. After successful surgery all symptoms disappeared. PMID:10463263
Summary An abundance of research has observed that patients with cancer experience multiple concurrent symptoms, and recent research suggests that certain clusters of symptoms may have a synergistic effect on one another and on future patient outcomes. In this study we first identified relevant symptom clusters for a sample of cancer patients, and then tested the effectiveness of an educational
Margot E. Kurtz; J Cleo Kurtz; Charles W. Given; Barbara Given
Fear of anxiety has previously been found to be a predictor of overall symptoms of posttraumatic stress disorder (PTSD). The current exploratory study examines the relationship between fear of anxiety and symptoms of PTSD in a sample of adults exposed to Hurricane Katrina. Fear of anxiety was found to partially mediate the relationship between the severity of trauma and the severity of PTSD. Further, this mediation was found to operate differently by gender, with the mediation holding true for men but not for women. For both men and women, fear of anxiety was positively correlated with PTSD symptoms. PMID:20684018
Reuther, Erin T; Davis, Thompson E; Matthews, Russell A; Munson, Melissa S; Grills-Taquechel, Amie E
The World Trade Center catastrophe and subsequent rescue and clearance operations caused unusual respiratory tract symptoms in fire fighters and rescue workers. Persistent cough was a common symptom, being extraordinarily often associated with the gastroesophageal reflux symptom. Irritant dusts caused reactive airways dysfunction syndrome (RADS). Tracheal hyperreactivity increased with the exposure, and the risk of asthma is estimated to have increased up to 12 times higher as compared with the normal population. Investigation and treatment of exposed persons have yielded generalizable information about the reactions of the respiratory system in situations of heavy exposure. PMID:19839191
Aro, Leena; Sauni, Riitta; Lusa, Sirpa; Lindholm, Harri; Uitti, Jukka
Ten consecutive patients with arachnoid cysts in the middle cranial fossa, diagnosed by CT, were studied. They were divided into three clinical groups: (1) four patients with progressive symptoms caused by secondary bleeding, (2) five patients with non-progressive symptoms of headache or epilepsy, and (3) one asymptomatic patient. The nine symptomatic patients were operated upon and eight showed clinical improvement.
A 20-year-old woman who was fit and well presented with a history of left nasal blockage for 2 years. She was noted on anterior rhinoscopy to have nasal septal deviation towards the left. She was listed for septoplasty with the aim of relieving nasal obstruction. At operation she was found to have a mildly deviated septum to the left. There was also a rhinolith in the left nostril posterior to the deviated septum (figure 1). Following removal of the rhinolith, her nasal airway appeared adequate; hence, septoplasty was not performed. Postoperatively, the patient was pleased with the outcome. When the patient was shown the foreign body she recalled inserting a pen cover into her nose about 10 years previously (figure 2). When she presented to the Accident and Emergency department at that time she was told that there was no foreign body in her nose. PMID:22778205
A 20-year-old woman who was fit and well presented with a history of left nasal blockage for 2 years. She was noted on anterior rhinoscopy to have nasal septal deviation towards the left. She was listed for septoplasty with the aim of relieving nasal obstruction. At operation she was found to have a mildly deviated septum to the left. There was also a rhinolith in the left nostril posterior to the deviated septum (figure 1). Following removal of the rhinolith, her nasal airway appeared adequate; hence, septoplasty was not performed. Postoperatively, the patient was pleased with the outcome. When the patient was shown the foreign body she recalled inserting a pen cover into her nose about 10 years previously (figure 2). When she presented to the Accident and Emergency department at that time she was told that there was no foreign body in her nose. Figure 1Endoscopic view of rhinolith. Figure 2Rhinolith.
This paper provides a review and synthesis of current knowledge about the associations of ventilation system types in office buildings with sick building syndrome symptoms and discusses potential explanations for the associations. Relative to natural ventilation, air conditioning, with or without humidification, was consistently associated with a statistically significant increase in the prevalence of one or more SBS symptoms. Prevalences were typically higher by approximately 30% to 200% in the air conditioned buildings. In two of three assessments from a single study, symptom prevalences were also significantly higher in air conditioned buildings than in buildings with simple mechanical ventilation and no humidification. In approximately half of assessments, SBS symptom prevalences were significantly higher in buildings with simple mechanical ventilation than in buildings with natural ventilation. Insufficient information was available for conclusions about the potential increased risk of SBS symptoms with humidification. The statistically significant associations of mechanical ventilation and air conditioning with SBS symptoms are much more frequent than expected from chance and also not likely to be a consequence of confounding by several potential personal, job, or building related confounders. The reasons for the increases in symptom prevalences with mechanical ventilation and particularly with air conditioning remain unclear. Multiple deficiencies in HVAC system design, construction, operation, or maintenance, including some which cause pollutant emissions from HVAC systems, may contribute to the increases in symptom prevalences.
Operation BREAKTHROUGH is a major research and development activity of HUD to modernize the housing industry and bring about volume production of industrialized housing. One aspect of this program involves the demonstration of innovative housing systems o...
Operant behavior is behavior "controlled" by its consequences. In practice, operant conditioning is the study of reversible behavior maintained by reinforcement schedules. We review empirical studies and theoretical approaches to two large classes of operant behavior: interval timing and choice. We discuss cognitive versus behavioral approaches to timing, the "gap" experiment and its implications, proportional timing and Weber's law, temporal dynamics and linear waiting, and the problem of simple chain-interval schedules. We review the long history of research on operant choice: the matching law, its extensions and problems, concurrent chain schedules, and self-control. We point out how linear waiting may be involved in timing, choice, and reinforcement schedules generally. There are prospects for a unified approach to all these areas. PMID:12415075
Objective: Contingency management (CM) is an empirically validated treatment for substance use disorders, but its effects on psychiatric symptoms have not been systematically examined. The purpose of this study was to examine the impact of CM on psychiatric symptoms of cocaine dependent patients receiving CM with standard care versus standard care alone. Method: Psychiatric symptoms were evaluated in 393 patients participating in 1 of 3 randomized trials of CM at treatment initiation and 1, 3 (posttreatment), 6, and 9 months later. Results: Patients randomized to CM evidenced significant reductions in psychiatric symptoms over time throughout the 9-month follow-up. In contrast, psychiatric symptoms remained stable relative to baseline in patients randomized to standard care. A significant time by treatment condition effect was noted (p < .05) for overall psychiatric distress as well as for specific indices of depression, hostility, interpersonal sensitivity, phobic anxiety and psychoticism symptoms. Reductions in drug use mediated the effects of CM on psychiatric symptoms. Conclusions: These data demonstrate that the effects of CM extend beyond their impact on drug use behaviors and the period in which reinforcers are in effect. (PsycINFO Database Record (c) 2013 APA, all rights reserved). PMID:23544678
Women report more intense, more numerous, and more frequent bodily symptoms than men. This difference appears in samples of medical patients and in community samples, whether or not gynecologic and reproductive symptoms are excluded, and whether all bodily symptoms or only those which are medically unexplained are examined. More limited, but suggestive, literature on experimental pain, symptom reporting in childhood, and pain thresholds in animals are compatible with these findings in adults. A number of contributory factors have been implicated, supported by varying degrees of evidence. These include innate differences in somatic and visceral perception; differences in symptom labeling, description, and reporting; the socialization process, which leads to differences in the readiness to acknowledge and disclose discomfort; a sex differential in the incidence of abuse and violence; sex differences in the prevalence of anxiety and depressive disorders; and gender bias in research and in clinical practice. General internists need to keep these factors in mind in obtaining the clinical history, understanding the meaning and significance that symptoms hold for each patient, and providing symptom relief.
Barsky, Arthur J; Peekna, Heli M; Borus, Jonathan F
In the last decade we have witnessed substantial progress towards the understanding of Parkinson's disease. According to pathological and neuroimaging studies, the traditional view of Parkinson's disease that begins with the development of motor symptoms such as bradykinesia, rigidity and tremor, has begun to change. It is now understood that there would be a "premotor" or "preclinical" period in which the alphasynuclein pathology begins outside of the substantia nigra in the lower brainstem and autonomic nervous system. Although the pathophysiology of this phase is still unclear, it is currently thought that its symptoms would correspond to the so-called "non-motor symptoms". Hyposmia, depression, constipation and REM sleep disorders are one of the most relevant non-motor symptoms at this "premotor" stage. The spectrum of non-motor symptoms is very broad and covers the domains of neuropsychiatric, dysautonomic, gastrointestinal and sensory symptoms as well as sleep disorders. Neuropsychiatric symptoms such as depression, impulse control disorder, psychosis and dementia, are a major cause of disability as they are directly related to quality of life. PMID:23979552
Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM.
Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.
OBJECTIVES—It has been assumed that nicotine dependence has a slow onset and occurs only after prolonged daily use of tobacco. A cohort of young adolescents was followed to determine when the first symptoms of nicotine dependence occur with respect to the duration and frequency of tobacco use.?DESIGN—A cohort of 681 seventh grade students (age 12-13 years) from seven schools in two small cities in central Massachusetts was followed over one year. Detailed information regarding tobacco use was obtained in individual confidential interviews conducted in school three times over the year. The latency time to the onset of symptoms of nicotine dependence was measured from the time a subject first smoked at a frequency of at least once per month.?RESULTS—22% of the 95 subjects who had initiated occasional smoking reported a symptom of nicotine dependence within four weeks of initiating monthly smoking. One or more symptoms were reported by 60 (63%) of these 95 subjects. Of the 60 symptomatic subjects, 62% had reported experiencing their first symptom before smoking daily or began smoking daily only upon experiencing their first symptom.?DISCUSSION—The first symptoms of nicotine dependence can appear within days to weeks of the onset of occasional use, often before the onset of daily smoking. The existence of three groups of individuals—rapid onset, slower onset, and resistant—distinguishable from one another by their susceptibility to nicotine dependence, is postulated.???Keywords: adolescents; nicotine; addiction; dependence
DiFranza, J.; Rigotti, N.; McNeill, A.; Ockene, J.; Savageau, J.; Cyr, D. S.; Coleman, M.
Background In our research we examined the frequency of somatic symptoms among bereaved (N?=?185) and non-bereaved men and women in a national representative sample (N?=?4041) and investigated the possible mediating factors between bereavement status and somatic symptoms. Methods Somatic symptoms were measured by the Patient Health Questionnaire (PHQ-15), anxiety with a four-point anxiety rating scale, and depression with a nine-item shortened version of the Beck Depression Inventory. Results Among the bereaved, somatic symptoms proved to be significantly more frequent in both genders when compared to the non-bereaved, as did anxiety and depression. On the multivariate level, the results show that both anxiety and depression proved to be a mediator between somatic symptoms and bereavement. The effect sizes indicated that for both genders, anxiety was a stronger predictor of somatic symptoms than depression. Conclusions The results of our research indicate that somatic symptoms accompanying bereavement are not direct consequences of this state but they can be traced back to the associated anxiety and depression. These results draw attention to the need to recognize anxiety and depression looming in the background of somatic complaints in bereavement and to the importance of the dissemination of related information.
As part of an effort to develop an instrument to measure grief, a 58-item questionnaire was completed by 211 subjects who had lost a loved one because of death. The results demonstrated wide individual variations in specific symptoms and in their intensity and duration. Long after the immediate grief period, most bereaved individuals continued to feel upset, empty, or tearful; many experienced anniversary reactions and/or physical symptoms; and some had persistent identification phenomena. Although the acute dysphoria peaked between 1 and 2 years, several grief-related feelings, symptoms, and behaviors continued indefinitely. The relevance of present work and directions for future studies are discussed. PMID:7149059
The purpose of the analysis was to evaluate an association between selected factors of home environment and respiratory symptoms (wheezing/whistling) and asthma diagnosed by physician in 4333 children of age 7-8 years in Pozna?. The data were collected within the scope of the EU funded multinational SAVIAH study. It was found that presence of the symptoms as well as asthma were significantly associated with presence of damp spots and/or mould at home and disturbance by traffic fumes and/or noise at home. The association of respiratory symptoms with ETS and presence of pets was less clear. PMID:8868202
In the present study, the authors examined the severity of psychiatric symptoms in undergraduate recreational (noncompetitive) athletes (n = 64) and National Collegiate Athletic Association (NCAA; competitive) athletes (n = 72). The results indicated that the 2 groups were similar in the severity of psychiatric symptoms. The recreational and NCAA athletes combined (n = 136) showed less severe global psychiatric symptoms when they were compared with an undergraduate control group (n = 435). The implications of the study are discussed in the context of those findings. PMID:14977030
Objective: Physical and psychological symptoms in cancer patients are frequently overlooked by medical staff. However, little is known regarding the potential impacts of concurrent physical and psychological symptoms on the overlooking of other symptoms. The aim of this study was to examine the impact of concurrent symptoms on the overlooking of other symptoms in cancer inpatients. Method: A total of 255 cancer inpatients in the general wards of one university hospital, who were referred to the palliative care team, were included. On the day of referral, nurses and patients were independently assessed for the presence of the following eight symptoms: pain, fatigue, nausea and vomiting, shortness of breath, lack of appetite, dry mouth, sleep problems, and distressed feelings. The presence of delirium was also separately assessed by nurses and psychiatrists on the team. A total of nine symptoms detected by nurses and those reported by patients or psychiatrists were compared, and logistic regression analysis was performed to identify the variables associated with the overlooking of these symptoms. Results: The most frequently reported symptom was pain (76.5%), followed by distressed feelings (49.8%), sleep problems (34.1%), and delirium (25.1%). The proportion of those overlooked was more than one quarter (25.0-63.6%) for all symptoms except pain (12.8%). Significant associations were found between the overlooking of shortness of breath and concurrent delirium (odds ratio [OR] = 110.9); the overlooking of sleep problems and concurrent lack of appetite (OR = 9.1); and the overlooking of distressed feelings and concurrent dry mouth (OR = 27.7). No patient demographic characteristic was associated with the overlooking of any other symptoms. Significance of results: The presence of some specific concurrent symptoms is likely to lead to the overlooking of other symptoms in cancer inpatients by nurses. Comprehensive assessments of physical and psychological symptoms in daily clinical practice are needed. PMID:23510702
A substantial number of military personnel who have served in Iraq (Operation Iraqi Freedom; OIF) and Afghanistan (Operating\\u000a Enduring Freedom; OEF) develop symptoms of posttraumatic stress disorder (PTSD) in response to their military experiences\\u000a and many of these same individuals will drink in a risky or problematic manner following deployment. If left untreated, PTSD\\u000a symptoms and alcohol problems can become
Amy Rubin; Justin L. Enggasser; Monica Roy; Terence M. Keane
Thymolipomas are rare slow-growing mediastinal thymic neoplasms. Most cases are asymptomatic and are sometimes discovered as a huge mass on chest x-ray films. A few cases have been discovered during examinations for other diseases. We report the second case of thymolipoma combined with hyperthyroidism in the English language literature. Neurological symptoms suddenly appeared in a 45-year-old woman. Central nervous system disorder was suggested but no significant abnormalities were found on brain MR nor were there any neurological signs. Several months later, neurological and systemic examinations on admission revealed hyperthyroidism and an anterior mediastinal tumor, 9.0x5.0x3.0 cm in size on chest CT films. Despite treatment of hyperthyroidism by medication, her neurological symptoms remained. Neurologists recommended resection of the mediastinal tumor. Malignancy could not be ruled out because of the irregularity of the tumor appearance on contrast-enhanced chest CT. Furthermore, the tumor appeared to be attached to the ascending aorta, so cytological and/or pathological diagnosis by CT-guided needle biopsy before operation were contraindicated. Extended thymectomy was performed in May 2005. The pathological diagnosis was benign thymolipoma consisting of mature fatty tissue and thymic tissue structures with Hassall's corpuscles. Her neurological symptoms seemed slightly but not markedly improved. The relationship between thymolipoma and hyperthyroidism is still unknown. PMID:17505419
Negative symptoms account for much of the functional disability associated with schizophrenia and often persist despite pharmacological treatment. Cognitive behavioral therapy (CBT) is a promising adjunctive psychotherapy for negative symptoms. The treatment is based on a cognitive formulation in which negative symptoms arise and are maintained by dysfunctional beliefs that are a reaction to the neurocognitive impairment and discouraging life events frequently experienced by individuals with schizophrenia. This article outlines recent innovations in tailoring CBT for negative symptoms and functioning, including the use of a strong goal-oriented recovery approach, in-session exercises designed to disconfirm dysfunctional beliefs, and adaptations to circumvent neurocognitive and engagement difficulties. A case illustration is provided. PMID:19572278
Age differences in depressive symptom experiences were investigated in a community sample of 368 women between the ages of 51 and 92 who were administered the SCL-90 Depression and Additional Symptoms Scales. Confirmatory factor analysis was used to assess and compare depressive symptom experiences in a younger (age 51-65) and older (age 66-92) age cohort. Findings show that two somewhat different depressive syndromes underlie symptom reporting patterns, one having higher levels in the older age cohort, the other having higher levels in the younger age cohort. In addition, three more delimited forms of distress -- feelings of enervation, dysphoria, and sleep disturbances -- show higher levels among the older cohort. Implications of these findings for future research on the relation between aging and depression are discussed. PMID:1890289
... Resources and Publications What are common symptoms of PKU? Page Content Children with untreated PKU appear normal at birth. But by age 3 ... than someone without the condition. If people with PKU do not restrict the phenylalanine in their diet, ...
Restless Legs Syndrome - Causes & Symptoms Causes What causes of restless legs syndrome varies from person to person. In some cases ... with brain cell communication that can lead to restless legs syndrome. If you think you have restless legs syndrome ...
Symptoms of estrogen deprivation commonly occur in breast cancer survivors as a result of natural menopause, or menopause that is precipitated prematurely by chemotherapy or anti-estrogen therapy with tamoxifen. In this research program, we are evaluating...
Symptoms of estrogen deprivation commonly occur in breast cancer survivors as a result of natural menopause, or menopause that is precipitated prematurely by chemotherapy or anti-estrogen therapy with tamoxifen. In this research program, we are evaluating...
Symptoms Qf estrogen deprivation commonly occur in breast cancer survivors as a result of natural menopause, or menopause that is precipitated prematurely by chemotherapy or anti-estrogen therapy with tamoxifen. In this research program we are evaluating ...
Symptoms of estrogen deprivation commonly occur in breast cancer survivors as a result of natural menopause, or menopause that is precipitated prematurely by chemotherapy or anti-estrogen therapy with tamoxifen. In this research program we are evaluating ...
... such as inflammatory bowel disease, colon cancer, or celiac disease. These signs and symptoms are referred to as “ ... history of inflammatory bowel disease, colon cancer, or celiac disease. These alarm signs usually do not occur because ...
... Doing Related Links Inside Knowledge Campaign Survivor Stories Television Public Service Announcements Radio Public Service Announcements Print ... when you pass urine or have sex. Many women who have vulvar cancer have signs and symptoms. ...
... message, please visit this page: About CDC.gov . West Nile Virus Share Compartir Add this to... Añadir en... ... Most people (70-80%) who become infected with West Nile virus do not develop any symptoms. Febrile illness ...
Because of persistent complaints of ozone-toxicity type symptoms among crew members of commercial airlines, we undertook a survey to determine the extent of the problem and the associated flight factors. Self-reported questionnaires and flight diaries were completed by 1,330 flight attendants, (FAs) working for three different airlines. Ozone-toxicity type symptoms were reported three or four times more frequently by FAs with airlines flying at high altitudes than by those with low-flying airlines. When examined by characteristics of flights, the ozone-toxicity type symptoms were significantly associated with flight altitude, duration and type of aircraft, but not with years worked, sex, medical history, or home residence. Other symptoms indicative of fatigue or stress were mainly associated with flight duration. While these indirect data cannot implicate ozone specifically, they offer evidence that ozone-related health problems do exist among a large proportion of FAs.
... it? How is it diagnosed? What are the treatments for it? Other FAQs NICHD Research Information Clinical Trials Resources and Publications What are the symptoms of uterine fibroids? Page Content ?Uterine fibroids can cause uncomfortable or ...
... Navigation Bar Home Current Issue Past Issues Feature Hepatitis Hepatitis: Symptoms, Diagnosis, Treatment & Prevention Past Issues / Spring 2009 ... No appetite Fever Headaches Diagnosis To check for hepatitis viruses, your doctor will test your blood. You ...
Despite advances made in the diagnostic and therapeutic field, acute intestinal ischemia remains a highly lethal condition. This is related to the variability of symptoms and the absence of typical laboratory alterations in early stage. PMID:19103138
Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16, 2009, in the Journal of Clinical Oncology.
Enomoto Industry Co., exclusively uses water-based cutting fluids in its aluminum alloy machining operations. Since the cost of disposal can be much greater than the cost of purchase, the treatability of spent cutting fluids is becoming a major criterion for cutting fluid selection. Samples were collected from the machining lines at Enomoto's facility to determine their characteristics and evaluate their treatability with centrifugation, chemical coagulation and electrochemical coagulation. As expected, oil and grease (O&G) and total suspended solids (TSS) are the main reasons that spent cutting fluids are prohibited from being discharged into local swage systems. The average O&G found in the spent cutting fluids is 87,354 mg/L with TSS of more than 70,000 mg/L. Both O&G and TSS are the major contributors to the high turbidity of these waste effluents. A centrifuge with a relative centrifugal force of 1318 x g, was able to reduce 60% of the turbidity. By adding the coagulant aluminum chloride, the oil-water emulsion was destabilized, and the turbidity was reduced from 3249 Formazin Attenuation Units (FAU) to around 314 FAU. With freshly generated aluminum ions in the spent cutting fluid, the electrochemical process destabilized the oil-water emulsion system. The coalesced oil droplets were adsorbed onto the highly dispersed aluminum coagulant. The oil-rich sludge that was generated in the operation was then floated to the surface, forming a blanket that was removed by skimming. The electrochemical treatment was able to reduce the turbidity to less than 14 FAU, which is the detection limit of the Hach DR/4000 UV-vis spectrophotometer. PMID:17850956
Phillips-Bute, B. G. and J. D. Lane.Caffeine withdrawal symptoms following brief caffeine deprivation.PHYSIOL BEHAV 63(1) 35–39, 1998.—The effects of short-term caffeine deprivation on mood, withdrawal symptoms and psychomotor performance were studied in habitual coffee drinkers. Thirty-one male and female coffee drinkers were tested twice at midday (1130 to 1330 h) 4 h after double-blind administration of 250 mg of caffeine
Parkinson’s disease (PD) is a neurodegenerative disorder which is often reduced to a mere dysfunction of motor performance.\\u000a Non-motor symptoms, however, are frequent impairments in PD and result in a major impact on the patients and their caregivers.\\u000a The major neuropsychiatric comorbidities depression, anxiety, and psychotic symptoms are briefly discussed. Additionally,\\u000a a brief outlook on deep brain stimulation and its
Frank Schneider; Astrid Althaus; Volker Backes; Richard Dodel
BACKGROUND: Patients' beliefs about symptoms are major influences on consultation and its consequences. However, little information is available about the beliefs of patients when they consult their general practitioner (GP). AIM: To describe and quantify the range of beliefs of patients about their symptoms before consultation, and to test the hypothesis that patients who attribute symptoms to stress or lifestyle would expect less benefit than others from physical medicine but more from lifestyle change and emotional support. METHOD: Interviews with 100 patients attending one of two general practices were used to form a questionnaire, which was completed by 406 patients attending one of three general practices in contrasting areas of Greater London. This measured the frequency of specific beliefs about the causes of their symptoms and about effective forms of help. Patients were seen before their consultation. RESULTS: The most common aetiological beliefs concerned stress and lifestyle. In general, the mechanisms underlying symptoms were thought to be disturbances in bodily functioning rather than pathological processes. The most valued form of help was explanation and discussion of symptoms. Nevertheless, about half the patients expected benefit from medication and only slightly fewer from hospital investigation or treatment. Patients who attributed symptoms to stress or lifestyle were no less likely to expect help from medication or specialist referral, but they were more likely to see benefit in explanation and counselling or lifestyle change. CONCLUSIONS: These findings suggest hypotheses for future research into the effects that patients' attributions of their symptoms to stress and lifestyle have on their health care demands, emphasize the importance of routinely assessing patients' beliefs on consulting the GP, and provide information that can help to direct this assessment in the individual case.
A growing body of literature supports the observed association between lower urinary tract symptoms and sexual dysfunction.\\u000a The causal relationship between these two conditions has not been determined. Ejaculatory function is an important aspect\\u000a of sexual functioning and recent studies have shown a high prevalence of this ejaculatory dysfunction in men with lower urinary\\u000a tract symptoms. Furthermore, the degree of
There is increasing recognition of an important interplay between psychiatric disorders and sleep. Clinical observations and several empirical studies have shown that later bedtimes are associated with obsessive-compulsive disorder (OCD). The current study examined the relationship of delayed bedtimes and symptoms of OCD. Two-hundred and sixty-six undergraduates completed a battery of questionnaires assessing sleep patterns, mood, and OC symptoms. Results
Meredith E. Coles; Jessica R. Schubert; Katherine M. Sharkey
The posttraumatic stress model has recently been applied to understand the impact of life-threatening illness in adults and in children. From 1991 to 2001, 20 studies have reported posttraumatic stress symptoms and\\/or posttraumatic stress disorder (PTSD) in childhood cancer survivors and\\/or their parents. A review of these studies is proposed. Prevalence of posttraumatic stress symptoms and\\/or PTSD in children and
Olivier Taïeb; MarieRose Moro; Thierry Baubet; Anne Revah-Lévy; Martine F. Flament
This study assessed associations between a number of demographic, medical and psychological risk factors and post-traumatic stress disorder (PTSD) symptoms following stroke. Individuals (N = 102) who had experienced a stroke within the previous year participated in the study. Participants completed questionnaires containing measures of PTSD symptoms and a range of psychological risk factors (i.e., anxiety, depression, negative affect, dissociation, cognitive appraisals).
BACKGROUND: On 4 October 1992, an El Al Boeing 747-F cargo aeroplane crashed on two apartment buildings in Amsterdam. Thirty-nine residents on the ground and the four crew members of the plane died. In the years after, a gradually increasing number of people attributed physical signs and symptoms to their presence at the disaster scene. AIM: To investigate the consistency between patients' symptoms attributed to the crash and GPs' diagnoses and perception of the association with the crash. DESIGN OF STUDY: Comparison between self-reported symptoms to a call centre and GPs' medical records on onset and type of symptoms, diagnoses, and GPs' perception of association with the disaster, assessed by questionnaire. SETTING: Consenting patients (n = 621) contacting the call centre and their GPs. METHOD: Patients were interviewed by the call centre staff and interview data were recorded on a database. Questionnaires were sent to the consenting patients' GPs, requesting their opinions on whether or not their patients' symptoms were attributable to the effects of disaster. Baseline differences and differences in reported symptoms between interviewed patients and their GP records were tested using the chi2 test. RESULTS: The 553 responders reported on average 4.3 symptoms to the call centre. The majority of these symptoms (74%) were reported to the GP. Of the ten most commonly reported symptoms, fatigue, skin complaints, feeling anxious or nervous, dyspnoea, and backache featured in 80% of symptoms reported to the GP. One out of four symptoms was either reported to the GP before the disaster took place, or six or more years after (1998/1999, during a period of much media attention). Depression (7%), post-traumatic stress disorder (PTSD) (5%) and eczema (5%) were most frequently diagnosed by GPs. They related 6% of all reported symptoms to the disaster. CONCLUSIONS: Most of the symptoms attributed to a disaster by patients have been reported to their GP, who related only a small proportion of these to the disaster.
Donker, G A; Yzermans, C J; Spreeuwenberg, P; van der Zee, J
The detection of oral cancer at an early stage is the most effective means to improve survival and reduce morbidity, disfigurement, duration of treatment, and hospital costs associated with this disease. However, approximately 30% of patients delay seeking help for more than 3 months following the self-discovery of symptoms of oral cancer. This study aimed to increase our understanding of patient delay for potentially malignant oral symptoms in order to inform the development of interventions to encourage early presentation of oral cancer. Newly referred patients (n = 80) with potentially malignant oral symptoms completed a questionnaire to determine influences on the timing of their decision to seek help. Logistic regression analyses were conducted to determine factors associated with patient delay. The analysis indicated that the gravity of patients' initial symptom interpretation, the level of deprivation, knowledge of oral cancer, severity of life events in the patient delay period, and perceived ability to seek help for oral symptoms were significantly related to the duration of patient delay, with the latter three variables being independent predictors. The results are discussed with reference to their implications for interventions aimed at reducing patient delay for symptoms of oral cancer. PMID:18353007
Many individuals with central auditory nervous system (CANS) pathology/disorder report a variety of auditory symptoms with difficulty hearing in noise being one of the most common complaints (Chermak and Musiek, 1992) Interestingly, there seems to be a paucity of information in the literature on lateralized hearing loss symptoms in patients with central auditory disorders. Reported here is a case where the patient reported auditory symptoms, specifically hearing loss that was lateralized distinctly to the right ear. This ear was contralateral to a stroke that involved the left hemisphere with neural compromise limited primarily to the left Heschl's gyrus. Although the patient reported other hearing difficulties, the lateralized symptom of right-sided hearing loss seemed to be the most noticed. While the pure-tone audiogram was totally disassociated from the right ear auditory symptoms, central auditory tests revealed a marked and consistent right ear deficit, which was consistent with the site of lesion. It is rare that a relatively small lesion in Heschl's gyrus results in the perception of hearing loss so specifically localized to the right ear. It is also of interest that a patient with definite complaints of hearing loss would yield a normal, highly symmetrical pure-tone audiogram. The triad of patient symptoms, anatomy of the lesion, and central auditory test findings in this case are discussed, and theories as to possible underlying mechanisms for the patient's auditory deficits are provided. PMID:24047943
Musiek, Frank; Guenette, Linda; Fitzgerald, Krista
The study population comprised 52 male printers and 52 controls. Each person was interviewed about job history, general health, and work-related symptoms. Symptoms from eyes and airways, neurological symptoms, and general symptoms were recorded. A lung function test and a measurement of the sense of smell were also carried out. The printers had significantly more eye, airway, and neurological symptoms
Recent studies suggest that three dimensions (negative, disorganized and psychotic) categorize schizophrenic symptoms. A developing literature indicates distinct cerebral correlates of each symptom cluster, but few investigations have determined their neuropsychological correlates. In the present study, the Schedules of Negative and Positive Symptoms measured symptom severity in 62 schizophrenics, and a subsequent principal components analysis revealed three symptom dimensions. Factor
Michael R. Basso; Henry A. Nasrallah; Stephen C. Olson; Robert A. Bornstein
Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called "somatopsychic disorders", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized. PMID:23436668
Explanations of the nature of thought and the methods of study underlying such explanations were explored from the viewpoints of introspective psychology, methodological behaviorism, and radical behaviorism. Empirical support for the radical behaviorists' interpretation of thought as covert operant behavior was examined. An experimental method was developed which attempted to analyze the functional properties of responsereinforcement connections in the environment
|The ailing economy has spared few schools and universities. Faced with funding cutbacks, most education administrators have had to make difficult choices about where to allocate dwindling resources. Even in the best of financial times, educating students is the first priority. When money is tight, school maintenance and operations (M&O) programs…
This study examined interrelationships among combat exposure, symptoms of posttraumatic stress disorder (PTSD), and family adjustment in a sample of male and female Operation Desert Storm veterans (N = 1,512). In structural equation models for both male and female veterans, higher combat exposure was associated with higher PTSD symptoms, which in turn were associated with poorer family adjustment, although these
Casey T. Taft; Jeremiah A. Schumm; Jillian Panuzio; Susan P. Proctor
We report the first measurements of CO, CH4, N2O, CO2, and H2O(g) in the exhaust trails of T-39, B-757, and DC-8 aircraft at cruise conditions. Emission indices (EI) derived from these in-situ measurements are presented. Results are in agreement with ground-based tests indicating aircraft act as a net sink for CH4 and recent airborne in-situ measurements that N2O is not an important exhaust constituent. Condensation of H2O(g) on exhaust particles resulted in EI(H2O(g)) values less than those expected from the combustion of fuel alone. Observed apparent negative EI(H2O(g)) values suggest that aircraft aerosol emissions, under unique atmospheric conditions, seed cloud formation and lead to dehydration of the exhaust-influenced air parcel. Such conditions may induce the formation of cirrus clouds from persistent contrails. Comparisons with the Boeing EMIT Code show measurement-derived CO emission index values consistent with model evaluations.
Vay, S. A.; Anderson, B. E.; Sachse, G. W.; Collins, J. E., Jr.; Podolske, J. R.; Twohy, C. H.; Gandrud, B.; Chan, K. R.; Baughcum, S. L.; Wallio, H. A.
BACKGROUND: Renal cell carcinoma (RCC) has multiple symptoms stemming from disease and treatments. There are few validated scales for evaluating RCC symptoms. METHODS: A national cross-sectional study of adult RCC patients was conducted from October to December 2003 to define patient-reported RCC symptomology. Participants were asked open-ended questions regarding their signs and symptoms and completed an 86-item pilot questionnaire of
Gale Harding; David Cella; Don Robinson; Parthiv J Mahadevia; Jason Clark; Dennis A Revicki
OBJECTIVE: To investigate the recognition of depressive symptoms of major depressive disorder (MDD) by general practitioners. INTRODUCTION: MDD is underdiagnosed in medical settings, possibly because of difficulties in the recognition of specific depressive symptoms. METHODS: A cross-sectional study of 316 outpatients at their first visit to a teaching general hospital. We evaluated the performance of 19 general practitioners using Primary Care Evaluation of Mental Disorders (PRIME-MD) to detect depressive symptoms and compared them to 11 psychiatrists using Structured Clinical Interview Axis I Disorders, Patient Version (SCID I/P). We measured likelihood ratios, sensitivity, specificity, and false positive and false negative frequencies. RESULTS: The lowest positive likelihood ratios were for psychomotor agitation/retardation (1.6) and fatigue (1.7), mostly because of a high rate of false positive results. The highest positive likelihood ratio was found for thoughts of suicide (8.5). The lowest sensitivity, 61.8%, was found for impaired concentration. The sensitivity for worthlessness or guilt in patients with medical illness was 67.2% (95% CI, 57.4–76.9%), which is significantly lower than that found in patients without medical illness, 91.3% (95% CI, 83.2–99.4%). DISCUSSION: Less adequately identified depressive symptoms were both psychological and somatic in nature. The presence of a medical illness may decrease the sensitivity of recognizing specific depressive symptoms. CONCLUSIONS: Programs for training physicians in the use of diagnostic tools should consider their performance in recognizing specific depressive symptoms. Such procedures could allow for the development of specific training to aid in the detection of the most misrecognized depressive symptoms.
Henriques, Sergio Goncalves; Fraguas, Renerio; Iosifescu, Dan V.; Menezes, Paulo Rossi; de Lucia, Mara Cristina Souza; Gattaz, Wagner Farid; Martins, Milton Arruda
Andropause is a syndrome that usually occurs during men's midlife. It is associated with clinical short-term and long-term effects, as well as some physiological and psychological symptoms due to subnormal levels of testosterone serum. The objective of this study was to identify the factors that significantly contribute to the prevalence of symptoms that may be related to androgen deficiency. The study used a cross-sectional structured questionnaire and a sample of 214 Kuwaiti men aged 40 years and older. The questionnaire consisted of the sociodemographic characteristics of the participants and the Androgen Deficiency of the Aging Male Scale of Andropausal Symptoms. The results of the study indicate that Kuwaiti men who were 40 to 49 years old reported fewer symptoms than did Kuwaiti men aged 50 years and older, including deterioration in their ability to play sports, easily falling asleep after dinner, anger, and hot flushes (p < .05); and Kuwaiti men aged 50 years and older reported experiencing decrease in muscle strength, decrease in sport performance, sweating, loss of height, decreased libido, as well as falling asleep after dinner. For those aged 40 to 49 years, lower education levels, marital status, and employment status were significantly associated with the men's symptoms (p < .05). On the other hand, in the case of respondents aged 50 years and older, only education level was significantly associated with their symptoms (p < .05). This is a preliminary study that reports the prevalence of aging male symptoms among Kuwaiti men. The findings will offer insight into the necessary health care provisions to educate, treat, and provide information related to andropause for the general public. PMID:23640979
...false Evaluation of symptoms, including pain. 220.114 Section 220.114 Employees...114 Evaluation of symptoms, including pain. (a) General. In determining...of the claimant's symptoms, including pain, and the extent to which...
...false Evaluation of symptoms, including pain. 220.114 Section 220.114 Employees...114 Evaluation of symptoms, including pain. (a) General. In determining...of the claimant's symptoms, including pain, and the extent to which...
... Twitter. What Are the Signs and Symptoms of Asthma? Common signs and symptoms of asthma include: Coughing . ... during the day or at night. What Causes Asthma Symptoms To Occur? Many things can trigger or ...
...important indicator of the intensity and persistence of the claimant's symptoms. Because symptoms, such as pain, are subjective and difficult to quantify, any symptom-related functional limitations and restrictions which the claimant, his...
... Navigation Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table ... Symptoms As with mild traumatic brain injury (TBI), PTSD symptoms can be very subtle. "For example, some ...
\\u000a This chapter describes the operation of a DNS system. Namely, you’ll learn about the following topics:\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a DNS queries: How does your browser find www.example.com? How does your mail software know where to send your outgoing e-mail? Such operations\\u000a use DNS queries.\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Reverse mapping: How does your mail software determine your identity? How do you find out who is
All About Circuits is a website that Ã¢ÂÂprovides a series of online textbooks covering electricity and electronics.Ã¢ÂÂ Written by Tony R. Kuphaldt, the textbooks available here are wonderful resources for students, teachers, and anyone who is interested in learning more about electronics. This specific section, Operational Amplifiers, is the eighth chapter in Volume III Ã¢ÂÂSemiconductors. A few of the topics covered in this chapter include: The "operational" amplifier; Negative feedback; Voltage-to-current signal conversion; and Differentiator and integrator circuits. Diagrams and detailed descriptions of concepts are included throughout the chapter to provide users with a comprehensive lesson. Visitors to the site are also encouraged to discuss concepts and topics using the All About Circuits discussion forums (registration with the site is required to post materials).
Students' will start with beginning levels of multiplication, and move when approved by Mrs.Hildenbrand. Monster match is a matter of trying to better your personal score by being quick at choosing the correct answers. Monster Math Match.... Scoop your ice cream to multiplication allows students to work on improvement of multiplication facts otherwise the game starts over! Scoop your ice cream to multiplication If you have extra time here are some fun games...... Operation determination. Percentage P.I. Target percentage ...
This is the second updated volume in a set of comprehensive referenced texts that encompasses well production operations from the time the first potential oil or gas horizon is penetrated until the well is abandoned. Topics covered include problem well analysis, paraffins and asphaltenes, remedial or squeeze cementing, sand control, formation damage, surfactants for well treatments, acidizing, hydraulic fracturing scale removal and prevention, corrosion control, and workover systems and planning. The authors also examine the use of personal computers.
Negative symptoms in schizophrenia negatively affect patients' social and occupational functioning, as well their long-term recovery. Patients may not overtly complain about negative symptoms, which can make them even more challenging to recognize. Clinicians should ask specific questions regarding negative symptoms, determine if the symptoms are primary or secondary, and then address them accordingly. This activity discusses recognizing negative symptoms in patients with schizophrenia and then addressing those symptoms in spite of a paucity of treatment options. PMID:23419229
Neuropsychiatric symptoms are commonly related to interferon alpha treatment. The paper summarises the current knowledge about their aetiology, course, and treatment. Interferon alpha is a cytokine with antiviral and antineoplasmatic activity. It is commonly used in the treatment of chronic hepatitis C and B, malignant melanoma, Kaposi sarcoma, renal cancers, and some haematological malignancies. Treatment with interferon alpha is associated with depressive symptoms, cognitive disturbances, chronic fatigue syndrome, dysphoria, anxiety symptoms, anorexia, mania and psychotic states. Up to a half of the patients need psychiatric consultations, 10-25% of them need psychiatric treatment. Neuropsychiatric symptoms are the results of direct affection of CNS by interferon and induced cytokines. They increase hypothalamic-pituitary-adrenal (HPA) activity, alter thyroid function and lead to a behavioural syndrome called 'sickness behaviour'. Moreover interferon induces the activity of 2, 3 indoloamine dioxygenase, the enzyme which converts tryptophan into kynurenine, leads to a reduced level of tryptophan, and thus to a reduced level of central serotonin and to an increased level of neurotoxic kynurenine metabolites. Interferon also affects central opioid receptors and changes dopaminergic and noradrenergic neurotransmission. Serotonin selective reuptake inhibitors (SSRI), other antidepressants i.e. nortriptyline, benzodiazepines, naltrexone, and neuroleptics (for maniac and psychotic states) are used to treat interferon associated psychiatric symptoms. Psychological therapy may also be useful, as well as psychoeducation and behavioural interventions. PMID:17068950
Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. Patients with BPH often present with a combination of obstructive and overactive bladder (OAB) symptoms. It is postulated that bladder outlet obstruction (BOO) from BPH results in concomitant OAB symptoms through ischemic induced variations in the response to neurotransmitters of both the detrusor and the urothelium. This altered response leads to the pathologic activation of the micturition reflex, generating sensory dysfunction and involuntary bladder contractions. Alpha-1 adrenoceptor antagonists (alpha-blockers) and 5-alpha reductase inhibitors (5-ARIs) are commonly used to treat the BOO caused by BPH. Anticholinergic agents are frequently used to treat concurrently OAB symptoms caused by the BOO. Unfortunately, anticholinergic medications demonstrate bothersome side effects and a theoretical risk of urinary retention. Basic science and clinical research has led to the development of a new class of pharmaceuticals for the treatment of overactive bladder with diminished risk of urinary retention and lacking many anticholinergic side effects. This novel compound, mirabegron (Mybertriq, Astellas Pharma US, Inc.), is a ?3-adrenoceptor agonist and represents a promising new class of oral agents designed for the treatment of OAB symptoms, with minimal effect on voiding. PMID:23913200
Suarez, Oscar; Osborn, David; Kaufman, Melissa; Reynolds, W Stuart; Dmochowski, Roger
In medically ill patients the term 'somatic symptoms' is used to understand those symptoms which cannot be fully understood in the light of existing medical illness(es). These include a number of physical symptoms and also certain clinical syndromes such as irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome among others. However, it is increasingly recognized that such patients have larger degrees of psychological morbidities, especially depressive and anxiety disorders, and have disproportionately elevated rates of medical care utilization, including outpatient visits, hospitalizations and total healthcare costs. In view of this psychological morbidity, significant distress and functional impairment, the role of the consultation-liaison psychiatrist is prominent in the management of these patients. A consultation-liaison (CL) psychiatrist is expected to be part of the primary care team to manage patient with unexplained SS, and at the same time is expected to guide colleagues to practice a patient-centred approach to improve the outcome of patients with such symptoms. The clinical work of a CL psychiatrist involves evaluation of patients with medically unexplained symptoms for probable psychiatric disorders and treatment of psychiatric morbidity and also management of patients without psychiatric morbidity. Management strategies include reattribution, cognitive behaviour therapy and antidepressants, with each strategy showing varying degrees of success. PMID:23383667
There is an insufficient amount of research about the symptoms, symptom distress, and symptom trajectory of breast cancer patients once adjuvant treatment for breast cancer is complete. Though these women get on with living after therapy, some still exper...
Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Scale (DTS) across three veteran samples: treatment-seeking Vietnam-era veterans, treatment-seeking post-Vietnam-era veterans, and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veteran research participants. Confirmatory factor analyses of DTS items demonstrated that a 4-factor structural model of the DTS (reexperiencing, avoidance, numbing, and hyperarousal) was superior to five alternate models, including the conventional 3-factor model proposed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Results supported factor invariance across the three veteran cohorts, suggesting that cross-group comparisons are interpretable. Implications and applications for DSM-IV nosology and the validity of symptom measures are discussed.
McDonald, Scott D.; Beckham, Jean C.; Morey, Rajendra; Marx, Christine; Tupler, Larry A.; Calhoun, Patrick S.
All schizophrenic symptoms remitted completely in six out of 14 adults who had not responded to phenothiazine drugs and who were then given propranolol. Another patient improved markedly and four improved moderately. Two had minimal or transient improvement, and one left hospital unchanged after a short, severe, toxic reaction. The six with complete remissions all began to improve within a few days of starting propranolol and the florid symptoms remitted completely after three to 26 days. They were stabilized on a daily dose of 500-3,500 mg of propranolol and at the time of writing had remained well for up to six months. Two patients who stopped propranolol after their symptoms remitted relapsed severely within a few days. Toxic effects (ataxia, visual hallucinations, and confusional states) were related to the rate of increase rather than to the absolute dose of propranolol. After the procedure was modified unwanted effects were usually mild or absent.
Yorkston, N. J.; Zaki, Saniha A.; Malik, M. K. U.; Morrison, R. C.; Havard, C. W. H.
The term Costen's syndrome has been used in the dentomedical literature to describe a constellation of craniofacial symptoms. Since some of the same complaints have been reported in patients with "generalized" psychological distress, symptoms associated with the syndrome may not be useful in differential diagnosis of temporomandibular disorders. The present study investigated whether some somatic complaints, particularly tinnitus and dizziness, were pathognomonic in patients with chronic temporomandibular pain. Illness behavior and personality factors were studied for possible interrelationships with these symptoms. Factor analysis revealed that tinnitus and dizziness loaded on separate factors. Tinnitus loaded with nasal stuffiness, tearing, and itching of the eyelids and nose, while dizziness loaded with complaints of altered taste and smell and blurred vision. Neither was consistently related to measures of pain or to indices of illness behavior or somatic focus. PMID:10527281
Subcutaneous infusions of fluid and electrolytes can be used for replacement and correction of imbalance, by a method known as hypodermoclysis (HDC). Since April 1982, the Palliative Care Unit of the Edmonton General Hospital has been using this method for symptom control, titrating the rate of infusion against the severity of the symptoms, when the oral route was no longer available. If incompatible drugs have to be given at the same time, or if two drugs have to be given at different rates, two sites are used simultaneously. HDC is an adequate method of symptom control for terminal patients; it has advantages over intravenous, intermittent subcutaneous or intramuscular routes and rectal infusion, when used as described.
Approximately 40,000 women die as a result of breast cancer each year and many more live with advanced disease. When breast cancer recurs, the goals of treatment often shift from one of cure to controlling the disease for as long as possible while palliating symptoms interfering with the patient's functional status and quality of life. This requires ongoing discussions with the patient and family about the goals of care. Many symptoms depend on the site of metastasis, with bone being the most frequent, and commonly occur with fatigue, depression, insomnia, and pain. The purpose of this paper is to identify and provide an overview of the management of the most common symptoms in patients with breast cancer metastases.
Chronic obstructive pulmonary disease (COPD) has traditionally been considered an inexorably progressive disease, associated with a constant increase of symptoms that occur as the forced expiratory volume in 1 second (FEV1) worsens, only intermittently interrupted by exacerbations. However, this paradigm has been challenged in recent decades by the available evidence. Recent studies have pointed out that COPD-related symptoms are not consistently perceived by patients in the same way, showing not only seasonal variation, but also changes in symptom perception during a week or even within a single day. According to the available data, patients experience the biggest increase in respiratory symptoms during the first hours of the early morning, followed by the nighttime. This variation over time is of considerable importance, since it impacts on daily life activities and health-related quality of life, as measured by a recently developed ad hoc questionnaire. Additionally, recent clinical trials have suggested that the use of rapid-onset long-acting bronchodilators may have an impact on morning symptoms, despite their current use as maintenance treatment for a determined period. Although this hypothesis is to be validated in future long-term clinical trials comparing fast-onset versus slow-onset inhaled drugs in COPD, it may bring forward a new concept of long-term bronchodilator therapy. At the present time, the two available long-acting, fast-onset bronchodilators used in the treatment of COPD are formoterol and the recently marketed indacaterol. Newer drugs have also been shown to have a rapid onset of action in preclinical studies. Health care professionals caring for COPD patients should consider this variation in the perception of symptoms during their clinical interview as a potential new target in the long-term treatment plan.
Lopez-Campos, Jose Luis; Calero, Carmen; Quintana-Gallego, Esther
Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs. Although these symptoms can be present individually it is more common that various psychopathological features co-occur simultaneously in the same patient. Thus, categorization of BPSD in clusters taking into account their natural course, prognosis, and treatment response may be useful in the clinical practice. The pathogenesis of BPSD has not been clearly delineated but it is probably the result of a complex interplay of psychological, social, and biological factors. Recent studies have emphasized the role of neurochemical, neuropathological, and genetic factors underlying the clinical manifestations of BPSD. A high degree of clinical expertise is crucial to appropriately recognize and manage the neuropsychiatric symptoms in a patient with dementia. Combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. Given the modest efficacy of current strategies, there is an urgent need to identify novel pharmacological targets and develop new non-pharmacological approaches to improve the adverse outcomes associated with BPSD.
Cerejeira, J.; Lagarto, L.; Mukaetova-Ladinska, E. B.
The purposes of this study were to describe: clinical symptoms in a sample of consecutive patients with supraventricular tachycardia (SVT); incidence of sudden death, syncope, and other disabling symptoms; whether these symptoms differ by tachycardia mechanism; and to identify predictor variables of syncope in patients with SVT. Data were collected from chart reviews of 167 consecutive patients with SVT admitted for radiofrequency ablation. Three patients (2%) had nonlethal cardiac arrest, and a total of 16% (26 of 183) received at least 1 external direct-current shock for arrhythmia management. Twenty percent of subjects (33 of 167) reported at least 1 episode of syncope which was preceded by palpitations. The most frequent symptoms were: palpitations (96%), dizziness (75%), and shortness of breath (47%). We found atrioventricular nodal reentrant tachycardia (AVNRT) in 64 patients, atrioventricular-reciprocating tachycardia (AVRT) in 59, atrial tachycardia in 22, and atrial flutter in 22. The symptom profiles of patients with AVNRT, AVRT, and atrial tachycardia were very similar, but differed significantly (p <0.05) from those reported in the atrial flutter group. Multivariate analysis showed that heart rate > or = 170 beats/min was the only independent risk factor for syncope. Chi-square analysis demonstrated that SVT patients with heart rate > or = 170 beats/min had significantly more dizziness and syncope. Thus, despite a low incidence of associated heart disease, and good left ventricular function, there was a high frequency of disabling, potentially life-threatening symptoms associated with episodes of SVT in this sample. SVT can have potentially lethal consequences, and is more disruptive than previously thought. PMID:9193013
|The current prospective study investigated transactional relations between maternal depressive symptoms and children's depressive and externalizing symptoms. Participants included 240 children (M age = 11.86 years, SD = 0.56; 53.9% female) and their mothers who were part of a 6-year longitudinal study. Measures of maternal depression (Beck…
Although much depression may be dysfunctional, the capacity to experience normal depressive symptoms in response to certain adverse situations appears to have been shaped by natural selection. If this is true, then different kinds of situations may evoke different patterns of depressive symptoms that are well suited to solving the adaptive challenges specific to each situation. The authors called this
We have developed a set of methods for discerning the context in which a patient's neurotic or psychosomatic symptoms appear and subside, especially during psychotherapy sessions. The essence of these methods (Luborsky & Auerbach, 1969) is to find points during interviews when a symptom appears and then to examine the context of the patient's thoughts around it. Our method inspects
Lester Luborsky; Thomas C. Todd; Jim Mintz; John Docherty; Sydnor Penick; Arthur Auerbach; Marilyn Johnson; Freda M. Greene; Joan Feingold; Albert Glowasky
A health questionnaire, which included a 91 item list of symptoms was administered to three groups of young Samoan adults. These young adults resided in a traditional Samoan village in Western Samoa (n=50), several villages in modernizing American Samoa (n=50) and in urban Honolulu, Hawaii (n=52). Each yes response to a symptom was followed by an expanded interview providing details.
Many of the symptoms experienced by patients with primary hyperparathyroidism (HPT) develop insidiously and have often been misinterpreted as normal aging. The purpose of this study was to quantify HPT patients' preoperative symptoms prospectively and study the impact of successful surgical intervention on these symptoms. Altogether 63 consecutive patients with primary HPT and 54 comparison patients with nontoxic thyroid disease were prospectively enrolled in the study. An outcome questionnaire documenting symptoms with a visual analog scale (VAS) was used. The questionnaire was filled out preoperatively and at 7 to 10 days and 3 and 12 months postoperatively. At 1 year the questionnaire also included a general health assessment and quality of life index. Demographic data and follow-up blood work was obtained. Descriptive statistics, parametric comparisons (t-tests, ANOVA), and nonparametric comparisons (Mann-Whitney U-test) were calculated. The HPT group demonstrated a significant decrease in reported symptoms between the preoperatively assessment and 7 to 10 days after operation (p < 0.001). There were no further statistically significant decreases in the HPT group's symptoms at 3 and 12 months, but there was a trend for these symptoms to decrease over time. HPT patients perceived a 60% increase in their general health at 1 year; the comparison group perceived no increase. There was no significant change in the symptoms reported by the comparison group between each of the study intervals. Surgical intervention on HPT patients significantly reduces preoperative symptoms, and this reduction is most marked within the first 10 days after surgery. PMID:9597921
Background We investigated the contributions of individual, family, and community-level factors for explaining anxiety symptoms among\\u000a rural adolescents in Mexico.\\u000a \\u000a \\u000a \\u000a Method As part of a large-scale survey, 3,553 adolescents and their mothers from 333 poor, rural communities in seven Mexican states\\u000a provided cross-sectional data on family level, socio-economic and psychosocial factors, and individual-level data on anxiety\\u000a symptoms. Community standard of living indicators
Emily J. Ozer; Lia C. H. Fernald; Sarah C. Roberts
Although there is not one specific sign or symptom related to alcoholic hepatitis (AH), a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy. Documentation of chronic and active alcohol abuse is paramount in making a diagnosis of AH. Clinical presentation after abstinence for more than 3 m should raise doubts about the diagnosis of AH and dictate the need for considering other causes of liver disease, decompensation of alcoholic cirrhosis, sepsis and malignancy as the cause of patient’s clinical profile.
Purpose To test the hypothesis that the type of surgical procedure influences the incidence of postoperative symptoms. Also the effect\\u000a of demographic and clinical risk variables: age, sex, ASA status, duration of anaesthesia on the postoperative symptoms were\\u000a evaluated for each type of surgery.\\u000a \\u000a \\u000a \\u000a Methods Demographic, medical, anaesthetic and surgical data on 1,017 patients were prospectively collected by a research assistant\\u000a who
Control of symptoms in cancer patients on a home care program was studied, to identify problems related to caring for these patients at home. The study was based on independent physician assessments of patients' medical charts, as well as interviews with the home care providers. The results showed problems in control of pain, nausea and constipation; the causes were less than optimal care and non-compliance. There is an urgent need to improve palliative care to home care patients and to provide better, more frequent reassessment of patients with uncontrolled symptoms.
Kirshner, Bram; Hall, Mary C.; Gilpin, Audrey; Day, Nancy
A panel of 277 children, aged 3-7 years, was used to study the association between air pollution (O3, SO2, NO2, and total suspended particles), meteorological factors (global radiation, maximum daytime temperature, daily averages of vapour pressure and air humidity) and respiratory symptoms. For 759 days the symptoms were recorded in a diary and modelling was based on a modification of the method proposed by Korn and Whittemore (Biometrics 35: 795-798, 1979). This approach (1) comprises an extension using environmental parameters at different time scales, (2) addresses the suitability of using the daily fraction of symptomatic individuals to account for inter-individual interactions and (3) enables the most significant weather effects to be identified. The resulting model consisted of (1) an individual specific intercept that takes account of the population's heterogeneity, (2) the individual's health status the day before, (3) a long-term meteorological effect, which may be either the squared temperature or global radiation in interaction with temperature, (4) the short-term effect of sulfur dioxide, and (5) the short-term effect of an 8-h ozone concentration above 60 µg/m3. Using the estimated parameters as input to a simulation study, we checked the quality of the model and demonstrate that the annual cycle of the prevalence of respiratory symptoms is associated to atmospheric covariates. Individuals suffering from allergy have been identified as a group of a particular susceptibility to ozone. The duration of respiratory symptoms appears to be free of scale and follows an exponential distribution function, which confirms that the symptom record of each individual follows a Poisson point-process. This supports the assumption that not only respiratory diseases, but also respiratory symptoms can be considered an independent measure for the health status of a population sample. Since a point process is described by only one parameter (namely the intensity of the point process), it is appropriate for records of respiratory symptoms to identify only one model which covers both the occurrence and duration of symptoms.
Evaluation of current emergency department discharge instructions and parental recognition of symptomatology requiring further care for traumatic brain injury (TBI) is not well understood. A convenience sample of 105 parents of children aged 5 to 17 years who were seen and discharged from the pediatric emergency department with TBI was identified. Parents were surveyed by telephone 2 to 5 days after injury and a questionnaire was completed regarding identification of TBI symptoms. This study demonstrated that despite verbal and written discharge instructions, many parents with symptomatic children reported that their children were asymptomatic, and unable to identify postconcussive symptoms in their children. PMID:21157249
Stevens, Penelope K; Penprase, Barbara; Kepros, John P; Dunneback, James
The etiology of cognitive impairment in older adults is almost always a clinical diagnosis without definitive biomarkers. The clinical evaluation, therefore, is indispensable. Evaluating cognitive symptoms requires a deliberate approach to define the onset, course, and nature of symptoms. An informant who knows the patient well is essential. The physician must have a working knowledge of the basics of cognitive function. The neurologic examination also is fundamental to defining the origin of cognitive impairment. Extraocular movements, speech, and gait are examples of high-yield examination findings that can be observed and tested quickly, adding to the clinical impression. PMID:24094297
This paper presents a summary of a panel presentation by agriculture health and safety scientists on ergonomics of industrialized dairy parlor operations in the United States. Dairy industry trends in the United States were discussed in the panel presentation, which took place during the New Paths: Health and Safety in Western Agriculture conference, November 11-13, 2008. Dairy production is steadily moving to large-herd operations because of associated economies of scale and other economic and social conditions. Large-herd operations utilize a parlor milking system, as compared to a stanchion system used primarily in smaller operations. Each milking system presents different risks for worker injury. Low back, knee, and shoulder musculoskeletal symptoms were most frequently reported among workers in smaller dairy operations. Another study analyzing workers' compensation (WC) data from large-herd milking operations found nearly 50% of livestock-handling injury claims involved parlor milking activities. Nearly 27% of injuries were to the wrist, hand, and fingers, nearly 13% to the head or face, and 11% to the chest. Results indicated the vulnerability of these body parts to injury due to the worker-livestock interface during milking. More focused research should investigate milking practices and parlor designs as they relate to worker safety and health. Additional dairy-related injury research is vital given the trend towards large industrial milking operations. PMID:19894161
Douphrate, David I; Nonnenmann, Matthew W; Rosecrance, John C
The range of symptoms experienced by refugees of war has not been empirically assessed. The New Mexico Refugee Symptom Checklist-121 (NMRSCL-121) was developed utilizing established guidelines and evaluated for its psychometric properties. Community-dwelling Kurdish and Vietnamese refugees reported 48 (SD = 31) persistent and bothersome somatic and psychological symptoms on the NMRSCL-121. Internal consistency and test-retest reliability for the total scale and for most subscales were acceptable, and construct and concurrent validity for the NMRSCL-121 data was shown. There were modest ethnic group differences on symptom severity and psychometric properties of NMRSCL-121 subscales. The NMRSCL-121 produces reliable and valid assessments of a wide range of symptoms in 2 broad community samples of displaced adult refugees. PMID:19214047
Forty two Crohn's disease patients were followed up after ileocolic resection with regard to symptoms and endoscopic appearance of the ileocolic anastomosis. Twenty eight patients resected because of colonic neoplasm served as controls. In all the Crohn's disease patients the ileal resection margin was disease free macroscopically at operation. In addition, intraoperative ileoscopy was performed in 13 and no sign
The importance of pain as a presenting symptom of breast cancer has been assessed in a series of 240 patients with operable breast cancer over four years. From an analysis of the case histories of 36 patients the diagnosis proved difficult in one-quarter of the cancers. This is explained by the high incidence of subclinical and lobular carcinoma in the
P E Preece; M Baum; R E Mansel; D J Webster; R W Fortt; I H Gravelle; L E Hughes
This study examined interrelationships among combat exposure, symptoms of posttraumatic stress disorder (PTSD), and family adjustment in a sample of male and female Operation Desert Storm veterans (N = 1,512). In structural equation models for both male and female veterans, higher combat exposure was associated with higher PTSD symptoms, which in turn were associated with poorer family adjustment, although these indirect effects did not reach statistical significance. The model for female veterans evidenced a significant direct negative association between combat exposure and family adjustment when it statistically accounted for PTSD symptoms. When the relative impacts of separate PTSD symptom groupings were examined, those reflecting withdrawal/numbing symptoms and arousal/lack of control symptoms significantly and indirectly accounted for the negative effects of combat exposure on family adjustment. Study findings indicate a number of possible pathways through which war-zone deployments negatively impact military families and suggest several avenues for future research. PMID:18665692
Taft, Casey T; Schumm, Jeremiah A; Panuzio, Jillian; Proctor, Susan P
AimThis study aimed to evaluate patient information provided, the management of post-operativesymptoms and post-operative care, and patient satisfaction with ambulatory breast surgery over a 1-year period.
F. Marchal; F. Dravet; J. M. Classe; L. Campion; T. François; D. Labbe; S. Robard; J. L. Théard; R. Pioud
... Headache Excessive sweating and clammy skin Loss of appetite, low energy, and fatigue Confusion, especially in older people Symptoms also can vary, depending on whether your pneumonia is bacterial or viral. In bacterial pneumonia, your temperature may rise as high as 105 degrees F. ...
This article reviews what is known about the etiology, assessment, and management of several symptoms chat are commonly associated with advanced cancer: pain, anorexia, nausea, and asthenia. A better awareness of cancer pain has resulted in major advances in the ability to manage the problem. The author points out that high-quality research is needed on the natural history and management
|Alpha-mannosidosis is characterized by mild to moderate intellectual disability (ID), moderate to severe neurosensory hearing loss, frequent infections, psychomotor disturbances and skeletal dysmorphism. For the first time, a panel of nine alpha-mannosidosis patients with psychiatric symptoms is presented. The clinical picture has several…
Alpha-mannosidosis is characterized by mild to moderate intellectual disability (ID), moderate to severe neurosensory hearing loss, frequent infections, psychomotor disturbances and skeletal dysmorphism. For the first time, a panel of nine alpha-mannosidosis patients with psychiatric symptoms is presented. The clinical picture has several…
|This study investigated the concurrent and longitudinal relations among children's peer victimization, empathy, and emotional symptoms. The sample consisted of 175 children (85 girls, mean age = 6.1 years) recruited from kindergartens in Switzerland and followed for 1 year (Time 2). Parents and teachers reported on the children's emotional…
Both patients and clinicians may incorrectly diagnose vulvovaginitis symptoms. Patients often self-treat with over-the-counter antifungals or home remedies, although they are unable to distinguish among the possible causes of their symptoms. Telephone triage practices and time constraints on office visits may also hamper effective diagnosis. This review is a guide to distinguish potential causes of vulvovaginal symptoms. The first section describes both common and uncommon conditions associated with vulvovaginitis, including infectious vulvovaginitis, allergic contact dermatitis, systemic dermatoses, rare autoimmune diseases, and neuropathic vulvar pain syndromes. The focus is on the clinical presentation, specifically 1) the absence or presence and characteristics of vaginal discharge; 2) the nature of sensory symptoms (itch and/or pain, localized or generalized, provoked, intermittent, or chronic); and 3) the absence or presence of mucocutaneous changes, including the types of lesions observed and the affected tissue. Additionally, this review describes how such features of the clinical presentation can help identify various causes of vulvovaginitis. PMID:18559121
Farage, Miranda A; Miller, Kenneth W; Ledger, William J
... immune system. For more information, see NIHâ??s AIDS . HIV/AIDS 101 What Is HIV/AIDS? How Do You ... one symptom or common illness that everyone with HIV/AIDS has? No. Although many people living with HIV/ ...
|Increasing evidence that decompensation into acute psychosis by schizophrenics can often be avoided with active pharmacological and psychosocial intervention at the early signs of relapse has stimulated research into the signs and symptoms prodromal to acute psychosis. In this study, 6-week periods prior to 17 psychotic relapses and to 11…
This study examined whether anxiety symptoms in preschoolers reflect subtypes of anxiety consistent with current diagnostic classification systems, or should be better regarded as representing a single dimension. Parents of a large community sample of preschoolers aged 2.5 to 6.5 years rated the frequency with which their children experienced a wide range of anxiety problems. Exploratory factor analysis indicated four
Susan H. Spence; Ronald Rapee; Casey McDonald; Michelle Ingram
- We recently reported several cases consistent with tran- sient radicular irritation after spinal anesthesia with hy- perbaric 5% lidocaine. The present prospective, blind, nonrandomized study was performed to determine the incidence of these transient neurologic symptoms and to identify factors that might be associated with their occurrence. We studied 270 patients scheduled for gy- necologic or obstetric procedures under
Karl F. Hampl; Markus C. Schneider; Wolfgang Ummenhofer; Jurgen Drewe
Researches the relation between hoarding and obsessive-compulsive disorders (OCD). In both college student and community samples, hoarding was associated with higher scores on the Yale-Brown Obsessive-Compulsive Scale. Hoarding also was associated with higher levels of general psychopathology as measured by the Brief Symptom Inventory. Results…
|Children with ADHD and autism have some similar features, complicating a differential diagnosis. The purpose of our study was to determine the degree to which core ADHD and autistic symptoms overlap in and discriminate between children 2-16 years of age with autism and ADHD. Our study demonstrated that 847 children with autism were easily…
Mayes, Susan Dickerson; Calhoun, Susan L.; Mayes, Rebecca D.; Molitoris, Sarah
The diagnosis of irritable bowel syndrome (IBS) should be considered when patients have had abdominal pain/discomfort, bloating, and change in bowel habits for 6 months. Patients may experience variation between periods of constipation and diarrhea. When evaluating patients with IBS, physicians should be alert for red flag symptoms, such as rectal bleeding, anemia, nighttime pain, and weight loss. Physicians also should consider other medical conditions that manifest similarly to IBS. Clinicians who are confident in diagnosing IBS based on symptoms typically do not obtain many tests unless the patient has red flag symptoms. Various etiologic mechanisms have been proposed for IBS, including abnormal bowel motility, inflammation, altered mucosal permeability, genetic predisposition, and visceral hypersensitivity. Lack of certainty about the etiology makes it difficult to develop effective management approaches; thus, management is directed toward symptom relief. Dietary changes, such as avoiding fermentable carbohydrates, may benefit some patients, especially those with bloating. Constipation-dominant IBS can be managed with antispasmodics, lubiprostone, or linaclotide, whereas diarrhea-dominant IBS can be managed with loperamide or alosetron, though the latter drug can cause ischemic colitis. For long-term therapy, tricyclic antidepressants or selective serotonin reuptake inhibitors have good efficacy. Peppermint oil and probiotics also may provide benefit. PMID:24124703
Objective Clinical studies suggest that psychiatric symptoms, particularly depression, anxiety and trauma, may be associated with inflammation, as indexed by proinflammatory cytokines. Such a link may be especially significant in pregnancy, and may shed additional light on the etiology of perinatal mood disorders. Methods We prospectively followed 145 women selected from a community obstetric clinic serving a primarily low-income, high psychosocial risk population. Women without evidence of medical high-risk pregnancies were screened (including psychiatric and trauma histories) and then assessed in detail (e.g. mood symptoms) at approximately 18 and 32 weeks gestation. Blood was drawn to measure key proinflammatory markers, interleukin (IL)-6 and tumor necrosis factor (TNF)-?. Data on pregnancy and obstetric outcome were derived from medical records. Results There was considerable stability of cytokine levels within individuals and a significant mean increase across pregnancy observed for IL-6 (p<.001) and TNF-? (p<.001). History of trauma was associated with significantly elevated TNF-? (F(1.135)=4.43, p<.05), controlling for psychosocial and obstetric covariates. In contrast, elevated measures of depression and anxiety were unrelated to proinflammatory cytokines (p>.10). Exploratory analyses indicated that neither psychiatric symptoms nor proinflammatory cytokines predicted birthweight, gestational age, or obstetric complications. Conclusions These findings suggest that antecedent trauma may be associated with persistently elevated TNF- ? levels during pregnancy. No evidence was found that a generalized proinflammatory state was associated with symptoms of depression or anxiety in pregnant women.
Blackmore, Emma Robertson; Moynihan, Jan A; Rubinow, David R; Pressman, Eva K; Gilchrist, Michelle; O'Connor, Thomas G
|A recent study by the Heritage Foundation (Rector, Johnson, & Noyes, 2003) found evidence of a positive relationship between early sexual intercourse and depressive symptoms. This finding has been used to bolster support for funding abstinence only sex education. However, promoting abstinence will only yield mental health benefits if there is a…
A recent study by the Heritage Foundation (Rector, Johnson, & Noyes, 2003) found evidence of a positive relationship between early sexual intercourse and depressive symptoms. This finding has been used to bolster support for funding abstinenceonly sex education. However, promoting abstinence will only yield mental health benefits if there is a causal link between sexual intercourse and depression. Using the
A recent study by the Heritage Foundation (Rector, Johnson, & Noyes, 2003) found evidence of a positive relationship between early sexual intercourse and depressive symptoms. This finding has been used to bolster support for funding abstinence only sex education. However, promoting abstinence will only yield mental health benefits if there is a…
Examined performance on neuropsychological tests (tapping the medial temporal lobe and related limbic structures, and the dorsolateral prefrontal cortex, respectively) in relation to performance on tasks assessing autistic symptoms in young children with autism, and developmentally matched children with Down syndrome or typical development.…
Dawson, Geraldine; Meltzoff, Andrew N.; Osterling, Julie; Rinaldi, Julie
Do You Have Celiac Disease? Find Your Symptoms The Celiac Sprue Association has an online application, that will allow the use to: Filter Systems ... Affected System Click here and try it now! Celiac Disease occurs in: 3.9 -12.3% of people ...
Objective: To examine the association of psychiatric symptoms with migraine and tension-type headache in children. Method: A questionnaire completed by 1,135 Finnish children in the sixth grade identified 154 children with migraine, 138 with tension-type headache, and 407 children who were headache-free. Seventy children were randomly selected…
|Examined the temporal association between body image and depressive symptoms in African American, Asian American, Hispanic American, and white adolescents. Found that girls were more influenced by body image change than boys. Compared to other ethnic groups, African American girls experienced a greater increase in psychological distress as body…
In the present study, the structure of obsessive-compulsive symptoms was investigated by means of the Padua Inventory (PI). Simultaneous Components Analysis on data from obsessive-compulsives (n = 206), patients with other anxiety disorders (n = 222), and a non clinical sample (n = 430) revealed a five-factor solution. These factors are: (I) impulses; (II) washing; (III) checking; (IV) rumination; and
Patricia Van Oppen; Rense J. Hoekstra; Paul M. G. Emmelkamp
Traditional methods of opioid detoxification: ion with opioid agonist such as methadone or non- opioid drugs such as clonidine hydrochloride involve relatively long processes compared to rapid or ultra rapid detoxification. Using new methods, clients are detoxified in a shorter period of time with less relapse rate and they don't experience withdrawal symptoms. This is a clinical analytic outcome study,
This study compares alcohol withdrawal severity during outpatient detoxification in alcohol dependent subjects (ALC) and in subjects dependent on both alcohol and cocaine (ALC\\/COC). Subjects included 123 ALC and 66 ALC\\/COC subjects. Baseline demographic and drug use variables, alcohol withdrawal symptoms, and the total amount of oxazepam taken during alcohol detoxification were compared between the two groups. Compared to ALC
Kyle M. Kampman; Helen Pettinati; Joseph Volpicelli; Gail Kaempf; Ellen Turk; Ambrose Insua; Craig Lipkin; Thorne Sparkman; Charles P. OBrien
People with depression, bipolar disorder, and schizophrenia manifest considerable cognitive deficits and impairments in everyday functional outcomes. The severity of current mood symptoms is associated with the severity of cognitive deficits in people with unipolar and bipolar disorder, but impairments are clearly still present in cases with minimal current mood symptoms. In people with schizophrenia, depression is less strongly associated with cognitive deficits on a cross-sectional basis, and some evidence suggests that depression and cognitive impairments are inversely related. Furthermore, in schizophrenia, mood symptoms seem to affect everyday functioning in a way that is unassociated with the severity of deficits in cognition and functional capacity. In contrast, in bipolar disorder, mood symptoms seem to affect real-world functioning through an adverse effect on the ability to perform critical functional skills. In both mood disorders and schizophrenia, depression appears to impact the motivation to perform potentially reinforcing acts, possibly through the induction of anhedonia. Clearly, depression has a major adverse impact on everyday functioning in all variants of severe mental illness, and improving its recognition (in the case of schizophrenia) and management has the potential to reduce the adverse impact of severe mental illness on everyday functioning. Reducing disability has the potential to have positive impacts in multiple objective and subjective aspects of functioning in severe mental illness.
|This document presents a definition and description of anorexia nervosa as a disorder that occurs predominantly in girls and that can affect 1 out of every 250 girls between the ages of 12 and 18 years. The existence of a distorted mental body image among anorexics is discussed and symptoms of the disorder are described, including amenorrhea…
Examined the temporal association between body image and depressive symptoms in African American, Asian American, Hispanic American, and white adolescents. Found that girls were more influenced by body image change than boys. Compared to other ethnic groups, African American girls experienced a greater increase in psychological distress as body…
All schizophrenic symptoms remitted completely in six out of 14 adults who had not responded to phenothiazine drugs and who were then given propranolol. Another patient improved markedly and four improved moderately. Two had minimal or transient improvement, and one left hospital unchanged after a short, severe, toxic reaction. The six with complete remissions all began to improve within a
N. J. Yorkston; Saniha A. Zaki; M. K. U. Malik; R. C. Morrison; C. W. H. Havard
BackgroundA Healthy People 2010 objective includes increasing public awareness of the warning signs of stroke, yet few data exist about the level of awareness. Recognition of stroke symptoms and awareness of the need to call 911 for acute stroke events were examined among the general population.
Kurt J Greenlund; Linda J Neff; Zhi-Jie Zheng; Nora L Keenan; Wayne H Giles; Carma A Ayala; Janet B Croft; George A Mensah
Research findings on acculturation and mental health are complex. Previous research has demonstrated mixed results indicating that an increasing level of acculturation can be associated with both detrimental and beneficial health outcomes. Research focusing on the association of acculturation and schizophrenia remains largely unexplored. This study evaluated the relationship between acculturation and symptom severity with 47 Latino, Black, and White
About 350,000 persons in the United States have multiple sclerosis, and primary care physicians are often called on to provide symptomatic therapy for these patients. We review our current pharmacologic approach to the management of multiple sclerosis exacerbations and the symptoms of spasticity, fatigue, bladder and bowel involvement, neurobehavioral complaints, pain syndromes, dystonic spasms, and tremor and ataxia.
Neuropsychiatric symptoms (NPS) are core features of Alzheimer’s disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration.
Dillon, Carol; Serrano, Cecilia M; Castro, Diego; Leguizamon, Patricio Perez; Heisecke, Silvina L; Taragano, Fernando E
|We explore dyadic parenting styles and their association with first-grade children's externalizing behavior symptoms in a sample of 85 working-class, dual-earner families. Cluster analysis is used to create a typology of parenting types, reflecting the parental warmth, overreactivity, and laxness of both mothers and fathers in two-parent…
The World Health Organization has recently launched an international study of somatoform disorders in different cultures. Five centres representing distinct cultures participated in phase I of the project, the main objective of which was to test the cross-cultural applicability and reliability of instruments for the assessment of somatoform disorders. The analysis of the assessed somatic symptoms showed that various aches
Mohan Isaac; Aleksandar Janca; Kimberly Christie Burke; Jorge Alberto Costa e Silva; Stanley Wilson Acuda; Carlo Altamura; C. R. Chandrashekar; Claudio T. Miranda; Gianluigi Tacchin
ObjectiveAlthough the relationship between religious practice and health is well established, the relationship between spirituality and health is not as well studied. The objective of this study was to ascertain whether participation in the mindfulness-based stress reduction (MBSR) program was associated with increases in mindfulness and spirituality, and to examine the associations between mindfulness, spirituality, and medical and psychological symptoms.
James Carmody; George Reed; Jean Kristeller; Phillip Merriam
With the help of the CCOPs, MB-CCOPs and Research Bases, more clinical trials than ever before are incorporating patient-reported outcomes to better capture the clinical benefit and risks of cancer therapies. CCOP network studies include symptom management, toxicity reduction, supportive and palliative care, and quality of life.
This study investigated the concurrent and longitudinal relations among children's peer victimization, empathy, and emotional symptoms. The sample consisted of 175 children (85 girls, mean age = 6.1 years) recruited from kindergartens in Switzerland and followed for 1 year (Time 2). Parents and teachers reported on the children's emotional…
Despite the importance of symptom control in the cancer population, few studies have systematically assessed the prevalence and characteristics of symptoms or the interactions between various symptom characteristics and other factors related to quality of life (QOL). As part of a validation study of a new symptom assessment instrument, inpatients and out-patients with prostate, colon, breast or ovarian cancer were
R. K. Portenoy; H. T. Thaler; A. B. Kornblith; J. McCarthy Lepore; H. Friedlander-Klar; N. Coyle; T. Smart-Curley; N. Kemeny; L. Norton; W. Hoskins; H. Scher
|Objective: Symptoms of oppositional defiant disorder (ODD) and depression show high rates of co-occurrence, both cross-sectionally and longitudinally. This study examines the extent to which variation in oppositional symptoms predict, variation in depressive symptoms over time, accounting for co-occurring depressive symptoms and measurement…
Boylan, Khrista; Georgiades, Katholiki; Szatmari, Peter
Selected university students who requested either personal counseling at the counseling center (43 males and 101 females) or psychotherapy at the mental health service (40 males and 53 females) were administered the Symptom Distress Checklist-90. This is a self-report symptom rating scale intended to assess the degree of distress associated with presenting symptoms; scores are organized along 9 symptom dimensions
In this thesis, three distinctly different methods were used to inform how symptoms reflecting two common child psychiatric disorders – oppositional defiant disorder and major depression – are developmentally related. Several hypotheses were explored: oppositional behaviours are risk factors for depressive symptoms, depressive symptoms are risk factors for oppositional behaviours, both symptoms present because they share common causes, and oppositional
An affective, somatic, and memory check-list of symptoms was administered to subjects who had no personal experience or knowledge of head injury. Subjects indicated their current experiences of symptoms, then imagined having sustained a mild head injury in a motor vehicle accident, and endorsed symptoms they expected to experience six months after the injury. The checklist of symptoms was also
In a sample of 240 adolescents assessed annually in Grades 6 through 11, the developmental trajectories of their depressive symptoms were examined using latent factor growth modeling. Growth in mother-reported adolescent depressive symptoms was quadratic; growth in adolescent-reported symptoms was linear. In the model with gender and maternal depression, girls reported a greater increase in depressive symptoms over time than
Objective: This study investigated the occurrence of obsessive-compulsive spectrum disorders (OCSDs) and associated symptomology in college students. Participants: Participants included 358 undergraduate students. Results: Results suggest that clinically significant levels of OCSD symptoms are relatively common. Additionally, OCSD symptoms co-occurred with each other and anxiety symptoms in general, yet not significantly with impulsivity symptoms. Conclusions: Given their prevalence in college
Michael L. Sulkowski; Amy Mariaskin; Eric A. Storch
Young women report symptoms associated with irritable bowel syndrome (IBS), such as pain, bloating, and changes in bowel movements, more often than young men. Young women with eating disorders also report these gastrointestinal symptoms frequently. We hypothesized that if dieting behaviors were associated with these symptoms, the prevalence and frequency of the symptoms would be positively related to dieting severity
Dean Krahn; Candace Kurth; Karen Nairn; Lezli Redmond; Adam Drewnowski; Edith Gomberg
Research has shown that 30-90% of women suffer from mild to moderate perimenstrual symptoms while 2-10% experience severe symptoms. Yet, after decades of study, neither a definite etiology for symptom development, nor an encompassing and effective treatment has been found. To reduce symptom severity and prevalence researchers are currently suggesting a combination of lifestyle modifications including, moderate exercise, stress management,
D. Novak; M. Archuleta; J. Benson; E. Trunnel; G. Yipchuck
Patients who undergo autologous peripheral blood stem cell (PBSC) transplantation experience multiple symptoms that adversely affect quality of life. We assessed symptoms during the acute phase of autologous PBSC transplantation to determine the severity of individual symptoms and to determine overall symptom profiles in 100 patients with multiple myeloma or non-Hodgkin's lymphoma. Study subjects completed the blood and marrow transplantation
K O Anderson; S A Giralt; T R Mendoza; J O Brown; J L Neumann; G M Mobley; X S Wang; C S Cleeland
Prospective studies suggest that dieting increases risk for bulimic symptoms, but experimental trials indicate dieting reduces bulimic symptoms. However, these experiments may be unrepresentative of real-world weight loss dieting. In addition, the fact that most dieters do not develop eating disorders suggests moderating factors may be important. Accordingly, we randomly assigned 157 female intermittent dieters to either diet as they usually do for weight loss or eat as they normally do when not dieting for 4 weeks. Naturalistic dieting halted the weight gain shown by controls, but did not result in significant weight loss. Although there was no main effect of the dieting manipulation on bulimic symptoms, moderation analyses indicated that naturalistic dieting decreased bulimic symptoms among participants with initially low depressive symptoms. Results suggest that self-initiated weight loss dieting is not particularly effective, which appears to explain several discrepancies in the literature. Additionally, depressive symptoms may be an important determinant of bulimic symptoms that eclipses the effects of naturalistic dieting on this outcome. PMID:17662503
Presnell, Katherine; Stice, Eric; Tristan, Jennifer
Functional impairment is a defining feature of psychotic disorders and usually appears well before their onset. Negative symptoms play a prominent role in the impaired functioning of individuals with schizophrenia and those at clinical-high-risk (CHR) for psychosis. Despite high rates of depression and anxiety in early psychosis, few studies have examined the contribution of these symptoms to functioning in the putative 'prodrome.' In the current study, we tested the hypotheses that 1) worse negative and disorganized, but not positive, symptoms would be significantly related to impaired social and role functioning in two cohorts of CHR individuals (combined N=98) and a separate sample of individuals with recent-onset (RO) psychotic disorders (N=88); and 2) worse anxiety and depression would be significantly related to impaired functioning in both samples, above and beyond the contributions of negative and disorganized symptoms. Findings largely supported our hypotheses that more severe negative and disorganized symptoms were related to poorer social and role functioning in both samples. Anxiety and depression severity were significantly related to poorer functioning in both samples. In addition, depression, but not anxiety, predicted poorer global and social functioning above and beyond that explained by negative symptoms in the CHR sample. These results suggest the need for phase-specific treatment in early psychosis, with a focus on symptom dimensions to improve functional outcomes for CHR individuals. PMID:23587696
Fulford, Daniel; Niendam, Tara A; Floyd, Erin G; Carter, Cameron S; Mathalon, Daniel H; Vinogradov, Sophia; Stuart, Barbara K; Loewy, Rachel L
This purpose of this study was to examine the relationship between exposure to wheat flour, soya flour and fungal amylase and the development of work-related symptoms and sensitization in bread and cake bakery employees who have regular exposure to these substances. The study populations consisted of 394 bread bakery workers and 77 cake bakery workers whose normal jobs involved the sieving, weighing and mixing of ingredients. The groups were interviewed with the aim of identifying the prevalence, nature and pattern of any work-related respiratory symptoms. They were also skin-prick tested against the common bakery sensitizing agents, i.e., wheat flour, soya flour, rice flour and fungal amylase. The results of personal sampling for sieving, weighing and mixing operations at the bakeries from which the study groups were taken were collated in order to determine typical exposures to total inhalable dust from the ingredients, expressed as 8 hour time-weighted average exposures. Data from the health surveillance and collated dust measurements were compared with the aim of establishing an exposure-response relationship for sensitization. The prevalence of work-related symptoms in bread bakery and cake bakery ingredient handlers was 20.4% and 10.4% respectively. However, in a large proportion of those reporting symptoms in connection with work, the symptoms were intermittent and of short duration. It is considered that the aetiology of such symptoms is likely to be due to a non-specific irritant effect of high total dust levels, rather than allergy. None of the cake bakers and only 3.1% of the bread bakers had symptoms which were thought to be due to allergy to baking ingredients. Using skin-prick testing as a marker of sensitization, the prevalence of positive tests to wheat flour was 6% for the bread bakers and 3% for the cake bakers. Comparable prevalences for soya flour were 7% and 1% respectively. However, the prevalence of positive skin-prick tests to fungal amylase was 16% amongst the bread baking group with only a single employee (1%) in the cake baking group having a positive test. Furthermore, this employee had previously worked in a bread bakery. The difference in rates of sensitization to wheat flour between the bread and cake bakers is not statistically significant, whereas the difference for soya flour is at the borderline of statistical significance (p = 0.045). In contrast, the difference in fungal amylase sensitization is significant at the 0.1% level. For both bread and cake bakers, the 8 hour time-weighted average exposures for each of the activities showed a wide variation with mixing having the lowest average exposure and sieving the highest. Out of the allergens studied in this investigation, fungal amylase is the principal sensitizer in large scale bread bakeries, with the main source of exposure being the handling of bread improvers. In contrast, the risk of sensitization to wheat flour is low in both bread and cake bakeries. The absence of positive skin-prick tests in the subgroup of cake bakery employees who regularly handle fungal-amylase-containing flour suggests that their levels of exposure are below the threshold for sensitization to amylase. PMID:9876416
Objective To select the potential targeted symptoms/syndromes as early warning indicators for epidemics or outbreaks detection in rural China. Introduction Patients’ chief complaints (CCs) as a common data source, has been widely used in syndromic surveillance due to its timeliness, accuracy and availability (1). For automated syndromic surveillance, CCs always classified into predefined syndromic categories to facilitate subsequent data aggregation and analysis. However, in rural China, most outpatient doctors recorded the information of patients (e.g. CCs) into clinic logs manually rather than computers. Thus, more convenient surveillance method is needed in the syndromic surveillance project (ISSC). And the first and important thing is to select the targeted symptoms/syndromes. Methods Epidemiological analysis was conducted on data from case report system in Jingmen City (one study site in ISSC) from 2004 to 2009. Initial symptoms/syndromes were selected by literature reviews. And finally expert consultation meetings, workshops and field investigation were held to confirm the targeted symptoms/syndromes. Results 10 kinds of infectious diseases, 6 categories of emergencies, and 4 bioterrorism events (i.e. plague, anthrax, botulism and hemorrhagic fever) were chose as specific diseases/events for monitoring (Table 1). Two surveillance schemes were developed by reviewing on 565 literatures about clinical conditions of specific diseases/events and 14 literatures about CCs based syndromic surveillance. The former one was to monitor symptoms (19 initial symptoms), and then aggregation or analysis on single or combined symptom(s); and the other one was to monitor syndromes (9 initial syndromes) directly (Table 2). The consultation meeting and field investigation identified three issues which should be considered: 1) the abilities of doctors especially village doctors to understand the definitions of symptoms/syndromes; 2) the workload of data collection; 3) the sensitive and specific of each symptom/syndrome. Finally, Scheme 1 was used and 10 targeted symptoms were determined (Table 2). Conclusions We should take the simple, stability and feasibility of operation, and also the local conditions into account before establishing a surveillance system. Symptoms were more suitable for monitoring compared to syndromes in resource-poor settings. Further evaluated and validated would be conducted during implementation. Our study might provide methods and evidences for other developing countries with limited conditions in using automated syndromic surveillance system, to construct similar early warning system.
Purpose To evaluate (i) the relationship between traditional and new clinical tests (lid-wiper epitheliopathy (LWE), lid-parallel conjunctival folds (LIPCOF)) and dry eye symptoms in non-contact lens wearers, and (ii) that a combination of these tests can improve predictive ability for the development of dry eye symptoms. Methods Tear meniscus height (TMH), non-invasive break-up time (NIBUT), ocular hyperaemia, LIPCOF, phenol red thread test (PRTT), corneal and conjunctival staining, and LWE grades were observed in a cohort of 47 healthy, non-lens wearers (male=17, female=30, median age=35 years, range=19–70). Symptoms were assessed using the Ocular Surface Disease Index (OSDI). Results LWE was significantly correlated to both temporal and nasal LIPCOF (0.537?0.248, P<0.001). Significant correlations were found between NIBUT and TMH (r=0.461, P=0.001) and PRTT (r=0.640, P<0.001). OSDI scores were significant correlated to NIBUT, TMH, PRTT, LIPCOF, and LWE (r>?0.31? P<0.05). Significant discriminators of OSDI+/? were NIBUT (area under the receiver operative characteristic curve (AUC)=0.895), TMH (0.715), PRTT (0.781), LIPCOF (temporal/nasal/Sum 0.748/0.828/0.816), and LWE (0.749). Best predictive ability was achieved by combining NIBUT with nasal LIPCOF (AUC=0.944). Conclusions The individual tests NIBUT, TMH, PRTT, LIPCOF, and LWE were significantly, but moderately, related to OSDI scores. The strongest relationship appeared by combining NIBUT with nasal LIPCOF.
Objectives To conduct a pilot trial of a primary care Symptoms Clinic for patients with medically unexplained symptoms and evaluate recruitment and retention, and acceptability of the intervention and to estimate potential treatment effects for a full trial. Trial design Randomised parallel group pilot trial. Setting Primary care in one locality. Participants Primary care database and postal questionnaire were used to identify patients with multiple specialist referrals and multiple physical symptoms unlikely to be explained by disease. Interventions General practitioner (GP) with special interest ‘Symptoms Clinic’ + usual care versus usual care alone. The Symptoms Clinic comprised one long (1?h) and three short (20?min) appointments. Outcomes Number of patients identified and recruited; acceptability of the intervention (items from Client Satisfaction Questionnaire and interview); Medical Outcomes Survey Short Form 12 (SF-12) physical component summary. Randomisation Automated blocked randomisation accessed by telephone. Blinding None. Numbers randomized 16 to intervention and 16 to usual care alone. Recruitment 72 patients, from seven GP practices, had repeated specialist referrals and a Patient Health Questionnaire (PHQ)-15 score of ?10 indicating a high probability of medically unexplained symptoms. 15 were ineligible and 25 declined to participate. Numbers analysed 26 patients; two patients randomised to the intervention group were incorrectly included, three patients in the intervention group and one control did not complete outcome measures. Outcome Most patients randomised to the Symptoms Clinic found the intervention acceptable: eight out of 11 reported the intervention helped them to deal with their problems. The mean difference between groups in SF-12 physical component summary, adjusted for baseline, was 3.8 points (SD 6). Harms No observed harms. Conclusions Patients with multiple medically unexplained symptoms can be systematically identified in primary care; a randomised trial comparing the Symptoms Clinic with usual care is feasible and has the potential to show clinically meaningful benefit. Trial registration ISRCTN63083469.
Weller, David; Marsden, Wendy; Worth, Allison; Sharpe, Michael
Sikes and French, Ltd., two National Priority List sites that are proximal to one another, are located approximately 20 mi (32 km) east of Houston, Texas. Dumping at Sikes occurred during the early 1960s and continued until 1967. Benzene, 1,2-dichloroethane, toluene, 1,1,2-trichloroethane, naphthalene, lead, fluorene, and pyrene are chemicals that pose a particular public health concern. French, Ltd., commenced operations in 1966, and dumping ceased in 1973. Chemicals of potential public health impact at the French, Ltd., site are benzene, benzo(a)anthracene, benzo(a)pyrene, copper, chrysene, chromium, dichlorodiphenyltrichloroethane, heptachlor, lead, nickel, polychlorinated biphenyls, tetrachloroethylene, trichloroethylene, and zinc. During the 1980s, both sites were placed on the National Priority List. Barrett Station is a stable black community located near the two sites. The question of whether levels of exposure to dumpsite chemicals were related to health complaints in the Barrett Station population was examined. The prevalence of 29 symptoms reported by 321 individuals who had been highly exposed was compared with symptoms reported by a group of 351 persons from the same community who had limited exposure. A meaningful difference between the two groups emerged for some of the symptoms, the most notable of which symptoms were neurologic. Almost twice as many subjects in the high-exposure group reported five or more neurologic symptoms, compared with the low-exposure group. This excess of neurological symptoms is consistent with the known toxic properties of the chemicals at the sites. PMID:7786046
Dayal, H; Gupta, S; Trieff, N; Maierson, D; Reich, D
Background Factor analysis is one of the most used statistical techniques to analyze the inter-relationships among symptoms reported by Gulf War veterans. The objective of this study was to apply factor analyses to binary symptom data from the UK study of Gulf War illness and the US Air Force study of Gulf War veterans, and to compare the symptom domains derived from the distinct samples. Methods UK veterans of the 1991 Gulf War (n = 3,454), individuals deployed to Bosnia on U.N. peacekeeping operations (n = 1,979) and Gulf War-era servicemen (n = 2,577) who were not deployed to the Gulf were surveyed in 1997–1998, and US 1991 Gulf War veterans from four Air Force units (n = 1,163) were surveyed in 1995 to collect health characteristics including symptoms. Each sample was randomly split in half for exploratory and confirmatory dichotomous factor analyses with promax oblique rotation. Results Four correlated factors were identified in each of the samples. Three factors (Respiratory, Mood-Cognition, Peripheral Nervous) overlapped considerably across the UK cohorts. The Gastrointestinal/Urogenital factor in the UK Gulf cohort was noticeably different from the Gastrointestinal factor identified from the Bosnia and Era cohorts. Symptoms from Gulf War UK and U.S cohorts yielded similar Gastrointestinal, Respiratory and Mood-Cognition factors, despite differences in symptom inventories between the two surveys. A Musculoskeletal factor was only elicited from the US Gulf sample. Conclusion Findings of this report are consistent with those from other factor analysis studies that identified similar symptom dimensions between Gulf and non-Gulf War veterans, except that the Gastrointestinal factor in Gulf veterans included other symptom types. Correlations among factors raise the question as to whether there is a general illness, even if not unique to Gulf veterans, representing the common pathway underlying the identified factors. Hierarchical factor analysis models may be useful to address this issue.
Nisenbaum, Rosane; Ismail, Khalida; Wessely, Simon; Unwin, Catherine; Hull, Lisa; Reeves, William C
Context Postpartum depression (PPD) is common and has serious implications for the mother and her newborn. A possible link between placental corticotropin-releasing hormone (pCRH) and PPD incidence has been discussed, but there is a lack of empirical evidence. Objective To determine whether accelerated pCRH increases throughout pregnancy are associated with PPD symptoms. Design Pregnant women were recruited into this longitudinal cohort study. Blood samples were obtained at 15, 19, 25, 31 and 37 weeks gestational age (GA) for assessment of pCRH, cortisol and ACTH. Depressive symptoms were assessed with a standardized questionnaire at the last four pregnancy visits and postpartum. Setting Subjects were recruited from two Southern California Medical Centers, and visits were conducted in university research laboratories. Participants 100 adult women with a singleton pregnancy. Main Outcome Measure PPD symptoms were assessed 8.7 weeks (SD = 2.94 wks) after delivery with the Edinburgh Postnatal Depression Scale. Results Sixteen women developed PPD symptoms. At 25 weeks GA, pCRH was a strong predictor of PPD symptoms (R2 = .21, ? = .46, p < .001), an effect that remained significant after controlling for prenatal depressive symptoms. No significant associations were found for cortisol and ACTH. Receiver Operating Characteristic curve analyses revealed that pCRH at 25 weeks GA is a useful diagnostic test (area under the curve = .78, p = .001). Sensitivity (.75) and specificity (.74) at the ideal cut-off point (56.86 pg/ml pCRH) were high. Growth curve analyses indicated that pCRH trajectories in women with PPD symptoms are significantly accelerated between 23 and 26 weeks GA. Conclusion There is a critical period in mid-pregnancy during which pCRH is a sensitive and specific early diagnostic test for PPD symptoms. If replicated, these results have implications for identification and treatment of pregnant women at risk of PPD.
Yim, Ilona S.; Glynn, Laura M.; Schetter, Christine Dunkel; Hobel, Calvin J.; Chicz-DeMet, Aleksandra; Sandman, Curt A.
The current study examined the psychometric properties of the Brief Negative Symptom Scale (BNSS), a next-generation rating instrument developed in response to the NIMH sponsored consensus development conference on negative symptoms. Participants included 100 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who completed a clinical interview designed to assess negative, positive, disorganized, and general psychiatric symptoms, as well as functional outcome. A battery of anhedonia questionnaires and neuropsychological tests were also administered. Results indicated that the BNSS has excellent internal consistency and temporal stability, as well as good convergent and discriminant validity in its relationships with other symptom rating scales, functional outcome, self-reported anhedonia, and neuropsychological test scores. Given its brevity (13-items, 15-minute interview) and good psychometric characteristics, the BNSS can be considered a promising new instrument for use in clinical trials. PMID:23127378
Strauss, Gregory P; Keller, William R; Buchanan, Robert W; Gold, James M; Fischer, Bernard A; McMahon, Robert P; Catalano, Lauren T; Culbreth, Adam J; Carpenter, William T; Kirkpatrick, Brian
Establishing whether men and women tend to express different symptoms of posttraumatic stress in reaction to trauma is important for both etiological research and the design of assessment instruments. Use of item response theory (IRT) can reveal how symptom reporting varies by gender and help determine if estimates of symptom severity for men and women are equally reliable. We analyzed responses to the PTSD Checklist (PCL) from 2,341 U.S. military veterans (51% female) who completed deployments in support of operations in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom [OEF/OIF]), and tested for differential item functioning by gender with an IRT-based approach. Among men and women with the same overall posttraumatic stress severity, women tended to report more frequent concentration difficulties and distress from reminders whereas men tended to report more frequent nightmares, emotional numbing, and hypervigilance. These item-level gender differences were small (on average d = 0.05), however, and had little impact on PCL measurement precision or expected total scores. For practical purposes, men's and women's severity estimates had similar reliability. This provides evidence that men and women veterans demonstrate largely similar profiles of posttraumatic stress symptoms following exposure to military-related stressors, and some theoretical perspectives suggest this may hold in other traumatized populations. PMID:23526678
King, Matthew W; Street, Amy E; Gradus, Jaimie L; Vogt, Dawne S; Resick, Patricia A
Individuals with cancer have multiple symptoms, which frequently co-occur. A nonrandom distribution of symptoms suggests a common mechanism. Symptom clusters (SCs) were considered part of various syndromes in the early years of medicine. The SC concept in clinical medicine is old. Symptom clusters were commonly described in the psychology/psychiatry and neurology literature. Symptom cluster may be defined either clinically or statistically. Statistically derived clusters can differ from clinically defined clusters. The clinical importance of statistically derived clusters is unclear. Pain-insomnia-fatigue and pain-depression-fatigue are commonly recognized clinical clusters. Nausea-vomiting and anxiety-depression are also statistically observed clusters. The longitudinal stability of clusters is unknown. Certain SCs, appear to have a greater adverse influence on outcomes (such as performance status and survival) than others. Comorbidities probably influence symptoms at different levels, but their effect on cancer clusters is unknown. Comprehensive symptom assessment is crucial to cluster identification. The potential use of the cluster concept to abbreviate symptom assessment tools needs validation. Symptom cluster can be disease and/or treatment related and may change as individuals undergo antitumor therapies. Polypharmacy in symptom management is frequent but could be minimized if 1 drug could be used to treat cluster symptoms. Symptom cluster appears to vary with the assessment tool, disease stage, symptom domain used to cluster, cluster methodology, and number of symptoms assessed. The validity and reliability of SCs need universally accepted statistical methods, assessment tools, and symptom domains. For now, nausea-vomiting is recognized as a consistent cluster across multiple studies. Pain-depression-fatigue and pain-insomnia-fatigue are also well recognized. Symptom clusters may help in cancer diagnosis, symptom management, and prognostication. However, the cluster method, reliability, and validity need to be established before assessment or treatment guidelines are established. Symptom clusters require further research before becoming part of routine medical symptom assessment and management. PMID:20351131
Kirkova, Jordanka; Walsh, Declan; Aktas, Aynur; Davis, Mellar P
Attention-deficit\\/hyperactivity disorder (ADHD) in adulthood is conceptualized as originating in child- hood. Despite considerable theoretical interest, little is known about how ADHD symptoms relate to normal personality traits in adults. In 6 studies, the Big Five personality dimensions were related to ADHD symptoms that adults both recalled from childhood and reported concurrently (total N 1,620). Substantial effects emerged that were
Joel T. Nigg; Oliver P. John; Lisa G. Blaskey; Cynthia L. Huang-Pollock; Erik G. Willicut; Stephen P. Hinshaw; Bruce Pennington
Vasomotor symptoms are the most common indication for the prescription of hormone replacement therapy since it is effective in over 80% of cases. In 1995, 37% of American women took hormone replacement therapy, principally for this purpose. However, following the publication of results from the Women's Health Initiative, as many as half of these women in the US and in the UK and New Zealand discontinued hormone therapy. Discontinuation of estrogen is often accompanied by a return of vasomotor symptoms; however, only a small number (18%) of women report restarting hormone therapy. Alternatives are available, but limited knowledge on etiology and mechanisms of hot flushing represents a major obstacle for the development of new, targeted, non-hormonal treatments, and no current alternatives are as effective as estrogen. PMID:23848489
The knowledge regarding celiac disease has increased dramatically in recent years, due to the availability of accurate serologic markers. Mass screening studies have shown that the prevalence of sensitization can be as high as 1/80. The range of symptoms is wide, from the classic growth failure, denutrition and diarrhea in infancy to clinically and histologically asymptomatic sensitized subjects. The interest of a routine mass screening is debated. The classical celiac disease in infancy is well known. Atypical symptoms and potentially associated disease are more frequent and potentially confounding. Physicians should be aware of any clue for celiac disease in atypical cases in order to improve the diagnostic yield, and therefore avoiding short or long term consequences. PMID:21616608
Cancer pain is one of most prevalent symptoms in patients with cancer. Acupuncture and related techniques have been suggested for the management of cancer pain. The National Comprehensive Cancer Network guidelines for adult cancer pain recommends acupuncture, as one of several integrative interventions, in conjunction with pharmacologic intervention as needed. This review presents the latest available evidence regarding the use of acupuncture for cancer pain. It also provides "actionable" acupuncture protocols for specific cancer pain conditions and related symptoms in order to provide more clinically relevant solutions for clinicians and cancer patients with pain. These conditions include postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy-induced neuropathy, aromatase inhibitor-associated joint pain, and neck dissection-related pain and dysfunction. PMID:23338773
Cinnamon, which is the bark of the Cinnamomum zeylanicum tree, contains cinnamic aldehyde, which is an irritant. Workers processing cinnamon before export are exposed to much cinnamon dust. Forty such workers with an average of four years' service in the industry were examined. Thirty five workers (87.5%) had symptoms, nine having had asthma (22.5%). Other symptoms, probably related to the irritant nature of cinnamon dust, were irritation of skin (50%), loss of hair (37.5%), and smarting of eyes while at work (22.5%). Loss of weight (65%) was the commonest finding. Contact dermatitis which has previously been described was not found in any of the workers. PMID:6232942
One hundred and thirty-seven undergraduates (81 females; mean age = 21 years-10 months) completed the Bulimic SEDS subscale and standardized measures of trust beliefs in close others (mother, father, and friend), disclosure to them, and loneliness. Structural Equation Modelling yielded: (1) a negative path between Bulimic Symptoms and trust beliefs, (2) a positive path between trust beliefs and disclosure, (3) a negative path between trust beliefs and loneliness, and (4) a negative path between disclosure and loneliness. As expected, trust beliefs statistically mediated the relations between Bulimic Symptoms and both disclosure and loneliness and disclosure statistically mediated the relation between trust beliefs and loneliness. The findings supported the conclusion that individuals with bulimia nervosa are prone to the social withdrawal syndrome comprising a coherent and integrated pattern of low trust beliefs in close others, low disclosure to close others, and high loneliness. PMID:23910767
Rotenberg, Ken J; Bharathi, Carla; Davies, Helen; Finch, Tom
Childhood exposure to trauma has been associated with increased rates of somatic symptoms (SS), which may contribute to diminished daily functioning. One hundred and sixty-one children residing at a residential treatment home who had experienced neglect and/or abuse were administered the Trauma Symptom Checklist for Children (TSCC), the Multidimensional Anxiety Scale for Children, and the Children's Depression Inventory (CDI). Primary caregivers completed the Child Behavior Checklist. Two composite measures of SS were formed to represent both child- and caregiver-rated SS. Over 95% of children endorsed at least one SS on the child-rated measure. Children who had experienced sexual abuse had higher rates of SS relative to children who had not. Child-rated SS were highly correlated with the CDI total score and the TSCC subscales of anxiety, depression, posttraumatic stress, dissociation, and anger. The TSCC anxiety subscale mediated the relationship between sexual abuse and child-rated SS. PMID:22395849
Kugler, Brittany B; Bloom, Marlene; Kaercher, Lauren B; Truax, Tatyana V; Storch, Eric A
As natural childbirth has become more popular, new prenatal training groups have developed, some of which are committed to only one method of dealing with labour and delivery. This paper describes five women and four men who sought psychiatric treatment within 6 months of attempted natural childbirth that did not proceed as planned. Their symptoms included depression, anxiety, obsessive-compulsive behaviour, phobic symptoms, and marital and sexual problems. Thus, natural childbirth, although undoubtedly beneficial in most instances, is not suitable for all deliveries and may occasionally have adverse effects. Prenatal programs should emphasize an individual, flexible approach to labour and delivery and should present the possibility of the need for analgesia, anesthesia or obstetric intervention in a positive light.
Symptoms of withdrawal after oral ?9-tetrahydrocannabinol (THC) administration have been reported, yet little is known about the development of dependence on\\u000a smoked marijuana in humans. In a 21-day residential study, marijuana smokers (n = 12) worked on five psychomotor tasks during the day (0915–1700 hours), and in the evening engaged in recreational activities\\u000a (1700–2330 hours); subjective-effects measures were completed 10
M. Haney; Amie S. Ward; Sandra D. Comer; Richard W. Foltin; Marian W. Fischman
Neff 's (2003a, 2003b) notion of self-compassion emphasizes kindness towards one's self, a feeling of connectedness with others, and mindful awareness of distressing experiences. Because exposure to trauma and subsequent posttraumatic stress symptoms (PSS) may be associated with self-criticism and avoidance of internal experiences, the authors examined the relationship between self-compassion and PSS. Out of a sample of 210 university
Scientists at the Rockland Psychiatric Center in Orangeburg, New York, reported of an improve- ment of schizophrenia symptoms in 4 patients who received oral dronabinol (THC) (Schwarcz et al. J Clin Psychopharmacol 2009;29(3):255-8). Only patients with a previous history of self- reported benefits from cannabis use were selected. In addition, they presented with a severe, re- fractory condition that made
This study was designed to determine whether perfectionism, as assessed by the revised almost perfect scale (APS-R; R. B.\\u000a Slaney, M. Mobley, J. Trippi, J. S. Ashby, & D. G. Johnson, 1996), was a significant predictor of obsessive-compulsive (OC)\\u000a symptoms in a non-clinical sample of 308 university students. Perfectionistic discrepancy emerged as a general predictor of\\u000a obsessive thought difficulties and
Sertraline, a novel selective serotonin re-uptake inhibitor, has been proven as effective as amitriptyline and imipramine, and more effective than placebo, in double-blind controlled studies in patients with major depressive disorder. The question 'Do symptoms predict response to treatment?' is an important one in clinical practice. In order to try and answer this question, four double-blind clinical trials in major
In a sample of almost 6000 8-year-old children, we found that 1.5% attended special schools for the educationally subnormal,\\u000a or training schools. Psychiatric symptoms were studied by means of three screening instruments: the Rutter Parent Questionnaire\\u000a (RA2) for the parents, the Rutter Teacher Questionnaire (RB2) for the teachers, and the Children’s Depression Inventory (CDI)\\u000a for the children. The prevalence rate
S. L. Linna; I. Moilanen; H. Ebeling; J. Piha; K. Kumpulainen; T. Tamminen; F. Almqvist
Nowadays, diving is being performed ever more frequently; it is thus important to take diving injuries into consideration in patients presenting with even minor complaints after diving. Every dive is risky and could result in decompression illness, barotrauma and/or death. We report on two cases of decompression illness: a 30-year old man, an occupational diver, and a 46-year old man, an experienced diver, who were both clinically suspected of having decompression illness and were treated with hyperbaric oxygen in a recompression chamber. Both were eventually symptom-free after several treatments. Decompression illness is caused by a reduction in ambient pressure, which results in intra- or extravascular bubbles. Symptoms vary and are dependent on the site affected: from minor pain to neurological symptoms and death. If patients are suspected of having diving injuries, we recommend contacting a centre specialised in diving and hyperbaric medicine. Recompression in a hyperbaric chamber is the definitive treatment for decompression illness and should be performed as soon as possible. PMID:22951132
Gho, J M I H Ing Han; Kramer, Irene Fleur; van Hulst, Rob A; Kramer, William L M
Fifty patients with Paget's disease of bone were reviewed with regard to the basis of their symptoms and the long-term results of treatment. Twenty-four patients (48%) presented with pain localised within bone, while 17 (34%) presented with symptoms of degenerative joint disease. Three patients presented with bone pain and arthritis and the remaining six with fractures, ataxia, or painless deformity. Symptomatic osteoarthritis of the hip (OA) developed in 25 patients (50%) with approximately half developing radiological changes identical to those of idiopathic OA. Among the other patients those with coxa vara tended to show medial (rather than superior) joint space narrowing and severe Paget's disease on both sides of the joint. Arthritic pain, stiffness, and reduced mobility in other joints (knee, ankle, and wrist) were associated clinically with bone deformity adjacent to the affected joint and radiologically with distorted articular surfaces and narrowed joint spaces; sclerosis, subarticular cyst formation, and osteophytosis were usually absent. Fifteen patients were treated with calcitonin for bone pain alone; all claimed long-term 'good to complete' relief. By contrast, none of the 14 with arthritic symptoms responded to calcitonin when assessed retrospectively. Results of surgical and other medical treatment were analysed. Careful clinical evaluation is a prerequisite for optimal treatment in Paget's disease. Images
In the current pediatric practice, respiratory symptoms are one of the most common reasons that lead to referral to a pediatric specialist. Although most such symptoms are generated by respiratory causes, mainly infectious ones, sometimes extra-respiratory pathogenesis is involved. In the last twenty years, pediatric gastroesophageal reflux (GER) has been more frequently recognized both because the increased awareness of the disease and the progresses concerning the diagnostic techniques. The reflux-related complications and not necessarily the number and severity of reflux episodes are the features which help distinguishing between functional or physiologic and pathologic GER. The actual gold standard for gastro-esophageal reflux disease (GERD) diagnosis is the twenty-four-hour pH monitoring of the distal esophagus. Real time ultrasound examination of the eso-gastric junction might also raise the suspicion of GERD. We report three clinical cases of GERD with distinct respiratory complications and non specific clinical picture in which anti-reflux therapy have successfully contributed symptoms remission. PMID:18822875
Anca, Ioana Alina; Popp, Alina St?nescu; Oros, Mihaela; Lag?ru, Nicolae
An increased understanding of the frequency and troublesomeness of symptoms for family members who are caring for a victim of Alzheimer's disease (AD) would be helpful for nurses in working with these families. This article reports on the changes of these symptoms over time as well as the troublesomeness of these symptoms for 30 families over an 18-month period. A symptom checklist based on George's Patient Illness Symptoms Checklist (George, 1983) was used. Over time the reported symptoms reflected increased mental impairment, which is associated with AD. For some of the symptoms, there was an increase in the symptoms' frequency, but their troublesomeness did not increase. Family caregivers who reported more symptoms for each time period also reported an increase in institutionalization of the AD member. PMID:7897470
Martinson, I M; Muwaswes, M; Gilliss, C L; Doyle, G C; Zimmerman, S
Background The timely and accurate identification of symptoms of 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 acute coronary syndrome (ACS) symptoms are related—symptom clusters—and to determine if sample characteristics, response times, and outcomes differ among symptom cluster groups. Methods In a multisite randomized clinical trial, 3522 patients with known cardiovascular disease were followed for two years. During follow-up, 331 (11%) had a confirmed ACS event. In this group, eight presenting symptoms were analyzed using cluster analysis. Differences in symptom cluster group characteristics, delay times, and outcomes were examined. Results The sample was predominately 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 two years (17%) than the other three clusters (2–5%, p<.001), even though prehospital delay time did not differ significantly. Conclusion Most ACS 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.
Unilateral visual neglect is commonly defined as impaired ability to attend to stimuli presented on the side of visual space contralateral to the brain lesion. However, behavioral analyses indicate that different neglect symptoms can dissociate. The neuroanatomy of the syndrome has been hotly debated. Some groups have argued that the syndrome is linked to posterior parietal cortex lesions, while others report damage within regions including the superior temporal gyrus, insula, and basal ganglia. Several recent neuroimaging studies provide evidence that heterogeneity in the behavioral symptoms of neglect can be matched by variations in the brain lesions, and that some of the discrepancies across earlier findings might have resulted from the use of different neuropsychological tests and/or varied measures within the same task for diagnosing neglect. In this paper, we review the evidence for dissociations between both the symptoms and the neural substrates of unilateral visual neglect, drawing on ALE (anatomic likelihood estimation) meta-analyses of lesion-symptom mapping studies. Specifically, we examine dissociations between neglect symptoms associated with impaired control of attention across space (in an egocentric frame of reference) and within objects (in an allocentric frame of reference). Results of ALE meta-analyses indicated that, while egocentric symptoms are associated with damage within perisylvian network (pre- and postcentral, supramarginal, and superior temporal gyri) and damage within sub-cortical structures, more posterior lesions including the angular, middle temporal, and middle occipital gyri are associated with allocentric symptoms. Furthermore, there was high concurrence in deficits associated with white matter lesions within long association (superior longitudinal, inferior fronto-occipital, and inferior longitudinal fasciculi) and projection (corona radiata and thalamic radiation) pathways, supporting a disconnection account of the syndrome. Using this evidence we argue that different forms of neglect link to both distinct and common patterns of gray and white matter lesions. The findings are discussed in terms of functional accounts of neglect and theoretical models based on computational studies of both normal and impaired attention functions.
Chechlacz, Magdalena; Rotshtein, Pia; Humphreys, Glyn W.
Objective Parkinson’s disease is frequently complicated by depression (dPD) and there is a paucity of controlled research that can inform the management of this disabling non-motor complaint. A randomized controlled trial of nortriptyline, paroxetine, and placebo for the treatment of dPD was recently completed. The purpose of this paper is to describe the baseline pattern of depressive symptom presentation in PD, the specific symptoms of dPD that improve with pharmacotherapy, and the residual symptoms which remain in patients who meet a priori criteria for response or remission after acute treatment (8-weeks). Setting The Departments of Psychiatry and Neurology at Robert Wood Johnson Medical School. Participants Fifty-two depressed patients (Major Depression or Dysthymia based on DSM-IV criteria) with Parkinson's disease (by research criteria). Design/Intervention A randomized controlled trial of nortriptyline, paroxetine, and placebo. Measurement The four subscales (core mood, anxiety, insomnia, somatic) and individual items from the Hamilton Rating Scale for Depression (HAM-D-17) were the focus of the current study. These measures were assessed at baseline and week 8. Results Baseline depressive symptoms were unrelated to motor functioning. Treatment response was associated with significant improvements in the core mood, anxiety, insomnia, and somatic symptoms seen in dPD. Residual symptoms, like sadness and loss of interest, persisted in treatment responders in a milder form than was initially present. Conclusions Antidepressants may influence all symptoms of dPD, including those which share great overlap with the physical disease process. Additional research regarding adjunctive interventions is needed to help optimize the management of dPD.
Using a sample of 388 father–adolescent and 399 mother–adolescent dyads in Chinese immigrant families, the current investigation tested Portes and Rumbaut's (1996) assertion that generational dissonance may indicate a family context that places children at increased risk for adverse outcomes. Study findings suggest that a high discrepancy in father–adolescent acculturation levels relates significantly to more adolescent depressive symptoms. The study further demonstrates that the quality of the parenting relationship between fathers and adolescents operates as a mediator between father–adolescent acculturation discrepancy and adolescent depressive symptoms. Specifically, a high level of discrepancy in American orientation between fathers and adolescents is associated with unsupportive parenting practices, which, in turn, are linked to more adolescent depressive symptoms. These relationships are significant even after controlling for the influence of family socioeconomic status and parents’ and adolescents’ sense of discrimination within the larger society.
Kim, Su Yeong; Chen, Qi; Li, Jing; Huang, Xuan; Moon, Ui Jeong
Background Symptom cluster research is an emerging field in symptom management. The ability to identify symptom clusters that are specific to pediatric oncology patients may lead to improved understanding of symptoms’ underlying mechanisms among patients of all ages. Objective The purpose of this study, in a sample of children and adolescents with cancer who underwent a cycle of myelosuppressive chemotherapy, was to compare the number and types of symptom clusters identified using patients’ ratings of symptom occurrence and symptom severity. Interventions/Methods Children and adolescents with cancer (10 to 18 years of age; N=131) completed the Memorial Symptom Assessment Scale 10–18 on the day they started a cycle of myelosuppressive chemotherapy, using a one week recall of experiences. Symptom data based on occurrence and severity ratings were examined using Exploratory Factor Analysis (EFA). The defined measurement model suggested by the best EFA model was then examined with a latent variable analysis. Results Three clusters were identified when symptom occurrence ratings were evaluated which were classified as a chemotherapy sequelae cluster, mood disturbance cluster, and a neuropsychological discomforts cluster. Analysis of symptom severity ratings yielded similar cluster configurations. Conclusions Cluster configurations remained relatively stable between symptom occurrence and severity ratings. The evaluation of patients at a common point in the chemotherapy cycle may have contributed to these findings. Implications for Practice Additional uniformity in symptom clusters investigations is needed to allow appropriate comparisons among studies. The dissemination of symptom clusters research methodology through publication and presentation may promote uniformity in this field.
The data on arachnoid cysts in children (0–15 years) operated upon between 1980 and 1988 were analysed in a retrospective, co-operative study. The results from 285 patients indicate a predominance of these lesions in boys (64%) more than girls (36%) and a mean age of 6 years at onset of symptoms. Focal EEG patterns corresponding to the cyst's location were
This prospective/longitudinal study examined the effects of Operation Iraqi Freedom-related emotional symptoms and mTBI exposure on post- deployment function. Both performance-based and self-report outcome measures were collected. Regression analytic stra...
Decreasing CO(2) emissions into the atmosphere is key for reducing global warming. To facilitate the CO(2) emission reduction efforts, our laboratory conducted experimental and theoretical investigations of the homogeneous gaseous reaction of CO(2)(g) + nH(2)O(g) + nNH(3)(g) ? (NH(4))HCO(3)(s)/(NH(4))(2)CO(3)(s) (n = 1 and 2) using Fourier transform infrared attenuated total reflectance (FTIR-ATR) spectroscopy and ab initio molecular orbital theory. Our FTIR-ATR experimental results indicate that (NH(4))(2)CO(3)(s) and (NH(4))HCO(3)(s) are formed as aerosol particulate matter when carbon dioxide reacts with ammonia and water in the gaseous phase at room temperature. Ab initio study of this chemical system suggested that the reaction may proceed through formation of NH(3)·H(2)O(g), NH(3)·CO(2)(g), and CO(2)·H(2)O(g) complexes. Subsequent complexes, NH(3)·H(2)O·CO(2) and (NH(3))(2)·H(2)O·CO(2), can be formed by adding gaseous reactants to the NH(3)·H(2)O(g), NH(3)·CO(2)(g), and CO(2)·H(2)O(g) complexes, respectively. The NH(3)·H(2)O·CO(2) and (NH(3))(2)·H(2)O·CO(2) complexes can then be rearranged to produce (NH(4))HCO(3) and (NH(4))(2)CO(3) as final products via a transition state, and the NH(3) molecule acts as a medium accepting and donating hydrogen atoms in the rearrangement process. Our computational results also reveal that the presence of an additional water molecule can reduce the activation energy of the rearrangement process. The high activation energy predicted in the present work suggests that the reaction is kinetically not favored, and our experimental observation of (NH(4))HCO(3)(s) and (NH(4))(2)CO(3)(s) may be attributed to the high concentrations of reactants increasing the reaction rate of the title reactions in the reactor. PMID:22900762
Background: The frequencies and types of anal symptoms were compared with the frequencies and types of benign anal diseases (BAD). Methods: Patients transferred from GPs, physicians or gynaecologists for anal and/or abdominal complaints/signs were enrolled and asked to complete a questionnaire about their symptoms. Proctologic assessment was performed in the knee-chest position. Definitions of BAD were tested in a two year pilot study. Findings were entered into a PC immediately after the assessment of each individual. Results: Eight hundred seven individuals, 539 (66.8%) with and 268 without BAD were analysed. Almost one third (31.2%) of patients with BAD had more than one BAD. Concomitant anal findings such as skin tags were more frequently seen in patients with than without BAD (<0.01). After haemorrhoids (401 patients), pruritus ani (317 patients) was the second most frequently found BAD. The distribution of stages in 317 pruritus ani patients was: mild (91), moderate (178), severe (29), and chronic (19). Anal symptoms in patients with BAD included: bleeding (58.6%), itch (53.7%), pain (33.7%), burning (32.9%), and soreness (26.6%). Anal lesions could be predicted according to patients' answers in the questionnaire: haemorrhoids by anal bleeding (p=0.032), weeping (p=0.017), and non-existence of anal pain (p=0.005); anal fissures by anal pain (p=0.001) and anal bleeding (p=0.006); pruritus ani by anal pain (p=0.001), itching (p=0.001), and soreness (p=0.006). Conclusions: The knee-chest position may allow for the accumulation of more detailed information about BAD than the left lateral Sims' position, thus enabling physicians to make more reliable anal diagnoses and provide better differentiated therapies.
Kuehn, Hans Georg; Gebbensleben, Ole; Hilger, York; Rohde, Henning
Cold stress as a result of whole-body cooling at low environmental temperatures exacerbates lower urinary tract symptoms, such as urinary urgency, nocturia and residual urine. We established a model system using healthy conscious rats to explore the mechanisms of cold stress-induced detrusor overactivity. In this review, we summarize the basic findings shown by this model. Rats that were quickly transferred from room temperature (27 ± 2°C) to low temperature (4 ± 2°C) showed detrusor overactivity including increased basal pressure and decreased voiding interval, micturition volume, and bladder capacity. The cold stress-induced detrusor overactivity is mediated through a resiniferatoxin-sensitve C-fiber sensory nerve pathway involving ?1-adrenergic receptors. Transient receptor potential melastatin 8 channels, which are sensitive to thermal changes below 25-28°C, also play an important role in mediating the cold stress responses. Additionally, the sympathetic nervous system is associated with transient hypertension and decreases of skin surface temperature that are closely correlated with the detrusor overactivity. With this cold stress model, we showed that ?1-adrenergic receptor antagonists have the potential to treat cold stress-exacerbated lower urinary tract symptoms. In addition, we showed that traditional Japanese herbal mixtures composed of Hachimijiogan act, in part, by increasing skin temperature and reducing the number of cold sensitive transient receptor potential melastatin channels in the skin. The effects of herbal mixtures have the potential to treat and/or prevent the exacerbation of lower urinary tract symptoms by providing resistance to the cold stress responses. Our model provides new opportunities for utilizing animal disease models with altered lower urinary tract functions to explore the effects of novel therapeutic drugs. PMID:23441811
Background Complicated Grief (CG) is under consideration as a new diagnosis in DSM5. We sought to add empirical support to the current dialogue by examining the commonly used Inventory of Complicated Grief (ICG) scale completed by 782 bereaved individuals. Methods We employed IRT analyses, factor analyses, and sensitivity and specificity analyses utilizing our full sample (n=782), and also compared confirmed CG cases (n=288) to non-cases (n=377). Confirmed CG cases were defined as individuals bereaved at least 6 months who were seeking care for CG, had an ICG ? 30, and received a structured clinical interview for CG by a certified clinician confirming CG as their primary illness. Non-cases were bereaved individuals who did not present with CG as a primary complaint (including those with depression, bipolar disorder, anxiety disorders and controls) and had an ICG<25. Results IRT analyses provided guidance about the most informative individual items and their association with CG severity. Factor analyses demonstrated a single factor solution when the full sample was considered, but within CG cases, six symptom clusters emerged: 1) yearning and preoccupation with the deceased, 2) anger and bitterness, 3) shock and disbelief, 4) estrangement from others, 5) hallucinations of the deceased, and 6) behavior change, including avoidance and proximity seeking. The presence of at least one symptom from three different symptom clusters optimized sensitivity (94.8%) and specificity (98.1%). Conclusions These data, derived from a diverse and predominantly clinical help seeking population, add an important perspective to existing suggestions for DSM5 criteria for CG.
Simon, Naomi M.; Wall, Melanie M.; Keshaviah, Aparna; Dryman, M. Taylor; LeBlanc, Nicole J.; Shear, M. Katherine
Study Objectives To describe trends in adverse drug reaction (ADR) scores as blood pressure (BP) came under control during a study of physician-pharmacist collaboration in the management of hypertension. Design Secondary analysis from a randomized controlled clinical trial. Setting Five primary care clinics affiliated with the University of Iowa, Iowa City, IA, USA. Subjects One hundred seventy-nine patients with uncontrolled primary hypertension aged 21-85 years taking 0-3 antihypertensive medications at baseline. Intervention Patient-reported symptoms suggestive of ADRs were recorded at each study visit using a structured ADR questionnaire. Social support (SS) and self-efficacy (SE) questionnaires were also administered at each study visit. Measurements and Main Results ADR scores decreased significantly from baseline to the end of the study (p<0.0001) in both the control (26.5 to 18.4) and intervention (29.9 to 22.7) groups although there were no differences between groups. Antihypertensive medication use increased for both intervention (1.5±1.0 to 2.4±0.9) and control (1.4±1.0 to 1.9±1.0) groups. We performed additional analyses on SE and SS to determine a potential reason for the reduction in adverse symptom scores despite an increase in medication use. Improvements in SE and SS scores were significantly and independently associated with improvement in ADR score (p<0.05). Conclusions ADR scores improved despite an increase in antihypertensive medication use. Improvements in SS and, to a lesser extent, SE are associated with improvements in ADR scores. Patients should not expect an increase in distressful symptoms as their BP becomes controlled with antihypertensive medications, especially when adequate social support is available.
In most episodes of health complaints reported in office buildings in the last-twenty years, causal factors have not been identified. In order to assess risk factors for work-related symptoms in office workers, a reanalysis was performed of previous studies, and an epidemiologic study was conducted. The reanalysis of data, showed remarkable agreement among studies. Air-conditioned buildings were consistently associated with higher prevalence of headache, lethargy, and eye, nose, or throat problems. Humidification was not a necessary factor for this higher prevalence. Mechanical ventilation without air-conditioning was not associated with higher symptom prevalence. A study was conducted among 880 office workers, within 12 office buildings selected without regard to worker complaints, in northern California. A number of factors were found associated with prevalence of work-related symptoms, after adjustment in a logistic regression model for personal, psychosocial, job, workspace, and building factors. Two different ventilation types were associated with increases Ln symptom prevalence, relative to workers in naturally ventilated buildings: mechanical supply and exhaust ventilation, without air conditioning and with operable windows; and air-conditioning with sealed windows. No study buildings were humidified. In both these ventilation types, the highest odds ratios (ORs) found were for skin symptoms (ORs-5.0, 5.6) and for tight chest or difficulty breathing (ORs-3.6, 4.3). Use of carbonless copies or photocopiers, sharing a workspace, carpets, new carpets, new walls, and distance from a window were associated with symptom increases. Cloth partitions and new paint were associated with symptom decreases.
This systematic review aims to assess the efficacy of aromatase inhibitors (AIs) in treating pain symptoms caused by endometriosis. A comprehensive literature search was conducted to identify all the published studies evaluating the efficacy of type II nonsteroidal aromatase inhibitors (anastrozole and letrozole) in treating endometriosis-related pain symptoms. The MEDLINE, EMBASE, PubMed, and SCOPUS databases and the Cochrane System Reviews were searched up to October 2010. This review comprises of the results of 10 publications fitting the inclusion criteria; these studies included a total of 251 women. Five studies were prospective non-comparative, four were randomized controlled trials (RCTs) and one was a prospective patient preference trial. Seven studies examined the efficacy of AIs in improving endometriosis-related pain symptoms, whilst three RCTs investigated the use of AIs as post-operative therapy in preventing the recurrence of pain symptoms after surgery for endometriosis. All the observational studies demonstrated that AIs combined with either progestogens or oral contraceptive pill reduce the severity of pain symptoms and improve quality of life. One patient preference study demonstrated that letrozole combined with norethisterone acetate is more effective in reducing pain and deep dyspareunia than norethisterone acetate alone. However, letrozole causes a higher incidence of adverse effects and does not improve patients' satisfaction or influence recurrence of symptoms after discontinuation of treatment. A RCT showed that combining letrozole with norethisterone acetate causes a lower incidence of adverse effects and lower discontinuation rate than combining letrozole with triptorelin. Two RCTs demonstrated that, after surgical treatment of endometriosis, the administration of AIs combined with gonadotropin releasing hormone analogue for 6 months reduces the risk of endometriosis recurrence when compared with gonadotropin releasing hormone analogue alone. In conclusion, AIs effectively reduce the severity of endometriosis-related pain symptoms. Since endometriosis is a chronic disease, future investigations should clarify whether the long-term administration of AIs is superior to currently available endocrine therapies in terms of improvement of pain, adverse effects and patient satisfaction.
... Press Room Social Media Publications CDC's Injury Center Concussion On this Page Signs and Symptoms When to ... Children What are the Signs and Symptoms of Concussion? Most people with a concussion recover quickly and ...
The correlation between a premenstrual syndrome based on emotional symptoms and primary affective disorder was prospectively studied in 105 college freshmen. Students with premenstrual symptoms were twice as likely as controls to have a history of a serio...
Foliar symptoms of nitrogen, phosphorus, potassium, calcium, magnesium, sulphur, iron, copper, zinc, manganese, and boron deficiencies and manganese and boron toxicities in Chloris gayana cv. Pioneer are described. Colour photographs of the foliar symptom...
... data collected on 2,171 children with preschool asthma-like symptoms participating the PIAMA study (development study) and 2,877 children with preschool asthma-like symptoms, participating in the multi-ethnic prospective ...
ObjectiveClinical experience suggests that reflexology may have beneficial effects on the symptoms occurring in menopausal women, particularly psychological symptoms. This study aims to examine that effect rigorously.
Jan Williamson; Adrian White; Anna Hart; Edzard Ernst
This study investigated the patterning of gastrointestinal (GI) symptoms and coping strategies in symptomatic and asymptomatic women. A three-group repeated measures design was used to contrast the patterns of GI symptoms, GI function, psychological and s...
Typical and atypical symptoms from acid reflux, dyspepsia, chronic constipation, fecal incontinence, and irritable bowel syndrome are extremely common in adults and remain so in the geriatric population. The presence of these problems may have profound effects on the functional status, independence, and quality of life in the vulnerable older population, making it essential for physicians to inquire actively about them and to be able to recognize atypical presentations when appropriate. This article summarizes the definitions, epidemiology, clinical presentation, and impact of these common problems in the geriatric patient. PMID:17923334
Objective To investigate the factor structure of the Rivermead Post Concussion Symptoms Questionnaire (RPQ) among individuals seen as\\u000a part of routine follow-up following traumatic brain injury.\\u000a \\u000a \\u000a \\u000a Methods RPQ data from 168 participants was examined (mean age 35.2, SD 14.3; 89% with post traumatic amnesia duration < 24 hours)\\u000a six months after admission to an Accident & Emergency Department following TBI. Structural equation modelling was
Seb Potter; Eleanor Leigh; Derick Wade; Simon Fleminger
The symptom of dry skin is seen in some skin diseases, in old people and under various physical and chemical influences. The main pathogenetic factor is the dehydratation of the corneocytes. Therefore waterprotective and waterbinding creams are used. All water-in-oil-emulsions and ointment basics are waterprotective. So called moisturizers are added to the ointments to improve the waterbinding capacity. One natural moisturizer is urea, which for instance is contained in Basodexan ointment. There are new therapeutic ways since the introduction of the liposomes. Liposomes represent longlasting and precisely applicable deposits for moisturizer and other active extracts. PMID:3064457
The current investigation uses a large non-clinical sample of undergraduate college students (N=189) to investigate schizotypal traits among cannabis and non-cannabis users, as well as the temporal order of the onset of these traits and cannabis use. Findings suggest that regular cannabis users are significantly more prone to cognitive and perceptual distortions as well as disorganization, but not interpersonal deficits, than non-regular users and those who have never used. Additionally, the onset of schizotypal symptoms generally precedes the onset of cannabis use. The findings do not support a causal link between cannabis use and schizotypal traits. PMID:15808288
Schiffman, Jason; Nakamura, Brad; Earleywine, Mitchell; LaBrie, Joseph
Lower urinary tract symptoms (LUTS) are a common complaint among aging men and are often caused by benign prostatic hyperplasia (BPH). A number of medical treatments for LUTS/BPH exist, such as ?-blockers, 5?-reductase inhibitors, anticholinergics, phosphodiesterase type 5 (PDE5) inhibitors, and combination therapies. Agonist binding of the ?1A-adrenergic receptor (AR), causing prostatic smooth muscle contraction, has been attributed to cause some LUTS. Therefore, medical therapy has aimed to block the ?1A-AR and improve LUTS. Determining which therapy to choose must take into account individual patient factors as well as cost and patient choice.
The present study aimed to determine which anxiety symptoms in children are associated with teacher awareness and whether teacher awareness differs according to student age and gender. The Multidimensional Anxiety Scale for Children (MASC) was completed by 453 second through fifth grade students and teachers nominated the three most anxious students in their classrooms. A multivariate analysis of variance was conducted with MASC scale scores as the dependent variables. Children identified by teachers as anxious had significantly higher levels of overall anxiety, physiological anxiety, social anxiety, and separation anxiety. Overall, teacher awareness did not differ based on student age or gender.
There are very few data about the efficacy and toxicity of adjuvant systemic therapies for breast cancer in non-western populations. In 1993 in Vietnam we began a randomized controlled clinical trial on premenopausal women with operable breast cancer comparing adjuvant surgical oophorectomy plus tamoxifen with observation and this same combined hormonal treatment on recurrence. We evaluated the symptoms reported at regular follow-up visits by the first 482 premenopausal women entered in this clinical trial and treated with surgical oophorectomy plus tamoxifen or observation. Hot flash frequency and intensity, vaginal discharge, and genital pruritus were the only symptoms to occur more frequently in oophorectomy and tamoxifen-treated subjects. Seventy-seven percent of oophorectomy/tamoxifen subjects reported grade 1 or more and 44% grade 2 or more hot flash frequency symptoms in the first 12 months, versus 9% and 1% of observation subjects, respectively. Twenty percent of oophorectomy/tamoxifen subjects had grade 2 or greater intensity of hot flashes some time in the first 12 months versus 0% in observation subjects. Through three years, vasomotor symptoms were reported more frequently in oophorectomy/tamoxifen-treated women (in 23% vs. 3% at three years, mostly grade 1 toxicities). While noted and persistent vasomotor symptoms were found with oophorectomy plus tamoxifen in this population of Vietnamese women, these were of lower grades and tolerable. This adjuvant treatment may be widely accepted if it is demonstrated to be effective in this population. PMID:10718489
Love, R R; Nguyen, B D; Nguyen, C B; Nguyen, V D; Havighurst, T C
Recent findings have suggested some potential psychological vulnerability factors for development of obsessive-compulsive (OC) symptoms, including cognitive factors of appraisal and thought control, religiosity, self-esteem and personality characteristics such as neuroticism. Studies demonstrating these associations usually come from Western cultures, but there may be cultural differences relevant to these vulnerability factors and OC symptoms. The present study examined the relationship between putative vulnerability factors and OC symptoms by comparing non-clinical samples from Turkey and Canada, two countries with quite different cultural characteristics. The findings revealed some common correlates such as neuroticism and certain types of metacognition, including appraisals of responsibility/threat estimation and perfectionism/need for certainty, as well as thought-action fusion. However, culture-specific factors were also indicated in the type of thought control participants used. For OC disorder symptoms, Turkish participants were more likely to utilize worry and thought suppression, while Canadian participants tended to use self-punishment more frequently. The association with common factors supports the cross-cultural validity of some factors, whereas unique factors suggest cultural features that may be operative in cognitive processes relevant to OC symptoms. PMID:19701960
Background: Depressive symptomology is an independent risk factor for cardiovascular disease. Over 15% of persons with cardiovascular disease have depressive symptoms, and women are twice as likely to experience these symptoms as men. Depressive symptoms in women “ at risk ” for cardiovascular disease has not been well studied.\\u000aPurpose: This study investigated the relationship between depressive symptoms, health-promoting lifestyle
The present study examined withdrawal symptoms and their intensities across a range of traditional and non-traditional addictive substances\\/losses (i.e., alcohol, nicotine, caffeine, food, and social\\/love relationship). Study one administered the Withdrawal Symptom Survey to Alcoholics Anonymous members and college students. Seven symptoms (irritability, restlessness, impatience, anxiousness, trouble concentrating, depression, and anger) were rated in the top 10 of symptom intensity
David G. Gilbert; Brenda O. Gilbert; Vicki L. Schultz
Background: This study examines the psychological symptoms of Bosnian children exposed to war and trauma, and detects changes in these\\u000a symptoms over time. Method: A total of 147 displaced children residing in refugee centers in Bosnia completed self-report assessments of anxiety, depressive,\\u000a and posttraumatic stress symptoms at two time points. Results: Symptoms of posttraumatic stress, anxiety, and depression showed a
Objective: To examine the clinical implications of manic symptoms in psychiatrically hospitalized children aged 5–12. Methods: DSMIIIR manic symptoms, along with symptoms of other psychiatric disorders, were rated by parents and teachers on the Child Symptom Inventory IIIR prior to hospitalization. The Child Behavior Checklist (CBCL; was also completed. During hospitalization children were evaluated by structured interview (K-SADS-E), and numerous
Purpose This study examined symptoms reported by patients after open-ended questioning vs those systematically assessed using a 48-question survey.Materials and methods Consecutive patients referred to the palliative medicine program at the Cleveland Clinic Foundation were screened. Open-ended questions were asked initially followed by a 48-item investigator-developed symptom checklist. Each symptom was rated for severity as mild, moderate, or severe. Symptom distress was
Jade Homsi; Declan Walsh; Nilo Rivera; Lisa A. Rybicki; Kristine A. Nelson; Susan B. LeGrand; Mellar Davis; Michael Naughton; Dragoslav Gvozdjan; Hahn Pham
Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS) is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS). Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.
Background: Anxiety and insomnia are associated with cardiovascular (CV) symptoms. We assessed whether the relation between anxiety and CV symptoms is modulated by insomnia. Methods: Independently living women (n = 1,440; mean age = 59.36 ± 6.53 years) were recruited by cluster sampling technique. We obtained data on demographic characteristics, health beliefs, access to health care, CV symptoms, sleep, stress
O. Olafiranye; G. Jean-Louis; C. Magai; F. Zizi; C. D. Brown; M. Dweck; J. S. Borer
Latent profile analysis was used to summarize profiles of depressive symptoms among a nationally representative sample of US-born and Caribbean-born Blacks. Analyses are based on the responses of 4915 African Americans and Caribbean Blacks from the National Survey of American Life. A high symptoms and a low symptoms class were identified. Age, gender, negative interaction within the individual's social network
Karen D. Lincoln; Linda M. Chatters; Robert Joseph Taylor; James S. Jackson
The aim of this study was to determine the prevalence of, and the changes in, anorectal symptoms following different modes of vaginal delivery in primiparous women. Six hundred and seventeen questionnaires were distributed to primiparous women 3–4 years after delivery. The questionnaires were designed to obtain information regarding the development of anorectal symptoms, including the type of symptoms experienced, their
S. E. Schraffordt Koops; H. A. M. Vervest; H. J. M. Oostvogel
Recent reports of improvement in the negative symptoms of schizophrenia following targeted cognitive interventions have prompted interest in the cognitive underpinnings of these symptoms. This review integrates current experimental research with the phenomenological accounts of patients participating in cognitive therapy for these specific symptoms. We propose that, in addition to the well-established role of neurobiological factors in their development and
The contribution of learning to the adult experience of illness was investigated by asking 351 nursing students how their mothers reacted to menstrual symptoms and cold symptoms during their adolescence and how their mothers behaved when they themselves had menstrual symptoms. Mothers of respondents were independently asked the same questions. Nursing students who had been encouraged to adopt a sick
William E. Whitehead; Catherine M. Busch; Barbara R. Heller; Paul T. Costa
|To investigate significance and measurement of depressive symptoms in young adolescents, 624 students were asked to complete the Center for Epidemiological Studies Depression Scale (CES-D) during home interviews. The presence of persistent symptoms varied by both race and sex. Results support the feasibility of using a self-report symptom scale…
Despite the major benefits of antiretroviral therapy on survival during HIV infection, there is an increasing need to manage symptoms and side effects during long-term drug therapy. Cannabis has been reported anecdotally as being beneficial for a number of common symptoms and complications in HIV infections, for example, poor appetite and neuropathy. This study aimed to investigate symptom management with
Emily Woolridge; Simon Barton; Jonathon Samuel; Jess Osorio; Andrew Dougherty; Anita Holdcroft
Palliative care is the management of patients with progressive, far-advanced disease for whom the prognosis is limited and the focus of care is quality of life. During the last days of life, it is important to redefine the goals, as previously present symptoms may increase and new symptoms may appear. To assess these symptoms, 176 patients were evaluated. A questionnaire
|This research examined two pathways through which depressive symptoms contribute to low social status (i.e., neglect and rejection) within the peer group over time: (a) depressive symptoms promote socially helpless behavior and consequent neglect by peers; and (b) depressive symptoms promote aggressive behavior and consequent rejection by peers.…
This 4-year longitudinal study of 191 girls and 185 boys living in intact families in the rural Midwest examines the trajectories of life events and depressive symptoms in adolescence. The trajectories of depressive symptoms differ between boys and girls. Compared with boys, girls experienced a greater number of depressive symptoms after age 13. Changes in uncontrollable events are associated with
Xiaojia Ge; Frederick O. Lorenz; Rand D. Conger; Glen H. Elder; Ronald L. Simons
Background:Previous studies that have assessed whether the presence of depressive symptoms predisposes to stroke in the general elderly population have been contradictory. Moreover, they did not distinguish between men and women and did not perform psychiatric workups in those with depressive symptoms. This study examines the association between depressive symptoms, depressive disorder and the risk of stroke in the general
M J Bos; T Lindén; P J Koudstaal; A Hofman; I Skoog; M M B Breteler; H Tiemeier
This research examined two pathways through which depressive symptoms contribute to low social status (i.e., neglect and rejection) within the peer group over time: (a) depressive symptoms promote socially helpless behavior and consequent neglect by peers; and (b) depressive symptoms promote aggressive behavior and consequent rejection by peers.…
Objective: Concerns about environmental and technological changes affecting health have been shown to be associated with symptom reports in cross-sectional studies. We aimed to investigate how worries about modernity affecting health, negative affectivity, and prior symptom complaints influence health complaints after environmental spraying in a prospective study. Methods: Two hundred ninety-two residents of West Auckland completed questionnaires measuring recent symptoms,
KEITH J. PETRIE; ELIZABETH A. BROADBENT; NADINE KLEY; R ONA MOSS-MORRIS; ROB HORNE; WINFRIED RIEF
Residual symptoms of variable intensity often persist following pharmaco\\/or psychotherapeutic interventions for treatment of major depression (MD). In several studies, such persistent symptoms have been clearly shown to be associated with a higher risk of relapse, chronicity and functional impairment, but their true nature is still controversial. Several authors consider that these symptoms belong to the range of depression proper
|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…
Prince, Alice; Bernard, Amy L.; Edsall, Patricia A.
Nurses and nursing aides (n = 418) currently working on a regular evening or day schedule were compared in terms of sleep disorder symptoms. The relationship between past nightwork and sleep disorder symptoms was also assessed. The prevalence of individual symptoms varied from 6 to 53%. Evening workers showed a pattern of sleep disorder compatible with sleep deprivation, whereas the
Claire Infante-Rivard; Marie Dumont; Jacques Montplaisir
Frontotemporal dementia (FTD) is often misdiagnosed as Alzheimer’s disease (AD). We hypothesized that the first symptoms associated with FTD would be different from those seen in AD and that the first symptoms in FTD would reflect loss of function in the frontal region with the greatest degree of degeneration. The objective of the study was to compare the earliest symptoms
M. Lindau; O. Almkvist; J. Kushi; K. Boone; S. E. Johansson; L. O. Wahlund; J. L. Cummings; B. L. Miller
Background and Purpose—Evidence is mounting linking cerebrovascular disease with depressive symptoms in the elderly. Lesions in both white and gray matter have been associated with depressive symptoms and major depression. We sought to investigate the relationship between depressive symptoms and white and gray matter lesions in subjects participating in the Cardiovascular Health Study. Methods—In a sample of 3660 men and
David C. Steffens; Michael J. Helms; K. Ranga Rama Krishnan; Gregory L. Burke
Symptoms are important patient-reported outcomes (PRO), which help to evaluate the impact of diseases and treatments and assess quality of care. Thorough symptom assessment is a challenge, as patients in palliative settings are often polysymptomatic and easily fatigued. There is no consensus about standardization of symptom assessment in palliative medicine. The available research provides some methodological guidance, but the psychometric
Objective. Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical ill- ness have been found to predict poor outcome in prelim- inary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large inves- tigation to assess prevalence and correlates of self-re- ported symptoms of posttraumatic stress
Lisa Libman Mintzer; Margaret L. Stuber; Debra Seacord; Marleen Castaneda; Violet Mesrkhani; Dorie Glover
The objective of this study was to provide prospectively collected data on the onset of pregnancy symptoms. Two hundred twenty-one women attempting pregnancy kept daily records of the occurrence of symptoms of pregnancy. Among 136 women delivering live infants, half began experiencing symptoms by day 36 after their last menstrual period (LMP), and 89% by the end of the eighth
Amy E Sayle; Allen J Wilcox; Clarice R Weinberg; Donna D Baird
The present study investigates the association between Obsessive–Compulsive (OC) symptoms and the expression of anger in a sample of 131 undergraduates. Participants were divided into two groups based on their self-reported OC symptoms and compared on their tendency to suppress anger inwardly, express anger outwardly, and control their anger. In addition, the associations between anger and specific OC symptoms were
This study was designed to examine hopeful thinking, depressive symptoms, and participation in meaningful activities and roles for survivors 3 months after stroke. It was predicted that: (a) participation would predict lower depressive symptoms; (b) higher hopeful thinking (i.e., beliefs in one's goal pursuit abilities) would predict lower depressive symptoms; and (c) higher hopeful thinking would predict better participation. Three
The vast majority of new mothers experience at least some depressive symptoms. Postpartum maternal depressive symptoms can greatly influence children's outcomes (e.g., emotional, cognitive, language, and social development). However, there have been relatively few longitudinal studies of how maternal depressive symptoms may influence children's…
Wu, Yelena P.; Selig, James P.; Roberts, Michael C.; Steele, Ric G.
PURPOSE: To characterize neuroglycopenic symptoms in the clinical presentation of patients with insulinomas.SUBJECTS AND METHODS: Patients with histologically confirmed islet cell adenomas or carcinomas were identified at a single institution. Patient symptoms and clinical features of the insulinomas were obtained by retrospective medical record review with special attention to neuroglycopenic and autonomic symptoms.RESULTS: Of the 59 patients, 51% were female.
Ana Marie Dizon; Stephan Kowalyk; Byron J Hoogwerf
The appearance of the so?called “bull?whip”; in leaves of maize plants has been recognized as a calcium deficiency symptom. Another characteristic symptom, in which the leaf edges of maize plants become serrated and curl, is often observed when there is a low calcium supply, especially in solution cultures. The effects of several factors on this symptom were investigated using solution
Concussion is a common injury in collision sports and is evidenced by a variety of signs and symptoms. The recording of neurological symptoms is an important component of screening for a concussion and in return-to-play decisions. However similar symptoms are prevalent in the general population and are reported to be associated with participation in physical activities. The purpose of this
Sridhar Alla; S. John Sullivan; Paul McCrory; Anthony G. Schneiders; Phil Handcock
In the present study, the structure of obsessive-compulsive symptoms was investigated by means of the Padua Inventory (PI). Simultaneous Components Analysis on data from obsessive-compulsives (n = 206), patients with other anxiety disorders (n = 222), and a non clinical sample (n = 430) revealed a five-factor solution. These factors are: (I) impulses; (II) washing; (III) checking; (IV) rumination; and (V) precision. Forty-one items were selected as measure of these factors. The reliability for the five subscales, assessing each of the five factors, was found to be satisfactory to excellent. Four subscales (washing, checking, rumination and precision) discriminated between panic disorder patients, social phobics and normals on the one hand and obsessive compulsives on the other. The Impulses subscale discriminated between obsessive-compulsives on the one hand and normals on the other, but not between obsessive-compulsives and social phobics or panic patients. Some evidence in support of the construct validity was found. The Padua Inventory-Revised (41-items) appears to measure the structure of obsessive compulsive symptoms: The main types of behaviours and obsessions as seen clinically are assessed by this questionnaire, apart from obsessional slowness. PMID:7872933
The purpose of this study involving a cross-cultural group of single, pregnant adolescents was to examine the association of depression with self-esteem, social support, discomforts of pregnancy, and selected sociodemographic variables. The sample comprised 62 pregnant adolescents recruited from a residential maternity home. Subjects ranged in age from 14 to 20 years (mean 16.67 years) and were predominantly Hispanic and black. All subjects completed the Center for Epidemiological Studies Depression Scale, Coopersmith's Self-Esteem Inventory, a physical discomfort checklist, and a sociodemographic questionnaire. A high level of depression symptoms was reported by the majority of participants. Nearly two thirds of the young women reported adequate levels of emotional support; however, the remaining subjects claimed inadequate levels. Results of the multiple regression analyses revealed that, of the predictor variables investigated, only the total self-esteem score was statistically significant (p = 0.0001) and explained 32.6% of the variance. In further statistical analysis a multifactor analysis of variance found social support to be a significant variable influencing depression. On the basis of these results, several recommendations for assessment and intervention with similar groups of pregnant adolescents are suggested, including screening for depression symptoms and development of treatment programs for affected youth. PMID:8869546
To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC).\\u000a Women were randomly assigned into MBSR(BC) or Usual Care (UC). Eligible women were ? 21 years, had been diagnosed with breast\\u000a cancer and completed treatment within 18 months of enrollment. Symptoms and interference with daily living were measured pre-\\u000a and post-MBSR(BC) using the M.D. Anderson Symptom Inventory.
Cecile A. LengacherRichard; Richard R. Reich; Janice Post-White; Manolete Moscoso; Melissa M. Shelton; Michelle Barta; Nancy Le; Pinky Budhrani
A guide to stinging and biting invertebrates (prominently featuring insects and other arthropods) of the world. This guide is not meant for public dissemination nor sale, and was created primarily for military use. Types of interactions include envenomation, myiasis, urtication, allergic reactions as well as delusory parasitosis. The guide provides a good synopsis of most of the medically important insects and associated arthropods.
Background: The controversy over the relationship between symptoms of anxiety and depression is an enduring issue. Various models have been proposed to explain this relationship. We explored the following research questions. First, using exploratory factor analysis (EFA), will the symptoms that define anxiety and depression (as in the Hopkins Symptom Checklist 25, HSCL-25) appear together in 1 factor, or are
Fawziyah A. Al-Turkait; Jude U. Ohaeri; Abdul-Hamid M. El-Abbasi; Ahmed Naguy
After head injuries, particularly mild or moderate ones, a range of post-concussion symptoms (PCS) are often reported by patients. Such symptoms may significantly affect patients' psychosocial functioning. To date, no measure of the severity of PCS has been developed. This study presents the Rivermead Post Concussion Symptoms Questionnaire (RPQ) as such a measure, derived from published material, and investigates its
N. S. King; S. Crawford; F. J. Wenden; N. E. G. Moss; D. T. Wade
Modern symptom validity tests (SVTs) use empirical cutoffs for decision making. However, limits to the applicability of these cutoffs may arise when severe cognitive symptoms are present. The purpose of the studies presented here was to explore these limits of applicability. In Experiment 1, a group of 24 bona fide neurological patients without clinically obvious cognitive symptoms was compared to
Chronic fatigue syndrome (CFS) is a disorder of uncertain aetiology which attracts increasing research interest. This paper describes the development of a multidimensional measure incorporating the diverse symptoms associated with the illness. The Profile of Fatigue-Related Symptoms (PFRS) has four scales: emotional distress, cognitive difficulty, fatigue and somatic symptoms. These showed good convergence with comparison measures, high reliability and high
Colette Ray; William R. C. Weir; Sarah Phillips; Sarah Cullen
According to the classic symptom perception hypothesis (Costa & McCrae, 1987; Watson & Pennebaker, 1989), the global predisposition to frequently experience a variety of negative emotions—that is, neuroticism (N) or trait negative affectivity (NA)—is associated with inflated physical symptom reporting. We tested a revision of this hypothesis, which posits distinctive roles for depression and anxiety in the physical symptom experience.
|Objective: To examine the factor structure of posttraumatic stress disorder (PTSD) symptoms in children and adolescents who have experienced an acute single-incident trauma, associations between PTSD symptom clusters and functional impairment, and the specificity of PTSD symptoms in relation to depression and general distress. Method: Examined…
Neglected children may be at increased risk for depressive symptoms. This study examines shame-proneness as an outcome of child neglect and as a potential explanatory variable in the relation between neglect and depressive symptoms. Participants were 111 children (52 with a Child Protective Services [CPS] allegation of neglect) seen at age 7. Neglected children reported more shame-proneness and more depressive symptoms than comparison children. Guilt-proneness, in contrast, was unrelated to neglect and depressive symptoms, indicating specificity for shame-proneness. The potential role of shame as a process variable that can help explain how some neglected children exhibit depressive symptoms is discussed.
Bennett, David S.; Sullivan, Margaret Wolan; Lewis, Michael
Our purpose in this study was to explore ethnic differences in symptoms experienced during the menopausal transition among four major ethnic groups in the U.S. using a feminist perspective. This was a cross-sectional correlational study among 158 midlife women. The instruments included are: questions on sociodemographic characteristics, health, and menopausal status, and the Midlife Women’s Symptom Index. The data were analyzed using descriptive and inferential statistics. Significant ethnic differences in the total number of symptoms (p<.01) were found. The most frequently reported symptoms differed by ethnicity. The symptoms experienced during the menopausal transition were significantly associated with some contextual factors.
Neglected children may be at increased risk for depressive symptoms. This study examines shame-proneness as an outcome of child neglect and as a potential explanatory variable in the relation between neglect and depressive symptoms. Participants were 111 children (52 with a Child Protective Services [CPS] allegation of neglect) seen at age 7. Neglected children reported more shame-proneness and more depressive symptoms than comparison children. Guilt-proneness, in contrast, was unrelated to neglect and depressive symptoms, indicating specificity for shame-proneness. The potential role of shame as a process variable that can help explain how some neglected children exhibit depressive symptoms is discussed. PMID:20724372
Bennett, David S; Sullivan, Margaret Wolan; Lewis, Michael
The diagnostic solution of complex, multidisorder cases requires a different approach from the standard paradigm of triggering hypotheses and scoring them. We investigate an alternative method that introduces an intermediate step of structuring the evidence. This method, called symptom clustering, emphasizes the attribution of diseases to symptoms, as represented by attributional models. The clinical analogue of the symptom clustering method is syndromic knowledge. The heuristic power of syndromes may be exploited to guide search for the correct attributional model. Syndromic knowledge and symptom clustering are analogues because both express propositions about common causality among symptoms.
Symptoms are important patient-reported outcomes (PRO), which help to evaluate the impact of diseases and treatments and assess quality of care. Thorough symptom assessment is a challenge, as patients in palliative settings are often polysymptomatic and easily fatigued. There is no consensus about standardization of symptom assessment in palliative medicine. The available research provides some methodological guidance, but the psychometric properties of structured multisymptom assessments are largely understudied. New approaches may improve the efficacy of clinical assessment and create instruments with greater clinical utility. In this article, we discuss current methodological concepts of symptom assessment in clinical practice, specifically with reference to symptom questionnaires appropriate for palliative medicine. PMID:19648572
Contains a listing of commercial operator and restricted operator licensees in operator name sequence. A crossreference of commercial operators by serial number is also included. This report is produced once a year and contains licenses issued seven or mo...
|This study extends previous research investigating the developmental pathways predicting adolescent alcohol and marijuana use by examining the cascading effects of externalizing and internalizing symptoms and academic competence in the prediction of use and level of use of these substances in adolescence. Participants (N = 191) were drawn from a…
The pathology of diseases such as Pierce's disease (PD) of grapevine (Vitis vinifera L.) that are caused by the xylem-limited bacterium Xylella fastidiosa (Xf) is widely attributed to vessel occlusion and subsequent water deficits. Grapevines (Vitis vinifera L. Chardonnay) were exposed to water deficits, stem inoculation with Xf, and combinations of both to evaluate whether symptoms of PD were a
Eleanor T. Thorne; Joshua F. Stevenson; Thomas L. Rost; John M. Labavitch; Mark A. Matthews
BACKGROUND: On 4 October 1992, an El Al Boeing 747-F cargo aeroplane crashed on two apartment buildings in Amsterdam. Thirty-nine residents on the ground and the four crew members of the plane died. In the years after, a gradually increasing number of people attributed physical signs and symptoms to their presence at the disaster scene. AIM: To investigate the consistency
G. A. Donker; C. J. IJzermans; P. Spreeuwenberg; J. van der Zee
Despite considerable comorbidity between mood disorders, binge eating disorder (BED), and obesity, the underlying mechanisms remain unresolved. Therefore, the purpose of this study was to examine models by which internalizing behaviors of depression and anxiety influence food intake in overweight/obese women. Thirty-two women (15 BED, 17 controls) participated in a laboratory eating-episode and completed questionnaires assessing symptoms of anxiety and depression. Path analysis was used to test mediation and moderation models to determine the mechanisms by which internalizing symptoms influenced kilocalorie (kcal) intake. The BED group endorsed significantly more symptoms of depression (10.1 versus 4.8, P = 0.005 ) and anxiety (8.5 versus 2.7, P = 0.003). Linear regression indicated that BED diagnosis and internalizing symptoms accounted for 30% of the variance in kcal intake. Results from path analysis suggested that BED mediates the influence of internalizing symptoms on total kcal intake (empirical P < 0.001 ). The associations between internalizing symptoms and food intake are best described as operating indirectly through a BED diagnosis. This suggests that symptoms of depression and anxiety influence whether one engages in binge eating, which influences kcal intake. Greater understanding of the mechanisms underlying the associations between mood, binge eating, and food intake will facilitate the development of more effective prevention and treatment strategies for both BED and obesity.
Despite considerable comorbidity between mood disorders, binge eating disorder (BED), and obesity, the underlying mechanisms remain unresolved. Therefore, the purpose of this study was to examine models by which internalizing behaviors of depression and anxiety influence food intake in overweight/obese women. Thirty-two women (15 BED, 17 controls) participated in a laboratory eating-episode and completed questionnaires assessing symptoms of anxiety and depression. Path analysis was used to test mediation and moderation models to determine the mechanisms by which internalizing symptoms influenced kilocalorie (kcal) intake. The BED group endorsed significantly more symptoms of depression (10.1 versus 4.8, P = 0.005 ) and anxiety (8.5 versus 2.7, P = 0.003). Linear regression indicated that BED diagnosis and internalizing symptoms accounted for 30% of the variance in kcal intake. Results from path analysis suggested that BED mediates the influence of internalizing symptoms on total kcal intake (empirical P < 0.001 ). The associations between internalizing symptoms and food intake are best described as operating indirectly through a BED diagnosis. This suggests that symptoms of depression and anxiety influence whether one engages in binge eating, which influences kcal intake. Greater understanding of the mechanisms underlying the associations between mood, binge eating, and food intake will facilitate the development of more effective prevention and treatment strategies for both BED and obesity. PMID:22778917
An affective, somatic, and memory check-list of symptoms was administered to subjects who had no personal experience or knowledge of head injury. Subjects indicated their current experiences of symptoms, then imagined having sustained a mild head injury in a motor vehicle accident, and endorsed symptoms they expected to experience six months after the injury. The checklist of symptoms was also administered to a group of patients with head injuries for comparison. Imaginary concussion reliably showed expectations in controls of a coherent cluster of symptoms virtually identical to the postconcussion syndrome reported by patients with head trauma. Patients consistently underestimated the premorbid prevalence of these symptoms compared with the base rate in controls. Symptom expectations appear to share as much variance with postconcussion syndrome as head injury itself. An aetiological role is suggested.
Mittenberg, W; DiGiulio, D V; Perrin, S; Bass, A E
OBJECTIVE:: The behavioral and psychological symptoms associated with dementia (BPSD) are highly burdensome to caregivers. While BPSD consist of a wide variety of patient behaviors including depression, physical aggression, and paranoid delusions, it remains unclear whether specific symptoms have a differential impact on caregivers. The aims of this study were 1) to assess how individual BPSD, categorized based on how they may affect caregivers, impact depressive symptoms for dementia patient caregivers and 2) to test the pathways by which BPSD clusters impact caregiver depressive symptoms. DESIGN:: Cross-sectional analysis of data from a longitudinal study of patients with Alzheimer disease and dementia with Lewy bodies. SETTING:: Multiple U.S. dementia clinics. PARTICIPANTS:: One hundred sixty patient-caregiver dyads. METHODS:: Using multivariate generalized estimating equation logistic models, we analyzed the relationship between four BPSD clusters (patient depressive symptoms, accusatory/aggressive behaviors, nonthreatening psychotic symptoms, and difficult to manage behaviors) and caregiver depressive symptoms and assessed mediators of these relationships. RESULTS:: Only the presence of patient depressive symptoms was associated with caregiver depression (odds ratio: 1.55; 95% confidence interval: 1.14-2.1). This relationship was mediated by caregiver report of both the symptom's impact on the patient and perceived burden to caregivers. CONCLUSION:: Patient depressive symptoms may be the most important driver of the relationship between BPSD and caregiver depression. Research in this field should further test the effects of individual BPSD and also consider how symptoms may negatively impact caregivers by increasing burden and evoking empathy for the patient. PMID:23011104
Ornstein, Katherine; Gaugler, Joseph E; Devanand, D P; Scarmeas, Nikos; Zhu, Carolyn; Stern, Yaakov
Numerous studies have shown an association between smoking and pain, with smokers reporting more pain and worse functioning. However, little is known about factors that impact this complex relationship. This study investigated the association between smoking, pain, and depressive symptoms. Participants were new patients seen at a multidisciplinary pain clinic. All patients were mailed an intake packet of validated questionnaires as part of an ongoing research and clinical care initiative. Of the 497 patients evaluated, 426 had valid smoking data. Among these patients, 32.6% (n = 139) reported being current smokers, 31.7% (n = 135) were classified as former smokers, and 35.7% (n = 152) were never smokers. A multivariate analysis of covariance (smoking status, age, gender, education) revealed a main effect for pain severity (F = 7.36, P<0.001), pain interference (F = 4.03, P = 0.001), and depressive symptoms (F = 7.87, P<0.001). Current smokers demonstrated higher pain severity, pain interference, and depressive symptoms compared with former smokers and never smokers (P<0.01 for all analyses), while there were no differences between the former-smoker and never-smoker groups. However, the effect of smoking on pain severity (P = 0.06) and pain interference (P = 0.22) was no longer significant after controlling for depressive symptoms in a mediation model. Additionally, among former smokers, longer quit duration was associated with less pain severity. In conclusion, smoking rates were high and smoking was associated with a worse chronic pain phenotype. Importantly, depressive symptoms emerged as a critical mediating factor in helping to explain the relationship between smoking and pain. PMID:22703693
Goesling, Jenna; Brummett, Chad M; Hassett, Afton L
Background The degrees to which residual symptoms in major depressive disorder (MDD) adversely affect patient functioning is not known. This post-hoc analysis explored the association between different residual symptoms and patient functioning. Methods Patients with MDD who responded (?50% on the 17-item Hamilton Rating Scale for Depression; HAMD-17) after 3?months of treatment (624/930) were included. Residual core mood-symptoms (HAMD-17 core symptom subscale ?1), residual insomnia-symptoms (HAMD-17 sleep subscale ?1), residual anxiety-symptoms (HAMD-17-anxiety subscale ?1), residual somatic-symptoms (HAMD-17 Item 13 ?1), pain (Visual Analogue Scale ?30), and functioning were assessed after 3?months treatment. A stepwise logistic regression model with normal functioning (Social and Occupational Functioning Assessment Scale ?80) as the dependent variable was used. Results After 3?months, 59.5% of patients (371/624) achieved normal functioning and 66.0% (412/624) were in remission. Residual symptom prevalence was: core mood symptoms 72%; insomnia 63%; anxiety 78%; and somatic symptoms 41%. Pain reported in 18%. Factors associated with normal functioning were absence of core mood symptoms (odds ratio [OR] 8.7; 95% confidence interval [CI], 4.6–16.7), absence of insomnia symptoms (OR 1.8; 95% CI, 1.2–2.7), episode length (4–24?weeks vs. ?24?weeks [OR 2.0; 95% CI, 1.1–3.6]) and better baseline functioning (OR 1.0; 95% CI, 1.0–1.1). A significant interaction between residual anxiety symptoms and pain was found (p?=?0.0080). Conclusions Different residual symptoms are associated to different degrees with patient functioning. To achieve normal functioning, specific residual symptoms domains might be targeted for treatment.
Defects in mitochondrial function are increasingly recognised as central to the pathogenesis of many diseases, both inherited and acquired. Many of these mitochondrial defects arise from abnormalities in mitochondrial DNA and can result in multisystem disease, with gastrointestinal involvement common. Moreover, mitochondrial disease may present with a range of non-specific symptoms, and thus can be easily misdiagnosed, or even considered to be non-organic. We describe the clinical, histopathological and genetic findings of six patients from three families with gastrointestinal manifestations of mitochondrial disease. In two of the patients, anorexia nervosa was considered as an initial diagnosis. These cases illustrate the challenges of both diagnosing and managing mitochondrial disease and highlight two important but poorly understood aspects, the clinical and the genetic. The pathophysiology of gastrointestinal involvement in mitochondrial disease is discussed and emerging treatments are described. Finally, we provide a checklist of investigations for the gastroenterologist when mitochondrial disease is suspected. PMID:23768727
Chapman, Thomas P; Hadley, Gina; Fratter, Carl; Cullen, Sue N; Bax, Bridget E; Bain, Murray D; Sapsford, Robert A; Poulton, Joanna; Travis, Simon P
Clark Hull's (1933) research on dissociation was based on a 'straw man' formulation of dissociation; he claimed that dissociation requires noninterference. Hull completely ignored the then-current paradigm of dissociation--dissociation as automatism--and claimed that he had refuted the validity of the phenomenon of dissociation. Hull's view of dissociation held sway in the hypnosis field for 60 years. This essay seeks to retrieve the Janetian paradigm of dissociation as automatism. Automatisms are unexpected, uninitiated, involuntary behaviors that just 'happen.' The author argues that human sensitivity to the experience of involuntariness (a) is quite important, (b) was selected by evolution, and (c) is central to both hypnotic responses and dissociative symptoms. This editorial urges the hypnosis field and the dissociation field to jointly undertake a renewed investigation of the experience of involuntariness and to follow recent neuroimaging studies which indicate that the parietal cortex underlies the experience of involuntariness. PMID:20063243
Bilastine is a potent inhibitor of the histamine H1 receptor. It was recently approved in 28 countries of the European Union for the symptomatic treatment of allergic rhinoconjunctivitis and urticaria in adults and children older than 12 years. Data from preclinical studies confirmed its selectivity for the histamine H1 receptor over other receptors, and demonstrated antihistaminic and antiallergic properties in vivo. Studies in healthy volunteers and patients have shown that bilastine does not affect driving ability, cardiac conduction or alertness. Bilastine has demonstrated a good safety profile, without serious adverse effects or antimuscarinic effects in clinical trials. There were no significant changes in laboratory tests, electrocardiograms or vital signs. In clinical studies, oral treatment with bilastine 20 mg once daily improved allergic rhinitis with greater efficacy than placebo and comparable to cetirizine and desloratadine. Bilastine 20 mg was more effective than placebo and equivalent to levocetirizine in chronic urticaria, relieving symptoms, improving quality of life and controlling sleep disorders. PMID:21573249
Sádaba Díaz de Rada, B; Azanza Perea, J R; Gomez-Guiu Hormigos, A
The definition of an auditory processing disorder (APD) is based on impairments of auditory functions. APDs are disturbances in processes central to hearing that cannot be explained by comorbidities such as attention deficit or language comprehension disorders. Symptoms include difficulties in differentiation and identification of changes in time, structure, frequency and intensity of sounds; problems with sound localization and lateralization, as well as poor speech comprehension in adverse listening environments and dichotic situations. According to the German definition of APD (as opposed to central auditory processing disorder, CAPD), peripheral hearing loss or cognitive impairment also exclude APD. The diagnostic methodology comprises auditory function tests and the required diagnosis of exclusion. APD is diagnosed if a patient's performance is two standard deviations below the normal mean in at least two areas of auditory processing. The treatment approach for an APD depends on the patient's particular deficits. Training, compensatory strategies and improvement of the listening conditions can all be effective. PMID:23907207
The relation between life events and psychiatric symptoms among wives of soldiers deployed to the Persian Gulf during Operation Desert Storm (ODS) was examined. Psychiatric symptoms were measured, using the 25-item Hopkins Symptom Checklist (HSCL), at two times, once while the soldiers were away and a second time several months after they returned. In a multiple regression analysis, symptoms at Time 2 were predicted by post-Desert Storm events as well as by events and emotional stressors that occurred during the military operation. The strongest predictor of post-Desert Storm events was pre-Desert Storm events. The impact of the deployment was also assessed on the basis of respondents' symptom profiles over time. Although 70% of the respondents were symptomatic during the deployment, 40% had recovered by Time 2; only 24% were symptomatic at both times. Even in the latter group, there was an improvement in symptoms between Time 1 (T1) and Time 2 (T2). PMID:8789649
To investigate prevalence and severity of symptoms and symptom clustering in breast cancer survivors who attended MBSR(BC). Women were randomly assigned into MBSR(BC) or Usual Care (UC). Eligible women were ? 21 years, had been diagnosed with breast cancer and completed treatment within 18 months of enrollment. Symptoms and interference with daily living were measured pre- and post-MBSR(BC) using the M.D. Anderson Symptom Inventory. Symptoms were reported as highly prevalent but severity was low. Fatigue was the most frequently reported and severe symptom among groups. Symptoms clustered into 3 groups and improved in both groups. At baseline, both MBSR(BC) and the control groups showed similar mean symptom severity and interference; however, after the 6-week post-intervention, the MBSR(BC) group showed statistically-significant reduction for fatigue and disturbed sleep (P < 0.01) and improved symptom interference items, compared to the control group. For the between-group comparisons, 11 of 13 symptoms and 5 of 6 interference items had lower means in the MBSR(BC) condition than the control condition. These results suggest that MBSR(BC) modestly decreases fatigue and sleep disturbances, but has a greater effect on the degree to which symptoms interfere with many facets of life. Although these results are preliminary, MBSR intervention post-treatment may effectively reduce fatigue and related interference in QOL of breast cancer survivors. PMID:21506018
Lengacher, Cecile A; Reich, Richard R; Post-White, Janice; Moscoso, Manolete; Shelton, Melissa M; Barta, Michelle; Le, Nancy; Budhrani, Pinky
Combined heat and power production has high priority in Danish energy planning. Interest has increased for establishing decentralised gas fired co-generation plants based on gas engines or turbines. Approximately 60 gas engines and 10 gas turbines have be...
This paper describes the Fast Flux Test Facility (FFTF) Operations initial training program utilizing the Operator Training Simulator (OTS). The OTS is a computer-driven system that provides real time response of essential FFTF plant functions to a contro...
Stimulated by our clinical work with patients who manifest unexplained "somatoform" symptoms in the primary care setting, this article addresses a theoretical black box in our understanding of somatization: how does culture mediate severe stress to produce symptoms that cannot be explained by the presence of physical illness? Despite various problems in his explanation of hysteria, Freud broke new ground by emphasizing narratives of traumatic experiences in the development and treatment of unexplained physical symptoms. Except in anthropologically oriented cultural psychiatry, contemporary psychiatry has traveled away from a focus on narrative in the study of somatization. On the other hand, recent interest in narrative has spread across many intellectual disciplines, including the humanities and literary criticism, psychology, history, anthropology, and sociology. We operationally define narratives as attempts at storytelling that portray the interrelationships among physical symptoms and the psychologic, social, or cultural context of these symptoms. Regarding somatization and trauma, we focus on the ways that narrative integrates the cultural context with traumatic life events. In explaining the black box, we postulate that extreme stress (torture, rape, witnessing deaths of relatives, forced migration, etc.) is processed psychologically as a terrible, largely incoherent narrative of events too awful to hold in consciousness. Culture patterns the psychologic and somatic expression of the terrible narrative. Methodologically, we have developed some techniques for eliciting narratives of severe stress and somatic symptoms, which we illustrate with observations from an ongoing research project. In designing interventions to improve the care of somatizing patients, we are focusing on the creation of social situations where patients may feel empowered to express more coherent narratives of their prior traumatic experiences. PMID:9255914