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  1. [PREDICTING FACTORS OF THE LIFE SPAN IN PATIENTS, SUFFERING METASTATIC COLORECTAL CANCER AND SYNCHRONOUS HEPATIC AFFECTION AFTER SURGICAL TREATMENT].

    PubMed

    Kolesnik, O O; Burlaka, A A; Lukashenko, A V; Pryimak, V V; Zhukov, Yu O; Makhmudov, D E; Volk, M O; Shchepotin, I B

    2015-05-01

    The results of treatment of 125 patients, suffering metastatic hepatic affection in colorectal cancer (pT1--4N0--2M1--in colonic cancer and pT1--3N0--2M1--in cancer recti), to whom in 2008-2015 yrs a one-staged (Group 1) or two-staged (Group II) surgical treatment was done. In affection of 4 regional lymph nodes and more (pN2) late results were less favorable, than in pN1 or pN0, not depending from surgical approach choosed. In 48 (38.4%) patients with one syndromal hepatic metastatic focus, the indices of general three-year and five-year cumulative survival were the best, than in other groups--82 and 63% (p = 0.001) accordingly; in monolobar affection--68 and 49%, and in bilobar--23 and 0%, not depending from method of surgical treatment (p < 0.001) choosed. Predictive factors were established, which impact negatively the indices of general survival in patients, suffering metastatic hepatic affection in colorectal cancer: hepatic metastatic foci number 4 and more, bilobar hepatic metastatic affection. PMID:26419027

  2. Reducing patient suffering through compassionate connected care.

    PubMed

    Dempsey, Christina; Wojciechowski, Sharyl; McConville, Elizabeth; Drain, Maxwell

    2014-10-01

    Patient experience continues to play an increasingly critical role in quality outcomes and reimbursement. Nurse executives are tasked with helping direct-care nurses connect with patients to improve care experiences. Connecting with patients in compassionate ways to alleviate inherent patient suffering and prevent avoidable suffering is key to improving the patient experience. The Compassionate Connected Care framework identifies strategies for meeting the challenges of connecting with patients and reducing suffering. Methods integrate clinical, operational, cultural, and behavioral aspects of care to target patient needs based on condition. Caregivers learn to better express empathy and compassion to patients, and nurse leaders are better equipped to engage nurses at the bedside. PMID:25208270

  3. Disturbances of Ligand Potency and Enhanced Degradation of the Human Glycine Receptor at Affected Positions G160 and T162 Originally Identified in Patients Suffering from Hyperekplexia

    PubMed Central

    Atak, Sinem; Langlhofer, Georg; Schaefer, Natascha; Kessler, Denise; Meiselbach, Heike; Delto, Carolyn; Schindelin, Hermann; Villmann, Carmen

    2015-01-01

    Ligand-binding of Cys-loop receptors is determined by N-terminal extracellular loop structures from the plus as well as from the minus side of two adjacent subunits in the pentameric receptor complex. An aromatic residue in loop B of the glycine receptor (GlyR) undergoes direct interaction with the incoming ligand via a cation-π interaction. Recently, we showed that mutated residues in loop B identified from human patients suffering from hyperekplexia disturb ligand-binding. Here, we exchanged the affected human residues by amino acids found in related members of the Cys-loop receptor family to determine the effects of side chain volume for ion channel properties. GlyR variants were characterized in vitro following transfection into cell lines in order to analyze protein expression, trafficking, degradation and ion channel function. GlyR α1 G160 mutations significantly decrease glycine potency arguing for a positional effect on neighboring aromatic residues and consequently glycine-binding within the ligand-binding pocket. Disturbed glycinergic inhibition due to T162 α1 mutations is an additive effect of affected biogenesis and structural changes within the ligand-binding site. Protein trafficking from the ER toward the ER-Golgi intermediate compartment, the secretory Golgi pathways and finally the cell surface is largely diminished, but still sufficient to deliver ion channels that are functional at least at high glycine concentrations. The majority of T162 mutant protein accumulates in the ER and is delivered to ER-associated proteasomal degradation. Hence, G160 is an important determinant during glycine binding. In contrast, T162 affects primarily receptor biogenesis whereas exchanges in functionality are secondary effects thereof. PMID:26733802

  4. Positive affects and the transformation of suffering into flourishing.

    PubMed

    Fosha, Diana

    2009-08-01

    Three investigative realms with widely divergent methodologies arrive at uncannily similar conclusions about the vital role of positive affective phenomena in optimal adaptation, resilience, affect regulation, cardiac health, and subjective well-being: research on resilience and human flourishing; Indo-Tibetan practices and the emergent yogic sciences; and the practice of AEDP (Accelerated Experiential Dynamic Psychotherapy), a healing-oriented, transformation-based model of psychotherapy. AEDP has explored the vital role of positive emotions in the process of change in general, and, more specifically, in therapeutic work with painful and overwhelming emotional experience, and has identified and descried a phenomenology of positive affective experiences, including the healing affects, and core state, which signal the operation of healing transformational processes. This chapter focuses on how, in the course of one therapeutic hour--through the moment-to-moment tracking of bodily rooted experience and dyadic affect regulation in the context of a relationship in which the individual feels safe and known--the processing of suffering, i.e., stress-based, traumatizing, painful emotional experiences naturally culminates in flourishing, i.e., deeply positive experiences of aliveness, hope, faith, clarity, agency, simplicity, compassion, joy, and truth. Key to this is the focus on and experiential processing of the experience of healing transformation. Thus, there unfolds a series of cascading transformations, with each transition somatically marked by positive transformational affects, until we arrive at core state, a state characterized by the positive affective phenomena that underlie some of our highest strivings and deepest joys. PMID:19735249

  5. Unburdening suffering: responses of psychiatrists to patients' suicide deaths.

    PubMed

    Talseth, Anne-Grethe; Gilje, Fredricka

    2007-09-01

    The research questions was: 'How do psychiatrists describe their responses to patients' suicidal deaths in the light of a published model of consolation?' The textual data (n = 5) was a subset of a larger (n = 19) study. Thematic analysis showed a main theme, 'unburdening grief', and six themes. Embedded in the results is a story about suffering that reveals that, through ethical reflectiveness, a meaning of suffering can be recreated that unburdens grief and opens up new understandings with and among disciplines. This can help to prepare health professionals to respond to people who suffer because of suicidal death. PMID:17901173

  6. Swedish ambulance nurses' experiences of nursing patients suffering cardiac arrest.

    PubMed

    Larsson, Ricard; Engström, Åsa

    2013-04-01

    Effective pre-hospital treatment of a person suffering cardiac arrest is a challenging task for the ambulance nurses. The aim of this study was to describe ambulance nurses' experiences of nursing patients suffering cardiac arrest. Qualitative personal interviews were conducted during 2011 in Sweden with seven ambulance nurses with experience of nursing patients suffering cardiac arrests. The interview texts were analyzed using qualitative thematic content analysis, which resulted in the formulation of one theme with six categories. Mutual preparation, regular training and education were important factors in the nursing of patients suffering cardiac arrest. Ambulance nurses are placed in ethically demanding situations regarding if and for how long they should continue cardio-pulmonary resuscitation (CPR) to accord with pre-hospital cardiac guidelines and patients' wishes. When a cardiac arrest patient is nursed their relatives also need the attention of ambulance nurses. Reflection is one way for ambulance nurses to learn from, and talk about, their experiences. This study provides knowledge of ambulance nurses' experiences in the care of people with cardiac arrest. Better feedback about the care given by the ambulance nurses, and about the diagnosis and nursing care the patients received after they were admitted to the hospital are suggested as improvements that would allow ambulance nurses to learn more from their experience. Further development and research concerning the technical equipment might improve the situation for both the ambulance nurses and the patients. Ambulance nurses need regularly training and education to be prepared for saving people's lives and also to be able to make the right decisions. PMID:23577977

  7. [Interdisciplinary care for a patient suffering from Diogenes syndrome].

    PubMed

    Beggah-Alioua, Sabah; Berger, Jérôme; Cheseaux, Michel

    2014-06-25

    Interdisciplinarity is the combined care of a patient by two or more healthcare professionals. Taking into account the contribution of the different healthcare partners improves patient follow-up, quality of the care and use of resources. General practitioner (GP) becomes the pivot of a combined interdisciplinary ambulatory care allowing a prolonged staying at home and avoiding the multiplication of care offers. This paper, by the clinical description of a patient suffering from Diogenes Syndrome, allows a cross of the care between the GP, home nurse and pharmacist. It deals with follow-up questions, acceptance, objectives of treatment, communication between healthcare partners and "false notes" in the follow-up. PMID:25055477

  8. Vascular responses in the hands of patients suffering from migraine

    PubMed Central

    Downey, J. A.; Frewin, D. B.

    1972-01-01

    The response of the hand blood vessels to a measured, controlled cold stimulus was determined, using venous occlusion plethysmography, in normal subjects and patients who suffered from migraine. The resting level of hand blood flow was found to be higher in the patients, but the percentage fall in flow that resulted when the cold stimulus was applied was less than in the normal subjects. The hand blood vessels of the patients responded to intra-arterial noradrenaline and tyramine in a normal fashion. PMID:5037037

  9. The moral aesthetics of simulated suffering in standardized patient performances.

    PubMed

    Taylor, Janelle S

    2011-06-01

    Standardized patient (SP) performances are staged clinical encounters between health-professional students and people who specialize in role-playing the part of patients. Such performances have in recent years become increasingly central to the teaching and assessment of clinical skills in U.S. medical schools. SP performances are valued for being both "real" (in that they involve interaction with a real person, unlike written examinations) and "not real" (in that the SP does not actually suffer from the condition portrayed, unlike an actual patient). This article considers how people involved in creating SP performances reconcile a moral commitment to avoid suffering (to keep it "not real"), with an aesthetic commitment to realistically portray it (to keep it "real"). The term "moral aesthetic" is proposed, to indicate a sensibility that combines ideas about what is morally right with ideas about what is aesthetically compelling. Drawing on ethnographic research among SPs and SP program staff and medical faculty who work closely with them, this article argues that their work of creating "realism" in simulated clinical encounters encompasses multiple different (and sometimes conflicting) understandings and practices of realism, informed by three different moral aesthetics: (1) a moral aesthetic of induction, in which an accurate portrayal with a well-documented provenance serves to introduce experientially distant forms of suffering; (2) a moral aesthetic of inoculation, in which the authenticity and emotional impact of a performance are meant to inoculate students against the impact of future encounters with suffering; (3) a moral aesthetic of presence, generating forms of voice and care that are born out of the embodied presence of suffering individuals in a clinical space. All are premised on the assumption that risk and suffering can be banished from SP performances. This article suggests, however, that SP performances necessarily raise the same difficult

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

    PubMed

    Pieretti, Lisa J

    2014-10-01

    The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis. PMID:25152350

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

    PubMed Central

    2013-01-01

    Background Heart valve disease is becoming a public health problem due to increasing life expectancy and new treatment methods. Patients are at risk of developing depression, anxiety or post-traumatic stress disorder after heart valve surgery. To better plan proper care, describing and understanding patients’ perception of recovery after heart valve replacement is essential. The objective was to describe the experience of recovery at home after heart valve replacement. Methods Qualitative interviews were conducted with 10 patients representing the population and these were later transcribed. The analysis was inspired by Ricoeur’s theory of interpretation, which consists of three levels: naive reading, structured analysis, and critical interpretation and discussion. Results The overall concept that emerged was suffering weakness and struggling to resume normality. Patients all struggled to resume normal living, both in regaining physical strength and in reestablishing balance in overall living. The overall concept can be interpreted in terms of the following themes: Disturbed network: Invaluable relatives, Contact with healthcare staff, Rehabilitation. Disturbed body: Stressful complications, Bodily attention, Physically affected, Physical capability. Recovery: Interrupted living, Suffering weakness, Gradual recovery, Achieving normality. Reflections: Thoughts about the procedure and Feeling sad and fragile. Conclusion The study presents the main themes of network, body, recovery and reflection for ten patients after heart valve replacement. These main themes can overall be summarized as suffering weakness and struggling to resume normality. Patients felt weak with a changed body, but after a long recovery process regained vitality and returned to their daily life. PMID:24070399

  12. A new frontier in healthcare risk management: Working to reduce avoidable patient suffering.

    PubMed

    Card, Alan J; Klein, Victor R

    2016-01-01

    This article presents a new avenue for healthcare risk managers to drive improvement for patients and healthcare organizations alike: working to reduce avoidable patient suffering. It briefly describes the problem of patient suffering, differentiates between avoidable and unavoidable suffering, and suggests that common risk management tools can be used to tackle the problem. It also highlights a success story from one large health system. PMID:26789746

  13. Processing of affective prosody in boys suffering from attention deficit hyperactivity disorder: A near-infrared spectroscopy study.

    PubMed

    Köchel, Angelika; Schöngaßner, Florian; Feierl-Gsodam, Silke; Schienle, Anne

    2015-01-01

    Neurobiological studies on facial affect recognition have demonstrated reduced response amplitudes to anger cues in patients suffering from attention deficit hyperactivity disorder (ADHD). It is still unclear whether a similar deficit exists in the auditory domain. Therefore, this near-infrared spectroscopy study focused on neuronal correlates of affective prosody processing. Fourteen boys suffering from ADHD and fourteen healthy boys were exposed to emotionally intoned, standardized sentences of the categories anger, sadness, happiness, and to affectively neutral sentences. Relative to controls, the patients displayed a diminished activation of the right superior temporal gyrus (STG) when processing anger prosody, which was correlated with aggressive behavior. There were no group differences for the other emotions. Additionally, the ADHD group showed increased supramarginal gyrus (SMG) activation in the anger condition. This might mirror compensatory attention allocation. In summary, we identified a selectively lowered STG activation to auditory anger cues in ADHD patients. Consequently, STG recruitment during anger exposure might be used for evaluation of psychotherapy effects. PMID:25721229

  14. [DISSEMINATION BY H. PYLORI IN PATIENTS, SUFFERING VARIOUS FORMS OF CHOLECYSTITIS].

    PubMed

    Kyazimov, I L; Takhmazova, Ch T

    2015-05-01

    Comparative analysis of dissemination by H. pylori of the bile portions in patients of a control group, suffering an acute calculous cholecystitis (ACCH), was performed. Dissemination of H. pylori in a control group was significantly less, than in a bile portions of patients, suffering ACCH. While analyzing the rate and degree of dissemination by H. pylori of the gastic and gallbladder mucosa biopsies of patients, suffering chronic non-calculous cholecystitis, associated with duodenogastric reflux and gastroduodenitis, bacteria were revealed trustworthy more often and in more number, than in a gallbladder mucosa in patients, suffering ACCH. PMID:26419024

  15. Increased frequency of self-reported parasomnias in patients suffering from vitiligo.

    PubMed

    Mouzas, Odysseas; Angelopoulos, Nikiforos; Papaliagka, Maria; Tsogas, Panagiotis

    2008-01-01

    Vitiligo is a skin disorder of unknown aetiology, affecting 0.1-2% of the general population. The aim of the present study was to investigate its relationship with sleep disorders, especially parasomnias. Two hundred and sixteen individuals were examined. Among them, 116 were suffering from vitiligo, 52 from other dermatological diseases and 48 were healthy subjects, serving as a control group. An inventory including items related to sleep disorders from childhood and adolescence was used. The study was focused specifically on parasomnias. Patients suffering from vitiligo reported a significantly higher occurrence of sleepwalking, nocturnal enuresis, night illusions, sleep terrors and nightmares than that of the control group, prior to the manifestation of the disease. Patients suffering from other dermatological diseases only reported significantly more often nightmares and nocturnal enuresis compared to the control group. A relationship between parasomnias during early life and later development of vitiligo was detected. This finding supports the hypothesis that neural mechanisms involving monoaminergic systems (especially the serotoninergic one) may potentially be involved in the aetiopathology of vitiligo. PMID:18424376

  16. [How to communicate with patients suffering from dementia].

    PubMed

    Füeßl, Hermann Sebastian

    2015-04-01

    The prevalence of patients with cognitive impairment will inevitably increase in general hospitals. Communication with these patients is difficult. However, it can be improved by implementing organisational measures and behaviour changes of the hospital staff. PMID:25945913

  17. [Group psychoeducational intervention in relatives of patients suffering from schizophrenia].

    PubMed

    Palli, A; Kalantzi-Azizi, A; Ploumpidis, D N; Kontoangelos, K; Economou, M

    2015-01-01

    The present research paper aims at assessing the effectiveness of a psychoeducational intervention in relatives' groups of patients with schizophrenia or schizoaffective disorder. It examines the possible influence of the intervention on family members as well as on the course of the patient illness. Of a total of 131 relatives, 83 consisted the experimental group and 48 the control group. The relatives of the experimental group were divided into 5 groups and attended 18 psychoeducational sessions. Their patients as well s the patients and the relatives of the control group attended no specific intervention and continued their routine care. The psychoeducational intervention included education about the illness, communication skills training and training in problem-solving. It combined educational and psychotherapeutic techniques. The psychometric tools administered were: The Family Burden Scale, The Family Rituals Scale, The General Health Questionnaire GHQ-28, the Center for Epidemiological studies - Depression Scale (CES-D), the Opinions about Mental Illness Scale OMI, two scales concerning the knowledge about the illness, two questionnaires concerning expectations and feedback about the group process and questionnaires regarding sociodemographic characteristics of the sample and information about the illness. The number of hospitalizations of patients (n=91) during the research year was investigated. An interaction between group and measurement was found. While patient hospitalizations of both research groups did not differ significantly at the year before the study with X2=0.54, p=0.46), they differed when measured a year after the intervention, where patients in the intervention group had statistically significant fewer hospitalizations compared to the patients in the control group (x2=4.58, significant at p=0.032). As to the "compliance" in the medication, two statistical tests were conducted, taking into consideration that "compliance" by patients starting

  18. Tooth wear among patients suffering from mental disorders

    PubMed Central

    Piccoli, Luca; Besharat, Laith Konstantinos; Cassetta, Michele; Migliau, Guido; Di Carlo, Stefano; Pompa, Giorgio

    2014-01-01

    Summary Aim Assess oral health, treatment needs and the correlation between tooth wear and medications in patients with psychiatric disease. Methodology 92 patients (40 male and 52 female) admitted in the Department of Neurology and Psychiatry of the Umberto I Hospital of Rome underwent an oral and dental clinical examination in accordance according to World Health Organization Basic Methods Criteria. One dentist performed all clinical examinations, training and calibration was carried out by an experienced clinical examiner. To measure the degree of inter-examiner agreement Kappa statistics was calculated. Level of tooth wear was assessed using the tooth wear classification of Johansson et al. Exact psychiatric pathology and medications of each patient were registrated. The Statistical Package for the Social Sciences (SPSS Inc., Chicago, Ill.) was used to analyze the data. A value of P < 0.05 was considered statistically significant. Results 34.78% of the sample regarding tooth wear demonstrated score 2. Men demonstrated 30% score 2, and 20% score 3 and 4 whereas female patients 38.46% score 2, 7.69% score 3 and none score 4. Conclusions Chronic exposure to neuroleptic drugs can cause phenomena of bruxism. There is a direct correlation between tooth wear, psychiatric disorders and administration of certain drugs. Poor oral hygiene and extensive unmet needs for dental treatment were widespread among psychiatric patients. PMID:25002918

  19. [HORMONAL-GENETIC SCREENING IN PATIENTS, SUFFERING GASTRODUODENAL ULCER HEMORRHAGE].

    PubMed

    Duzhiy, I D; Romanyuk, A M; Lyndin, M C; Bratushka, V V; Dubnytskiy, V Yu; Shevchenko, Yu Yu; Kharchenko, S V

    2015-11-01

    Genetic-hormonal regulation plays a key pathophysiologic role in a blood loss on background of complicated gastroduodenal ulcer disease, but a clinical significance of some genes of compensatory steroidogenesis remains unrevealed. Examination of 63 patients, using a chain reaction with polymerase (CRP); analysis of length of restriction fragments (CRP-RFLP) and immunohistochemical investigation of gastroduodenal mucosa were performed on the base of a Sumsky Rural Clinical Hospital. Trustworthy difference of distribution of polymorphic genes ESR1 and VKORC1 in patients of both gender in presence of the ulcer hemorrhage was not revealed, excluding genotype A/A VKORC1, what trustworthy more frequently was revealed in women (p < 0.05). There was established, that intact zone of gastric fundus owes immunoreactivity towards alpha-receptors of estrogen in nuclei of epitheliocytes and stromocytes. Diagnosis of polymorphic gene VKORC1 and expression of the estrogen receptors may serve the base for pathogenetic therapy in patients with hemorrhage occurrence. PMID:26939421

  20. [Physiotherapy for young patients suffering from malignant bone tumors].

    PubMed

    Bové, Bertrand; Triantafyllou, Caroline; Duché, Anne; Sanzey, Camille; Aristide, Camille; Mejane, Clotilde; Ansinelli, Jean-Michel

    2013-01-01

    Resection-reconstruction procedures for bone tumours are highly specialised. Rehabilitation therapists must take into account the specific context in order to successfully fulfil their mission.The hospitalisation of the patient in a specialised institution facilitates the provision of physiotherapy treatment adapted to these difficult and complex situations. PMID:23379066

  1. Therapeutic efficacy of topical OLEOZON® in patients suffering from onychomycosis.

    PubMed

    Menéndez, Silvia; Falcón, Leopoldina; Maqueira, Yordana

    2011-09-01

    The results of the use of ozonised sunflower oil (OLEOZON(®)) in the treatment of onychomycosis, based on its known antimycotic action and good skin tolerance, by means of a controlled randomised phase III assay are presented. A total of 400 outpatients were randomly divided into two groups: experimental, treated with topical OLEOZON(®), two times per day and control, treated also two times per day, with ketoconazole cream 2%, for 3 months. A patient was considered cured when the sick nails regained the normal colour, growth and thickness, with a negative mycological study. In the experimental group, a regression of signs was achieved from the first month of treatment, while in the control group, it was obtained after the third month of treatment. All patients treated with OLEOZON(®) had improvement in their condition (9.5%) or were cured (90.5%). However, in the control group, only 13.5% of patients were cured, 27.5% improved and 59% remained the same, with significant differences between both the groups. After 1 year of follow-up, experimental and control groups presented 2.8% and 44.4% of relapses, respectively. Topical OLEOZON(®) demonstrated effectiveness in the treatment of onychomycosis, superior to that of ketoconazole. No side effects were observed. PMID:20492527

  2. The relation between type D personality and the clinical condition of patients suffering from psoriasis

    PubMed Central

    Woźniewicz, Agnieszka

    2013-01-01

    Introduction Type D personality is the last distinguished specific type of personality that is characterised by two dimensions: a tendency for feeling negative emotions – depression, anxiety, anger or hostility, and a tendency for withdrawal from the society. The latest research shows the significant role played by type D personality in the aetiology and course of a variety of diseases. Aim The article discusses the problem of the occurrence of type D personality in the group of patients suffering from psoriasis. Diversities in the clinical condition of psoriasis patients due to increasing type D personality traits are specified. Material and methods Ninety psoriasis patients and 86 healthy subjects participated in the research. In the research questionnaires, the scale for assessing increasing psoriasis complaints and the DS-14 scale to assess type D personality were applied. Results Research results made it possible to corroborate more frequent occurrence of type D personality among psoriasis patients. Moreover, it was found that with increasing negative affectivity – one of type D personality components – complaints increase as far as the clinical condition of psoriasis patients is concerned. Conclusions Monitoring of psychological well-being of psoriasis patients, especially within type D personality, seems to be a vital element, irrespective of purely medical treatment. PMID:24494001

  3. Presence of C1-Inhibitor Polymers in a Subset of Patients Suffering from Hereditary Angioedema

    PubMed Central

    Madsen, Daniel Elenius; Hansen, Søren; Gram, Jørgen; Bygum, Anette; Drouet, Christian; Sidelmann, Johannes Jakobsen

    2014-01-01

    Hereditary angioedema (HAE) is a potentially life-threatening disease caused by mutations in the gene encoding the serine protease inhibitor (serpin) C1 inhibitor (C1-inh). The mutations cause decreased functional plasma levels of C1-inh, which triggers unpredictable recurrent edema attacks. Subjects suffering from HAE have been classified in type I patients with decreased functional and antigenic levels of C1-inh, and type II patients with decreased functional but normal antigenic C1-inh levels. However, a few reports have demonstrated that some mutations cause C1-inh polymerization in vitro, and it is speculated that C1-inh polymers may exist in patient plasma, challenging the current classification of HAE patients. To investigate the presence of C1-inh polymers in patient plasma samples, we developed an immunological method, where monoclonal antibodies produced against polymerized C1-inh were applied in native PAGE western blotting. Using this approach we analyzed genuine plasma samples from 31 Danish HAE families, and found that plasma samples from three genotypically distinct HAE type I families (classified upon C1-inh plasma concentrations) contained C1-inh polymers. Identical C1-inh polymerization phenotypes were observed in four affected family members from one of these families. Genotyping of the families revealed that the polymerogenic mutations of two families were located in proximity to the reactive center loop insertion site in C1-inh (p.Ile271Thr and p.Ser258_Pro260del),and one mutation affected helix C (p.Thr167Asn). In conclusion, we demonstrate that C1-inh polymers are present in the plasma of a subgroup of HAE type I patients. PMID:25369003

  4. [HORMONALLY-GENETICALLY DEPENDENT THERAPY, USING VITAMIN K IN PATIENTS, SUFFERING THE ULCER HEMORRHAGE].

    PubMed

    Duzhyi, I D; Kharchenko, S V

    2016-04-01

    Pathophysiological mechanisms of the vitamin K impact, including those in the gut with ulcerative affection, are studied still insufficiently. Investigations of pharmacogenomics of the vitamin K gives a new approach to therapy in patients, suffering gastro-intestinal hemorrhage. Possibilities of titration of the vitamin K3 (menadione) doses, depending on level of estrogenemia and genetic constitution, concerning genes-candidates ESR1 (rs2234693) and VKORC1 (rs9923231), were studied. There were examined 36 patients, who were treated for the ulcer hemorrhage. The blood serum concentration of estradiol was investigated in accordance to method of solid phase enzyme immunoassay, the genotyping procedure was performed in accordance to indices of polymerase chain reaction with analysis of the restrictional fragments length. The initial daily dose of menadione have constituted 20 mg. After a genotype determination made (first-second day after admittance to hospital) in patients with normoestrogenemia in genotypes CC/GG, CC/GA, CT/GG, CT/GA a vitaminotherapy was prolonged in daily dose of 20 mg, and in a conditionally-pathological variant of genotype the dose of vitamin K was enhanced up to 30 mg. Determination of hormones and the patients' genetic constitution makes possible to apply a personified approach for the vitamin K3 application in the ulcerative hemorrhage. PMID:27434945

  5. Escaping affect: how motivated emotion regulation creates insensitivity to mass suffering.

    PubMed

    Cameron, C Daryl; Payne, B Keith

    2011-01-01

    As the number of people in need of help increases, the degree of compassion people feel for them ironically tends to decrease. This phenomenon is termed the collapse of compassion. Some researchers have suggested that this effect happens because emotions are not triggered by aggregates. We provide evidence for an alternative account. People expect the needs of large groups to be potentially overwhelming, and, as a result, they engage in emotion regulation to prevent themselves from experiencing overwhelming levels of emotion. Because groups are more likely than individuals to elicit emotion regulation, people feel less for groups than for individuals. In Experiment 1, participants displayed the collapse of compassion only when they expected to be asked to donate money to the victims. This suggests that the effect is motivated by self-interest. Experiment 2 showed that the collapse of compassion emerged only for people who were skilled at emotion regulation. In Experiment 3, we manipulated emotion regulation. Participants who were told to down-regulate their emotions showed the collapse of compassion, but participants who were told to experience their emotions did not. We examined the time course of these effects using a dynamic rating to measure affective responses in real time. The time course data suggested that participants regulate emotion toward groups proactively, by preventing themselves from ever experiencing as much emotion toward groups as toward individuals. These findings provide initial evidence that motivated emotion regulation drives insensitivity to mass suffering. PMID:21219076

  6. Food Hypersensitivity in Patients Over 14 Years of Age Suffering from Atopic Dermatitis

    PubMed Central

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

    2014-01-01

    Background: Patients suffering from atopic dermatitis often describe food hypersensitivity. Rising prevalence of food hypersensitivity and severe allergic reactions to foods have been reported, but the data are scarce. Aims and Objectives: Evaluation of food hypersensitivity reactions in patients suffering from atopic dermatitis. Materials and Methods: The dermatological examination was performed in patients of age 14 years and above and the detailed history was taken concerning the food hypersensitivity. Results: A total of 228 patients were examined-72 men, 156 women, average age 26.2 (SD 9.5) years. The food hypersensitivity reactions were recorded in 196 patients from 228 (86%), no reactions were recorded in 32 patients (24%). Foods with the most often recorded reactions are: Nuts (in 35% of patients), tomatoes (in 20%), and kiwi (in 17, 5%), apples and spices (in 16%), tangerines and oranges (in 15%), capsicum (in 13%), fishes (in 12%), celery (in 9%), and chocolate (in 7%). Conclusion: Food hypersensitivity reactions are recorded in 86% of patients suffering from atopic dermatitis. Nuts, tomatoes, and pollen–associated foods play a role in the majority of patients suffering from atopic dermatitis. PMID:24891679

  7. [About suffering].

    PubMed

    Hárdi, István

    2007-01-01

    From ancient times the Bible, theology and philosophy have dealt with the problem of human suffering. The German concept of "Leidensdruck" means a "pressure" caused by suffering, which prompts the patient to see a doctor. It is worthwhile to deal with suffering from a holistic point of view as well, which can be described as somatic, mental, social and spiritual forms of distress. As all kinds of human suffering are summed up (reflected by) in the psyche, they are mostly followed by psychopathological alterations (i.e. depression); therefore, it is another reason why it is useful to deal with the problem. If suffering is considered as multi-causal condition, personality elements have to be excluded as they can decrease or increase pain. In addition to aetiological factor, the role of coping and defence mechanisms has to be considered as well. The process of suffering - mainly with chronic diseases - goes along with the increase of pain (e.g. with malignant tumours), or luckily with discontinuation of pain by therapy. In a doctor-patient relationship dealing with suffering, a holistic attitude is needed in order to understand the patient better. It may contribute to what Michael Bálint proposed to doctors who use psychotherapy in their practice: the so-called autogenous picture of the disorder developed by the patient has to be reconciled with the doctor's iatrogenous one. The clearer the perspective, the view of the disease, the better patient compliance can be expected. PMID:18421095

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

    SciTech Connect

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

    1980-01-01

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

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

    PubMed

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

    2012-01-01

    The aim of this study is to understand the suffering of a patient with an illness, by using a secondary research method, that is, a qualitative meta-study. The primary data source of the meta-study includes "biographical reports". This project is based on a case study, in which the first-hand experiences of a patient with an illness were collected. The findings of the reports were compiled using the Archivos de la Memoria collection of the Index Foundation (Granada, Spain) and journals specialized in editing these materials. A selection of 20 biographical reports was targeted. The results of the meta-study show that suffering is a multidimensional process within a framework of ambiguous feelings. The suffering involves family and social network participation. Patients develop a range of strategies to overcome the illness. One of the effects is the fear of illness relapse or worsening. PMID:22991127

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  12. [Affect processing in psychosomatic patients. I].

    PubMed

    Ahrens, S

    1984-01-01

    The present article reports the results of an empirical investigation concerned with specific characteristics of psychosomatic patients. Subjects suffering from ulcus duodeni or from colitis ulcerosa designated as psychosomatic patients. Controls were chosen from among neurotic patients and from among patients with only somatic illness. Against the background of the criticism with regard to the scientific approaches so far, our own approach was conceived as an experiment. Film episodes of two contrating (friendly versus unfriendly) interactions between physician and patient were offered to the test subjects as triggering situations. The contents of these film segments were organized in a manner calculated to produce an affective embarrassment in the psychosomatic patients. The reactions of the test subjects were inventoried on two levels. One of the levels of investigation was geared to cognitive processes by the application of Hofstätter's list of polarities (1955, 1973). In this case the psychosomatic patients distinguished themselves from the two control groups in that they misinterpreted the differences in the affective contents of both film sequences. On the other level of investigation subconscious processes were recorded by the application of Gottschalk's analysis of verbal contents. In this context all three groups in the investigation reacted in a similar manner to friendly connotations in the behaviour of the physician, namely with hidden aggressions. The results infer an affective resonance of the investigated psychosomatic patients on a subconscious level which, however, does not become evident on the conscious cognitive level. PMID:6485587

  13. [Phlebotrophic therapy with venarus in patients suffering from lower limb chronic venous insufficiency].

    PubMed

    Gudymovich, V G; Stoĭko, Iu M; Iakovleva, N M; Nikitina, A M

    2013-01-01

    The article deals with medicamentous therapy of lower limb chronic venous insufficiency (LLCVI). The authors analysed herein the results of treating patients suffering from LLCVI using Venarus whose basic components are diosmin and hesperidin. The obtained findings demonstrated that clinical administration of this phlebotonic agent is effective in the given cohort of patients during the whole therapeutic course, with a maximum positive effect observed within the first 4 weeks. The parameters of quality of life of the patients with LLCVI improved significantly on the background of taking the phlebotonic Venarus. PMID:24429564

  14. Hyperbaric oxygen can induce neuroplasticity and improve cognitive functions of patients suffering from anoxic brain damage

    PubMed Central

    Hadanny, A.; Golan, H.; Fishlev, G.; Bechor, Y.; Volkov, O.; Suzin, G.; Ben-Jacob, E.; Efrati, S.

    2015-01-01

    Abstract Purpose: Cognitive impairment may occur in 42–50% of cardiac arrest survivors. Hyperbaric oxygen therapy (HBO2) has recently been shown to have neurotherapeutic effects in patients suffering from chronic cognitive impairments (CCI) consequent to stroke and mild traumatic brain injury. The objective of this study was to assess the neurotherapeutic effect of HBO2 in patients suffering from CCI due to cardiac arrest. Methods: Retrospective analysis of patients with CCI caused by cardiac arrest, treated with 60 daily sessions of HBO2. Evaluation included objective computerized cognitive tests (NeuroTrax), Activity of Daily Living (ADL) and Quality of life questionnaires. The results of these tests were compared with changes in brain activity as assessed by single photon emission computed tomography (SPECT) brain imaging. Results: The study included 11 cases of CCI patients. Patients were treated with HBO2, 0.5–7.5 years (mean 2.6 ± 0.6 years) after the cardiac arrest. HBO2 was found to induce modest, but statistically significant improvement in memory, attention and executive function (mean scores) of 12% , 20% and 24% respectively. The clinical improvements were found to be well correlated with increased brain activity in relevant brain areas as assessed by computerized analysis of the SPECT imaging. Conclusions: Although further research is needed, the results demonstrate the beneficial effects of HBO2 on CCI in patients after cardiac arrest, even months to years after the acute event. PMID:26409406

  15. Psychological aspects of weekend headache sufferers in comparison with migraine patients.

    PubMed

    Nattero, G; De Lorenzo, C; Biale, L; Allais, G; Torre, E; Ancona, M

    1989-02-01

    Sometimes the relaxation after stress may trigger a migraine attack. This is the principle that underlies that particular variant of migraine called "weekend headache". We hypothesize the presence in weekend headache prone subjects of a particular psychological background, different from that of common migraine sufferers. In order to detect possible differences supporting our hypothesis, we studied 104 new outpatients: 46 patients suffering from headache only on weekends (23 males and 23 females) and 58 matched common migraineurs (26 males and 32 females) with no weekend predilection. The psychological assessment was performed using the following psychometric tools: MMPI, BDI, STAIX1-X2. A clinical assessment of each patient was also carried out. Significant differences were found after statistically analyzing the test results. Most of the MMPI scales were found to be more elevated in both male and female weekend headache sufferers. From a clinical point of view, the weekend headache attacks proved to be similar to those of common migraine, but with a significantly higher incidence of concomitant symptoms. Our study confirms the important role that psychological factors play in the pathogenesis and clinical development of migraine and leads us to conclude that a psychic tension component is associated with the vascular one in weekend headache. PMID:2708043

  16. Coping strategies for existencial and spiritual suffering in Israeli patients with advanced cancer

    PubMed Central

    2014-01-01

    Coping with existential and spiritual concerns is inescapable in end-of-life care although not enough is known about the strategies and mechanisms involved. This pilot study focused on identifying the strategies for coping with existential and spiritual suffering at the end of life of secular Jews with advanced-stage cancer. Using the phenomenological approach to data collection, in-depth interviews were conducted with 22 patients receiving symptom relief care at a daycare oncology clinic. The interviews were recorded and transcribed verbatim, and the content was analyzed. Advanced-stage cancer patients employ several approaches to cope with existential and spiritual concerns. The themes emerging from the interviews present five dimensions of coping strategies: openness and choosing to face reality, connectedness and the significance of family, pursuit of meaning, the connection of body, mind and spirit and, lastly, humor and a positive outlook. Conclusions Since these concerns cause suffering and distress, intervention models targeting existential and spiritual suffering should be disseminated among professionals involved in caring for people with life-threatening illnesses. PMID:24984840

  17. [Physician-assisted suicide of a patient suffering from a psycho-organic disorder].

    PubMed

    van der Meer, S; de Veen, R C; Noorthoorn, E O; Kraan, H F

    1999-04-24

    A 71-year-old man suffering from vascular dementia since four years asked for physician-assisted suicide. In the Netherlands physician-assisted suicide, which is forbidden by law, remains an intricate dilemma in medical practice. As far as it concerns untreatable terminal patients who decide to put an end to their lives in agreement with and assisted by their physician, procedures are well defined. The present case may be used as an example in the development of a protocol for physician-assisted suicide in patients who are not terminal in the short term, but who suffer unbearably with no prospect of remission. After the protocol securing various formal and medical consequences was run through, the patient was assisted by handling him a high-dose solution of a barbiturate which he drank himself. The procedure incorporates several second and third opinions. First, the chief psychiatrist of the psychiatric hospital assesses the request. Second, a committee consisting of a number of independent professionals form a second opinion. They have no direct responsibility in the treatment of the patient. The patient also may consult an independent consultant psychiatrist with specific knowledge in the domain of his disorder for a third opinion. This procedure was found legally as well as medically sound, and was approved by the public prosecutor after consultation with the Dutch forum of Procurators-General. PMID:10347661

  18. The experiences of suffering of palliative care patients in Malaysia: a thematic analysis.

    PubMed

    Beng, Tan Seng; Guan, Ng Chong; Seang, Lim Kheng; Pathmawathi, Subramaniam; Ming, Moy Foong; Jane, Lim Ee; Chin, Loh Ee; Loong, Lam Chee

    2014-02-01

    A qualitative study was conducted with semi-structured interviews to explore the experiences of suffering in 20 adult palliative care inpatients of University Malaya Medical Centre. The results were thematically analyzed. Ten basic themes were generated (1) loss and change → differential suffering, (2) care dependence → dependent suffering, (3) family stress → empathic suffering, (4) disease and dying → terminal suffering, (5) health care staff encounters → interactional suffering, (6) hospital environment → environmental suffering, (7) physical symptoms → sensory suffering, (8) emotional reactions → emotional suffering, (9) cognitive reactions → cognitive suffering, and (10) spiritual reactions → spiritual suffering. An existential-experiential model of suffering was conceptualized from the analysis. This model may inform the development of interventions in the prevention and management of suffering. PMID:22956340

  19. Mental Health Nurses' Experiences of Caring for Patients Suffering from Self-Harm

    PubMed Central

    Talseth, Anne-Grethe

    2014-01-01

    The aim of this study was to explore mental health nurses' experiences of caring for inpatients who self-harm during an acute phase. The setting was four psychiatric clinics in Norway. Fifteen mental health nurses (MHNs) were recruited. Semistructured interviews comprised the method for data collection, with content analysis used for data analysis. Two main categories emerged: challenging and collaborative nurse-patient relationship and promoting well-being through nursing interventions. The underlying meaning of the main categories was interpreted and formulated as a latent theme: promoting person-centered care to patients suffering from self-harm. How MHNs promote care for self-harm patients can be described as a person-centered nursing process. MHNs, through the creation of a collaborative nurse-patient relationship, reflect upon nursing interventions and seek to understand each unique patient. The implication for clinical practice is that MHNs are in a position where they can promote patients' recovery processes, by offering patients alternative activities and by working in partnership with patients to promote their individual strengths and life knowledge. MHNs strive to help patients find new ways of living with their problems. The actual study highlighted that MHNs use different methods and strategies when promoting the well-being of self-harm patients. PMID:25512876

  20. [Electrophysiological examinations (ABR and DPOAE) of hearing organ in hemodialysed patients suffering from chronic renal failure].

    PubMed

    Gierek, Tatiana; Markowski, Jarosław; Kokot, Franciszek; Paluch, Jarosław; Wiecek, Andrzej; Klimek, Dariusz

    2002-01-01

    Deterioration of function of hearing organ is one of the most important clinical problem in uremic patients with chronic renal failure. The present study aimed to assess the function of hearing organ using the brainstem auditory evoked responses (ABR), impedance audiometry and distortion product otoacoustic emission cochlear function (DPOAE) in 31 haemodialysed patients with chronic renal failure (16 females and 15 males, mean age 43.0 years). The control group consisted of 15 healthy subjects. The latency of the waves I, III, V and I-V interpeak in evoked response audiometry were significantly longer in the patients with CRF (chronic renal failure) compared to the control group. Measurement of DPOAE showed decrease of DPOAE level in patients suffering from CRF. A influence of single hemodialysis and treatment of hemodialysis by 6 months on ABR latencies and DPOAE values were not observed. PMID:12094644

  1. [Losartan for the correction of thrombocyte activity in patients suffering from arterial hypertension with metabolic syndrome].

    PubMed

    Simonenko, V B; medvedev, i N; Kumova, T A

    2008-01-01

    The aim of the study was to evaluate therapeutic effects of losartan on intravascular thrombocyte activity (ITA) in patients suffering from arterial hypertension with metabolic syndrome (MS). The subjects of the study were 35 patients administered losartan 50 mg a day for 4 months. The dynamics of the following parameters were evaluated: anthropometric parameters, blood lipids, lipid peroxidation in blood plasma and thrombocytes, the anti-oxidative protection of the liquid part of blood and platelets, and ITA. Student criterion was used for statistical analysis. In patients with AH and MS losartan had a positive effect on peroxidation syndrome and optimized ITA. To maintain the positive effects, prolonged administration of losartan is needed. In order to lower body mass in AH patients with MS losartan should be used in combination with non-drug means. PMID:18326282

  2. Transfusion of sickle cells may be a therapeutic option for patients suffering metastatic disease.

    PubMed

    Goldberg, Joel S

    2010-04-01

    Red blood cells from patients with sickle cell disease will sickle under conditions of hypoxemia and acidosis which is a similar milieu found in malignant tumors. While control of tumor angiogenesis has long been a goal of cancer therapy, selective occlusion of tumor blood supply may be achieved by transfusion of sickle cells into patients who suffer metastatic cancer. Although this potential therapy has not been previously reported in the medical literature, the concept may have been elusive to medical mainstream thinking because it requires transfusion of diseased cells. For this therapy to be effective, other environmental factors may need to be manipulated such inducing mild hypoxemia or hypercarbia (respiratory acidosis) to induce red cell sickling. Preliminary evidence supportive of this therapeutic approach to cancer treatment is provided by case evidence that sickle cell occlusion of a malignant brain tumor (glioma) produced tumor necrosis. Also sickle cells have been successfully transfused into primates. Furthermore, donor blood is crossmatched and transfused into patients suffering from sickle cell disease regularly in clinics and this procedure is associated with acceptable morbidity. Most importantly, animal models of sickle cell disease and cancer currently exist, and this theory could be tried with available technologies including ultrasound detection of vaso-occlusion. While the proposed therapy may not cure metastatic cancer, this treatment could prove useful for decreasing the size and perhaps the pain from metastatic tumor burden. Therefore, it is hypothesized that ABO Rh compatible crossmatched sickle cells transfused into patients who suffer metastatic cancer under controlled conditions of blood oxygenation and pH will selectively produce vaso-occlusive infarcts in malignant tumors and be a useful therapy. The author hopes for further investigations. PMID:20022432

  3. Noninvasive estimation of tissue edema in healthy volunteers and in patients suffering from heart failure

    NASA Astrophysics Data System (ADS)

    Gurfinkel, Yuri I.; Mikhailov, Valery M.; Kudutkina, Marina I.

    2004-06-01

    Capillaries play a critical role in cardiovascular function as the point of exchange of nutrients and waste products between tissues and circulation. A common problem for healthy volunteers examined during isolation, and for the patients suffering from heart failure is a quantitative estimation tissue oedema. Until now, objective assessment body fluids retention in tissues did not exist. Optical imaging of living capillaries is a challenging and medically important scientific problem. Goal of the investigation was to study dynamic of microcriculation parameters including tissue oedema in healthy volunteers during extended isolation and relative hypokinesia as a model of mission to the International Space Station. The other aim was to study dynamic of microcirculation parameters including tissue oedema in patients suffering from heart failure under treatment. Healthy volunteers and patients. We studied four healthy male subjects at the age of 41, 37, 40, and 48 before the experiment (June 1999), and during the 240-d isolation period starting from July3, 1999. Unique hermetic chambers with artidicial environmental parameters allowed performing this study with maximum similarity to real conditions in the International Space Station (ISS). With the regularity of 3 times a week at the same time, each subject recorded three video episodes with the total length of one-minute using the optical computerized capillaroscope for noninvasive measurement of the capillary diameters sizes, capillary blood velocity as well as the size of the perivascular zone. All this parameters of microcirculation determined during three weeks in 15 patients (10 male, 5 female, aged 62,2+/-8,8) suffering from heart failure under Furosemid 40 mg 2 times a week, as diuretic. Results. About 1500 episodes recorded on laser disks and analyzed during this experiment. Every subject had wave-like variations of capillary blood velocity within the minute, week, and month ranges. It was found that the

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

    PubMed Central

    2013-01-01

    Background Primary care physicians provide palliative home care. In cancer patients dying at home in the Netherlands (45% of all cancer patients) euthanasia in about one out of every seven patients indicates unbearable suffering. Symptom prevalence, relationship between intensity of symptoms and unbearable suffering, evolvement of symptoms and unbearability over time and quality of unbearable suffering were studied in end-of-life cancer patients in primary care. Methods 44 general practitioners during three years recruited cancer patients estimated to die within six months. Every two months patients quantified intensity as well as unbearability of 69 symptoms with the State-of-Suffering-V (SOS-V). Also overall unbearable suffering was quantified. The five-point rating scale ranged from 1 (not at all) to 5 (hardly can be worse). For symptoms assessed to be unbearable the nature of the suffering was additionally investigated with open-ended questions. The final interviews were analyzed; for longitudinal evolvement also the pre-final interviews were analyzed. Symptom intensity scores 4 and 5 were defined to indicate high intensity. Symptom unbearability scores 4 and 5 were defined to indicate unbearable suffering. Two raters categorized the qualitative descriptions of unbearable suffering. Results Out of 148 requested patients 51% participated; 64 patients were followed up until death. The SOS-V was administered at least once in 60 patients (on average 30 days before death) and at least twice in 33 patients. Weakness was the most frequent unbearable symptom (57%). Pain was unbearable in 25%. Pain, loss of control over one’s life and fear of future suffering frequently were unbearable (89-92%) when symptom intensity was high. Loss of control over one’s life, vomiting and not being able to do important things frequently were unbearable (52-80%) when symptom intensity was low. Unbearable weakness significantly increased between pre-final and final interview. Physical

  5. Multifractal properties of ECG patterns of patients suffering from congestive heart failure

    NASA Astrophysics Data System (ADS)

    Dutta, Srimonti

    2010-12-01

    The multifractal properties of two-channel ECG patterns of patients suffering from severe congestive heart failure (New York Heart Association (NYHA) classes III-IV) are studied and are compared with those for normal healthy people using the multifractal detrended fluctuation analysis methodology. Ivanov et al (1999 Nature 399 461) have studied the multifractality of human heart rate dynamics using the wavelet transformation modulus maxima (WTMM) methodology. But it has been observed by several scientists that multifractal detrended fluctuation analysis (MFDFA) works better than the WTMM method in the detection of monofractal and multifractal characteristics of the data. Galaska et al (2008 Ann. Noninvasive Electrocardiol. 13 155) have observed that MFDFA is more sensitive compared to the WTMM method in the differentiation between multifractal properties of the heart rate in healthy subjects and patients with left ventricular systolic dysfunction. In the present work the variation of two parameters of the multifractal spectrum—its width W (related to the degree of multifractality) and the value of the Hölder exponent α0—for the healthy and congestive heart failure patients is studied. α0 is a measure of the degree of correlation. The degree of multifractality varies appreciably (85-90% C.L.) for the normal and the CHF sets for channel I. For channel II no significant change in the values is observed. The degree of correlation is found to be comparatively high for the normal healthy people compared to those suffering from CHF.

  6. Pharmacokinetics of N-demethyldiazepam in patients suffering from insomnia and treated with nortriptyline.

    PubMed Central

    Tognoni, G; Gomeni, R; De Maio, D; Alberti, G G; Franciosi, P; Scieghi, G

    1975-01-01

    1 Hospitalized patients suffering from insomnia were treated with N-demethyldiazepam (30 mg p.o.) for 10 days, while continuing treatment with nortriptyline (75 or 100 mg daily). 2 Clinical evaluation performed by objective rating scales showed a positive therapeutic effect. No correlation was found however between drug plasma levels and clinical efficacy. A high inter-individual variability was observed. 3 In three cases the N-demethyldiazepam disappearance curve showed a biexponential decay, with a slow first component followed by a faster one. 4 Compared with diazepam the tested drug has a longer plasma apparent half-life and a lower relative clearance. PMID:791321

  7. The psychological impact of Buddhist counseling for patients suffering from symptoms of anxiety.

    PubMed

    Rungreangkulkij, Somporn; Wongtakee, Wiwat

    2008-06-01

    The purpose of this study was to examine the outcomes of individual Buddhist counseling interventions for patients suffering from symptoms of anxiety. A single-group pretest and posttest design was used to measure outcomes. Twenty-one patients participated in the study as voluntary subjects, all of whom completed two sessions of Buddhist counseling interventions. The individual Buddhist counseling program was developed by the investigators based on the Buddhist doctrine. The outcomes were evaluated with the use of the State-Trait Anxiety Inventory. Data were analyzed using the Friedman test, which provides an indicator for evidence-based outcomes related to anxiety reduction scores. The results revealed that the scores on the state anxiety test in relation to the trait anxiety test had been reduced at the 1-month follow-up. The findings from content analysis showed that when the patients practiced mindfulness, they were able to accept unpleasant situations calmly. Sixteen patients were prescribed lower doses of antianxiety medications. Furthermore, medication was discontinued for two patients, and three other patients continued their prescribed medication regimen completely. The study indicates that counseling as a basis from Buddhist principles has the potential to benefit patients with emotional anxiety-based problems. PMID:18505694

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

    PubMed Central

    Bagheri, Farshid; Ebrahimzadeh, Mohammad H.; Moradi, Ali; Bidgoli, Hamid Farahpour

    2016-01-01

    Background: Frozen shoulder is resulting in limb disability and reduction of quality of life but the factors associated with patients’ disability and quality of life is not clear. To assess pain, disability, the quality of life and factors associated with them in patients suffering from frozen shoulder. Methods: We enrolled 120 patients (37 men and 83 women) with phase-II idiopathic frozen shoulder in our cross-sectional study. Demographic data were collected and shoulder range of motion was measured in four different directions (elevation, abduction, external and internal rotation) in both upper limbs. Patients were asked to fill out Visual Analog Scale for pain (VAS) and, Short-Form Health Survey questionnaire (SF-36) as well as Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. We asked the patients to fill out the Hamilton anxiety and depression questionnaires. Results: The mean of VAS pain, DASH, PCS, and MCS scores were 69(18), 53(17), 35(8.0), and 42(10) respectively. All the domains of SF36 questionnaires where below the normal population except physical function. VAS pain score was correlated to Hamilton depression scores in both bivariate and mulivarilable analysis. DASH score were correlated to sex, age, ROM, and both Hamilton anxiety and depression scores; However, DASH score only impact with Hamilton anxiety and ROM independently. PCS is correlated to age and MCS to Hamilton depression. Conclusion: Patient with frozen shoulder are more suffering from pain and disability secondary to psychiatric parameters such as depression and anxiety than demographic features or even restriction of range of motion. PMID:27517070

  9. [Schizoaffective psychosis and the lithium therapy of patients suffering from schizoaffective schizophrenia].

    PubMed

    Baastrup, P C

    1975-01-01

    The historic aspects of the term "schizo-affective psychoses" is considered. On the basis of the results obtained in therapeutic and prophylactic use of lithium it is concluded that it is today hardly possible to create a homogenous nomenclature of mental diseases and that in the indication for the use of lithium in the treatment of schizo-affective psychoses have to be evaluated for each patient depending on the character of the affective components of the pathological picture. PMID:1179906

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

    PubMed

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

    2015-06-01

    Drug addiction is a serious health problem. The aim of this study was to gain an understanding of the core of love when caring for patients suffering from addiction. The study had a hermeneutical approach. Four nurses working at a detoxification unit were interviewed. Data were interpreted using a hermeneutical text interpretation based on Gadamer's hermeneutics. The results revealed the core of love in four dimensions: love as an inner driving force, searching for the human being behind the addiction, faith in the inner power of human beings and love as a movement of giving and receiving. The hermeneutical interpretation revealed the core of love as sacrifice, showing that sacrifice is an ethical dimension and that sacrifice involves searching for the patient's ontological suffering. Sacrifice is connected to faith, and faith in love is decisive for a life without drugs. Sacrifice involves being mutual gifts to one another, a self-reinforcing motion of sacrifice that energizes the nurses to go on with their work. PMID:25250789

  11. Characterization of patients who suffer asthma exacerbations using data extracted from electronic medical records.

    PubMed

    Himes, Blanca E; Kohane, Isaac S; Ramoni, Marco F; Weiss, Scott T

    2008-01-01

    The increasing availability of electronic medical records offers opportunities to better characterize patient populations and create predictive tools to individualize health care. We determined which asthma patients suffer exacerbations using data extracted from electronic medical records of the Partners Healthcare System using Natural Language Processing tools from the "Informatics for Integrating Biology to the Bedside" center (i2b2). Univariable and multivariable analysis of data for 11,356 patients (1,394 cases, 9,962 controls) found that race, BMI, smoking history, and age at initial observation are predictors of asthma exacerbations. The area under the receiver operating characteristic curve (AUROC) corresponding to prediction of exacerbations in an independent group of 1,436 asthma patients (106 cases, 1,330 controls) is 0.67. Our findings are consistent with previous characterizations of asthma patients in epidemiological studies, and demonstrate that data extracted by natural language processing from electronic medical records is suitable for the characterization of patient populations. PMID:18999057

  12. Predictive factors for recovery time in patients suffering from severe OHSS

    PubMed Central

    2014-01-01

    Background To evaluate predictive factors for recovery time from severe ovarian hyperstimulation syndrome (OHSS). Methods In a retrospective cohort study, 201 women who were hospitalized for severe OHSS were included. Patients with recurrent OHSS were excluded. All the patients received standardized treatment including intravenous hydration, plasma volume expansion, human albumin, furosemid, subcutaneous heparin, and paracentesis if necessary. The main outcome parameter was recovery time from OHSS. Recovery was defined if a morning hematocrit <40%, rebalance of electrolytes, and serum creatinine <1 mg/dL were reached during the standardized therapy and the patient had not suffered from abdominal pain and discomfort at least for one day without any OHSS-specific infusions or medications. Results Pregnant patients (n = 80, 39.8%) revealed a longer median duration until recovery than non-pregnant patients (n = 121, 60.2%; 10 days, IQR 7-13, vs. 8 days, IQR 6-10, respectively; p = 0.001). In a generalized linear model, presence of polycystic ovary syndrome before controlled ovarian hyperstimulation (beta = 0.3342 +/- 0.1335, p = 0.012) and use of hCG for ovulation induction (beta = 0.222 +/- 0.1389, p = 0.048) were associated with a longer recovery time in pregnant patients. In non-pregnant patients, none of the tested factors was associated with recovery time. Conclusions Pregnant patients with severe OHSS needed a significantly longer recovery time than non-pregnant patients. In pregnant patients, presence of polycystic ovary syndrome and ovulation induction with hCG were associated with longer recovery times. PMID:24996451

  13. [Correction of neurotrophic disorders in patients, suffering consequences of a spinal cord and peripheral nerves trauma].

    PubMed

    2014-08-01

    On clinical base of cathedra of the disasters medicine, military medicine, anesthesiology and reanimatology in 2010 - 2013 yrs 62 patients were treated for neurotrophic disorders, in 12 of them the method was applied, elaborated in the clinic. For neurotrophic ulcers in 5 patients autodermoplasty was performed, using splitted cutaneous flap, in 1 for the wound defect on a forearm--plasty, using rotational cutaneo-adipose flap, based on axial blood supply. In 44 patients after a spinal cord trauma a neurotrophic defects degree III - IV have formed. The kind of operative intervention was selected depending on size of the defect, the wound depth and functional peculiarities of the injured area. Introduction of a new method of treatment of neurotrophic ulcers of the lower extremities, using preparation of hyaluronic acid with sodium succinate, expands the perspectives of treatment in patients, suffering defects of cover tissues. Differentiated approach to choice of the wound closure method, caused by damage of central and peripheral neural system, have permitted to achieve positive results in 98.1% of patients. PMID:25507021

  14. [Correction of neurotrophic disorders in patients, suffering consequences of a spinal cord and peripheral nerves trauma].

    PubMed

    Ponomarenko, O V

    2014-08-01

    On clinical base of cathedra of the disasters medicine, military medicine, anesthesiology and reanimatology in 2010 - 2013 yrs 62 patients were treated for neurotrophic disorders, in 12 of them the method was applied, elaborated in the clinic. For neurotrophic ulcers in 5 patients autodermoplasty was performed, using splitted cutaneous flap, in 1 for the wound defect on a forearm--plasty, using rotational cutaneo-adipose flap, based on axial blood supply. In 44 patients after a spinal cord trauma a neurotrophic defects degree III - IV have formed. The kind of operative intervention was selected depending on size of the defect, the wound depth and functional peculiarities of the injured area. Introduction of a new method of treatment of neurotrophic ulcers of the lower extremities, using preparation of hyaluronic acid with sodium succinate, expands the perspectives of treatment in patients, suffering defects of cover tissues. Differentiated approach to choice of the wound closure method, caused by damage of central and peripheral neural system, have permitted to achieve positive results in 98.1% of patients. PMID:25417293

  15. Comparative Effectiveness of Blood Pressure-lowering Drugs in Patients who have Already Suffered From Stroke

    PubMed Central

    Wang, Wei-Ting; You, Li-Kai; Chiang, Chern-En; Sung, Shih-Hsien; Chuang, Shao-Yuan; Cheng, Hao-Min; Chen, Chen-Huan

    2016-01-01

    Abstract Hypertension is the most important risk factor for stroke and stroke recurrence. However, the preferred blood pressure (BP)-lowering drug class for patients who have suffered from a stroke has yet to be determined. To investigate the relative effects of BP-lowering therapies [angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blockers (ARB), β blockers, calcium channel blockers (CCBs), diuretics, and combinations of these drugs] in patients with a prior stroke history, we performed a systematic review and meta-analysis using both traditional frequentist and Bayesian random-effects models and meta-regression of randomized controlled trials (RCTs) on the outcomes of recurrent stroke, coronary heart disease (CHD), and any major adverse cardiac and cerebrovascular events (MACCE). Trials were identified from searches of published hypertension guidelines, electronic databases, and previous systematic reviews. Fifteen RCTs composed of 39,329 participants with previous stroke were identified. Compared with the placebo, only ACEI along with diuretics significantly reduced recurrent stroke events [odds ratio (OR) = 0.54, 95% credibility interval (95% CI) 0.33–0.90]. On the basis of the distribution of posterior probabilities, the treatment ranking consistently identified ACEI along with diuretics as the preferred BP-lowering strategy for the reduction of recurrent stroke and CHD (31% and 35%, respectively). For preventing MACCE, diuretics appeared to be the preferred agent for stroke survivors (34%). Moreover, the meta-regression analysis failed to demonstrate a statistical significance between BP reduction and all outcomes (P = 0.1618 for total stroke, 0.4933 for CHD, and 0.2411 for MACCE). Evidence from RCTs supports the use of diuretics-based treatment, especially when combined with ACEI, for the secondary prevention of recurrent stroke and any vascular events in patients who have suffered from stroke. PMID:27082571

  16. Frequency of methicillin-resistant Staphylococcus aureus nasal colonization among patients suffering from methicillin resistant Staphylococcus aureus bacteraemia

    PubMed Central

    Aslam, Nadia; Izhar, Mateen; Mehdi, Naima

    2013-01-01

    Objective: To determine rate of nasal colonization in Patients suffering from bacteraemia caused by methicillin resistant Staphylococcus aureus. Methods: This descriptive cross sectional study was carried out in a tertiary ca re, University Teaching Hospital (Shaikh Zayed Hospital, Lahore) from October 2010 to August 2011. Nasal swabs were taken from patients suffering from MRSA bacteraemia and were plated on mannitol salt agar plates to isolate Staphylococcus aureus (S. aureus) which were then tested for oxacillin susceptibility. Results: Nasal colonization was present in 52.5% of patients suffering from MRSA bacteraemia. Conclusion: Nasal colonization rates with MRSA were high among patients suffering from MRSA bacteraemia especially in those undergoing dialysis or surgical procedures. Therefore, screening and nasal decolonization should be practiced in hospitals. PMID:24550968

  17. Sex and Age Aspects in Patients Suffering From Out-Of-Hospital Cardiac Arrest

    PubMed Central

    Piegeler, Tobias; Thoeni, Nils; Kaserer, Alexander; Brueesch, Martin; Sulser, Simon; Mueller, Stefan M.; Seifert, Burkhardt; Spahn, Donat R.; Ruetzler, Kurt

    2016-01-01

    Abstract Cardiopulmonary resuscitation (CPR) is indicated in patients suffering from out-of-hospital cardiac arrest. Several studies suggest a sex- and age-based bias in the treatment of these patients. This particular bias may have a significant impact on the patient's outcome. However, the reasons for these findings are still unclear and discussed controversially. Therefore, the aim of this study was to retrospectively analyze treatment and out-of-hospital survival rates for potential sex- and age-based differences in patients requiring out-of-hospital CPR provided by an emergency physician in the city of Zurich, Switzerland. A total of 3961 consecutive patients (2003–2009) were included in this retrospective analysis to determine the frequency of out-of-hospital CPR and prehospital survival rate, and to identify potential sex- and age-based differences regarding survival and treatment of the patients. Seven hundred fifty-seven patients required CPR during the study period. Seventeen patients had to be excluded because of incomplete or inconclusive documentation, resulting in 743 patients (511 males, 229 females) undergoing further statistical analysis. Female patients were significantly older, compared with male patients (68 ± 18 [mean ± SD] vs 64 ± 18 years, P = .012). Men were resuscitated slightly more often than women (86.4% vs 82.1%). Overall out-of-hospital mortality rate was found to be 81.2% (492/632 patients) with no differences between sexes (82.1% for males vs 79% for females, odds ratio 1.039, 95% confidence interval 0.961–1.123). No sex differences were detected in out-of-hospital treatment, as assessed by the different medications administered, initial prehospital Glasgow Coma Scale, and prehospital suspected leading diagnosis. The data of our study demonstrate that there was no sex-based bias in treating patients requiring CPR in the prehospital setting in our physician-led emergency ambulance service. PMID:27149475

  18. The Practice of Continuous Palliative Sedation in Long-Term Care for Frail Patients with Existential Suffering.

    PubMed

    van Deijck, Rogier H P D; Hasselaar, Jeroen G J; Krijnsen, Petrus J Cc; Gloudemans, Amadea J M; Verhagen, Stans C A H H V M; Vissers, Kris C P; Koopmans, Raymond T C M

    2015-01-01

    Some guidelines and recommendations identify existential suffering as a potential refractory symptom for which continuous palliative sedation (CPS) can be administered under certain conditions. However, there has been little research on the characteristics of patients with existential suffering treated with CPS and the degree to which the preconditions are fulfilled. The aim of this study was to provide insight into this specific indication for CPS. Questionnaires were sent to nursing home physicians in The Netherlands, who described 314 patients. Existential suffering was a refractory symptom in 83 of the patients. For most of the patients with refractory existential suffering, other refractory symptoms were also reported, and life expectancy was seven days or less; informed consent for initiating CPS had been obtained in all cases. Consultation and intermittent sedation before the start of CPS were far less frequently reported than one would expect based on the guidelines. Multivariate analysis showed that being male, having previously requested euthanasia, having a nervous system disease, or having an other diagnosis were positively correlated with the administration of CPS for existential suffering. We conclude that more attention should be paid to the suggested preconditions and to the presence of existential suffering in male patients or patients with a nervous system disease. PMID:26514019

  19. Living in a misty marsh: A qualitative study on the experiences of self-care suffering of patients with thalassemia

    PubMed Central

    Pouraboli, Batool; Abedi, Heidar Ali; Abbaszadeh, Abbas; Kazemi, Majid

    2014-01-01

    Background: Thalassemia major is the most common hereditary anemia in Iran. Thalassemia major patients require lifelong care and suffer much pain during self-care. Knowledge of the nature, meaning, and impact of suffering from the perspective of patients is needed to determine which interventions are helpful. This study was designed to understand the experience of suffering in patients with thalassemia. Materials and Methods: This was a qualitative study conducted with content analysis method. In the present study, 21 patients with thalassemia were selected by purposive sampling. The research was performed at Kerman Samen Alhojaj Medical Center, Iran, in 2013. Data collection method was conducting unstructured interviews using open-ended questions and field notes. In addition, data were analyzed using qualitative content analysis and conventional approach. Results: Data analysis resulted in the emergence of the four central categories of physical exhaustion, mental and spiritual restlessness, society's behaviors and beliefs, and surviving a hard life, which were the suffering themes of the patients. Conclusions: Results showed that thalassemia in the physical, psychological, social, and spiritual aspects is very stressful for patients. Moreover, culture plays an important role in the patients’ experience of suffering. Results of this study can help nurses improve nursing care to alleviate suffering based on these experiences. PMID:25949257

  20. Interaction between Streptococcus pneumoniae and Staphylococcus aureus in paediatric patients suffering from an underlying chronic disease.

    PubMed

    Esposito, Susanna; Marseglia, Gian Luigi; Colombo, Carla; Iughetti, Lorenzo; Terranova, Leonardo; Ierardi, Valentina; Gambino, Monia; Principi, Nicola

    2015-12-01

    Little is known about the interaction between Streptococcus pneumoniae and Staphylococcus aureus in school-age children and adolescents suffering from an underlying chronic disease. To increase our knowledge in this regard, an oropharyngeal swab was obtained from school-age children and adolescents suffering from asthma (n = 423), cystic fibrosis (CF) (n = 212) and type 1 diabetes mellitus (DM1) (n = 296). S. pneumoniae detection and serotyping were performed using a real-time polymerase chain reaction, and S. aureus detection was performed using the RIDAGENE MRSA system. Among asthmatic, CF and DM1 patients, both pathogens were identified in 65/423 (15.4%), 21/212 (9.9%) and 62/296 (20.9%) children, respectively; S. pneumoniae alone was identified in 127/434 (30.0%), 21/212 (9.9%) and 86/296 (29.1%), respectively; S. aureus alone was identified in 58/434 (13.7%), 78/212 (36.8%) and 49/296 (16.6%), respectively. S. pneumoniae colonisation rates were higher in younger children and declined with age, whereas the frequency of S. aureus colonisation was quite similar in the different age groups. Among asthmatic and CF patients aged 6-9 years, S. aureus carriage was significantly higher in children who were positive for S. pneumoniae (P <0.05). No significant association emerged between S. aureus carriage and carriage of S. pneumoniae serotypes included in the pneumococcal conjugate vaccines (PCVs). This study shows for the first time that school-age children and adolescents with asthma, CF and DM1 are frequently colonised by S. pneumoniae and S. aureus and that no negative relationship seems to exist between these pathogens. Moreover, the supposed protection offered by PCV administration against S. aureus colonisation was not demonstrated. PMID:26395386

  1. Effects of cognitive function on gait and dual tasking abilities in patients with Parkinson's disease suffering from motor response fluctuations.

    PubMed

    Plotnik, Meir; Dagan, Yaacov; Gurevich, Tanya; Giladi, Nir; Hausdorff, Jeffrey M

    2011-01-01

    Recent studies have demonstrated that cognitive loading aggravates the gait impairments that are typically seen in Parkinson's disease (PD). To better understand the relationship between cognition and gait in PD, we evaluated 30 subjects with PD who suffer from motor response fluctuations. The subjects were clinically and cognitively assessed using standard clinical (e.g., Unified Parkinson's Disease Rating Scale) and cognitive tests while in the "ON" period of the medication cycle. In addition, the subjects wore force-sensitive insoles to quantify the timing of the gait cycles during 80-m walks at a self-selected, comfortable pace during three randomly presented gait conditions: (1) usual-walking, (2) dual tasking (DT), performing serial 3 subtractions (DT_S3), and (3) DT_S7. Stride length, gait speed, gait variability and bilateral coordination of gait were affected by DT, compared to the usual-walking (P < 0.001) as was gait asymmetry (P = 0.024). Stepwise regression analyses showed that a subset of the cognitive performance scores accounted for the changes seen in the gait parameters during DT, e.g., set shifting capabilities as expressed by the Trial Making Test Scores (P < 0.001). Affect (e.g., anxiety) was not associated with DT-related gait changes. For most gait features, DT had a large impact on the DT_S3 condition with only minimal additional effect in the DT_S7 condition. These results demonstrate that the complex cognitive-motor interplay in the control of gait in patients with PD who suffer from motor response fluctuations has a profound and marked effect during DT conditions on gait variability, asymmetry and bilateral coordination, even in the "ON" state when patients are likely to be most active, mobile and vulnerable to the negative effects of dual tasking. PMID:21063692

  2. Effects of Therapy in Patients Suffering from Chronic Back Pain Treated with Spinal Cord Stimulation.

    PubMed

    Mosiewicz, Anna; Rutkowska, Elżbieta; Matacz, Monika; Mosiewicz, Barbara; Kaczmarczyk, Robert; Trojanowski, Tomasz

    2015-10-01

    Pain in the lumbosacral part of the spine in the course of degenerative disease is the most common cause of physical activity limitation in adults. Treatment includes pharmacotherapy, physiotherapy, psychotherapy, health promotion, and sometimes surgery. Surgical treatment is not always successful, and the various clinical and psychosomatic symptoms that result from surgical treatment failure are known as failed back surgery syndrome. For some patients with this condition, spinal cord stimulation can provide relief. The aim of the work was to define subjective and objective spinal cord stimulation effects by assessing chosen disability and physical activity limitation ratios. Pain intensity, level of disability, and presence of neurological symptoms were assessed. The examination was performed twice: before the stimulator implantation and at least 6 months postimplantation. The study was conducted at the Department of Neurosurgery and Paediatric Neurosurgery in Lublin. Thirty-six patients suffering from failed back surgery syndrome were recruited for this study. The Visual Analog Scale, modified Laitinen's pain questionnaire, and Oswestry Disability Index were used in this work. The study showed that spinal cord stimulation was effective in treating spinal and lower limb pain in 64% of patients, similar to results obtained in other departments. Although back pain and neuropathic pain radiating to the lower limbs decreased, moderate physical activity impairment was still observed according to the Oswestry Disability Index scale. The decrease in neuropathic pain radiating to the lower limbs had the most significant influence on reducing physical activity impairment. PMID:26187548

  3. Antiandrogenic Therapy with Ciproterone Acetate in Female Patients Who Suffer from Both Androgenetic Alopecia and Acne Vulgaris

    PubMed Central

    CONEAC, ANDREI; MURESAN, ADRIANA; ORASAN, MEDA SANDRA

    2014-01-01

    Background. Androgenetic Alopecia in Women (AGA) occurs due to an underlying susceptibility of hair follicles to androgenic miniaturization, caused by androgens. Clinically, AGA is characterized by progressive hair loss, with a marked hair thinning in the fronto-parietal area so that the scalp can be easily seen. Acne vulgaris is androgen-dependent and often affects the skin that has an increased number of oil glands: face, back and chest. Although the sebaceous glands are present on the scalp too, it is very rare to get acne at this site, as the hair acts as a wig and allows the sebum to drain and does not block the pores. Both AGA and Acne Vulgaris are signs of hyperandrogenism. Cyproterone acetate/ethinyl estradiol (2mg/0.035mg) products are authorized for the treatment of androgenetic symptoms in women, such as acne, seborrhea, mild forms of hirsutism and androgenetic alopecia. Our study had a double purpose: - To evaluate the result of the study regimen Melleva 35 (one pill per day, for 3 consecutive months) in patients with moderate to severe acne, suffering also from Androgenetic Alopecia;- To establish the efficacy of the drug on acne and alopecia improvement, both from the doctor’s and patient’s point of view. Patients and methods. After being informed of the aims and procedures of the study, participants provided a written informed consent. A number of 35 female subjects with moderate to severe acne vulgaris remained in the study. The subjects had also been diagnosed as suffering from AGA, on the basis of clinical criteria, including the pattern of hair loss and trichoscopy assessment. Results 83% of study subjects reported that their hair did not continue to fall after 3 months of antiandrogen therapy. The females were evaluated using trichoscopy and the doctor noticed hair regrowth in 77% of the cases. Regarding the improvement of acne lesions after the treatment, 40% of study subjects recorded good improvement and 26% recorded excellent results

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

    PubMed Central

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

    2015-01-01

    Severe trauma is the most frequent cause of death in young people, in civilized countries with major social and vital costs. The speed of diagnostic decision making and the precocity of treatment approaches are both essential and depend on the specialists’ colaboration. The present study aims to emphasize the actual situation of medical interventions in case of cardiorespiratory arrest due to trauma. 1387 patients who suffered a cardio respiratory arrest both traumatic and non-traumatic were included in order to point out the place of traumatic arrest. Resuscitation of such patients is considered useless and resource consumer by many trauma practitioners who are reporting survival rates of 0%-3.5%. As the determinant of lesions, trauma etiology was as it follows car accidents – 43%, high falls – 30%, suicidal attempts – 3%, domestic violence – 3%, other causes – 21%. Hypovolemia remains the major cause of cardiac arrest and death and that is why the efforts of emergency providers (trauma team) must be oriented towards “hidden death” in order to avoid it. This condition could be revealed and solved easier with minimal diagnostic and therapeutic maneuvers in the emergency department. PMID:26366226

  5. [A patient with vertebral artery dissection who initially suffered from pharyngeal pain].

    PubMed

    Hamada, Omi; Ogata, Toshiyasu; Abe, Hiroshi; Okawa, Masakazu; Higashi, Toshio; Matsumoto, Juntaro; Takano, Koichi; Inoue, Tooru

    2013-12-01

    We have encountered a case of a patient with bilateral vertebral artery (VA) dissection who suffered from severe pharyngeal pain. A 61-year-old man, who initially visited a nearby hospital for investigation of mild headache, was pointed out to have a left VA aneurysm. The next morning, severe pharyngeal pain on the right side suddenly occurred. The cause was unknown even when consultation was made to an otolaryngology and oral and maxillofacial surgeon. Sore throat improved in two days. On the 12th day after pharyngeal pain, the patient entered our hospital with a diagnosis of VA dissection. Imaging studies indicated severe stenosis of the right VA and an aneurysm of the left VA which confirmed the diagnosis of bilateral VA dissection. After severe stenosis of the right VA improved a little, the trapping of the left VA aneurysm was performed with bypass surgery of the occipital artery to the posterior inferior cerebellar artery. Although there have been reports of glossopharyngeal neuralgia due to compression of dissective aneurysms of VA, no report exists in terms of a sore throat due to VA dissection without glossopharyngeal neuralgia. This symptom was considered to be involved in the referred pain. PMID:24317884

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

    PubMed Central

    Catthoor, Kirsten; Feenstra, Dine J; Hutsebaut, Joost; Schrijvers, Didier; Sabbe, Bernard

    2015-01-01

    Background The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs). Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ) and Perceived Devaluation–Discrimination Questionnaire (PDDQ). Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD is the strongest predictor of experiences of stigma. More severely personality disordered adolescents tend to experience the highest level of stigma. PMID:25999774

  7. Catheter-related urinary tract infection in patients suffering from spinal cord injuries.

    PubMed

    Dedeić-Ljubović, Amela; Hukić, Mirsada

    2009-02-01

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

  8. Classification tree for risk assessment in patients suffering from congestive heart failure via long-term heart rate variability.

    PubMed

    Melillo, Paolo; De Luca, Nicola; Bracale, Marcello; Pecchia, Leandro

    2013-05-01

    This study aims to develop an automatic classifier for risk assessment in patients suffering from congestive heart failure (CHF). The proposed classifier separates lower risk patients from higher risk ones, using standard long-term heart rate variability (HRV) measures. Patients are labeled as lower or higher risk according to the New York Heart Association classification (NYHA). A retrospective analysis on two public Holter databases was performed, analyzing the data of 12 patients suffering from mild CHF (NYHA I and II), labeled as lower risk, and 32 suffering from severe CHF (NYHA III and IV), labeled as higher risk. Only patients with a fraction of total heartbeats intervals (RR) classified as normal-to-normal (NN) intervals (NN/RR) higher than 80% were selected as eligible in order to have a satisfactory signal quality. Classification and regression tree (CART) was employed to develop the classifiers. A total of 30 higher risk and 11 lower risk patients were included in the analysis. The proposed classification trees achieved a sensitivity and a specificity rate of 93.3% and 63.6%, respectively, in identifying higher risk patients. Finally, the rules obtained by CART are comprehensible and consistent with the consensus showed by previous studies that depressed HRV is a useful tool for risk assessment in patients suffering from CHF. PMID:24592473

  9. Validation and relevance of Rheumatoid Arthritis Pain Scale (RAPS) in Indian (Asian) patients suffering from rheumatoid arthritis.

    PubMed

    Kianifard, Toktam; Kianyfard, Taghi; Chopra, Arvind

    2016-01-01

    Pain in RA is multifaceted and complex. Measuring instruments are inadequate. Rheumatoid Arthritis Pain Scale (RAPS) (Arthritis Care Res 45:317-323, 2001) was designed to measure pain comprehensively but has been sparsely reported. We decided to validate a suitable version for our community. Post translation (contextual), RAPS was administered (face to face interview) to 172 consenting patients of moderately severe RA (mean pain visual analogue scale (VAS) 5.4 cm) in a cross-sectional study using standard rheumatology case record form. RAPS contained 24 questions (numeric score, anchored at 0 (never) and 6 (always); range 0-144). Fifty-seven cohort patients on supervised rheumatology care were followed for 16 weeks. SPSS (v16) was used for statistical analysis, significant p < 0.05. RAPS showed good face and content validity (consensus). Construct/criterion validity was demonstrated for subclass domains and total RAPS (Cronbach's alpha 0.91, test-retest interclass correlation (Pearson) 0.71). Fair to modest correlation (p < 0.05) was seen with swollen joint count (0.16), Indian health assessment questionnaire (0.23), medical outcome short form (SF), 36 physical score (-0.35), SF 36 mental score (-0.21) and C-reactive protein (0.25), not with pain VAS. Similar results were shown for subclass domains (physiologic, affective, sensory, cognitive), except low alpha for affective. Age, disease duration and SF 36 were significant predictors (linear regression). In factor analysis, RAPS loaded with SF 36. The standardized response mean (0.6) was equal to pain VAS and DAS 28. RAPS was found to be a valid and clinically relevant instrument for measuring pain in Indian patients suffering from RA. It merits more widespread clinical use. PMID:26361944

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

    PubMed

    Shirotani, Toshiki; Takahara, Takashi; Arimoto, Hirohiko; Inohara, Masashi; Ono, Kenichiro; Shimizu, Akira

    2002-07-01

    An early diagnosis of the outcome of patients with cerebrovascular disease is important for selecting the optimal treatment strategy. The purpose of this study was to estimate the prognosis of Wallerian degeneration on MRI in stroke patients with hemiparesis. The subjects consisted of 87 stroke patients, 50 hemorrhagic patients and 37 ischemic patients, who were evaluated by MRI at 1 to 6,275 days after stroke onset. Among the 36 patients who were evaluated by consecutive MRI, 161 films were obtained and analyzed. Wallerian degeneration was diagnosed when a small prolonged T 2 lesion was seen in the corticospinal tract of the brainstem on at least two contiguous slices. The atrophic rate of the midbrain was calculated as: (the area of the unaffected side of the midbrain--the area of the affected side of the midbrain)/2 x (the area of the unaffected side of the midbrain). The patients' ability to perform the activities of daily living was scored by the Barthel index (BI). Wallerian degeneration in the ipsilateral brainstem was seen for two to three months in 32 cases (37%) and in 58 films (36%) and disappeared about 3 years after the onset of stroke. Wallerian degeneration correlated with the BI scores from 2 to 6 months after stroke (p < 0.05), although no relationship was observed at 7 months or later. From 2 to 6 months after stroke, the shrinkage of the midbrain on MRI correlated with the BI scores (p < 0.001), although no relationship was observed at 7 months or later. It was therefore both Wallerian degeneration and a shrunken midbrain observed on MRIs, evaluated from 2 to 6 months after stroke were thus suggested to indicate a poor outcome in such patients. PMID:12187715

  11. Substrate deprivation therapy: a new hope for patients suffering from neuronopathic forms of inherited lysosomal storage diseases.

    PubMed

    Jakóbkiewicz-Banecka, Joanna; Wegrzyn, Alicja; Wegrzyn, Grzegorz

    2007-01-01

    Lysosomal storage diseases are a group of disorders caused by defects in enzymes responsible for degradation of particular compounds in lysosomes. In most cases, these diseases are fatal, and until recently no treatment was available. Introduction of enzyme replacement therapy was a breakthrough in the treatment of some of the diseases. However, while this therapy is effective in reduction of many somatic symptoms, its efficacy in the treatment of the central nervous system is negligible, if any, mainly because of problems with crossing the blood-brain-barrier by intravenously administered enzyme molecules. On the other hand, there are many lysosomal storage diseases in which the central nervous system is affected. Results of very recent studies indicate that in at least some cases, another type of therapy, called substrate deprivation therapy (or substrate reduction therapy) may be effective in the treatment of neuronopathic forms of lysosomal storage diseases. This therapy, based on inhibition of synthesis of the compounds that cannot be degraded in cells of the patients, has been shown to be effective in several animal models of various diseases, and recent reports demonstrate its efficacy in the treatment of patients suffering from Niemann-Pick C disease and Sanfilippo disease. PMID:17998597

  12. Efficacy of Bacillus clausii strain UBBC-07 in the treatment of patients suffering from acute diarrhoea.

    PubMed

    Sudha, M Ratna; Bhonagiri, S; Kumar, M Asin

    2013-06-01

    This study was conducted to evaluate the anti-diarrhoeal activity of Bacillus clausii strain UBBC 07 in patients suffering from acute diarrhoea. A total of 27 patients (average age of 35.44±8.08 years) with acute diarrhoea were included in a prospective, Phase II clinical study after informed consent and ethical committee approval. The criteria included for all subjects were ≥3 loose stool motions within 24 hours and for more than 7 days. All patients were assigned to receive one capsule of B. clausii strain UBBC-07 (containing 2×109 cfu) two times a day for a period of 10 days. Efficacy assessment of duration of diarrhoea, frequency of defecation, abdominal pain and stool consistency were tested on days 1, 3, 6 and 10. Safety was evaluated by assessing the incidence and type of adverse effects such as increase in blood pressure and pulse rate, physical examination and clinical laboratory tests, i.e. complete blood count, serum glutamic pyruvic transaminase, serum creatinine, and stool examination and microscopy, on day 1 and day 10. The results of this study clearly showed that the mean duration of diarrhoea decreased from 34.81±4.69 to 9.26±3.05 (P<0.0001) min per day, the frequency of defecation also decreased from 6.96±1.05 to 1.78±0.50 (P<0.0001) times per day, abdominal pain decreased from 3.22±0.93 (severe) to 0.74±0.71 (absent) (P<0.0001), and stool consistency improved from 3.93±0.38 (watery) to 1.22±0.42 (soft) (P<0.0001). No significant change in safety parameters were observed during treatment. This study shows that the B. clausii strain UBBC-07 can potentially be effective in alleviating the symptoms of diarrhoea without causing any adverse effects. PMID:23443952

  13. Motor loop dysfunction causes impaired cognitive sequencing in patients suffering from Parkinson's disease.

    PubMed

    Schönberger, Anna R; Hagelweide, Klara; Pelzer, Esther A; Fink, Gereon R; Schubotz, Ricarda I

    2015-10-01

    Cognitive impairment in Parkinson's disease (PD) is often attributed to dopamine deficiency in the prefrontal-basal ganglia-thalamo-cortical loops. Although recent studies point to a close interplay between motor and cognitive abilities in PD, the so-called "motor loop" connecting supplementary motor area (SMA) and putamen has been considered solely with regard to the patients' motor impairment. Our study challenges this view by testing patients with the serial prediction task (SPT), a cognitive task that requires participants to predict stimulus sequences and particularly engages premotor sites of the motor loop. We hypothesised that affection of the motor loop causes impaired SPT performance, especially when the internal sequence representation is challenged by suspension of external stimuli. As shown for motor tasks, we further expected this impairment to be compensated by hyperactivity of the lateral premotor cortex (PM). We tested 16 male PD patients ON and OFF dopaminergic medication and 16 male age-matched healthy controls in an functional Magnetic Resonance Imaging study. All subjects performed two versions of the SPT: one with on-going sequences (SPT0), and one with sequences containing non-informative wildcards (SPT+) increasing the demands on mnemonic sequence representation. Patients ON (compared to controls) revealed an impaired performance coming along with hypoactivity of SMA and putamen. Patients OFF compared to ON medication, while showing poorer performance, exhibited a significantly increased PM activity for SPT+ vs. SPT0. Furthermore, patients' performance positively co-varied with PM activity, corroborating a compensatory account. Our data reveal a contribution of the motor loop to cognitive impairment in PD, and suggest a close interplay of SMA and PM beyond motor control. PMID:26382750

  14. Curative gastric resection for the elderly patients suffering from gastric cancer

    PubMed Central

    AL MANSOUR, M.; IZZO, L.; MAZZONE, G.; GABRIELE, R.; DI CELLO, P.; BASSO, L.; RANIERI, E.; COSTI, U.; JOVANOVIC, T.; IZZO, P.

    2016-01-01

    The improvement of the socio-economic conditions and the progress of medicine have extended the life span of the world’s population and as a result, the number of patients with malignant neoplasms has increased. Gastric cancer is the third most common cancer (after lung and prostate) and the second leading cause of death caused by cancer (after lung bronchogenic cell carcinoma) in males; while it’s the fifth cancer by frequency and the fourth cause of cancer death in females. It presents a peculiar geographical distribution with a lower incidence in Western Europe and North America, and higher incidence in the Far East, South America and Eastern Europe. Its incidence in Italy is 122 cases per 100000 inhabitants in males and 83 cases per 100000 inhabitants in females (in Italy). It occurs more frequently in old age, is quite rare in individuals under the age of 45. The aim of this work is to analyze the clinical and pathological characteristics of gastric carcinoma and the feasibility of curative surgery in patients over 75, identifying the factors affecting mortality, morbidity, survival and quality of life after surgery. These data have been compared with those of younger patients to assess the correct type of surgery. PMID:27142820

  15. Curative gastric resection for the elderly patients suffering from gastric cancer.

    PubMed

    Al Mansour, M; Mazzone, G; Gabriele, R; Di Cello, P; Basso, L; Ranieri, E; Costi, U; Jovanovic, T; Izzo, P

    2016-01-01

    The improvement of the socio-economic conditions and the progress of medicine have extended the life span of the world's population and as a result, the number of patients with malignant neoplasms has increased. Gastric cancer is the third most common cancer (after lung and prostate) and the second leading cause of death caused by cancer (after lung bronchogenic cell carcinoma) in males; while it's the fifth cancer by frequency and the fourth cause of cancer death in females. It presents a peculiar geographical distribution with a lower incidence in Western Europe and North America, and higher incidence in the Far East, South America and Eastern Europe. Its incidence in Italy is 122 cases per 100000 inhabitants in males and 83 cases per 100000 inhabitants in females (in Italy). It occurs more frequently in old age, is quite rare in individuals under the age of 45. The aim of this work is to analyze the clinical and pathological characteristics of gastric carcinoma and the feasibility of curative surgery in patients over 75, identifying the factors affecting mortality, morbidity, survival and quality of life after surgery. These data have been compared with those of younger patients to assess the correct type of surgery. PMID:27142820

  16. Eleven Interpretations of Personal Suffering.

    ERIC Educational Resources Information Center

    Foley, Daniel P.

    This document defines suffering as the affective aspect of the pain experience while the cognitive aspect of the pain experience is the sensation of pain. It considers personal suffering, which mean's one's own suffering, and not the suffering of other people. It notes that a particular interpretation of suffering may be formulated in any number…

  17. Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva.

    PubMed Central

    Lommatzsch, P. K.; Lommatzsch, R. E.; Kirsch, I.; Fuhrmann, P.

    1990-01-01

    Eighty-one cases of conjunctival melanoma treated between 1960 and 1988 were studied to determine factors that might affect outcome in patients with such lesions. The therapeutic procedures performed were local excision (16), local excision followed by brachytherapy with Sr-90/Y-90 (32), local excision followed by cryotherapy with liquid nitrogen (16), brachytherapy with Sr-90/Y-90 (12), local excision followed by external beam irradiation (3), and local excision followed by brachytherapy and cryotherapy (2). The median follow-up period was 5.5 years (longest 26, shortest 1 year). Sixty two patients (76.5%) showed a complete regression of the melanoma, 19 (23.5%) developed recurrences, and 15 (18.5%) died from metastases. The melanomas had developed with almost equal frequency from a pre-existing naevus (25.9%), from primary acquired melanosis (25.9%), and 'de novo' (30.9%). Small tumours had a higher chance of regressing (80.6%) than larger ones (68.6%). The cumulative survival rate was 76% after five years and 60% after 10 years from any causes of death and 87.6% after five years and 76.3% after 10 years from deaths caused by metastases. Most deaths from metastases occurred within 5 years. At 88.5%, the cumulative survival rate of patients with small tumours (less than one quadrant of the bulbar conjunctiva and less than 2 mm thickness) was significantly higher than that of patients with larger tumours (more than one quadrant of the bulbar conjunctiva and/or more than 2 mm thickness) with 65% after eight years. Local excision followed by beta ray irradiation (Sr-90/Y-90) or cryotherapy can be recommended as the treatment of choice. Nevertheless the behaviour of conjunctival melanomas remains unpredictable in individual cases. Images PMID:2285686

  18. Saliva DHEAS Changes in Patients Suffering from Psychopathological Disorders Arising from Bullying at Work

    ERIC Educational Resources Information Center

    Lac, Gerard; Dutheil, Frederic; Brousse, Georges; Triboulet-Kelly, Celine; Chamoux, Alain

    2012-01-01

    Background: Psychological disorders arising from bullying at work (BW) are common. The relationship between these disorders and putative markers is not well established. Aims: To measure saliva dehydroepiandrosterone sulphate (DHEAS) and saliva cortisol as putative markers in individuals suffering from BW. Methods: Forty one subjects suffering…

  19. Perceived Treatment Effectiveness of Family Therapy for Chinese Patients Suffering from Anorexia Nervosa: A Qualitative Inquiry

    ERIC Educational Resources Information Center

    Ma, Joyce L. C.; Lai, Kelly

    2006-01-01

    Although family therapy has become highly acceptable in the West, its applicability and acceptability for Chinese adolescents and young women with anorexia nervosa (AN) remains unknown. In this article, we report the results of a qualitative study using post-treatment in-depth interviews to understand the subjective perceptions of sufferers of AN…

  20. [The multi-factorial model of satisfaction of medical care by hospital patients suffering from borderline psychic disorders].

    PubMed

    Tsigankov, B D; Maligin, Ya V

    2015-01-01

    The satisfaction of patients with medical care determines their consumer behavior. The factors of satisfaction with medical care vary depending on level of its provision and profile of medical specialty. At that, there are only sporadic studies dedicated to factors of satisfaction with psychiatric care. The study was carried out to examine factors of satisfaction with hospital psychiatric care by patients suffering from depressive and neurotic disorders. The sampling consisted of 356 hospital patients suffering from depressive and neurotic disorders. The survey in written form was carried out using originally developed questionnaire. The statistical analysis was implemented by compiling equation of multiple regression. It is established that key factors of satisfaction include functioning of medical nurses of department, functioning of attending physician, comfort of wards, proportions and quality of psychiatric care capability of physician to empathic listening. The developed mathematical model explains 81% of variation of satisfaction with treatment. PMID:26012273

  1. Der p 11 is a major allergen for house dust mite-allergic patients suffering from atopic dermatitis.

    PubMed

    Banerjee, Srinita; Resch, Yvonne; Chen, Kuan-Wei; Swoboda, Ines; Focke-Tejkl, Margit; Blatt, Katharina; Novak, Natalija; Wickman, Magnus; van Hage, Marianne; Ferrara, Rosetta; Mari, Adriano; Purohit, Ashok; Pauli, Gabrielle; Sibanda, Elopy N; Ndlovu, Portia; Thomas, Wayne R; Krzyzanek, Vladislav; Tacke, Sebastian; Malkus, Ursula; Valent, Peter; Valenta, Rudolf; Vrtala, Susanne

    2015-01-01

    House dust mites (HDMs) belong to the most potent indoor allergen sources worldwide and are associated with allergic manifestations in the respiratory tract and the skin. Here we studied the importance of the high-molecular-weight group 11 allergen from Dermatophagoides pteronyssinus (Der p 11) in HDM allergy. Sequence analysis showed that Der p 11 has high homology to paramyosins from mites, ticks, and other invertebrates. A synthetic gene coding for Der p 11 was expressed in Escherichia coli and rDer p 11 purified to homogeneity as folded, alpha-helical protein as determined by circular dichroism spectroscopy. Using antibodies raised against rDer p 11 and immunogold electron microscopy, the allergen was localized in the muscle beneath the skin of mite bodies but not in feces. IgE reactivity of rDer p 11 was tested with sera from HDM-allergic patients from Europe and Africa in radioallergosorbent test-based dot-blot assays. Interestingly, we found that Der p 11 is a major allergen for patients suffering from atopic dermatitis (AD), whereas it is only a minor allergen for patients suffering from respiratory forms of HDM allergy. Thus, rDer p 11 might be a useful serological marker allergen for the identification of a subgroup of HDM-allergic patients suffering from HDM-associated AD. PMID:24999597

  2. Der p 11 Is a Major Allergen for House Dust Mite-Allergic Patients Suffering from Atopic Dermatitis

    PubMed Central

    Banerjee, Srinita; Resch, Yvonne; Chen, Kuan-Wei; Swoboda, Ines; Focke-Tejkl, Margit; Blatt, Katharina; Novak, Natalija; Wickman, Magnus; van Hage, Marianne; Ferrara, Rosetta; Mari, Adriano; Purohit, Ashok; Pauli, Gabrielle; Sibanda, Elopy N.; Ndlovu, Portia; Thomas, Wayne R.; Krzyzanek, Vladislav; Tacke, Sebastian; Malkus, Ursula; Valent, Peter; Valenta, Rudolf; Vrtala, Susanne

    2015-01-01

    House dust mites (HDMs) belong to the most potent indoor allergen sources worldwide and are associated with allergic manifestations in the respiratory tract and the skin. Here we studied the importance of the high-molecular-weight group 11 allergen from Dermatophagoides pteronyssinus (Der p 11) in HDM allergy. Sequence analysis showed that Der p 11 has high homology to paramyosins from mites, ticks, and other invertebrates. A synthetic gene coding for Der p 11 was expressed in Escherichia coli and rDer p 11 purified to homogeneity as folded, alpha-helical protein as determined by circular dichroism spectroscopy. Using antibodies raised against rDer p 11 and immunogold electron microscopy, the allergen was localized in the muscle beneath the skin of mite bodies but not in feces. IgE reactivity of rDer p 11 was tested with sera from HDM-allergic patients from Europe and Africa in radioallergosorbent test–based dot-blot assays. Interestingly, we found that Der p 11 is a major allergen for patients suffering from atopic dermatitis (AD), whereas it is only a minor allergen for patients suffering from respiratory forms of HDM allergy. Thus, rDer p 11 might be a useful serological marker allergen for the identification of a subgroup of HDM-allergic patients suffering from HDM-associated AD. PMID:24999597

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

    PubMed

    Kustryo, V I; Langazo, O V

    2015-11-01

    Colostomy was done in 49 patients, suffering an acute obturative impassability of large bowel (AOILB). In 28 patients (1st group) colostomy was conducted in accordance to standard method; in 21 (2nd group)--in accordance to the method, proposed by us. Application of the method proposed for surgical treatment of AOILB have guaranteed a reduction of postoperative paracolostomal complications rate in 6.8 times, of postoperative lethality--in 2.2 times, duration of the patient stationary treatment--in 1.4 times, the rate of dressings and the dressing material expanses--in 10 times. PMID:26939423

  4. Timing of surgery for feminizing genitoplasty in patients suffering from congenital adrenal hyperplasia.

    PubMed

    Eckoldt-Wolke, Felicitas

    2014-01-01

    This chapter refers only to female patients with congenital adrenal hyperplasia (CAH). CAH represents the largest subgroup of individuals with 46,XX disorders of sex development. The stimulation of the androgen production leads to a prenatal virilization among these girls. The phenotype is influenced by the severity of the enzyme defect, leading to a virilization of the external genitalia in varying degrees. On the other hand, the affected girls are clearly anatomically female with regularly developed female internal genitalia. Female puberty and potential female fertility are therefore to be expected. The operation to feminize the genitalia includes the separation of the sinus urogenitalis, the creation of a functionally wide enough vagina, the remodeling of the labioscrotal folds to create larger labia, and, if necessary, a reduction clitoroplasty. Considering the lack of scientific evidence, it is not possible to make definitive statements regarding the timing of surgery for girls with CAH. There are no studies that prove whether one- or two-stage surgery provides more or clearer advantages. PMID:25247657

  5. Clinical Determinants of Left Ventricular Ejection Fraction Deterioration in Patients Suffered From Complete Left Bundle Branch Block

    PubMed Central

    Hashemi Jazi, Mohammad; Nilforoush, Peyman; Gharipour, Mojgan; Batvandi, Azadeh; Mohammadi, Robabeh; Najafi, Roya

    2015-01-01

    Background: Recently, the deleterious effects of left bundle branch block (LBBB) on left ventricular systolic function have been taken into consideration. Objectives: The present study aimed to identify underlying factors that predict left ventricular ejection fraction (LVEF) deterioration in patients suffered from complete LBBB. Patients and Methods: In a retrospective case-control study, the data of 220 consecutive patients diagnosed with LBBB on their electrocardiograms were assessed. They were referred to Isfahan Heart Center in Isfahan Province, Iran in 2013. LVEF deterioration was defined as a decrease in LVEF at least 10% between the baseline and follow-up echocardiography study. Thus, achieving the LVEF values ≤ 40% in patients with an initial EF of > 50% was considered LVEF deterioration. Results: Among 220 patients, 40% of LBBB patients suffered LVEF deterioration within 3 months of initial assessment. The group with LVEF deterioration had higher male to female ratio, had higher NYHA score, and suffered more from systolic hypertension than another group. Those with coronary artery disease (CAD) had also significantly lower LVEF than non-CAD ones. Adverse associations were revealed between systolic blood pressure and LVEF measurement (r = -0.193, P = 0.006) as well as between NYHA score and LVEF (r = -0.215, P = 0.002). A multivariable logistic regression model showed that among baseline variables, male gender (OR = 3.218, P < 0.001), history of systolic hypertension (OR = 2.012, P = 0.029), higher NYHA score (OR = 1.623, P = 0.005), and the presence of coronary artery disease (OR = 2.475, P = 0.028) could effectively predict LVEF deterioration in patients with LBBB. Conclusions: Male gender, history of hypertension, high NYHA score, and the presence of CAD predict LVEF deterioration in patients with LBBB. PMID:25838930

  6. Adipokine profile in celiac patients: differences in comparison with patients suffering from diarrhea-predominant IBS and healthy subjects.

    PubMed

    Russo, Francesco; Chimienti, Guglielmina; Clemente, Caterina; D'Attoma, Benedetta; Linsalata, Michele; Orlando, Antonella; De Carne, Massimo; Cariola, Filomena; Semeraro, Francesco P; Pepe, Gabriella; Riezzo, Giuseppe

    2013-12-01

    OBJECTIVE. The role of adipokines such as resistin, leptin, and adiponectin could be pivotal in the molecular crosstalk between the inflamed intestine and the surrounding mesenteric adipose tissue. Our aims were to a) evaluate their circulating concentrations in patients with active celiac disease (ACD) and compare them to those in patients with diarrhea-predominant irritable bowel syndrome (IBS-d) and healthy subjects; b) establish the impact of genetic variability in resistin; and c) evaluate whether a 1-year gluten-free diet (GFD) modifies circulating concentrations of resistin, leptin, and adiponectin in celiac patients. MATERIAL AND METHODS. The study included 34 ACD patients, 29 IBS-d patients, and 27 healthy controls. Circulating concentrations of resistin, leptin, adiponectin, IL-6, and IL-8 were evaluated at the time of enrollment. Resistin +299 G/A polymorphism was also analysed. In CD patients, biochemical measurements were repeated after a 1-year GFD. RESULTS. Along with higher IL-6 and IL-8 plasma levels, higher resistin and adiponectin concentrations were found in ACD and IBS-d patients compared with controls (p: 0.0351 and p: 0.0020, respectively). Resistin values proved to be predictable from a linear combination of IL-8 and +299 polymorphism. GFD affected resistin (p: 0.0009), but not leptin and adiponectin concentrations. CONCLUSIONS. Our data suggest that these adipokines are involved in modulating inflammatory processes in both CD and IBS-d patients. Alterations in the adipokine profile as well as the higher prevalence of the resistin +299 G/A SNP A allele compared to controls support the hypothesis that, at least in well-defined cases of IBS, a genetic component may also be supposed. PMID:24164320

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

    PubMed Central

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

    2015-01-01

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

  8. Haemobilia causing cholangitis in a patient on dual anti-platelet treatment suffering from acute acalculous cholecystitis

    PubMed Central

    Luhmann, Andreas; Buter, Anton; Abela, Jo-Etienne

    2013-01-01

    INTRODUCTION Haemobilia is a rare cause of upper gastro-intestinal haemorrhage which can be difficult to diagnose. PRESENTATION OF CASE We present the case of a patient who suffered from acute acalculous cholecystitis while on dual anti-platelet therapy with aspirin and clopidogrel. We describe the diagnostic and treatment challenges arising from the patient's complicated past history and the steps leading to the diagnosis of haemobilia causing biliary obstruction and cholangitis. Our patient did not, at any point, manifest anaemia or evidence of haemorrhage. DISCUSSION Haemobilia has a varied aetiology. To our knowledge there is no association with dual anti-platelet treatment in the literature to date. Diagnosis is difficult and relies on multiple modalities. In our patient the final diagnosis was only made in the course of open bile duct exploration. CONCLUSION In acute biliary obstruction we recommend the consideration of haemobilia in the differential diagnosis, especially in patients with a bleeding tendency. PMID:23466686

  9. Echocardiography based cardiac evaluation in the patients suffering from chronic obstructive pulmonary disease.

    PubMed

    Shrestha, B; Dhungel, S; Chokhani, R

    2009-03-01

    Chronic obstructive pulmonary disease (COPD) is the most common medical problem in Nepal. Echocardiography based cardiac evaluation in COPD is rare in Nepal. The purpose of this study is to evaluate the echocardiography based cardiac function in consecutively admitted COPD patients (507) in medical wards of Nepal Medical College Teaching Hospital during 13th April 2007 to 12th April 2008. Male female ratio was 0.9:1. Age (mean +/- SD) was 66.1 +/- 10.9 yr. Brahman and Chhetri ethnic group comprised of more than half of total COPD patients followed by similar number of patients in Newar (22.1%) and Mongolian ethnic groups (21.5%). More than half of the COPD patients were in age group 60-75 years, followed by less number of patients (approximately 20.0%) in both 45-59 years and 75-89 years age groups. Of the total patients (507), 141 patients underwent echocardiographic evaluation. Among them significant number of patients had poor LVEF (29, 20.6%) with statistically significant difference in LVEF (36.0 +/- 10.5 vs. 64.3 +/- 8.5%, p value < 0.01). More than half of the total patients showed features of chronic cor pulmonale (56.3%), followed by valvular heart disease (49.3%), diastolic dysfunction (38.7%) and left ventricular hypertrophy (14.1%). Mild pulmonary artery hypertension (PAH) was detected in approximately half of patients (49.1%), followed by moderate PAH in 17.6% patients. Transthoracic echocardiography was found to be very useful to identify various concomitant cardiac abnormalities demanding special treatment consideration in managing clinically COPD like patients. PMID:19769230

  10. Comprehensive mutation screening for 10 genes in Chinese patients suffering very early onset inflammatory bowel disease

    PubMed Central

    Xiao, Yuan; Wang, Xin-Qiong; Yu, Yi; Guo, Yan; Xu, Xu; Gong, Ling; Zhou, Tong; Li, Xiao-Qin; Xu, Chun-Di

    2016-01-01

    AIM: To perform sequencing analysis in patients with very early-onset inflammatory bowel disease (VEO-IBD) to determine the genetic basis for VEO-IBD in Chinese pediatric patients. METHODS: A total of 13 Chinese pediatric patients with VEO-IBD were diagnosed from May 2012 and August 2014. The relevant clinical characteristics of these patients were analyzed. Then DNA in the peripheral blood from patients was extracted. Next generation sequencing (NGS) based on an Illumina-Miseq platform was used to analyze the exons in the coding regions of 10 candidate genes: IL-10, IL-10RA, IL-10RB, NOD2, FUT2, IL23R, GPR35, GPR65, TNFSF15, and ADAM30. The Sanger sequencing was used to verify the variations detected in NGS. RESULTS: Out of the 13 pediatric patients, ten were diagnosed with Crohn’s disease, and three diagnosed with ulcerative colitis. Mutations in IL-10RA and IL-10RB were detected in five patients. There were four patients who had single nucleotide polymorphisms associated with IBD. Two patients had IL-10RA and FUT2 polymorphisms, and two patients had IL-10RB and FUT2 polymorphisms. Gene variations were not found in the rest four patients. Children with mutations had lower percentile body weight (1.0% vs 27.5%, P = 0.002) and hemoglobin (87.4 g/L vs 108.5 g/L, P = 0.040) when compared with children without mutations. Although the age of onset was earlier, height was shorter, and the response to treatment was poorer in the mutation group, there was no significant difference in these factors between groups. CONCLUSION: IL-10RA and IL-10RB mutations are common in Chinese children with VEO-IBD. Patients with mutations have an earlier disease onset, lower body weight and hemoglobin, and poorer prognosis. PMID:27350736

  11. [Psychophysiological mechanisms involved in the affective regulation and food restriction of women at risk of suffering from bulimia nervosa].

    PubMed

    Rodríguez, Sonia; Mata, José Luis; Moreno, Silvia; Fernández, Maria Carmen; Vila, Jaime

    2007-02-01

    The aim of the study was to explore the effect of visualizing food images under different mood states and food restriction conditions on the emotional modulation of two defense reflexes (startle reflex and cardiac defense). 72 women at risk of suffering from bulimia nervosa were assigned to two groups: 1) a group under induced positive, neutral, or negative mood state and, 2) a 6-hour-food-deprived group or a non-deprived group. Second-by-second heart rate and electromyogram activity from the orbiculari oculi region were recorded after the auditory stimulus. The results showed that, while viewing food images, non-deprived women under negative mood state potentiated the cardiac defense response and the startle motor reflex. Results are discussed in the context of emotional eating theories and Peter Lang's motivational priming model. PMID:17295980

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

    PubMed Central

    Huis in ’t Veld, Rianne M.H.A.; Schönauer, Christian; Kaufmann, Hannes; Hermens, Hermie J.; Vollenbroek-Hutten, Miriam M.R.

    2013-01-01

    Abstract Introduction Over recent years, the popularity of videogames has gone beyond youth and gamers and is slowly entering the field of professional healthcare. Exergames are an attractive alternative to physical therapy. The primary aim of this pilot study was to explore the user experience (usability, satisfaction, level of motivation, and game experience) of the patient with the “PlayMancer” exergame. The secondary aim was to explore the progression of the performed motor skills (walking velocity, overhead reach ability, and cervical range of motion) and the clinical changes (to physical condition, disability, and pain intensity) in a group of patients with chronic musculoskeletal pain using an exergame for 4 weeks. Materials and Methods In the European PlayMancer project, an exergame for physical rehabilitation of chronic pain patients was developed. This exergame is controlled by relevant motions of the patient's body captured by a motion suit and several infrared cameras. In three different integrated minigames, the patient can train the following motor skills: Walking velocity, overhead reaching, and neck mobility. Results Ten patients participated in this study and completed the 4 weeks of gaming. Patients rated the usability of the exergames as good (score of 78.5 [standard deviation 9.7; range, 60.0–97.5]) on the System Usability Scale, and the game motivated all patients to perform their exercises. Patients enjoyed playing and were pleased with both the game environment and the game play. Overall, the patients made a progression in the examined motor skills during the minigames over the 4 weeks of gaming. Conclusions The “PlayMancer” exergame is a potential tool for achieving physical rehabilitation because it motivates patients to perform their exercises and as a result increases their motor skills and physical condition. PMID:24761327

  13. Unrecognized suffering in the ICU: Addressing dyspnea in mechanically ventilated patients

    PubMed Central

    Schmidt, Matthieu; Banzett, Robert B.; Raux, Mathieu; Morélot-Panzini, Capucine; Dangers, Laurence; Similowski, Thomas; Demoule, Alexandre

    2014-01-01

    Background Intensive care unit (ICU) patients are exposed to many sources of discomfort. Although growing attention has been given to the detection and treatment of pain, very little has been given to the detection and treatment of dyspnea (defined as ‘breathing discomfort’). Discussion In this article, we review the published information on prevalence, mechanisms and potential negative impacts of dyspnea in mechanically ventilated patients. In addition, we review the most appropriate tools to detect and quantify dyspnea in ICU patients. Conclusions Growing evidence suggests that dyspnea is a frequent issue in mechanically ventilated ICU patients, is highly associated with anxiety and pain, and is improved in many patients by altering ventilator settings. Future studies are needed to better delineate the impact of dyspnea in the ICU, and to define diagnostic, monitoring and therapeutic protocols. PMID:24132382

  14. Evaluation of the efficacy and safety of sobrerol granules in patients suffering from chronic rhinosinusitis.

    PubMed

    Bellussi, L; Manini, G; Buccella, M G; Cacchi, R

    1990-01-01

    In a double-blind, randomized, placebo-controlled clinical trial, the safety and efficacy of 900 mg/day sobrerol granules given for up to 10 days was assessed in 40 patients with chronic catarrhal rhinosinusitis. At the beginning of treatment a total of six patients had a fever, whereas body temperature was normal in all patients at the end of the treatment. Treatment with sobrerol significantly (P less than 0.01) reduced frontal headache and rhinorrhoea, efficacy being confirmed by rhinomanometry. Patients treated with placebo experienced an improvement in frontal headache, rhinorrhoea,and overall rhinomanometry scores. Treatment with sobrerol was well tolerated but two patients treated with placebo reported adverse reactions (stomach pain and cutaneous rash). These preliminary data suggest that sobrerol could be useful if administered with an anti-inflammatory drug for the treatment of chronic catarrhal rhinosinusitis. PMID:2292326

  15. Tapentadol prolonged release for patients with multiple myeloma suffering from moderate-to-severe cancer pain due to bone disease

    PubMed Central

    Coluzzi, Flaminia; Raffa, Robert B; Pergolizzi, Joseph; Rocco, Alessandra; Locarini, Pamela; Cenfra, Natalia; Cimino, Giuseppe; Mattia, Consalvo

    2015-01-01

    Context Myeloma bone disease (MBD) is a devastating complication of multiple myeloma that leads to severe pain. Objectives The aim of this study was to evaluate the efficacy and tolerability of tapentadol prolonged release (PR) in the management of patients with MBD suffering from moderate-to-severe cancer pain. Methods A 12-week prospective study was carried out in 25 opioid-naïve MBD patients. Patients initially received twice-daily doses of tapentadol PR 50 mg. Doses were then managed to maintain adequate relief or dose-limiting toxicity. The following parameters were recorded at weekly intervals for 4 weeks, and then at weeks 8 and 12: pain, opioid-related adverse effects, use of other analgesics, DN4 (Douleur Neuropathique 4) score. Quality of life (SF-36 [36-item short-form health survey]) was measured at baseline and at final evaluation. Results Of 25 patients, 22 completed the study. Pain intensity significantly decreased from baseline to all the week intervals (P<0.01). Quality of life significantly improved with respect to all SF-36 subscale parameters (P<0.01), and so did both the physical and mental status (P<0.01). Tapentadol PR significantly reduced DN4 mean value (P<0.01) and the number of patients with neuropathic component (DN4 ≥4) (P<0.01). After 8 weeks of treatment, all patients were negative for the DN4 score. Tapentadol PR was well tolerated, and the use of other analgesics was reduced during the study period. Conclusion Tapentadol PR started in doses of 100 mg/day was effective and well tolerated in opioid-naïve MBD patients with moderate-to-severe pain. Tapentadol PR can be considered a first-choice opioid in cancer patients suffering from mixed pain with a neuropathic component. PMID:26064064

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

    PubMed Central

    Ahmadian, Alireza; Mirzaee, Jafar; Omidbeygi, Maryam; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Background War, as a stressor event, has a variety of acute and chronic negative consequences, such as posttraumatic stress disorder (PTSD). In this context, early maladaptive schema-based problems in PTSD have recently become an important research area. The aim of this study was to assess early maladaptive schemas in patients with acute and chronic PTSD. Method Using available sampling methods and diagnostic criteria, 30 patients with chronic PTSD, 30 patients with acute PTSD, and 30 normal military personnel who were matched in terms of age and wartime experience were selected and assessed with the Young Schema Questionnaire-Long Form, Beck Depression Inventory second version (BDI-II), the Beck Anxiety Inventory (BAI), and the Impact of Events Scale (IES). Results Both acute and chronic PTSD patients, when compared with normal military personnel, had higher scores for all early maladaptive schemas. Additionally, veterans suffering from chronic PTSD, as compared with veterans suffering from acute PTSD and veterans without PTSD, reported more impaired schemas related, for instance, to Self-Control, Social Isolation, and Vulnerability to Harm and Illness. Discussion The results of the present study have significant preventative, diagnostic, clinical, research, and educational implications with respect to PTSD. PMID:26203249

  17. Bilateral Femoral Neck Fractures in A Young Patient Suffering from Hypophosphatasia, Due to A First Time Epileptic Seizure

    PubMed Central

    Sharma, N; Bache, E; Clare, T

    2015-01-01

    Introduction: We report a case of an adolescent sustaining bilateral femoral neck fractures due to a first time epileptic seizure, as a result of expansion of his known syrinx. Case Report: A 19-year-old patient suffering from hypophosphatasia (HPP), Arnold-Chiari malformation, and a ventriculoperitoneal shunt sustained a trivial fall with profound pain and an inability to mobilize. Radiographs demonstrated a right-sided Garden-4 femoral neck and left-sided multi-fragmentary intracapsular/extracapsular fractures. The patient had previously suffered bilateral proximal femoral shaft fractures, treated with intramedullary unlocked nail fixation that was still in situ. Operative treatment with an exchange to Synthes Adolescent Lateral Recon nail was performed on the right with two Recon screws inserted into the femoral head. On the left, the existing Pedinail was preserved with an additional single screw inserted into the femoral head. In addition, 3 months of non-mobilization was required for adequate bone healing. After 1-year from time of injury, there is no avascular necrosis on radiographs and the patient is mobilizing pain-free. Conclusion: Patients with hypophosphatasia have delayed bone healing. We recommend surgical fixation with an intramedullary device and periods of non-mobilization until there is radiographical evidence of adequate bone healing. PMID:27299074

  18. [A case of severe hyponatremia in a patient suffering from epilepsy and using oxcarbazepine].

    PubMed

    Gumbrevicius, Gintautas; Sveikata, Audrius

    2006-01-01

    A 70-year-old patient treated with oxcarbazepine experienced severe hyponatremia. The patient used oxcarbazepine (600 mg twice a day) concomitantly with diuretics (torasemide 10 mg and indapamide 1.25 mg once per day), perindopril, an angiotensin-converting enzyme inhibitor, and amlodipine, a Ca(2+) channel blocker. The patient complained of a nausea, malaise, diplopia, drowsiness, apathy, decreased diuresis (creatinine clearance - 41.51 ml/min), and exacerbation of epileptic seizures. Sodium concentration in the plasma was 113 mmol/l. The patient was hospitalized. It was suggested that a decrease in plasma sodium concentration was caused by oxcarbazepine used together with diuretics for six months. Oxcarbazepine-induced hyponatremia is reported in 22.2-50% of patients, although symptoms are present only in 5.9% of patients. The most common symptoms of central nervous system injury, experienced by patients, are drowsiness, dizziness, decreased cognitive function, coordination impairment, etc. Physicians not always in time pay proper attention to undesirable antiepileptic drug-induced effects, which can be dangerous. PMID:16963831

  19. Treatments’ Outcomes of Patients Suffered from Trigeminal Neuralgia in Kerman, Iran

    PubMed Central

    Faryabi, Javad; Joolhar, Maryam

    2014-01-01

    Statement of the Problem: Trigeminal neuralgia (TN) presents with a shooting pain in maxillofacial region which compels the involved patients to visit many medical and dental physicians to relieve the pain. Hence, assessing the outcomes of different treatment modalities may help the patients and their clinicians choose a suitable practical method of treatment. Purpose: The study was aimed to evaluate the outcomes of different treatments of TN and to determine which surgical or non-surgical treatment is better for controlling the pain. Materials and Method: This study included 42 patients with trigeminal neuralgia. A questionnaire was completed for each patient in order to evaluate the pain control status of patients’ treatment with non-surgical (pharmaceutical) and surgical modalities. The questionnaire consisted of questions on an datasheet , concerning the duration of involvement with the condition, type and dose of the medication(s) used, the surgical technique administrated, patient satisfaction with the treatment modality and the intensity and frequency of the pain if present. The purpose of the study and the necessary information regarding the questions of the data sheet was given in detail to the patients for a careful completion of the questionnaires. Data was analyzed by adopting t-test using SPSS software. Results: The results showed that the patients treated with pharmaceutical modalities had relatively lower improvement rate than those treated with surgery combined with medication (p< 0.035). Carbamazepine was the most consumed medication for pain control and the microvascular decompression was the most performed surgical method in patients. Conclusion: Although medication therapy alone was less effective than surgery combined with medication, both treatment modalities were significantly effective in controlling the pain of patients. PMID:25191664

  20. [Impact of abdominoplasty on quality of life in patients, suffering anterior abdominal wall deformity and obesity].

    PubMed

    Dronov, O I; Koval's'ka, I O; Roshchyna, L O; Fedoruk, V I; Burov, E Iu; Fedoruk, P V

    2011-12-01

    The modern tendencies of surgery development include not only the operative procedures improvement but guaranteeing also a maximally high level achievement in the patients quality of life in the early, as well as during remote, postoperative period. The quality of life analysis was done in 132 patients, operated on for the anterior abdominal wall defects, obesity and other surgical diseases, using special questionnaire SF-36. The patients have aged 23-65 years old, in all of them the excessive body mass or obesity of abdominal type was noted. PMID:22432186

  1. Clinical analysis of patients suffering from chronic hepatitis B superinfected with other hepadnaviruses.

    PubMed

    Fu, Jia; Guo, Dan; Gao, Dandan; Huang, Wenxiang; Li, Ziqiong; Jia, Bei

    2016-06-01

    To compare the clinical manifestations, laboratory examinations, and prognoses of patients with chronic hepatitis B (CHB) who were superinfected with hepatitis A virus (HAV), hepatitis C virus (HCV), hepatitis D virus (HDV), or hepatitis E virus (HEV). Two hundred and eleven patients with confirmed CHB in our hospital, a tertiary teaching hospital in China, between 2005 and 2014 were analyzed retrospectively. Among 211 patients with CHB, 35 were superinfected with HAV, 31 were superinfected with HCV, 22 were superinfected with HDV, and 53 were superinfected with HEV. We analyzed and compared the clinical features of the five groups. The tested biochemical indices and markers of liver function included serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), prothrombin activity (PTA), serum albumin (Alb), and the serum levels of HBV DNA. The peak values of ALT, AST, and TBil were significantly higher in all of the superinfected groups. Lower peak Alb concentration and PTA were also observed in the superinfected patients, with the exception of patients in the CHB + HAV group. The CHB + HCV, and CHB + HEV groups had higher death rates than the CHB monoinfected group, and the difference was statistically significant. Further analysis of the liver failure groups showed that the level of HBV DNA was not correlated with prognosis. The comparison of clinical outcomes revealed that CHB patients superinfected with HCV, HDV, and HEV compared with CHB monoinfection had statistically greater incidences of exacerbation of the condition and poor prognosis, whereas the patients superinfected with HAV generally had better outcomes. J. Med. Virol. 88:1003-1009, 2016. © 2015 Wiley Periodicals, Inc. PMID:26509653

  2. Low-grade risk of hypercoagulable state in patients suffering from diabetes mellitus type 2*

    PubMed Central

    Ruszkowska-Ciastek, Barbara; Sokup, Alina; Wernik, Tomasz; Rhone, Piotr; Góralczyk, Krzysztof; Bielawski, Kornel; Fijałkowska, Agata; Nowakowska, Aleksandra; Rhone, Elżbieta; Rość, Danuta

    2015-01-01

    Objective: Diabetes, including type 1 and type 2, is associated with the hypercoagulable state. The aim of this study is to evaluate the concentration of selected hemostatic parameters and vascular endothelial growth factor-A (VEGF-A) in diabetic subjects. Methods: The study was conducted in 62 patients with diabetes. Group I consisted of 27 patients having uncontrolled diabetes with microalbuminuria and Group II included 35 well-controlled diabetic patients. The control group was made up of 25 healthy volunteers. In the citrate plasma, the concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, and D-dimer were assayed. Serum concentrations of VEGF-A, lipid profile, creatinine, and plasma fasting glucose were measured and in the versene plasma the concentration of HbA1c was determined. Results: In the patients with uncontrolled diabetes, higher concentrations of TF, TFPI, and VEGF-A were observed, as compared with the well-controlled diabetics group and the control group. A significantly lower activity of antiplasmin was reported in patients from Group I as compared with the control group. In Group I, using the multivariate regression analysis, the glomerular filtration rate was independently associated with VEGF-A and dependently associated with total cholesterol. Conclusions: The study showed higher concentrations of TF and TFPI in the patients with uncontrolled diabetes with microalbuminuria, which is associated with rapid neutralization of the thrombin formation, since TFPI inhibits the complex of TF/VIIa/Ca2+. The manifestation of the above suggestions is the correct TAT complexes and D-dimer, which indicates a low grade of prothrombotic risk in this group of patients, but a higher risk of vascular complications. PMID:26365121

  3. Patients suffering from nonspecific work-related upper extremity disorders exhibit insufficient movement strategies.

    PubMed

    Bloemsaat, Jules G; Ruijgrok, Joop M; Van Galen, Gerard P

    2004-01-01

    The purpose of this research was to investigate whether patients experiencing nonspecific complaints of the forearm caused by sustained use of the personal computer exhibit deviant movement strategies as compared to healthy participants. Patients (N=10) and controls (N=24) performed a graphical aiming task combined with an auditory memory task. Force production (pen pressure), kinematic- and performance variables were recorded. During a trial, the control group gradually increased pen pressure from the stationary phases to the dynamic phase. The patients increased their pen pressure much more abruptly and to such a degree that the final pressure during real-time movement far exceeded that of the controls. Memory load led to a greater increase of pen pressure from the stationary phase to the dynamic phase in the patient group. Patients further displayed longer reaction times. The results are discussed within the framework of our recent theory on the role of neuromotor noise in the regulation of task performance under conditions of stress. PMID:14734239

  4. [Complete dental care of patients suffering from localized aggressive periodontitis. Case report].

    PubMed

    Nagy, Zsolt; Nemes, Júlia; Nyárasdy, Ida

    2015-12-01

    A 34 years old male patient was referred to our clinic for restorative dental treatment. During detailed consultation and dental examination a relatively rare form of periodontal disease had been diagnosed. Intraoral examination included recording of dental and periodontal status. Based on patient's dental history, measurements of probing pocket depths (PPD), clinical attachment level (CAL), and also the X-ray findings, Localized Aggressive Periodontitis (LAP) unknown by the patient was diagnosed. After patient's consent the comprehensive treatment plan covered the dental prevention, periodontal non-surgical and surgical therapy and rehabilitation. The treatment started with oral hygienic instruction, motivation then supra- and subgingival scaling and rootplaning. Later extraction and elective root canal treatment were performed, followed by open flap periodontal surgery combined with hemisection of two molars. After a full mouth conservative restorative therapy, function and esthetics were restored by fix dental prostheses. This case is a good example to underline the importance of periodontal examination during the dental screening and dental status recording for each patients showing up at dental clinics. Otherwise in many cases this asympthomatic disease can remain undetected. PMID:26863818

  5. A model for the determination of pollen count using google search queries for patients suffering from allergic rhinitis.

    PubMed

    König, Volker; Mösges, Ralph

    2014-01-01

    Background. The transregional increase in pollen-associated allergies and their diversity have been scientifically proven. However, patchy pollen count measurement in many regions is a worldwide problem with few exceptions. Methods. This paper used data gathered from pollen count stations in Germany, Google queries using relevant allergological/biological keywords, and patient data from three German study centres collected in a prospective, double-blind, randomised, placebo-controlled, multicentre immunotherapy study to analyse a possible correlation between these data pools. Results. Overall, correlations between the patient-based, combined symptom medication score and Google data were stronger than those with the regionally measured pollen count data. The correlation of the Google data was especially strong in the groups of severe allergy sufferers. The results of the three-centre analyses show moderate to strong correlations with the Google keywords (up to >0.8 cross-correlation coefficient, P < 0.001) in 10 out of 11 groups (three averaged patient cohorts and eight subgroups of severe allergy sufferers: high IgE class, high combined symptom medication score, and asthma). Conclusion. For countries with a good Internet infrastructure but no dense network of pollen traps, this could represent an alternative for determining pollen levels and, forecasting the pollen count for the next day. PMID:25045360

  6. Laser biostimulation of patients suffering from multiple sclerosis in respect to the biological influence of laser light

    NASA Astrophysics Data System (ADS)

    Peszynski-Drews, Cezary; Klimek, Andrzej; Sopinski, Marek; Obrzejta, Dominik

    2003-10-01

    The authors discuss the results, obtained so far during three years' clinical examination, of laser therapy in the treatment of patients suffering from multiple sclerosis. They regard both the results of former laboratory experiments and so far discovered mechanisms of biological influence of laser light as an objective explanation of high effectiveness of laser therapy in the csae of this so far incurable disease. They discuss wide range of biological mechanisms of laser therapy, examined so far on different levels (cell, tissue, organ), allowing the explanation of beneficial influence of laser light in pathogenetically different morbidities.

  7. Comparative Pharmacokinetics of Levofloxacin in Healthy Volunteers and in Patients Suffering from Typhoid Fever

    PubMed Central

    Usman, Muhammad; Ashraf, Muhammad; Khokhar, Muhammad Imran; Ashiq, Bilal; Masood, Muhammad Irfan; Afzal, Shehryar; Omer, Ovais; Ali, Mohsin; Qadir, M. Imran

    2013-01-01

    The aim of this study was to characterize the effect of typhoid fever on pharmacokinetic parameters of levofloxacin (LF) and compare the pharmacokinetic parameters of the said antibiotic in healthy human volunteers and patients with typhoid fever. Total of 12 subjects were divided into two groups “A” (healthy volunteers) and “B” (typhoid patients). Single oral dose of LF 500 mg was given and 5 mL of blood was collected from each subject at 0, 0.25, 0.5, 1, 2, 3, 6, 12, 24, 36 and 72 h. Plasma concentrations of LF were measured by HPLC. Pharmacokinetic parameters were calculated from plasma concentration-time data by using MW/PHARM pharmacological analysis. In healthy volunteers, the average pharmacokinetic parameters were as Cmax (6.79 μg/mL), Tmax (1.84 h), T½ (10.03 h), Ka (2.23 h-1), AUC (110.09 μgh/mL), Vd (85.84 L), Cl (4.57 L/h) and in typhoid patients were Cmax (6.90 μg/mL), Tmax (1.82 h), T½ (9.42 h), Ka (2.21 h-1), AUC (105.55 μgh/mL), Vd (64.31 L), Cl (4.75 L/h). The difference between pharmacokinetic parameters of LF in healthy human volunteers and typhoid patients was calculated by using unpaired t-test. As the p-value in case of all pharmacokinetic parameters was more than 0.05, the difference between pharmacokinetic parameters in both healthy human volunteers and typhoid patients was insignificant. It is concluded that there is no need to adjust the dose of LF in typhoid patients. PMID:24250583

  8. Efficacy and tolerability of Entacapone versus Cabergoline in parkinsonian patients suffering from wearing-off.

    PubMed

    Deuschl, Günther; Vaitkus, Antanas; Fox, Gabriele-Cornelia; Roscher, Torsten; Schremmer, Dieter; Gordin, Ariel

    2007-08-15

    In this 12-wk, multi-center, randomized, open-label, rater-blinded study, efficacy and tolerability of Entacapone (ENT) or Cabergoline (CBG) in conjunction with levodopa were compared in 161 older Parkinson's disease patients with wearing-off. Patients received either ENT, 3 to 5 times daily, or CBG, titrated according to requirements to a maximum of 6 mg/d. A significant decrease of nearly 2 hours in the daily OFF-time (primary efficacy variable) was recorded in both treatment groups. The non-inferiority test failed despite a trend in favor of ENT. Reduction in OFF-time occurred faster in the ENT compared to the CBG treated patients. A decrease of approximately 20% was detected in parts II and III of the UPDRS, with no differences between the groups. Forty-three percent of the patients in the ENT group reported dyskinesias at baseline, and 35% at the final visit. The corresponding figures in the CBG group were 46% and 43%. Quality of life, measured by PDQ-39, increased substantially with both ENT and CBG. The mean daily dosage at the final visit was 698 mg for ENT (plus 447 mg levodopa) and 3.45 mg for CBG (plus 475 mg levodopa). Adverse events (AE), leading to discontinuation, were reported in 8.5% of the ENT and 13.9% of the CBG treated patients. Nausea was the most common AE in each group, corresponding figures being 7.3% with ENT and 25.3% with CBG (P=0.0024). A probable or possible causal relationship with ENT was reported in 41% and with CBG in 64% of the AE. Among these, only one serious AE (dehydration) was recorded with each treatment group. ENT and CBG reduced the patient's motor complications effectively and to a similar degree. The clinical benefit was more quickly apparent with ENT, which also showed a more favorable AE profile than CBG. PMID:17516484

  9. Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure.

    PubMed

    Yang, Xing; Huang, Rui; Wang, Yan-fang; Liang, Xiao-yan

    2016-02-01

    Long-term gonadotropin-releasing hormone agonist (GnRHa) administration before in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term GnRHa treatment might also be beneficial for the idiopathic repeated implantation failure (RIF) patients. In the 21 patients receiving GnRHa and hormone replacement therapy (G-HRT) protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone (previous protocols). Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior GnRHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients. PMID:26838753

  10. Effective implantation of autologous chondrocytes in a patient suffering from a painful and invalidating rizoarthrosis: a case report

    PubMed Central

    Sgherzi, Stefano; Sillani, Alessandro; Magris, Cecilia

    2009-01-01

    A 45-year-old patient, caucasian, affected by severe, painful and invalidating rizoarthrosis has been treated by implanting autologous chondrocytes, normally used for degenerative joint diseases of the knee and ankle. PMID:19918494

  11. Effective implantation of autologous chondrocytes in a patient suffering from a painful and invalidating rizoarthrosis: a case report.

    PubMed

    Carelli, Francesco; Sgherzi, Stefano; Sillani, Alessandro; Magris, Cecilia

    2009-01-01

    A 45-year-old patient, caucasian, affected by severe, painful and invalidating rizoarthrosis has been treated by implanting autologous chondrocytes, normally used for degenerative joint diseases of the knee and ankle. PMID:19918494

  12. Introduction of Auricular Acupuncture in Elderly Patients Suffering from Major Depression: Protocol of a Mixed Methods Feasibility Study

    PubMed Central

    Geib, Janina; Rieger, Monika A.; Eschweiler, Gerhard W.; Dresler, Thomas; Metzger, Florian G.

    2015-01-01

    Background. Due to an increasing number of elderly people suffering from major depression and potential side effects of the prescribed drugs, the introduction of new therapeutic approaches is needed. Currently, in Germany, auricular acupuncture is no part of clinical care for gerontopsychiatric patients. Based on promising clinical experiences and existing evidence for treating addiction and trauma, a benefit of auricular acupuncture integrated in existing treatment programs in elderly patients may be hypothesized. Within this project auricular acupuncture according to the National Acupuncture Detoxification Association (NADA) will be integrated in the multimodal treatment regime for elderly patients with major depression in a daytime ward setting. Methods/Design. To evaluate the feasibility and acceptance a mixed method approach is used. In a day clinic, a sample of 20 psychogeriatric patients with the diagnosis of major depression will be enrolled. The patients will receive a total of nine auricular acupuncture treatments according to the standardized NADA protocol in a group setting. The therapeutic process, its organization, the experience, and the willingness of patients to participate will be evaluated by interviews with patients and the therapeutic team. Data will be analyzed qualitatively using content analysis. Additionally, quantitative outcome parameters will be measured by standardized questionnaires. PMID:25954756

  13. [The look into the look: how patients' suffering is perceived by health workers].

    PubMed

    Bazzana, Emanuela; Spada, Simonetta; Braibanti, Paride; Lembo, Antonino

    2011-01-01

    The literature about the surgical treatment of the urologic patient shows an increased attention to the outcome measures related to the quality of life and satisfaction of the treated subject. In this context, a crucial position must be attributed to the quality of the relationships among all the subjects involved in the therapeutic process, and especially among caregivers and patients. Cognitive and emotional dimensions play an important role at this regard, to which a spread sensitivity as for the "local culture" of care must correspond. The aim of this study is to identify the health workers' perception and representation of the cognitive and emotional needs of the patients and their relationship with the organizational complexity of the department. The study was implemented in the Urology Department of the Ospedali Riuniti in Bergamo. It involved eleven health workers (two medical doctors and nine nurses). Each of them underwent a semi-structured interview. The anonymous interview transcripts were analyzed using the T-Lab thematic content analysis program. The study highlighted sensitive areas such as: informative dialogue with the patient, reactivity facing the intervention according to gender, the subject's self-adapting process to the clinical environment and the organizational functioning of the department. The health workers' need of new approaches to meet the needs of the subjects under treatment and their family is underlined. Furthermore, the requirement of consistent functional organizational changes to improve the quality of relationships in the process of care is pointed out. The health workers reported both critical situations, efforts, perceived difficulties and important relational resources to face them. PMID:21452162

  14. Short-term effects of relaxation music on patients suffering from primary open-angle glaucoma

    PubMed Central

    Bertelmann, Thomas; Strempel, Ilse

    2015-01-01

    Purpose To evaluate whether additive relaxation music (RM) has an adjuvant short-term effect on physiological and psychological parameters in patients with primary open-angle glaucoma. Methods Prospective, randomized clinical trial. Patients in the therapy group (TG) received a 30-minute RM via headphones, whereas members of the control group (CG) did not. Best corrected visual acuity, intraocular pressure, visual field testing, short- and long-term mental states, and blood levels of different stress hormones were analyzed and compared. Results A total of 25 (61%)/16 (39%) patients were assigned to the TG/CG. Best corrected visual acuity, daily intraocular pressure, and short-term mental state (KAB) development were significantly better in the TG in comparison to controls. Visual field testing, long-term mental well-being (profile of mood states), and adrenalin, cortisol, and endothelin-I blood levels did not differ significantly between both groups. Conclusion Additive RM applied on a daily basis can positively impact various physiological and psychological parameters in the short term. PMID:26543350

  15. Rheological properties of erythrocytes in patients suffering from erysipelas. Examination with LORCA device.

    PubMed

    Biesiada, Grazyna; Krzemień, Joanna; Czepiel, Jacek; Teległów, Aneta; Dabrowski, Zbigniew; Spodaryk, Krzysztof; Mach, Tomasz

    2006-01-01

    The rheological properties of erythrocytes: elongation and the aggregation, as well as basic peripheral blood parameters: RBC number, hematocrit, MCV, MCH, MCHC reticulocytes, fibrinogen level, ESR, and glucose level were studied in a group of erysipelas patients. The concentration of malonyl dialdehyde (MDA) in erythrocytes was also measured, as an indicator of oxidative stress exerted. The study involved 18 erysipelas patients and 18 healthy subjects. The rheological properties and the aggregation of erythrocytes were studied with the use of a LORCA instrument (Laser-assisted Optical Rotational Cell Analyser). Differences were found in elongation index (EI) between the blood control (C) and patients (P), with an increase of this value only at 0.58 Pa shear stress and at 1.13 Pa shear stress. Upstroke were used as the indexes of RBC deformability, and the following aggregation parameters: intensity of light scattering in the prior disaggregation (Isc dis) - C - 43.0 au (arbitrary units), P - 44.8 au, time when cells are round and not aggregated (Isc top) - C - 51.6 au, P - 49.3 au, the amplitude of aggregation, the difference between Isc max and Isc min (AMP) - C - 39.9 au, P - 28.7 au, aggregation index (AI) - C - 64.6%, P - 70.0%, time for reach one half of the maximum aggregation (t(1/2)) - C - 2.0 s, P - 1.5 s, threshold shear stress, the lowest force that breaks the aggregation formed (Y(thr)) in P exceed 170% control group were measured. A decrease in the elasticity of erythrocytes in erysipelas patients was associated with the simultaneous increase of MDA - C - 0.08 nM/mgHb, P - 0.11 nM/mgHb content in the membranes of red blood cells. Basic peripheral blood parameters studied in patients with erysipelas did not differ significantly from the control group except for WBC, fibrinogen (C - 3.8 g/l, P - 7.8 g/l), and ESR (C - 6.1 mm/h, P - 45.4 mm/h) which were significantly higher. PMID:16614462

  16. Evaluation of the progression of visual field damage in patients suffering from early manifest glaucoma

    PubMed Central

    Perdicchi, Andrea; Abdolrahimzadeh, Solmaz; Cutini, Alessandro; Ciarnella, Angela; Scuderi, Gian Luca

    2016-01-01

    Background This retrospective study aimed to determine how often a perimetric examination should be carried out in order to identify visual field (VF) changes in patients with relatively early manifestation glaucoma. Materials and methods Patients included had a relatively recent manifestation of primary open-angle glaucoma. Patients with a minimum follow-up of 5 years and a minimum of seven VF tests were included. Statistical analysis was performed to verify the trend of variations in mean defect (MD) over time (PeriData). The results were subjected to a t-test for a comparative analysis of progression of VF changes over time. The annual rate of progression provided by PeriData considering all the VFs analyzed was compared with that obtained on half of the VF examinations during the same follow-up period. An analysis of the MD trend over time was also carried out in relationship to the number of VF tests done and by dividing the sample into a high-frequency group (more than eight VFs) and a low-frequency group (fewer than eight VFs) in the follow-up period. Results A total of 96 eyes of 96 patients were included, and overall 846 VFs were examined. The paired t-test performed comparing the MD index of all the VFs against half of them did not show statistical significance (P=0.537). The high-frequency group comprised 39 eyes (average VF 11.05±1.91, average time interval 0.76 years) while the low-frequency group comprised 57 eyes (average VF 6.95±0.6, average time interval 1.21 years). The analysis of the MD trend in the high-frequency patients showed significance (P=0.017); the low-frequency group did not show statistical significance (P=0.08). Conclusion The number of VFs in a determined time interval was not significant. However, a greater frequency of tests provides a predictive evaluation of the rate of progression of early manifestation open-angle glaucoma. PMID:27601881

  17. Rebelliousness in patients suffering from schizophrenia-spectrum disorders--a possible predictor of attitudes towards medication.

    PubMed

    Nitzan, Uri; Bukobza, Gabriel; Aviram, Shai; Fennig, Shmuel; Lev-Ran, Shaul; Braw, Yoram; Bloch, Yuval

    2013-10-30

    The inclusive trait of rebelliousness has a proven role both in development and in the understanding of non-psychotic psychopathologies. The present study focused on evaluating rebelliousness levels and their possible correlation with the attitude towards medication among patients suffering from schizophrenia-spectrum disorders. Patient suffering from schizophrenia-spectrum disorders (n=75) and non-psychotic disorders (n=53) underwent a thorough clinical evaluation. The attitude towards medication was evaluated using the Drug Attitude Inventory (DAI-10), and levels of rebelliousness via the validated rebelliousness scale. Rebelliousness was also assessed in an additional control group (n=64). A significant negative correlation between levels of rebelliousness and the attitude towards medication was found uniquely in the schizophrenia group (r=-0.434, p<0.001). In a regression model rebelliousness levels were found to be the strongest predictor of the attitude towards medication ((β=-0.434, p<0.01)) compared with other demographic variables such as drug abuse (β=-0.256, p<0.05) and involuntary treatment (β=0.236, p<0.05). The intriguing correlation between rebelliousness and drug attitude (as an indicator of adherence) should be further studied in additional longitudinal prospective studies. PMID:23352744

  18. Sonoelastography – A Useful Adjunct for Parotid Gland Ultrasound Assessment in Patients Suffering from Chronic Inflammation

    PubMed Central

    Wierzbicka, Małgorzata; Kałużny, Jarosław; Ruchała, Marek; Stajgis, Marek; Kopeć, Tomasz; Szyfter, Witold

    2014-01-01

    Background Shear wave elastography (SWE) is widely used in breast, liver, prostate and thyroid evaluations. Elastography provides additional information if used to assess parotid gland pathology. We assessed parotid glands by means of SWE to compare the parenchyma properties in different types of inflammation. Material/Methods Prospective analysis included 78 consecutive patients with parotid gland pathology: sialolithiasis (33), Stensen’s duct stenosis (15), chronic inflammation (10), and primary Sjögren syndrome (pSS) (20) treated at the Department of Otolaryngology, Head and Neck Surgery of PUMS. The primary predictor variable was type of parotid pathology, and secondary predictor variables were patient age and the duration and intensity of complaints. Ultrasound pictures were compared with elastography values of parotid parenchyma. Results Mean elasticity values for pSS (111 Kilopascals (kPa), Stensen’s duct stenosis (63 kPa), sialolithiasis (82 kPa), and chronic inflammation (77 kPa) were significantly higher than the mean value for healthy patients (24 kPa). Elasticity increased proportionally to the intensity of complaints: mild (51 kPa), moderate (78 kPa), and strong (90 kPa). Increased elasticity did not correspond with ultrasonographic pictures. In pSS the parenchyma was almost twice as stiff as in chronic inflammation (p=0.02), although subjective complaints were mostly mild or moderate, and the ultrasonographic picture did not present features of fibrosis. Conclusions Sonoelastography, by improving routine ultrasonographic assessment, might be a useful tool for parotid evaluations during the course of chronic inflammation. An extraordinarily high degree of stiffness was revealed in pSS despite lack of fibrosis by ultrasonography and moderate subjective complaints, suggesting that sonoelastography could be a valuable diagnostic tool. PMID:25398237

  19. Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps

    PubMed Central

    Fang, Rui-Li; Chen, Lin-Xing; Shu, Wen-Sheng; Yao, Shu-Zhong; Wang, Si-Wen; Chen, Yu-Qing

    2016-01-01

    Results of this study showed that the bacterial composition in vagina (V) greatly differed from intrauterine microbiome (I). Microbiomes were present in all intrauterine samples of healthy women (Group H (I)) and patients with endometrial polyps (EP) (including Group EP (I) and Group EP/chronic endometritis (CE) (I)). Indeed, the intrauterine bacteria population in Group EP/CE (I) were more diverse than those in Groups EP (I) and H (I). The result also confirmed the bacterial composition differences between vagina and uterus as well as the intrauterine microbiome alteration in the patients, compared to the healthy. Although bacteria of Proteobacteria, Firmicutes and Actinobacteria, dominated the intrauterine microbiome in all samples, however, proportions of Firmicutes from Group EP/CE (I) and Group EP (I) were much higher than that from Group H (I), in contrast, the proportions of Proteobacteria were far lower than the healthy. At the genus level, compared to Group H (I), it is found that proportions of Lactobacillus, Gardnerella, Bifidobacterium, Streptococcus, and Alteromonas were significantly higher, and that of Pseudomonas were significantly lower in Group EP/CE (I) or Group EP (I). In addition, lower proportions of Enterobacter and Sphingomonas and a higher proportion of Prevotella were also observed in Group EP/CE (I). In conclusion, uterine microbiomes between patients with EP and the healthy are significantly different and all the potentially important variation of uterine microbes may cause EP, but not definitively related to CE. Further experiments should be performed to test these relationships to endometritis occurrence. PMID:27186283

  20. Barcoded sequencing reveals diverse intrauterine microbiomes in patients suffering with endometrial polyps.

    PubMed

    Fang, Rui-Li; Chen, Lin-Xing; Shu, Wen-Sheng; Yao, Shu-Zhong; Wang, Si-Wen; Chen, Yu-Qing

    2016-01-01

    Results of this study showed that the bacterial composition in vagina (V) greatly differed from intrauterine microbiome (I). Microbiomes were present in all intrauterine samples of healthy women (Group H (I)) and patients with endometrial polyps (EP) (including Group EP (I) and Group EP/chronic endometritis (CE) (I)). Indeed, the intrauterine bacteria population in Group EP/CE (I) were more diverse than those in Groups EP (I) and H (I). The result also confirmed the bacterial composition differences between vagina and uterus as well as the intrauterine microbiome alteration in the patients, compared to the healthy. Although bacteria of Proteobacteria, Firmicutes and Actinobacteria, dominated the intrauterine microbiome in all samples, however, proportions of Firmicutes from Group EP/CE (I) and Group EP (I) were much higher than that from Group H (I), in contrast, the proportions of Proteobacteria were far lower than the healthy. At the genus level, compared to Group H (I), it is found that proportions of Lactobacillus, Gardnerella, Bifidobacterium, Streptococcus, and Alteromonas were significantly higher, and that of Pseudomonas were significantly lower in Group EP/CE (I) or Group EP (I). In addition, lower proportions of Enterobacter and Sphingomonas and a higher proportion of Prevotella were also observed in Group EP/CE (I). In conclusion, uterine microbiomes between patients with EP and the healthy are significantly different and all the potentially important variation of uterine microbes may cause EP, but not definitively related to CE. Further experiments should be performed to test these relationships to endometritis occurrence. PMID:27186283

  1. Curable or treatable? The implications of different definitions of illness when treating patients suffering from amyotrophic lateral sclerosis.

    PubMed

    Cappellato, Valeria; Bosco, Nicoletta; Chiò, Adriano; Calvo, Andrea

    2015-01-01

    People suffering from amyotrophic lateral sclerosis (ALS) have complex health and care needs. The purpose of this study was to gain insight into the gaps in the health and community service care provided to ALS patients. In order to ensure continuity of care, specialist centres have to build effective relationships with local primary health care services and community services, health managers, physicians, patients, families and the surrounding support networks. We undertook a qualitative study that examined the specialist centres in hospitals, communities and primary care services. In 2010 we carried out 47 semi-structured interviews and one group interview in Italy, targeting all those involved in ALS care, on all levels. We used purposive sampling to obtain maximum variation across professions, sectors and services. Participants reported gaps arising when local health managers have to assess patient eligibility for certain services. The need to set priorities when allocating resources means that professionals 'categorize' patients without considering the multidimensional nature of their needs. For instance, rehabilitation is generally guaranteed for people with temporary or non-progressive functional limitations, yet it is not granted to degenerative patients. Patients with similar physical conditions, with perceived differences of other kinds (i.e. curable vs. treatable), may experience differential access to care. PMID:26467979

  2. German translation and external validation of the Radboud Skills Questionnaire in patients suffering from Complex Regional Pain Syndrome 1

    PubMed Central

    2010-01-01

    Background Patients suffering from Complex Regional Pain Syndrome commonly complain of substantial limitations in their activities of daily living. The Radboud Skills Questionnaire measures alterations in the level of disability of patients with Complex Regional Pain Syndrome, but this instrument is currently not available in German. The goals of our study were to translate the Dutch Radboud Skills Questionnaire into German and to assess its external criterion validity with the German version of the Disabilities of the Arm, Shoulder and Hand Questionnaire. Methods We translated the Radboud Skills Questionnaire according to published guidelines. Demographic data and validity were assessed in 57 consecutive patients with Complex Regional Pain Syndrome 1 of the upper extremity. Information on age, duration of symptoms, type of Complex Regional Pain Syndrome 1 and type of initiating event was obtained. We assessed the external criterion validity by comparing the German Radboud Skills Questionnaire and the German Disabilities of the Arm, Shoulder and Hand Questionnaire and calculated the prediction intervals. Results Score values ranged from 55.4 ± 22.0 for the Disabilities of the Arm, Shoulder and Hand Questionnaire score and 140.1 ± 39.2 for the Radboud Skills Questionnaire. We found a high correlation between the Radboud Skills Questionnaire and the Disabilities of the Arm, Shoulder and Hand Questionnaire (R2 = 0.83). Conclusion This validation of the Radboud Skills Questionnaire demonstrates that this German version is a simple and accurate instrument to assess and quantify disabilities of patients suffering from Complex Regional Pain Syndrome 1 of the upper extremity for clinical and research purposes PMID:20515455

  3. RSI: oxygen consumption, blood flow, and reoxygenation in patients suffering RSI measured by noninvasive optical spectroscopy

    NASA Astrophysics Data System (ADS)

    Thijssen, Dick H. J.; van Uden, Caro J. T.; Krijgsman, Hans; Colier, Willy N. J. M.

    2003-07-01

    Background: Repetitive Strain Injury (RSI) is a major problem in nowadays health care and creates high financial costs and personal distress. Average prevalence rates in the Netherlands vary from 20-40% of the working population. Insight into the patho-physiological mechanism of RSI is important in order to establish adequate treatment and prevention programs. Objective: The aim of this study was to gain insight in muscle oxygen consumption (mVO2), blood flow (BF), and reoxygenation (ReOx) in the forearm of computer workers with stage III Repetitive Strain Injury (RSI). Method: We have used continuous wave infrared spectroscopy (NIRS) to measure these variables. Measurements were conducted on the extensor and flexor muscle in both arms as well in RSI-patients (n=10) as in control subjects (n=21). A protocol of increased isometric repetitive contraction in a handgrip ergonometer was used with increasing levels of strength. Results: mVO2 in the extensor muscle in RSI-subjects (dominant side) was increased compared to control subjects and compared to the non-dominant side (p<0.05). ReOx was not increased in RSI (dominant side-extensor muscle). However, there was a tendency towards statistical significance (p=0.065). BF in rest was equal in both groups, however after exercise it tended to be increased. Half-time recovery (T ») was measured during only one part of the protocol and it was significantly increased (p<0.05). Conclusion: mVO2 in RSI is impaired. BF and ReOx did not show difference between both groups. Future research should aim at a microvascular dysfunction in RSI.

  4. [Chronic hypercapnia at rest or exercise-induced and ventilatory patterns in patients suffering from chronic obstructive bronchopulmonary disease].

    PubMed

    Van Meerhaeghe, A; Sergysels, R

    1984-01-01

    The authors review the recent literature on hypercapnia at rest and on exertion in patients suffering from chronic airflow obstruction. At rest, the data in the literature has shown that for varying degrees of airflow obstruction, chronic hypercapnic patients show similar occlusion pressures to normocapnic patients. (The occlusion pressure is an index of the amplitude of neuro-muscular signals coming from the respiratory centre). However, their respiratory profile is characterised by a smaller tidal volume due to a reduction of the inspiratory time and often of a more rapid respiratory rate at a lower minute ventilation (VE). This pattern alone could explain CO2 retention by alveolar hypoventilation. On effort, various authors have shown that hypercapnic patients, or those becoming so during exercise, differ from normals by adopting a ventilatory pattern characterised by a reduction in ventilation linked to their airflow obstruction and a smaller tidal volume. The limited increase in tidal volume on effort is dependent on the duration of inspiration and the reduction of vital capacity and inspiratory capacity. As at rest, the two populations cannot be distinguished in terms of occlusion pressure. PMID:6463357

  5. [A clinical investigation of pediatric patients with sleep-disordered breathing who suffered perioperative respiratory complications of adenotonsillectomy].

    PubMed

    Ogawa, Makoto; Hosokawa, Kiyohito; Inohara, Hidenori

    2014-03-01

    The aim of this study was to investigate the clinical background and identify the risk factors for perioperative respiratory complication in pediatric patients with sleep-disordered breathing (SDB) who underwent adenotonsillectomy (AT). Of the 186 pediatric subjects (male: 131, female: 55) undergoing AT as the first surgical treatment for SDB, 14 patients (male: 9, female: 5) fulfilled the following criteria: 1) disturbed ventilation, 2) cyanosis with an oxygen saturation of less than 90% on pulse oximetry during the perioperative period and 3) the subsequent need for medical intervention, including immediate intubation, continuous positive airway pressure (CPAP) or airway insertion. Among these 14 patients, nine were less than 3 years of age. In addition, 5 and 3 patients had hypotonia due to cerebral paralysis and metabolic disturbances, respectively. Seven had a short stature with an SD of worse than - 1.5. A statistical analysis showed that cases with either an age of less than 3 years, hypotonia or a short stature had a high risk for suffering from respiratory complications, and suggested that low body weight and a high value for preoperative apnea-hypopnea index were additional risk factors. However, a chart review exhibited that, of the 14 cases with respiratory complications, the 8 cases whose age was under 3 years had either of hypotonia or a short stature. In thirteen of the 14 cases, respiratory complications were associated with the process of general anesthesia, and ten patients exhibited pharyngeal collapse. After surgery, 7 and 3 patients required intensive care in the ICU and the pediatric recovery unit, respectively. Based on these results, it is suggested that pediatric SDB cases under 3 years of age and either with hypotonia or a short stature have a high risk for respiratory complications associated with AT, and therefore AT for such patients should only be performed in medical facilities with an ICU or an equivalent department. PMID:24783453

  6. Molecular mechanism of yisui shengxue granule, a complex chinese medicine, on thalassemia patients suffering from hemolysis and anemia of erythrocytes.

    PubMed

    Chu, Na-Li; Wu, Zhi-Kui; Zhang, Xin-Hua; Fang, Su-Ping; Wang, Wen-Juan; Cheng, Yan-Ling

    2014-01-01

    The objective of this study was to investigate the therapeutic biological mechanism of Yisui Shengxue Granule (YSSXG), a complex Chinese medicine, on the hemolysis and anemia of erythrocytes from patient with thalassemia disease. Sixteen patients with thalassemia (8 cases of α-thalassemia and 8 cases of β-thalassemia) disease were collected and treated with YSSXG for 3 months. The improvements of blood parameter demonstrated that YSSXG had a positive clinical effect on patients with thalassemia disease. For patients with α-thalassemia disease, RT-PCR showed that YSSXG upregulated the relative mRNA expression level of α-globin to β-globin and downregulated DNMT1, DNMT3a, and DNMT3b mRNA compared with pretreatment. Western blotting showed that YSSXG downregulated the expression of DNMT1 and DNMT3a. For patients with β-thalassemia disease, the relative expression level of (A) γ-globin to α-globin had an increasing trend and the level of BCL11A mRNA expression obviously increased. For all patients, RT-PCR showed that YSSXG upregulated mRNA expression of SPTA1 and SPTB. Activities of SOD and GSH-Px significantly increased and MDA obviously reduced on erythrocyte and blood serum after YSSXG treatment. TEM showed that YSSXG decreased the content of inclusion bodies. Activities of Na(+)K(+)-ATPtase and T-ATPtase of erythrocyte increased significantly after YSSXG treatment. This study provides the basis for mechanisms of YSSXG on thalassemia suffering with hemolysis and anemia of erythrocytes from patient. PMID:25574177

  7. [The evaluation of mineral crystallinity of mandibular bone tissue using electron paramagnetic resonance (EPR) in patients suffering from renal osteodystrophy].

    PubMed

    Wojtowicz, Andrzej; Dijakiewicz, Maciej; Wandzel, Barbara; Wesołowski, Piotr; Rutkowski, Bolesław; Fiedor, Piotr; Stachowicz, Wacław; Ostrowski, Kazimierz

    2006-01-01

    Mineral crystallinity of bone tissue is subject to changes during one's development, as well as in many systemic diseases, especially renal osteodystrophy. The aim of the study was qualitative evaluation of the mandibular bone tissue in patients suffering from renal osteodytrophy, treated with renal-replacement therapy: hemo-dialysis or allogeneic kidney transplantation. The mineral crystallinity coefficient was evaluated using electron paramagnetic resonance (EPR) based on the observation that ionizing radiation induces paramagnetic centers in hydroxyapatites. The concentration of these centers was used to establish an indicator of crystallinity rate which is a measure of the crystallinity of tissue mineral. On the basis of these results, it is possible to widen the indications for implantological treatment in specific clinical cases. PMID:17479865

  8. Distinct subcutaneous emphysema following surgical wisdom tooth extraction in a patient suffering from ‘Gilles de la Tourette syndrome’

    PubMed Central

    Tomasetti, Patrick; Kuttenberger, Johannes; Bassetti, Renzo

    2015-01-01

    Subcutaneous emphysema is a rare complication in oral surgery. In most cases, it resolves spontaneously. However, air might disperse into deeper facial spaces causing life-threatening complications such as compression of the tracheobronchial tree or the development of pneumomediastinum. Moreover, microorganisms might spread from the oral cavity into deeper spaces. Hence, rapid diagnosis of subcutaneous emphysema is important. Characteristic signs are both a shiftable swelling and crepitation. In this case report, a 30-year-old man, suffering from the Gilles de la Tourette Syndrome, with a distinct subcutaneous emphysema after bilateral surgical wisdom tooth extraction is presented. Induced by a specific motor tic, air accumulated from the periorbital through to the parapharyngeal region. Applying a 10-cm-long Redon drainage tube as air valve, 10 days after wisdom teeth extraction, the patient was asymptomatic with complete resolution of the emphysema. PMID:26077530

  9. Surprised by joy: a journey through suffering.

    PubMed

    Afeef, Majeda; Alkhoulli, Laila

    2010-01-01

    Understanding suffering as possible meaning of cancer for patients and their families is a necessary part of cancer nursing care. Suffering occurs when the intactness or integrity of the individuals is threatened or disrupted (Cassel 1999); the authors believe that exploring cancer patients' suffering is vital to improve patient quality care. This article discusses suffering as a feature for oncology patients at tertiary hospital in Jordan. We are aiming through understanding the three following narratives of cancer patients who experience and witness the suffer during their disease journey to illustrate how the suffering reflect their behavior and day to day life. The first case is a young man of 24 years old who was diagnosed with nasopharyngeal carcinoma five years ago, treated then relapsed and receiving palliative care up to moment, the narrative focus on his suffering from corrupted relations with his wife due to infected face wound and loss of the financial support. The Second case is a 38 years old female who diagnosed with melanoma 15 years ago, she experience psychological suffering due to changes in her body image. She is taking care of motor handicapped husband in addition to her Kids. The Last case is a 54 years old female who had lung cancer. She is still fighting her disease. Consequently, she is suffering from the disease, cause to affect her job.We found out that their spirituality and beliefs system enables them to endure and fight their disease, alleviate suffering, enhance adaptation and redefine hope. The health care team who provide the care for these cases focus interdisciplinary team approach who affirm that the transcendental is there when disease and mute or expressive suffering are recognized together, they do the work of creating a full meaning for patients and families. Nurses play a crucial role in managing such cases .It is the core of nursing care to presence the mean of listening, touching, acknowledging, honoring patient's wishes

  10. Correlation between headaches and affective symptoms in patients with epilepsy.

    PubMed

    Seo, Ji-Hye; Joo, Eun Yeon; Seo, Dae-Won; Hong, Seung Bong

    2016-07-01

    Headaches are a neglected entity in patients with epilepsy (PWE), although PWE have a high chance of suffering from seizure-related as well as seizure-unrelated headaches. We aimed to identify the prevalence and characteristics of headaches and investigate the correlation between headaches and affective symptoms in PWE. Consecutive PWE who visited our tertiary outpatient clinic were interviewed about headaches and epilepsy. Affective symptoms were evaluated using the Korean version of the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and suicidality portion of the Mini-International Neuropsychiatric Interview. We classified headaches as interictal or seizure-related headaches (SRHs; pre- and postictal). Tension-type headache and migraine were defined based on International Classification of Headache Disorders criteria. From the initial cohort of 177 patients (92 men, mean age: 37.1years), 73 (41.2%) reported suffering from interictal (N=34, 19.2%), preictal (N=3, 1.7%), and postictal (N=48, 27.1%) headaches. Univariate analysis revealed significantly higher BDI and BAI scores in the headache group. Tension-type headaches were the most frequent, and half of the interictal headaches and most of the SRHs were untreated. Spearman's partial correlation analyses showed that headaches overall were significantly related with depression and anxiety. Interictal headaches were correlated with depression only, and postictal headaches were correlated with depression as well as suicidality, separately. These results show that investigating and controlling headaches may relieve affective symptoms and ultimately improve the quality of life of PWE. PMID:27236023

  11. Pre-operative lymphocyte-to-monocyte ratio as a predictor of overall survival in patients suffering from osteosarcoma

    PubMed Central

    Liu, Tao; Fang, Xuan-Cheng; Ding, Zhen; Sun, Ze-Gan; Sun, Li-Ming; Wang, Yi-Lian

    2015-01-01

    Inflammatory markers have been proposed to predict clinical outcomes in many types of cancers. The purpose of this study was to explore the influence of the lymphocyte-to-monocyte ratio (LMR) on clinical prognosis of patients with osteosarcoma. This study collected 327 patients who underwent surgical treatment for osteosarcoma during the period 2006–2010. LMR was calculated from pre-operative peripheral blood cells counts. The optimal cut-off value of LMR was determined based on receiver operating characteristic curve analysis. Overall survival (OS) and event free survival (EFS) was plotted using the Kaplan–Meier method and evaluated by the log-rank test. A predictive model was established to predict clinical prognosis for OS, and the predictive accuracy of this model was determined by concordance index (c-index). Our results showed that young age, elevated alkaline phosphatase, metastasis at diagnosis, chemotherapy, lymphocyte and monocyte counts were significantly associated with LMR. Low LMR was associated with shorter OS and EFS (P < 0.001), and was an independent predictor of both OS and EFS (HR = 1.72, 95% CI = 1.14–2.60, P = 0.010; HR = 1.89, 95% CI = 1.32–2.57, P = 0.009). The nomogram performed well in the prediction of overall survival in patients with osteosarcoma (c-index 0.630). In conclusion, low pre-operative LMR is associated with a poor prognosis in patients suffering from osteosarcoma. A prospective study is warranted for further validation of our results. PMID:26380812

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

    PubMed

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

    2014-12-01

    Although illness perception has been shown to be associated with illness outcomes in various chronic physical diseases, the association of illness perception and rumination are not well elucidated in mental disorders. This study aims to investigate the mediational effects of adaptive and maladaptive rumination in the relationship between illness perception and negative emotions (depression, anxiety and stress) in male and female patients (N=110) suffering from depressive disorders. The results showed that maladaptive rumination mediated the relationship between illness perception and negative emotions in both male and female depressive patients. However, no mediating effects of adaptive rumination were found in the relationship between illness perception and negative emotion. Maladaptive rumination mediated the relationship between perceived identity, chronicity of illness, consequences of illness and emotional representation of illness and negative emotions in males. It also mediated the relationship between perceived identity and emotional representation of illness and negative emotions in females. The results, possible clinical implications and limitations of this study are also discussed. PMID:25440564

  13. PSEUDOBULBAR AFFECT IN MULTIPLE SCLEROSIS PATIENTS.

    PubMed

    Vidović, Viktor; Rovazdi, Merisanda Časar; Kraml, Oto; Kes, Vanja Bašić

    2015-06-01

    The aim of the study was to determine the prevalence of pseudobulbar affect (PBA) in patients with multiple sclerosis (MS) and to analyze the link between PBA and patient age, sex, clinical course of MS, disease duration and degree of disability. The study was conducted on 79 MS patients that underwent inpatient rehabilitation at the Lipik Special Hospital for Medical Rehabilitation in the period from August 15, 2014 to February 15, 2015. PBA is a term used for an emotional disinhibition syndrome characterized by sudden and involuntary episodes of crying or laughing which are not in proportion to the stimulus applied or occur without stimulus. The condition can be present in patients with various neurological disorders, such as amyotrophic lateral sclerosis, Alzheimer's disease, Parkinson's disease, patients having recovered from stroke, or following traumatic brain injury. The estimated prevalence in patients with MS ranges from 10% to 46.2%. As a measuring instrument in the study, we used the Center for Neurologic Study-Lability Scale (CNS-LS), where a sum 17 denoted positive finding. The total number of respondents was 79, of which 33 (41.8%) met the CNS-LS criteria for the diagnosis of PBA. There was no statistically significant correlation between PBA, age and degree of disability, although PBA was more common in women and in patients with a secondary progressive form of the disease. We found that 42.4% of respondents with positive CNS-LS criteria for PBA did not inform their neurologist on the presence of sudden mood changes. The high frequency of PBA and the fact that a significant proportion of patients did not inform the neurologist on their affective disturbances call for an active approach to diagnosis and treatment. PMID:26415311

  14. Neuron-Specific Enolase Is Correlated to Compromised Cerebral Metabolism in Patients Suffering from Acute Bacterial Meningitis; An Observational Cohort Study

    PubMed Central

    Bartek, Jiri; Thelin, Eric Peter; Ghatan, Per Hamid; Glimaker, Martin; Bellander, Bo-Michael

    2016-01-01

    Introduction Patients suffering from acute bacterial meningitis (ABM) with a decreased level of consciousness have been shown to have an improved clinical outcome if treated with an intracranial pressure (ICP) guided therapy. By using intracranial microdialysis (MD) to monitor cerebral metabolism in combination with serum samples of biomarkers indicating brain tissue injury, S100B and Neuron Specific Enolase (NSE), additional information might be provided. The aim of this study was to evaluate biomarkers in serum and MD parameters in patients with ABM. Methods From a prior study on patients (n = 52) with a confirmed ABM and impaired consciousness (GCS ≤ 9, or GCS = 10 combined with lumbar spinal opening pressure > 400 mmH2O), a subgroup of patients (n = 21) monitored with intracerebral MD and biomarkers was included in the present study. All patients were treated in the NICU with intracranial pressure (ICP) guided therapy. Serum biomarkers were obtained at admission and every 12 hours. The MD parameters glucose, lactate, pyruvate and glycerol were analyzed. Outcome was assessed at 12–55 months after discharge from hospital. Mann-Whitney U-Test and Wilcoxon matched-pairs signed rank test were applied. Results The included patients had a mean GCS of 8 (range, 3–10) on admission and increased ICP (>20 mmHg) was observed in 62% (n = 13/21) of the patients. Patients with a lactate:pyruvate ratio (LPR) >40 (n = 9/21, 43%) had significantly higher peak levels of serum NSE (p = 0.03), with similar, although non-significant observations made in patients with high levels of glycerol (>500 μmol/L, p = 0.11) and those with a metabolic crisis (Glucose <0.8 mmol/L, LPR >25, p = 0.09). No associations between serum S100B and MD parameters were found. Furthermore, median MD glucose levels decreased significantly between day 1 (0–24h) and day 3 (48–72h) after admission to the NICU (p = 0.0001). No correlation between MD parameters or biomarkers and outcome was found

  15. Reasons for recall following conditional discharge: explanations given by male patients suffering from dual diagnosis in a London Forensic Unit.

    PubMed

    Chiringa, J; Robinson, J E; Clancy, C

    2014-05-01

    Patients who have been discharged from forensic services often have conditions they have to abide by as part of their discharge, and failure to do so leads to recall. We interviewed six men who had been conditionally discharged from forensic services and then been recalled into hospital to find out what they thought went wrong. The reasons they gave for why things went wrong included feeling that the system was unfair and made them feel like criminals even though they did not feel they had put anyone at risk. Some of them were not fully aware of the conditions they needed to adhere to, and some of them had breached the conditions but did not take responsibility for what had happened. In addition, supervision was felt to be very controlling and disruptive rather than supportive when patients were often lonely, bored and needing support. Most participants reported that they experienced poor standards of aftercare in hostels they were required to reside in. In the future, care of patients after conditional discharge should include better communication between patients and their supervisory team, recognition of the need for more support and improvements in the standards of care in hostels, as well as a collaborative approach to risk assessment that might reduce the frequency of relapse and readmission. This study explores how male patients suffering from dual diagnosis in a forensic unit perceive being recalled and readmitted following conditional discharge and their views about how services might be improved. A qualitative approach was used drawing on grounded theory techniques. Audiotaped semistructured interviews collected data from a purposefully selected sample of six participants who had been recalled and met the inclusion criteria of the study. Data were analysed using the constant comparative method. Most participants perceived the recall system as unfair, inappropriately criminalized their behaviour and was based on an assessment of risk that they did not

  16. Skin changes in patients claiming to suffer from "screen dermatitis": a two-case open-field provocation study.

    PubMed

    Johansson, O; Hilliges, M; Björnhagen, V; Hall, K

    1994-10-01

    An open-field provocation, in front of an ordinary TV set, of 2 patients regarding themselves as suffering from skin problems due to work at video display terminals (VDTs) is presented. Using immunohistochemistry, in combination with a wide range of antisera directed towards cellular and neurochemical markers, we were able to show a high-to-very high number of somatostatin-immunoreactive dendritic cells as well as histamine-positive mast cells in skin biopsies from the anterior neck taken before the start of the provocation. At the end of the provocation the number of mast cells was unchanged; however, the somatostatin-positive cells had seemingly disappeared. The reason for this latter findings is discussed in terms of loss of immunoreactivity, increase of breakdown, etc. The high number of mast cells present may explain the clinical symptoms of itch, pain, edema and erythema. Naturally, in view of the present public debate, the observed results are highly provocative and, we believe, have to be taken seriously. PMID:7881769

  17. HFS-14, a Specific Quality of Life Scale Developed for Patients Suffering from Hand–Foot Syndrome

    PubMed Central

    Dalenc, Florence; Chevreau, Christine; Roché, Henri; Delord, Jean-Pierre; Mourey, Loïc; Lacaze, Jean-Louis; Rahhali, Nora; Taïeb, Charles

    2011-01-01

    Background. Hand–foot syndrome (HFS) is a common reaction to certain chemotherapies and new targeted therapies, impairing patient quality of life (QoL). However, there is currently no specific tool to measure QoL in patients with HFS. Objective. The objective was to develop and validate a HFS-specific QoL questionnaire (HFS-14). Patients and Methods. From a list of 31 items identified from a literature review and patient interview notes, item reduction and pilot testing by cognitive debriefing resulted in a final 14-item questionnaire with excellent internal reliability. Clinical validity was assessed in 43 patients with HFS by comparing the HFS-14 score according to HFS clinical grade based on the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 3.0, and by measuring its correlation with the Dermatology Life Quality Index (DLQI), Skindex-16, and short-form 12 health-related questionnaires and pain measurement. Results. The mean HFS-14 score was significantly higher in patients with clinical grade 2 and grade 3 HFS than in those with grade 1 HFS. The higher the HFS-14 score, the greater the QoL impairment. The HFS-14 score was highly correlated with the DLQI and Skindex-16 scores. In the population of patients with severe grade 3 NCI-CTCAE HFS, the HFS-14 score was significantly higher in patients having both hands and feet severely involved than in those with severe involvement of one limb (hands or feet) with the other one less severely affected. Conclusions. This scale specifically developed for patients with HFS is a valid and valuable tool for measuring HFS-related QoL impairment. PMID:21964002

  18. Recording signs of deterioration in acute patients: The documentation of vital signs within electronic health records in patients who suffered in-hospital cardiac arrest.

    PubMed

    Stevenson, Jean E; Israelsson, Johan; Nilsson, Gunilla C; Petersson, Göran I; Bath, Peter A

    2016-03-01

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety. PMID:24782478

  19. Comparison of two walk tests in determining the claudication distance in patients suffering from peripheral arterial occlusive disease

    PubMed Central

    Dixit, Snehil; Chakravarthy, Kalyana; Reddy, Ravi Shankar; Tedla, Jaya Shanker

    2015-01-01

    Background: The purpose of this study was to compare the six-minute walk test (6MWT) and the incremental shuttle walk test (ISWT) in terms of the initial onset of pain (IOP), maximal claudicating pain (MCP), maximum walking distance (MWD), initial ankle brachial index (IABI), post ankle brachial index (PABI), and difference in ankle brachial index (DFABI), as well as to correlate changes in IOP and MWD, MCP and MWD, IABI and MWD, PABI and MWD, and DFABI and MWD in the 6MWT and ISWT. Materials and Methods: Participants (n = 19, 17 men and 2 women) were randomly allocated to the 6MWT or ISWT and crossed over to the other test after 24 hours. The baseline ankle brachial index (ABI) measurements were taken using the Doppler, following which the participants performed the tests. Post-test MWD, IOP, MCP, and ABI were measured. The paired t test was used pre- and post the walk test and the Pearson correlation was used to find any relationship between the desired variables. Results: The paired t test at 95% confidence interval for IABI and PABI (P > 0.05) was insignificant for the 6MWT and ISWT. The Pearson correlation of MWD with IOP showed a fair correlation, and the correlation of MWD to MCP showed a strong correlation in ISWT. Conclusion: ISWT can be of vital importance as a tool to assess the functional status of patients suffering from Peripheral Arterial Occlusive Disease (PAOD) in both the clinical and research areas, and reflects a better assessment of the functional limitation when walking with PAOD as compared to the 6MWT. PMID:26261825

  20. Effectiveness of a manualized imagery rehearsal therapy for patients suffering from nightmare disorders with and without a comorbidity of depression or PTSD.

    PubMed

    Thünker, Johanna; Pietrowsky, Reinhard

    2012-09-01

    Nightmares are a common and serious problem in psychotherapeutic practice, although they are seldom considered as independent mental disorders. There are some promising approaches to the treatment of nightmares, notably Imagery Rehearsal Therapy, a cognitive-restructuring treatment. The core of this approach is the modification of the nightmare script and repeated imagination of the new script. However, most evaluation surveys have been conducted only with trauma patients, and thus far there is no standardized manual in the German language. 69 participants were examined using self-rating questionnaires. Participants belonged to three groups: 22 primarily nightmare sufferers, 21 patients with major depression and nightmares, 26 with PTSD and nightmares. 12 of the PTSD patients were randomly assigned to a control condition. Primary outcome measures were nightmare frequency and anxiety during nightmares. Overall, nightmare frequency and the anxiety they caused decreased following the treatment. Nightmare frequency and anxiety during the nightmares were highest in the PTSD group initially. Nightmare frequency decreased in all groups. Anxiety scores decreased least in PTSD patients, in depressive patients and primarily nightmare sufferers anxiety scores decreased during intervention. In primarily nightmare sufferers anxiety remained low up to the catamnesis period as well. Thus, those who suffered primarily from nightmares showed the strongest benefit from the nightmare treatment. PMID:22738908

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

    PubMed

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

    2014-01-01

    The purpose of this study was to determine which scales are being used to evaluate pain in old people suffering from dementia. A search strategy was developed to retrieve all articles (randomized controlled trials and clinical trials without randomization) published in MEDLINE, Cochrane Library Plus, PEDro and Dialnet and BMC Geriatrics from January 2000 to January 2012. Exclusion criteria were articles that did not use scales for evaluating pain in elderly patients suffering from dementia, and other type of articles (case studies, reviews...). Finally, 13 studies were included in this review. From the results obtained it appears that more studies are needed to confirm the pain scales used for the elderly suffering from dementia. Observational scales may be useful to evaluate pain in these patients. PMID:24211068

  2. Comparison of the analgesic effect of ultrasound and low-level laser therapy in patients suffering from plantar fasciitis (calcar calcanei)

    NASA Astrophysics Data System (ADS)

    Navratil, Leos; Skopek, Jiri; Hronkova, Hana; Kymplova, Jaroslava; Knizek, Jiri

    2001-10-01

    To compare the effectiveness of the two therapeutic approaches, ultrasound and low level laser (LLLT) used in 181 patients suffering from calcar calcanei-plantar fasciitis. The effectiveness of the treatment was determined according to the evaluation of the patient using certain criteria described in the table. The complete disappearance of pain was seen in 50% of 60 patients treated with US and partial improvement in 16.6% and 69 patients were treated with LLLT from which 67% described complete pain relief, and 20% partial improvement. The results show that the LLLT is a good therapeutic approach in the treatment of pain in patients suffering from calcar calcanei-plantar fasciitis. The treatment with laser was significantly more successful then the ultrasound therapy, which is currently the most common therapy used for plantar fasciitis.

  3. Effect of saffron on liver metastases in patients suffering from cancers with liver metastases: A randomized, double blind, placebo-controlled clinical trial

    PubMed Central

    Hosseini, Azar; Mousavi, Seyed Hamed; Ghanbari, Anis; Homaee Shandiz, Fatemeh; Raziee, Hamid Reza; Pezeshki Rad, Masoud; Mousavi, Seyed Hadi

    2015-01-01

    Objective: Cancer represents the second cause of mortality in the world. Saffron as a medicinal plant is known for its anti-cancer and anti-depressant properties. In this randomized double blind clinical trial, the effects of saffron on response to treatment in patients suffering from liver metastasis were evaluated. Materials and Methods: Thirteen patients suffering from liver metastases who referred to Ghaem and Imam Reza hospital, Mashhad, Iran were included in this study and then divided into two different groups. Both groups received chemotherapy regimen. Patients in group one were treated with saffron capsule (50 mg, twice daily) during chemotherapy periods whereas patients in group two received placebo. A sum of the longest diameter were calculated and compared for all lesions in IV contrast CT scan before and after the treatment. Results: from 13 patients included in this study, six patients quit and seven continued until the end. In saffron-treated group, two patients showed partial and complete response (50%) whereas in placebo group, no response was seen. Also, two deaths in placebo and one in saffron group occurred. Conclusion: This research suggests that saffron might be useful in patients suffering from liver metastasis. However, further investigations with larger sample size are required. PMID:26468463

  4. Importance of CT Scan of Paranasal Sinuses in the Evaluation of the Anatomical Findings in Patients Suffering from Sinonasal Polyposis.

    PubMed

    Varshney, Himanshu; Varshney, Jitendra; Biswas, Subhradev; Ghosh, S K

    2016-06-01

    Sinonasal polyps are benign lesions arising from nose and/or sinuses mucosa. Paranasal sinuses computed tomogram (CT) scan are important for functional endoscopic sinus surgery (FESS) as their information assist the surgeon in pre-operative planning. This study aimed to show importance of CT scan in evaluation of anatomical variations to prove a correlation with disease process and extent of disease in sinonasal polyposis patients. A study was done from Sept, 2010 to Sept, 2011 with 33 patients presenting with nasal polyps. All recruited patients, after thorough history, general examination and thorough ENT examination, were examined by nasal endoscopy and sinus CT scans. All scans were carried out using a 3 mm thickness in axial and coronal planes with sagittal reconstruction. An analysis was then carried out to see anatomical variations and disease extent in CT scans. Maxillary sinus was the most commonly and most severely affected sinus, while the sphenoid sinus was the least involved sinus. Ostiomeatal complex (OMC) was found to be blocked in 84.85 % cases. There were few anatomic variations (57.58 %) found as hypertrophied uncinate process (30.30 %), septal deviation (21.21 %), skull base type-2, Concha bullosa, Haller's cell, Paradoxical middle turbinate, Onodi cell, pneumatized crista galli and dehiscent skull base. Hyperdense and heterogeneous opacification in paranasal sinuses was seen in 12.12 % patients. Importance of CT scans is to know anatomical variations as etiology, fungal etiology, to know extent of polyposis and anatomical variations to prevent complications during FESS and Navigation sinus surgery. PMID:27340631

  5. [Comparative evaluation of the influence of sulfhydryl and phosphate ACE inhibitors on thrombocyte aggregation in patients suffering from atrerial hypertension with metabolic syndrome].

    PubMed

    Simonenko, V B; Medvedev, I N; Tolmachev, V V

    2007-01-01

    The purpose of the study was to compare the influence of two ACE inhibitors--captopril, a sulfhydryl one, and fozinopril, a phosphate one--on the aggregation activity of thrombocytes in patients suffering from arterial hypertension (AH) with metabolic syndrome (MS). Sixty-nine patients suffering from AH with MS were examined; 36 patients were administered captopril during 16 weeks, while 33 patients were treated with fozinopril during the same period of time. Changes in anthropometric parameters, blood lipid spectrum, lipid peroxidation in blood plasma and thrombocytes, and the antioxidative protection of liquid part of blood and platelets, as well as the aggregation activity of thrombocytes were assessed. The data received were processed using Student criterion and system multifactor analysis. The study shows that the use of fozinopril in patients with AH and metabolic syndrome attenuates peroxidation syndrome and optimizes thrombocyte aggregation. Prolonged fozinopril application will stabilize the achieved effect. Captopril did not have a positive effect on the parameters under study. In conclusion, fozinopril should be applied in combination with non-drug means to lower body weight in patients suffering from AH with MS. PMID:17564032

  6. Sex differences in trauma symptoms, body image and intensity of pain in a Polish sample of patients suffering from chronic pain.

    PubMed

    Rzeszutek, Marcin; Oniszczenko, Włodzimierz; Schier, Katarzyna; Biernat-Kałuża, Edyta; Gasik, Robert

    2016-10-01

    The main goal of the current study was to investigate sex differences in the relationship between the level of trauma symptoms appearing in posttraumatic stress disorder (PTSD) and intensity of pain in a sample of 300 Polish patients suffering from chronic pain, specifically rheumatoid arthritis and lower back pain. We also focused on participants' body image with body esteem as a mediator. To assess the intensity of pain among participants, we used the Numerical Rating Scale. The level of trauma symptoms was assessed with the PTSD Factorial Version Inventory. To measure body image among participants, we used the Body Esteem Scale. The results of our study suggest that trauma symptoms and body image dimensions were significant predictors of pain intensity among men suffering from chronic pain. Moreover, trauma symptoms and age were significant predictors of pain intensity among women suffering from chronic pain. Finally, we demonstrated that sex differentiates the reaction to chronic pain. PMID:26609737

  7. [Pain and suffering. Ethics aspects].

    PubMed

    Gasull, María

    2010-01-01

    The understanding of pain and suffering have evolved throughout the different stages of history. In modern times, pain, thanks to scientific and technological advances has been dealt with more efficiently although there is still a long way to go towards the relief of suffering due to its complexity. Good nursing care requires nurses to have good training as well as having the ability to relate to patients. They also need professional maturity in order to deal with emotional problems arising from pain and suffering. New nursing theories place responsibility with the nurse when treating the challenges brought about by pain and suffering. PMID:20825144

  8. Chronic Intermittent Hypoxia Is Independently Associated with Reduced Postoperative Opioid Consumption in Bariatric Patients Suffering from Sleep-Disordered Breathing

    PubMed Central

    Turan, Alparslan; You, Jing; Egan, Cameron; Fu, Alex; Khanna, Ashish; Eshraghi, Yashar; Ghosh, Raktim; Bose, Somnath; Qavi, Shahbaz; Arora, Lovkesh; Sessler, Daniel I.; Doufas, Anthony G.

    2015-01-01

    Background Evidence suggests that recurrent nocturnal hypoxemia may affect pain response and/or the sensitivity to opioid analgesia. We tested the hypothesis that nocturnal hypoxemia, quantified by sleep time spent at an arterial saturation (SaO2) < 90% and minimum nocturnal SaO2 on polysomnography, are associated with decreased pain and reduced opioid consumption during the initial 72 postoperative hours in patients having laparoscopic bariatric surgery. Methods With Institutional Review Board approval, we examined the records of all patients who underwent laparoscopic bariatric surgery between 2004 and 2010 and had an available nocturnal polysomnography study. We assessed the relationships between the time-weighted average of pain score and total opioid consumption during the initial 72 postoperative hours, and: (a) the percentage of total sleep time spent at SaO2 < 90%, (b) the minimum nocturnal SaO2, and (c) the number of apnea/hypopnea episodes per hour of sleep. We used multivariable regression models to adjust for both clinical and sleep-related confounders. Results Two hundred eighteen patients were included in the analysis. Percentage of total sleep time spent at SaO2 < 90% was inversely associated with total postoperative opioid consumption; a 5-%- absolute increase in the former would relatively decrease median opioid consumption by 16% (98.75% CI: 2% to 28%, P = 0.006). However, the percentage of total sleep time spent at SaO2 < 90% was not associated with pain. The minimum nocturnal SaO2 was associated neither with total postoperative opioid consumption nor with pain. In addition, neither pain nor total opioid consumption was significantly associated with the number of apnea/hypopnea episodes per hour of sleep. Conclusions Preoperative nocturnal intermittent hypoxia may enhance sensitivity to opioids. PMID:26010491

  9. Parallel fluctuations of psychiatric and neurological symptoms in a patient with multiple sclerosis and bipolar affective disorder.

    PubMed

    Salmaggi, A; Eoli, M; La Mantia, L; Erbetta, A

    1995-11-01

    The case of a female patient affected by simultaneously onsetting multiple sclerosis and bipolar affective disorder at age 33 is reported. Over the following years, the patient displayed minor mood fluctuations but, at the ages of 41 and 42 years, respectively, she suffered from a major depressive and a manic episode, both of which were concomitant with a marked worsening in her neurological condition. PMID:8613416

  10. Exploring the option of voluntarily stopping eating and drinking within the context of a suffering patient's request for a hastened death.

    PubMed

    Schwarz, Judith

    2007-12-01

    There is an acknowledged difficulty in distinguishing between some morally and legally accepted acts that hasten dying, such as refusing life-sustaining treatment, and other acts that also hasten dying that are labeled as acts of "suicide." Recent empirical findings suggest that most terminally ill and suffering patients who voluntarily chose to stop eating and drinking as a means to hasten their dying generally experienced a "good" death. This paper explores the moral and legal status of a decision to stop eating and drinking as a means to hasten dying that is voluntarily chosen by a competent, terminally ill and suffering patient. The option of voluntarily forgoing food and fluid will be compared to other end-of-life clinical practices known to hasten dying, with emphasis on the issue of whether such practices can or should be distinguished from suicide. PMID:18095807

  11. Perception of affective prosody in patients at an early stage of relapsing-remitting multiple sclerosis.

    PubMed

    Kraemer, Markus; Herold, Michele; Uekermann, Jennifer; Kis, Bernhard; Daum, Irene; Wiltfang, Jens; Berlit, Peter; Diehl, Rolf R; Abdel-Hamid, Mona

    2013-03-01

    Cognitive dysfunction is well known in patients suffering from multiple sclerosis (MS) and has been described for many years. Cognitive impairment, memory, and attention deficits seem to be features of advanced MS stages, whereas depression and emotional instability already occur in early stages of the disease. However, little is known about processing of affective prosody in patients in early stages of relapsing-remitting MS (RRMS). In this study, tests assessing attention, memory, and processing of affective prosody were administered to 25 adult patients with a diagnosis of RRMS at an early stage and to 25 healthy controls (HC). Early stages of the disease were defined as being diagnosed with RRMS in the last 2 years and having an Expanded Disability Status Scale (EDSS) of 2 or lower. Patients and HC were comparable in intelligence quotient (IQ), educational level, age, handedness, and gender. Patients with early stages of RRMS performed below the control group with respect to the subtests 'discrimination of affective prosody' and 'matching of affective prosody to facial expression' for the emotion 'angry' of the 'Tübingen Affect Battery'. These deficits were not related to executive performance. Our findings suggest that emotional prosody comprehension is deficient in young patients with early stages of RRMS. Deficits in discriminating affective prosody early in the disease may make misunderstandings and poor communication more likely. This might negatively influence interpersonal relationships and quality of life in patients with RRMS. PMID:23126275

  12. [Campylobacter spp.: prevalence and pheno-genotypic characterization of isolates recovered from patients suffering from diarrhea and their pets in La Pampa Province, Argentina].

    PubMed

    Tamborini, Ana L; Casabona, Luis M; Viñas, María R; Asato, Valeria; Hoffer, Alicia; Farace, María I; Lucero, María C; Corso, Alejandra; Pichel, Mariana

    2012-01-01

    The prevalence of Campylobacter spp. was investigated in 327 patients suffering from diarrhea and in 36 animals (dogs, cats and chickens) owned by the patients that presented infection by Campylobacter in Santa Rosa, La Pampa, Argentina. Campylobacter spp. was isolated in 50/327 patients and in 12/36 animals, being Campylobacter jejuni the most common species. Resistance to ciprofloxacin (65 %) and tetracycline (32 %) was found among 35 isolates of human origin studied. Seven genetic subtypes were observed among 13 C. jejuni isolates by pulsed field gel electrophoresis. Two subtypes grouped isolates belonging to patients and their respective dogs whereas another subtype grouped one isolate of human origin and two isolates from the patient's chickens. The results of this investigation highlight the need to strengthen surveillance of Campylobacter spp. not only in poultry, which is recognized as the main reservoir, but also in pets, which were shown to be asymptomatic carriers of the pathogen. PMID:23267623

  13. Assessment of the usefulness of skin autofluorescence as an indicator of disease activity and of the risk of developing diabetes in patients suffering from rheumatoid arthritis

    PubMed Central

    Jeka, Sławomir; Kolossa, Katarzyna; Wojciechowski, Rafał; Wilińska-Jankowska, Arnika; Waszczak, Marzena

    2015-01-01

    Objectives Diabetes develops much more often in patients suffering from rheumatoid arthritis (RA) than in healthy population. One of the parameters which allow to evaluate the risk of developing diabetes and cardiovascular diseases (CVD) is the level of advanced glycation end products (AGE) in the skin. In patients suffering from RA, an increase in AGE level may be also linked with the course of the underlying disease. The aim of the study was to evaluate the correlation between the AGE level and the course of RA as well as other risk factors for the development of diabetes and CVD. Material and methods The study included 148 patients divided into three groups: group I – patients with RA (n = 102, 79 F/23 M), group II – patients with RA and diabetes (n = 21, 14 F/7 M), group III – healthy individuals (n = 25, 16 F/9 M). Each patient underwent a skin autofluorescence signal (SAF) examination with an AGE Reader, which allows the assessment of AGE level, as well as being subjected to the laboratory tests panel. Additionally, patients from group I and II have had their DAS28 (ESR) indicator calculated. Results In groups I, II, and III, the respective mean SAF values, expressed in arbitrary units [au], were to 2.54, 2.74, and 1.96 au. Between-group differences in terms of mean SAF values were statistically significant (p < 0.05). Conclusions Significantly higher mean SAF values in groups I and II as compared to group III suggest that the increase in the AGE level in patients with RA is linked with the underlying disease and does not have to correspond with the real risk of diabetes and CVD. In conclusion, despite the known limitations of the technique, measuring AGE levels allows for closer monitoring of RA patients who are at a higher risk of developing diabetes.

  14. [PROGNOSTICATION OF "HARD" TRACHEAL INTUBATION IN PATIENTS, SUFFERING PURULENT-INFLAMMATORY DISEASES OF THE JAW-FACIAL REGION].

    PubMed

    Artemenko, V Yu; Budnyuk, O O

    2015-11-01

    Clinical follow-up was conducted in 75 patients, to whom the operation and intensive therapy were performed in 2006-2015 yrs for phlegmon of the neck. Difficulties while providing passability of respiratory ways have occurred in 73.3% patients. It was established, that the predictors of "hard" tracheal intubation in patients, operated on for cervical phlegmon, are follows: the cervical tissues oedema, restriction of the mouth opening lesser than 3 cm, odontogenous phlegmon of oral cavity and the neck, rigid epiglottis, the larynx oedema. Presence of these factors demands application of endoscopic methods for tracheal intubation in such patients. PMID:26939430

  15. [The new technologies of kinesiotherapy for the rehabilitation of the patients suffering from the post-stroke locomotor disorders].

    PubMed

    Gusarova, S A; Styazhkina, E M; Gurkina, M V; Chesnikova, E I; Sycheva, A Yu

    2016-01-01

    This paper was designed to report the results of the application of two therapeutic modalities for the rehabilitation of 44 patients presenting with post-stroke locomotor disorders in the form of spastic hemiparesis. The patients allocated to the main group were treated with the use of the new kinesiotherapeutic methods including cryomassage and the Armeo robotic complex. The patients of the control group had to perform traditional therapeutic physical exercises in combination with classical massage and remedial gymnastics. It is concluded that the application of the combination of the modern kinesiotherapeutic factors exerting the positive corrective influence on different aspects of the locomotor deficiency in the upper extremities and the psychoemotional status of the patients has advantages over traditional physical exercise therapy in terms of clinical efficiency because it enhances the rehabilitative potential for these patients with serious locomotor problems. PMID:27213941

  16. The Norwegian version of the Quality of Life Scale (QOLS-N). A validation and reliability study in patients suffering from psoriasis.

    PubMed

    Wahl, A; Burckhardt, C; Wiklund, I; Hanestad, B R

    1998-01-01

    The aim of this study was to adapt, validate, and test for reliability the Quality of Life Scale in Norwegian (QOLS-N) for patients suffering from psoriasis. Two hundred and eighty-two patients with psoriasis were included in the study. Self-reported health was measured using the SF-36. Disease severity was also measured in 95 patients using the Psoriasis Area and Severity Index (PASI). The reliability of the QOLS-N was computed using the internal consistency reliability (Cronbach's alpha) and the test-retest reliability test. Face and content validity and construct discriminant ability of the QOLS-N were assessed. The results indicated that the QOLS-N has highly satisfactory rates of test-retest reliability (r = 0.83) and internal consistency reliability (alpha 0.86). As expected, the QOLS-N had a lower correlation with physical health (r = 0.24, p < 0.000) and self-reported symptoms (r = -0.20, p < 0.001), and a higher correlation with mental health (r = 0.52, p < 0.000). The correlation with disease severity was not significant (-0.06). The results reported in the present paper are in accordance with those derived in other validation studies. The QOLS-N seems to be a reliable and valid measure of global quality of life in patients suffering from psoriasis. PMID:10067647

  17. Positive associations between infections of Toxoplasma gondii and seropositivity with Anisakis simplex in human patients suffering from chronic urticaria.

    PubMed

    Fernández-Fígares, V; Rodero, M; Valls, A; De Frutos, C; Daschner, A; Cuéllar, C

    2015-11-01

    Toxoplasma gondii is a food-borne and orofecal microorganism which produces chronic infection, and attempts have been made to prove its negative association with atopy in the context of the hygiene hypothesis. Anisakis simplex is a fish parasite associated with chronic urticaria (CU) in endemic regions. We analysed the relationship between both infectious agents in CU. We included 42 patients with chronic urticaria (18 patients with CU associated with A. simplex sensitization and 24 not sensitized CU patients). Patients were assessed for atopy by a skin prick test (SPT) against common aeroallergens and for respiratory symptoms. Anisakis simplex sensitization was assessed by SPT and specific IgE by CAP fluoro-enzyme immunoassay (CAP-FEIA). Anti-T. gondii IgG levels were measured by enzyme-linked immunosorbent assay (ELISA). CU patients were analysed with respect to T. gondii seropositivity, A. simplex sensitization, atopy and immigrant status. The seroprevalence of T. gondii was 40.5% in CU patients and 42.1% in the control group. Immigrants were more frequently infected by T. gondii (41.2% versus 12%; P =0.036). Anti-T. gondii IgG antibodies were associated with past A. simplex parasitism (odds ratio 6.73; P =0.03) and independently with atopic sensitization (odds ratio 5.85; P =0.04). In CU patients, T. gondii has no protective effect on atopic sensitization or A. simplex sensitization. PMID:24991841

  18. Genetic variation in glutathione S-transferase genes and risk of nonfatal cerebral stroke in patients suffering from essential hypertension.

    PubMed

    Polonikov, Alexey; Vialykh, Ekaterina; Vasil'eva, Oksana; Bulgakova, Irina; Bushueva, Olga; Illig, Thomas; Solodilova, Maria

    2012-07-01

    Oxidative stress resulting from an increased amount of reactive oxygen species and an imbalance between oxidants and antioxidants has been implicated in pathogenesis of cerebral stroke. The purpose of this study was to investigate the relationship between common polymorphisms of glutathione S-transferase M1, T1, and P1 genes and risk of stroke in hypertensive individuals. A total of 667 unrelated Russian individuals with hypertension, including 306 hypertensives who suffered from cerebral stroke and 361 hypertensives who did not have cerebrovascular accidents, were recruited for the study. The deletion polymorphisms of GSTM1 and GSTT1 genes and polymorphism Ile105Val of the GSTP1 gene were genotyped by a multiplex polymerase chain reaction and restriction analyses, respectively. No differences in GSTM1 and GSTP1 genotype distributions between the cases and controls have been observed. The null GSTT1 genotype was found to be associated with increased risk of cerebral stroke after Bonferroni correction and adjusting for confounding variables such as gender, blood pressure, body mass index, and antihypertensive medication use (odds ratio 1.51 95 % CI 1.09-2.07, P = 0.01). The present study was the first to show the association of null genotype of the GSTT1 gene with increased risk of cerebral stroke. PMID:22528457

  19. Discriminating the Presence of Psychological Distress in Patients Suffering from Psoriasis: An Application of the Clinimetric Approach in Dermatology.

    PubMed

    Offidani, Emanuela; Del Basso, Donatella; Prignago, Francesca; Tomba, Elena

    2016-08-23

    Psoriasis is a chronic dermatologic disease that negatively impacts physical and mental health of patients as well as their social and work life. The aim of this study is to illustrate, by a clinimetric approach the differences in psychological distress and well-being between patients with mild and moderate to severe psoriasis. Seventy patients with psoriasis were evaluated using the Structured Clinical Interview for DSM-IV (SCID-I), the Diagnostic Criteria for Psychosomatic Research (DCPR), along with the following self-report instruments: the Symptoms Questionnaire (SQ), the Psychological Well-being scales (PWB) and the Temperament and Character Inventory (TCI). Illness severity was evaluated using the Psoriasis Area and Severity Index (PASI). While no differences were reported between groups in terms of psychiatric diagnoses, patients with greater severity (PASI <10) presented higher rates of demoralization (61.5%) and Type A behavior (53.8%) than subjects with mild severity (17.5% and 21.1%, respectively). Patients with moderate/severe psoriasis also reported impaired levels of psychological well-being in terms of lower autonomy, environmental mastery, personal growth and purpose in life. Furthermore, according to TCI, patients with severe psoriasis reported greater harm avoidance and lower self-directness than individuals with milder psoriasis levels. Overall results highlighted the need in psoriasis care of a more comprehensive psychological and psychosomatic assessment not limited to the customary psychiatric diagnostic criteria. PMID:27283722

  20. Bed bugs reproductive life cycle in the clothes of a patient suffering from Alzheimer's disease results in iron deficiency anemia.

    PubMed

    Sabou, Marcela; Imperiale, Delphine Gallo; Andrès, Emmanuel; Abou-Bacar, Ahmed; Foeglé, Jacinthe; Lavigne, Thierry; Kaltenbach, Georges; Candolfi, Ermanno

    2013-01-01

    We report the case of an 82-year-old patient, hospitalized for malaise. Her clothes were infested by numerous insects and the entomological analysis identified them as being Cimex lectularius (bed bugs). The history of the patient highlighted severe cognitive impairment. The biological assessment initially showed a profound microcytic, aregenerative, iron deficiency anemia. A vitamin B12 deficiency due to pernicious anemia (positive intrinsic factor antibodies) was also highlighted, but this was not enough to explain the anemia without macrocytosis. Laboratory tests, endoscopy and a CT scan eliminated a tumor etiology responsible for occult bleeding. The patient had a mild itchy rash which was linked to the massive colonization by the bed bugs. The C. lectularius bite is most often considered benign because it is not a vector of infectious agents. Far from trivial, a massive human colonization by bed bugs may cause such a hematic depletion that severe microcytic anemia may result. PMID:23673315

  1. A controlled comparison of oxyfedrine, isosorbide dinitrate and placebo in the treatment of patients suffering attacks of angina pectoris.

    PubMed

    Whittington, J; Raftery, E B

    1980-09-01

    1 In a group of 23 patients with documented ischaemic heart disease who experienced angina pectoris, oral oxyfedrine (24 mg three times daily) was compared with isosorbide dinitrate (10 mg three times daily) and placebo in a double-blind double-crossover clinical trial. 2 Isosorbide dinitrate appeared no better than placebo, either in terms of symptomatic relief or ECG responses to exercise. Thirty eight per cent of patients complained of headaches and 28% had to cease taking the drug for this reason. 3 Oxyfedrine produced statistically significant improvements in both symptom level (P < 0.01) and ECG ST-segment responses to exercise (P < 0.01). The only side effect noted was a reversible loss of taste sensation by one patient. 4 Neither drug produced any adverse changes in any haematological or biochemical parameters. 5 Oxyfedrine is, therefore, to be preferred to isosorbide dinitrate, being both much better tolerated and more efficacious. PMID:7002181

  2. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study

    PubMed Central

    HONDA, Mitsuru; ICHIBAYASHI, Ryo; YOKOMURO, Hiroki; YOSHIHARA, Katsunori; MASUDA, Hiroyuki; HAGA, Daisuke; SEIKI, Yoshikatsu; KUDOH, Chiaki; KISHI, Taichi

    2016-01-01

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1–3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3–4, GCS5–6, and GCS7–8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  3. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study.

    PubMed

    Honda, Mitsuru; Ichibayashi, Ryo; Yokomuro, Hiroki; Yoshihara, Katsunori; Masuda, Hiroyuki; Haga, Daisuke; Seiki, Yoshikatsu; Kudoh, Chiaki; Kishi, Taichi

    2016-08-15

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1-3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3-4, GCS5-6, and GCS7-8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  4. Dysregulation of Mitochondrial Dynamics and the Muscle Transcriptome in ICU Patients Suffering from Sepsis Induced Multiple Organ Failure

    PubMed Central

    Fredriksson, Katarina; Tjäder, Inga; Keller, Pernille; Petrovic, Natasa; Ahlman, Bo; Schéele, Camilla; Wernerman, Jan; Timmons, James A.; Rooyackers, Olav

    2008-01-01

    Background Septic patients treated in the intensive care unit (ICU) often develop multiple organ failure including persistent skeletal muscle dysfunction which results in the patient's protracted recovery process. We have demonstrated that muscle mitochondrial enzyme activities are impaired in septic ICU patients impairing cellular energy balance, which will interfere with muscle function and metabolism. Here we use detailed phenotyping and genomics to elucidate mechanisms leading to these impairments and the molecular consequences. Methodology/Principal Findings Utilising biopsy material from seventeen patients and ten age-matched controls we demonstrate that neither mitochondrial in vivo protein synthesis nor expression of mitochondrial genes are compromised. Indeed, there was partial activation of the mitochondrial biogenesis pathway involving NRF2α/GABP and its target genes TFAM, TFB1M and TFB2M yet clearly this failed to maintain mitochondrial function. We therefore utilised transcript profiling and pathway analysis of ICU patient skeletal muscle to generate insight into the molecular defects driving loss of muscle function and metabolic homeostasis. Gene ontology analysis of Affymetrix analysis demonstrated substantial loss of muscle specific genes, a global oxidative stress response related to most probably cytokine signalling, altered insulin related signalling and a substantial overlap between patients and muscle wasting/inflammatory animal models. MicroRNA 21 processing appeared defective suggesting that post-transcriptional protein synthesis regulation is altered by disruption of tissue microRNA expression. Finally, we were able to demonstrate that the phenotype of skeletal muscle in ICU patients is not merely one of inactivity, it appears to be an actively remodelling tissue, influenced by several mediators, all of which may be open to manipulation with the aim to improve clinical outcome. Conclusions/Significance This first combined protein and

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

    PubMed

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

    2014-02-01

    The purpose of this study was to analyse the associations of emotional control with sociodemographic and clinical variables in a sample of patients with a range of chronic somatic diseases. The relationships between emotional control, coping styles and adjustment to the disease were investigated. The sample consisted of 300 patients with the mean age of 54.60 ± 17.57 years. Courtauld Emotional Control Scale was used to measure the patients' tendency to suppress negative emotions, Coping Inventory for Stressful Situations was used to measure coping styles and Acceptance of Illness Scale was applied to determine adjustment to the disease. Patients with neurological conditions showed significantly lower suppression of anger. Levels of emotional control were found to be related to gender, age and educational level but not to the place of residence. Task-oriented style of coping with stress correlated positively with suppression of depression and anxiety, whereas acceptance of illness correlated negatively with suppression of anger. Levels of emotional control are only weakly related to the type of diagnosis; however, some clinical samples may show lower suppression of anger. Suppression of negative emotions is weakly related to adjustment indicators such as certain coping styles and acceptance of illness. PMID:23653433

  6. Evaluation of risk markers fluctuation during an initial therapy with rosiglitazon in patients suffering from metabolic syndrome.

    PubMed

    Macić-Dzanković, Amra; Dzanković, Fuad; Pojskić, Belma; Velija-Asimi, Zelija

    2009-11-01

    The aim of this study was to examine the effects of hypoglycaemic drug-agonists of PPAR-gama receptors-rosiglitazone (Avandia,4 mg - Glaxo Smith Kline) on values of wide-spread risk - markers-fibrinogen, C-reactive protein and uric acid and glicolysated haemoglobin HbA1C as parameter of metabolic control .We included fourty patients with criteria for metabolic syndrome and evaluated results into groups of diabetic and prediabetic patients according to criteria of IDF (International Diabetic Federation)These risk markers and glicolysated haemoglobin HbA1C were observed at the start of therapy, then after four, eight and twelve weeks and results were compared and statistically calculated. Three months initial therapy with rosiglitazone significantly reduced values of HbA1C, fibrinogen and CRP but not uric acid in prediabetic patients.Rosiglitazone initial three months therapy significantly reduced HbA1C, fibrinogen and uric acid, but not CRP in diabetic patients. PMID:20001999

  7. Efficacy and Safety of Low-Dose Doxepin in Depressed Patients Suffering From Insomnia: A Retrospective, Naturalistic Case Series Analysis

    PubMed Central

    Mews, Marie Rosa; Rombold, Felicitas

    2014-01-01

    Objective: Low-dose doxepin has produced favorable results in healthy adults and elderly persons with chronic or transient insomnia, while exhibiting an amenable adverse event profile. The aim of this article is to investigate the efficacy and safety of low-dose doxepin for insomnia in depressed patients. Method: In this retrospective case series analysis, the files of 17 inpatients diagnosed with major depressive disorder (MDD) and comorbid insomnia between January 1, 2011, and October 1, 2012 who had received a course of off-label doxepin (< 25 mg/d) were analyzed with regard to dose, efficacy, and safety for up to 4 weeks of treatment. Hamilton Depression Rating Scale (HDRS) sleep item scores were used to estimate efficacy. Results: Our results showed no improvement in sleep onset and sleep maintenance insomnia in patients with MDD during the 4 weeks of treatment. We found a significant improvement in insomnia between baseline and week 3 when considering all 3 HDRS sleep items (P = .058). Conclusion: Contrasting previous results in healthy subjects, low-dose doxepin does not seem to improve sleep onset or maintenance in patients with MDD. Further research, preferably placebo-controlled, double-blind sleep laboratory trials, is necessary to determine whether low-dose doxepin may be beneficial in this important patient subgroup. PMID:24940524

  8. [Susceptibility of induced sickle in samples of heterozygous hemoglobin S patients (sickle cell trait) suffering diabetes mellitus type 2].

    PubMed

    Díaz-Piedra, Pablo; Cervantes-Villagrana, Alberto Rafael; Ramos-Jiménez, Raúl; Presno-Bernal, José Miguel; Cervantes-Villagrana, Rodolfo Daniel

    2015-01-01

    Hemoglobin S is an abnormal protein that induces morphological changes in erythrocyte in low-oxygen conditions. In Mexico, it is reported that up to 13.7% of the population with mutation in one allele are considered asymptomatic (sickle cell trait). The sickle cell trait and diabetes mellitus are conditions that occur together in more than one million patients worldwide. Both diseases possibly produce microvascular changes in retinopathy and acute chest syndrome. The aim of this study was to evaluate the induction of sickle cells in samples of diabetic patients with sickle cell trait to identify altered red cell parameters. We obtained samples of diabetic patients to determine hemoglobin A1c and S; furthermore, red blood cell biometrics data were analyzed. We found that older men with diabetes were susceptible to generate sickle cells and this correlated with reduced red blood cell count and an increase in media cell volume. In samples of women diabetes, there were no differences. We conclude that samples from patients with sickle cell trait and diabetes can cause sickle cells with high frequency in men, with lower red blood cells count and increased mean corpuscular volume as susceptibility parameters. PMID:26581534

  9. Clinical outcomes of a coping with stress training program among patients suffering from schizophrenia and schizoaffective disorder: a pilot study.

    PubMed

    Vázquez Pérez, María Luisa; Godoy-Izquierdo, Débora; Godoy, Juan F

    2013-03-01

    This study evaluated the clinical effects of an intervention aimed at enhancing specific self-efficacy for coping with stress (CSSE) among patients with psychosis. Fourteen patients, 21-60 years old, diagnosed with schizophrenia or schizoaffective disorder voluntarily participated and were randomly assigned to a training and a control group. The Brief Psychiatric Rating Scale-24 was used to assess psychotic symptoms (primary outcomes) at baseline, post-intervention, and three- and six-month follow-ups. The participants also completed self-reports on well-being and satisfaction with intervention outcomes (secondary outcomes) at post-intervention and at the two follow-up assessments. Trained patients showed a significant decrease in all measures of psychotic symptoms (for disorientation, not significant (NS); effect sizes up to d=4.80). This decline in symptoms remained significant at the follow-ups, with clinical enhancements on some of the subscales. By contrast, control participants showed no significant change in their symptoms. Short- and long-term overall well-being and satisfaction with outcomes were higher among the participants who received the training program. Our findings point out the relevance of enhancing CSSE among patients with psychosis, along with enhancing their coping skills for managing their illness. We conclude that CSSE training should be considered in future therapeutic interventions for psychotic disorders. PMID:22300334

  10. [Living situation of the in-home patients suffering from amyotrophic lateral sclerosis in Aichi prefecture, Japan].

    PubMed

    Ichikawa, Yuko; Tsunoda, Yuka; Nishikawa, Tomoko; Fujikake, Akifumi; Fukuoka, Taka-Aki; Tokui, Keisuke; Niwa, Jun-Ichi; Izumi, Masayuki; Nakao, Naoki; Doyu, Manabu

    2012-01-01

    It is essential that we know the real situation of at-home patients with amyotrophic lateral sclerosis (ALS) in order to improve their medical support system. We indirectly investigated the daily living status of ALS patients and their families at home by conducting on individual questionnaires survey for nurses working at public health centers in Aichi prefecture, Japan. Detailed information about 136 cases was obtained, and we could clarify the need for variety of communication methods, plasticity of medical interrelations and care between neurologists and home doctors, incomplete utilization of social resources including various official support, overwork among single caregivers, and underdeveloped immature individual medical care support programs for them. Thus it might be important that we should promote the sure utilization of social resources and programming the individual medical care support in their earlier stages. And moreover, we should also consider constructing a general support system for at-home patients with ALS, in which each professional would owe the dividing responsibility, without role duplications. These strategies would lead to overall the better quality of life among ALS patients, and their families. PMID:22688111

  11. 'Islamic fatalism': life and suffering among Bangladeshi psychiatric patients and their families in London--an interview study 2.

    PubMed

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in eastern London demonstrated frequent appeals to God and deprecation of personal agency. This paper offers an interpretation of this apparent 'fatalism', which argues for the logical downplaying of human agency and ambition in archaic Arabia, contemporary rural Sylhet and among first generation Sylheti migrants in London. PMID:24670160

  12. [Neuro-otological Studies of Patients Suffering from Dizziness with Cerebrospinal Fluid Hypovolemia after Traffic Accident-associated Whiplash Injuries].

    PubMed

    Yokota, Jun-Ichi; Shimoda, Satoe

    2015-05-01

    Vertigo and dizziness are common clinical manifestations after traffic accident-associated whiplash injury. Recently, Shinonaga et al. (2001) suggested that more than 80% of patients with whiplash injury complaining of these symptoms showed cerebrospinal (CSF) hypovolemia on radioisotope (RI) cisternography (111In-DTPA). However, neuro-otological studies to investigate the pathophysiological mechanisms underlying these symptoms have been insufficient. In the present study, patients complaining of these symptoms with CSF hypovolemia after traffic accidents were investigated with posturography and electronystagmography (ENG). Fourteen patients (4 men, 10 women; 24-52 yr) were examined with posturography and showed parameters (tracking distance & area) significantly (p<0.01) larger than those of healthy subjects. Among them, five cases (1 man, 4 women; 31-52 yr) were further investigated with ENG. The slow phase peak velocities of optokinetic nystagmus (OKN) and optokinetic-after nystagmus (OKAN) were significantly (p<0.01) reduced (62.64±6.9 SD deg/sec, 60.76±10.74 SD deg/sec, respectively) and frequencies of OKN were reduced (139.7±10.75 SD), while the ocular smooth pursuit was relatively preserved. Magnetic resonance images (sagittal view) of these five patients demonstrated the downward displacement of the cerebellar tonsils and flattening of the pons, which are characteristic features of CSF hypovolemia, called "brain sagging." Our results suggest that brain sagging due to CSF hypovolemia impairs vestibular and vestibulocerebellar functions, which may cause dizziness and vertigo. PMID:25957209

  13. The effect of age on result of straight leg raising test in patients suffering lumbar disc herniation and sciatica

    PubMed Central

    Tabesh, Homayoun; Tabesh, Ariyan; Fakharian, Esmaeil; Fazel, Mohammadreza; Abrishamkar, Saeid

    2015-01-01

    Background: Ninety percent of all people sometimes during their lives experience low back pain, and 30-40% develops radicular leg pain with the sciatica characteristics. Although for clinical diagnosis of lumbar disc herniation (LDH) straight leg raising (SLR) test in 85-90% of cases indicates LDH, but in our practice with LDH patients this test is frequently negative despite radicular leg pain due to LDH. Hence, we decided to evaluate this test in LDH in different age groups. Materials and Methods: All patients with leg pain referring to neurosurgery clinic were enrolled. Those with a history of pain other than sciatica excluded and SLR test and magnetic resonance imaging (MRI) of the lumbosacral spine performed. The patients with negative MRI findings excluded and finally 269 patients with true sciatica and positive MRI were included. SLR tests were performed for different age groups. Results: Of 269 patients, 167 were male. The age range was 16-80 years. The most involved levels were L5-S1 (47%) and L4-L5 (42%), respectively. The rate of positive SLR result, which was 100%, 87% and 82% for 10-19, 20-29 and 30-39 years age group respectively. With an increment of age, the rate of positive test regularly declined. The chance of positive SLR in men is 1.3 times the women (odds ratio [OR] 2.4; 95% confidence interval [CI] = 1.265-4.557; P = 0.007). Increasing the age has suppression effect in positivity of SLR so that for each 1-year the chance of SLR become 0.27 times less to become positive and this is also statically meaningful (OR = 0.271;95% CI = 0.188-0.391; P,0.001). The chance of positive SLR for patients under 60 is 5.4 folds more than patients above 60 years old (OR = 5.4; 95% CI = 4-8.3; P, 0.001). Conclusion: Age, sex (male), and disk level had statistically the effect on SLR positive test. PMID:25983767

  14. A prospective randomized study comparing alfuzosin and tamsulosin in the management of patients suffering from acute urinary retention caused by benign prostatic hyperplasia

    PubMed Central

    Agrawal, Madhu S.; Yadav, Abhishek; Yadav, Himanshu; Singh, Amit K.; Lavania, Prashant; Jaiman, Richa

    2009-01-01

    Objective: Prospective randomized study to compare the efficacy and safety of alfuzosin and tamsulosin in patients suffering from acute urinary retention caused by benign prostatic hyperplasia (BPH). Methods: Patients with acute urinary retention (AUR) due to BPH (total 150) were catheterized and randomized into three groups: Group A: alfuzosin 10 mg (50 patients), Group B: tamsulosin 0.4 mg (50 patients), Group C: placebo (50 patients). After three days, catheter was removed, and patients were put on trial without catheter (TWOC). Patients with successful TWOC were followed up for three months, taking into account the prostate symptom score (AUA Score), post-void residual urine volume (PVRV), and peak flow rate (PFR). ANOVA was used for statistical analysis. Results: Both group A (alfuzosin) and group B (tamsulosin) had similar results of TWOC (group A – 66%, group B – 70%), which were significantly superior than group C (placebo) – 36%. In follow up, three (9.1%) patients in group A, three (8.6%) patients in group B and eight (44.4%) patients in group C had retention of urine, requiring recatheterization. These patients were withdrawn from the study. After three months, alfuzosin- or tamsulosin-treated patients showed a significant decrease in AUA score and PVRV; and a significant increase in PFR as compared to placebo. Conclusions: TWOC was more successful in men treated with either alfuzosin or tamsulosin and the subsequent need for recatheterization was also reduced. Tamsulosin was comparable to alfuzosin in all respects, except a small but significant side effect of retrograde ejaculation. PMID:19955671

  15. Roundtable on public policy affecting patient safety.

    PubMed

    Crane, Robert M; Raymond, Brian

    2011-03-01

    On April 15, 2010, patient safety experts were assembled to discuss the adequacy of the public policy response to the Institute of Medicine report "To Err is Human" 10 years after its publication. The experts concluded that additional government actions should be considered. Actions that deserve consideration include the development of an educational campaign to improve public and provider understanding of the issue as a means to support change similar to successful public health campaigns, support the evolution of payment reform away from fee for service, create a clearer aim or goal for patient safety activities, support the development and use of better safety measures to judge status and improvement, and support for additional learning of what works particularly on implementation issues. Participants included: Moderator Robert Crane, senior advisor, Kaiser Permanente Participants Doug Bonacum, vice president, Safety Management, Kaiser Permanente Janet Corrigan, PhD, president and CEO, National Quality Forum Helen Darling, MA, president and CEO, National Business Group on Health Susan Edgman-Levitan, PA, executive director, John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital David M. Lawrence, MD, MPH, chairman and CEO (Retired), Kaiser Foundation Health Plan and Hospitals, Inc Lucian Leape, MD, adjunct professor of Health Policy, Harvard School of Public Health Diane C. Pinakiewicz, president, National Patient Safety Foundation Robert M. Wachter, MD, professor and associate chairman, Department of Medicine, University of California, San Francisco. PMID:22026014

  16. Suffering and salutogenesis.

    PubMed

    Oliveira, Clara Costa

    2015-06-01

    In considering pain and suffering, some considerations will appear about epistemological beliefs shaping the clinical practices of health-care workers. With this, we try to understand the usual omission of human suffering in the training of many health professionals. So, we emphasize the role of the pathogenic paradigm in how human suffering is viewed in health care. In contrast to those who see suffering only as pathogenic, we defend that suffering can be a source of significant learning for both the sufferer as well as those who undertake caring in certain circumstances. We therefore argue that it is necessary to educate for health and not only for illness, choosing a holistic paradigm: Aaron Antonovky's salutogenic model that encloses positive aspects of human suffering when it is lived with an internal sense of coherence. PMID:25073763

  17. DNA analysis of renal electrolyte transporter genes among patients suffering from Bartter and Gitelman syndromes: summary of mutation screening.

    PubMed

    Urbanová, M; Reiterová, J; Stěkrová, J; Lněnička, P; Ryšavá, R

    2011-01-01

    Patients with renal diseases associated with salt-losing tubulopathies categorized as Gitelman and classic form of Bartter syndrome have undergone genetic screening for possible mutation capture in two different genes: SLC12A3 and CLCNKB. Clinical symptoms of these two diseases may overlap. Patients with clinical symptoms of antenatal form of Bartter syndrome were screened for mutations in two different genes: KCNJ1 and SLC12A1. The aim was to establish genetic mutation screening of Bartter/Gitelman syndrome and to confirm the proposed diagnosis. We have identified seven different causative mutations in the SLC12A3 gene, four in the CLCNKB gene, two in the SLC12A1 gene, and none in the KCNJ1 gene. Nine of these mutations are novel. In one case, genetic analysis led to re-evaluation of diagnosis between the Gitelman and classic form of Bartter syndrome. PMID:21631963

  18. Potential Inherited Causes of Recurrent Prosthetic Mitral Valve Thrombosis in a Pregnant Patient Suffering from Recurrent Miscarriage

    PubMed Central

    Gursoy, M. Ozan; Karakoyun, Suleyman; Yesin, Mahmut; Astarcioglu, Mehmet Ali; Ozkan, Mehmet

    2014-01-01

    An effective anticoagulation is critical in pregnant patients with prosthetic heart valves. Inherited disorders may interfere with the coagulation cascade and may be associated with obstetrical complications as well as with prosthetic valve-derived complications. The patient in the present case had a history of recurrent prosthetic heart valve thrombosis (PHVT) despite an effective anticoagulation. She underwent a thrombolysis with low-dose prolonged infusion of tissue-type plasminogen activator for the management of her recurrrent prosthetic valve thrombosis. The genetic testing showed homozygous mutations of methylenetetrahydrofolate reductase (MTHFR) A 1298 C and heterozygous mutations of β-fibrinogen 455 G-A. Inherited disorders such as MTHFR A 1298 C and fibrinogen 455G/A polymorphisms may be involved in the pathogenesis of recurrent PHVT and/or pregnancy loss. PMID:25089140

  19. A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician.

    PubMed

    Booij, Suzanne J; Engberts, Dick P; Rödig, Verena; Tibben, Aad; Roos, Raymund A C

    2013-10-01

    Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases. PMID:23264360

  20. Evaluation of the Effectiveness of a Novel Brain and Vestibular Rehabilitation Treatment Modality in PTSD Patients Who have Suffered Combat-Related Traumatic Brain Injuries

    PubMed Central

    Carrick, Frederick R.; McLellan, Kate; Brock, J. Brandon; Randall, Cagan; Oggero, Elena

    2015-01-01

    Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a “signature injury.” Vestibular complaints are the most frequent sequelae of mTBI, and vestibular rehabilitation (VR) has been established as the most important treatment modality for this group of patients. Materials and Methods: We studied the effectiveness of a novel brain and VR treatment post-traumatic stress disorder (PTSD) in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6). We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores pre- and post-treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results: Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. Forty-one subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment, we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion: Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family, and society. PMID:25699246

  1. Psychological and behavioral intervention improves the quality of life and mental health of patients suffering from differentiated thyroid cancer treated with postoperative radioactive iodine-131

    PubMed Central

    Wu, Hong-Xia; Zhong, Hua; Xu, Yue-Dong; Xu, Cui-Ping; Zhang, Ying; Zhang, Wei

    2016-01-01

    Background We examined the effects of psychological and behavioral intervention on health-related quality of life and mental health among patients suffering from differentiated thyroid cancer (DTC) treated with postoperative radioactive iodine-131 (RAI). Methods Sixty patients with DTC, undergoing RAI, were randomly assigned to receive either conventional nursing (n=30) or a 1-year psychological and behavioral intervention based on conventional nursing (n=30). Health-related quality of life and mental health issues, depression, and anxiety were measured using the Quality of Life Core Questionnaire, Self-rating Depression Scale, and Self-rating Anxiety Score, respectively. Results After RAI treatment, patients in both groups showed improved functional capacities (ie, physical, role, cognitive, emotional, and social) and global quality of life, along with reduced depression and anxiety (P<0.05). At 1-year follow-up, compared with patients in the routine nursing group, those in the psychological and behavioral intervention group demonstrated greater improvements in functional capacities, global quality of life, and depression and anxiety symptoms (P<0.05). Conclusion Psychological and behavioral interventions for patients with DTC undergoing RAI facilitated positive outcomes, suggesting that nursing care models that include psychological and behavioral interventions may be a complementary strategy for this patient population. PMID:27194911

  2. Evaluating periodontal risk for patients at risk of or suffering from atherosclerosis: recent biological hypotheses and therapeutic consequences.

    PubMed

    Huck, Olivier; Saadi-Thiers, Kenza; Tenenbaum, Henri; Davideau, Jean-Luc; Romagna, Christine; Laurent, Yves; Cottin, Yves; Roul, José G

    2011-05-01

    Cardiovascular disease, such as atherosclerosis, is the main cause of mortality in developed countries. Most atherosclerosis risk factors have been identified and are treated, improving patient cardiovascular status and reducing mortality, but some remain unknown. Periodontal disease is generally defined as inflammatory disease initiated by accumulation of dental bacterial plaque, leading to the destruction of tissues that support the teeth. Severe forms have a high prevalence (15% of the population) and are associated with the presence of virulent pathogens such as Porphyromonas gingivalis. Epidemiological studies have shown that severe periodontal disease negatively influences cardiovascular status. The aim of this paper was to present a synthesis of the most recent biological data related to the link between periodontal and cardiovascular disease. The potential biological mechanisms involved in these two inflammatory diseases (bacteriological theory, inflammatory theory, immune theory) were developed. According to the observed positive effects of periodontal treatment on systemic conditions, the benefit of a reinforced collaboration between dentists and cardiologists was discussed, especially for patients at risk for cardiovascular disease. PMID:21693372

  3. [IMPACT OF QUERCETIN ON SYSTEMIC AND SPLANCHNIC BLOOD CIRCULATION IN A COMPLEX OF PREOPERATIVE PREPARATION IN PATIENTS, SUFFERING AN ACUTE PANCREATITIS].

    PubMed

    Datsyuk, O I

    2016-01-01

    The results of prospective investigation of 76 patients, suffering an acute pancreatitis, in whom Quercetin was applied in content of a starting liquid resuscitation in complex of preoperative preparation, were studied. Its impact on the indices of systemic and splanchnic blood circulation, as well as results of an acute pancreatitis treatment was studied. Inclusion of Quercetin into a scheme of the patients preoperative preparation have promoted the improvement of indices of systemic hemodynamics and the cardiac pump function and enhancement of the left ventricle mechanical work by 18.4% (p < 0.01) at average. A trustworthy reduction of the peak systolic velocity of blood flow in the splanchnic space vessels was established. The systemic and regional blood circulation improvement caused a reduction of the organ dysfunction rate, as well as polyorgan insufficiency from 71.4 to 28.6%. PMID:27249917

  4. Desperation and Other Affective States in Suicidal Patients

    ERIC Educational Resources Information Center

    Hendin, Herbert; Maltsberger, John T.; Haas, Ann Pollinger; Szanto, Katalin; Rabinowicz, Heather

    2004-01-01

    Data collected from 26 therapists who were treating patients when they died by suicide were used to identify intense affective states in such patients preceding the suicide. Eleven therapists provided comparable data on 26 patients they had treated who were seriously depressed but not suicidal. Although the two groups had similar numbers diagnosed…

  5. The art of useless suffering.

    PubMed

    Edgar, Andrew

    2007-12-01

    The purpose of this paper is to explore the role that modernism in the arts might have in articulating the uselessness and incomprehensibility of physical and mental suffering. It is argued that the experience of illness is frequently resistant to interpretation, and as such, it will be suggested, to conventional forms of artistic expression and communication. Conventional narratives, and other beautiful or conventionally expressive aesthetic structures, that presuppose the possibility and desirability of an harmonious and meaningful resolution to conflicts and tensions, may fundamentally misrepresent the patient's experience. By drawing on the work of Emmanuel Levinas (on useless suffering) and the aesthetic theories of Nietzsche and T. W. Adorno, it will be argued first that a faith in the possibility of harmonious resolution of suffering is misplaced and does violence to the experience of suffering. Second, it will be argued that the expression of suffering lies not in finding words, images or sounds that communicate the experience of that suffering to others, but rather in the persistent and radical disruption of any illusion of meaning and coherence that might be imposed upon the experience, so that the very possibility of communication is also disrupted. PMID:17619112

  6. [The phenomenology and psychodynamics of affects in borderline patients].

    PubMed

    Leichsenring, Falk

    2004-01-01

    This paper presents a review of the phenomenology and psychodynamics of affects in borderline patients. The first part demonstrates that in most current conceptions of the borderline disorder affective disturbances are regarded as to be characteristic. In this context, the strong overlap between borderline disorders and affective disorders found in many empirical studies is described and different hypotheses are presented to explain this phenomenon. The second part of this review is concerned with the psychodynamics of affects in borderline patients. The role of affects in thinking, behaviour, self perception and the regulation of object relations is discussed. Borderline and other severe personality disorders are assessed from the perspective of affective disturbances. The psychodynamic functions of particularly characteristic affects such as anger, anxiety, depression and boredom are discussed. The close connection between affective and cognitive functioning in borderline patients is described and evaluated with regard to modern theories of affect and cognition. Finally, the role of affects in the treatment of borderline patients is discussed. PMID:15510348

  7. The development of a knowledge test of depression and its treatment for patients suffering from non-psychotic depression: a psychometric assessment

    PubMed Central

    Gabriel, Adel; Violato, Claudio

    2009-01-01

    Background To develop and psychometrically assess a multiple choice question (MCQ) instrument to test knowledge of depression and its treatments in patients suffering from depression. Methods A total of 63 depressed patients and twelve psychiatric experts participated. Based on empirical evidence from an extensive review, theoretical knowledge and in consultations with experts, 27-item MCQ knowledge of depression and its treatment test was constructed. Data collected from the psychiatry experts were used to assess evidence of content validity for the instrument. Results Cronbach's alpha of the instrument was 0.68, and there was an overall 87.8% agreement (items are highly relevant) between experts about the relevance of the MCQs to test patient knowledge on depression and its treatments. There was an overall satisfactory patients' performance on the MCQs with 78.7% correct answers. Results of an item analysis indicated that most items had adequate difficulties and discriminations. Conclusion There was adequate reliability and evidence for content and convergent validity for the instrument. Future research should employ a lager and more heterogeneous sample from both psychiatrist and community samples, than did the present study. Meanwhile, the present study has resulted in psychometrically tested instruments for measuring knowledge of depression and its treatment of depressed patients. PMID:19754944

  8. Dispositional Affect in Unique Subgroups of Patients with Rheumatoid Arthritis

    PubMed Central

    Rice, Danielle B.; Mehta, Swati; Pope, Janet E.; Harth, Manfred; Shapiro, Allan; Teasell, Robert W.

    2016-01-01

    Background. Patients with rheumatoid arthritis may experience increased negative outcomes if they exhibit specific patterns of dispositional affect. Objective. To identify subgroups of patients with rheumatoid arthritis based on dispositional affect. The secondary objective was to compare mood, pain catastrophizing, fear of pain, disability, and quality of life between subgroups. Methods. Outpatients from a rheumatology clinic were categorized into subgroups by a cluster analysis based on dispositional affect. Differences in outcomes were compared between clusters through multivariate analysis of covariance. Results. 227 patients were divided into two subgroups. Cluster 1 (n = 85) included patients reporting significantly higher scores on all dispositional variables (experiential avoidance, anxiety sensitivity, worry, fear of pain, and perfectionism; all p < 0.001) compared to patients in Cluster 2 (n = 142). Patients in Cluster 1 also reported significantly greater mood impairment, pain anxiety sensitivity, and pain catastrophizing (all p < 0.001). Clusters did not differ on quality of life or disability. Conclusions. The present study identifies a subgroup of rheumatoid arthritis patients who score significantly higher on dispositional affect and report increased mood impairment, pain anxiety sensitivity, and pain catastrophizing. Considering dispositional affect within subgroups of patients with RA may help health professionals tailor interventions for the specific stressors that these patients experience. PMID:27445594

  9. Altered dynamics in the circadian oscillation of clock genes in dermal fibroblasts of patients suffering from idiopathic hypersomnia.

    PubMed

    Lippert, Julian; Halfter, Hartmut; Heidbreder, Anna; Röhr, Dominik; Gess, Burkhard; Boentert, Mathias; Osada, Nani; Young, Peter

    2014-01-01

    From single cell organisms to the most complex life forms, the 24-hour circadian rhythm is important for numerous aspects of physiology and behavior such as daily periodic fluctuations in body temperature and sleep-wake cycles. Influenced by environmental cues - mainly by light input -, the central pacemaker in the thalamic suprachiasmatic nuclei (SCN) controls and regulates the internal clock mechanisms which are present in peripheral tissues. In order to correlate modifications in the molecular mechanisms of circadian rhythm with the pathophysiology of idiopathic hypersomnia, this study aimed to investigate the dynamics of the expression of circadian clock genes in dermal fibroblasts of idiopathic hypersomniacs (IH) in comparison to those of healthy controls (HC). Ten clinically and polysomnographically proven IH patients were recruited from the department of sleep medicine of the University Hospital of Muenster. Clinical diagnosis was done by two consecutive polysomnographies (PSG) and Multiple Sleep Latency Test (MSLT). Fourteen clinical healthy volunteers served as control group. Dermal fibroblasts were obtained via punch biopsy and grown in cell culture. The expression of circadian clock genes was investigated by semiquantitative Reverse Transcriptase-PCR qRT-PCR analysis, confirming periodical oscillation of expression of the core circadian clock genes BMAL1, PER1/2 and CRY1/2. The amplitude of the rhythmically expressed BMAL1, PER1 and PER2 was significantly dampened in dermal fibroblasts of IH compared to HC over two circadian periods whereas the overall expression of only the key transcriptional factor BMAL1 was significantly reduced in IH. Our study suggests for the first time an aberrant dynamics in the circadian clock in IH. These findings may serve to better understand some clinical features of the pathophysiology in sleep - wake rhythms in IH. PMID:24454829

  10. Comparative Effectiveness of Blood Pressure-lowering Drugs in Patients who have Already Suffered From Stroke: Traditional and Bayesian Network Meta-analysis of Randomized Trials.

    PubMed

    Wang, Wei-Ting; You, Li-Kai; Chiang, Chern-En; Sung, Shih-Hsien; Chuang, Shao-Yuan; Cheng, Hao-Min; Chen, Chen-Huan

    2016-04-01

    Hypertension is the most important risk factor for stroke and stroke recurrence. However, the preferred blood pressure (BP)-lowering drug class for patients who have suffered from a stroke has yet to be determined.To investigate the relative effects of BP-lowering therapies [angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blockers (ARB), β blockers, calcium channel blockers (CCBs), diuretics, and combinations of these drugs] in patients with a prior stroke history, we performed a systematic review and meta-analysis using both traditional frequentist and Bayesian random-effects models and meta-regression of randomized controlled trials (RCTs) on the outcomes of recurrent stroke, coronary heart disease (CHD), and any major adverse cardiac and cerebrovascular events (MACCE). Trials were identified from searches of published hypertension guidelines, electronic databases, and previous systematic reviews.Fifteen RCTs composed of 39,329 participants with previous stroke were identified. Compared with the placebo, only ACEI along with diuretics significantly reduced recurrent stroke events [odds ratio (OR) = 0.54, 95% credibility interval (95% CI) 0.33-0.90]. On the basis of the distribution of posterior probabilities, the treatment ranking consistently identified ACEI along with diuretics as the preferred BP-lowering strategy for the reduction of recurrent stroke and CHD (31% and 35%, respectively). For preventing MACCE, diuretics appeared to be the preferred agent for stroke survivors (34%). Moreover, the meta-regression analysis failed to demonstrate a statistical significance between BP reduction and all outcomes (P = 0.1618 for total stroke, 0.4933 for CHD, and 0.2411 for MACCE).Evidence from RCTs supports the use of diuretics-based treatment, especially when combined with ACEI, for the secondary prevention of recurrent stroke and any vascular events in patients who have suffered from stroke. PMID:27082571

  11. Affective instability in patients with chronic pain: a diary approach.

    PubMed

    Rost, Silke; Van Ryckeghem, Dimitri M L; Koval, Peter; Sütterlin, Stefan; Vögele, Claus; Crombez, Geert

    2016-08-01

    Affective instability, conceptualized as fluctuations in mood over time, has been related to ill-health and psychopathology. In this study, we examined the role of affective instability on daily pain outcomes in 70 patients with chronic pain (Mage = 49.7 years; 46 females) using an end-of-day diary. During a baseline phase, patients completed self-reported questionnaires of pain severity, pain duration, disability, depression, and anxiety. During a subsequent diary phase, patients filled out an electronic end-of-day diary over 14 consecutive days assessing daily levels of pain severity, disability, cognitive complaints, negative affect (NA) and positive affect. Affective instability was operationalized as the mean square of successive differences in daily mood (separately for NA and positive affect), which takes into account the size of affective changes over consecutive days. Results indicated that NA instability was positively associated with daily disability, beyond the effects of daily pain severity. Furthermore, NA instability moderated the relationship between daily pain severity and daily disability and the relationship between daily pain severity and daily cognitive complaints. Positive affect instability, however, showed to be unrelated to all outcomes. Current findings extend previous results and reveal the putative role of affective instability on pain-related outcomes and may yield important clinical implications. Indeed, they suggest that targeting NA instability by improving emotion regulation skills may be a strategy to diminish disability and cognitive complaints in patients with chronic pain. PMID:27075427

  12. Health Insurance Status May Affect Cancer Patients' Survival

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_160304.html Health Insurance Status May Affect Cancer Patients' Survival 2 studies ... certain cancers in America could depend on your health insurance status. Despite improvements in cancer diagnosis and treatment, ...

  13. New aspects on patients affected by dysferlin deficient muscular dystrophy

    PubMed Central

    Klinge, Lars; Aboumousa, Ahmed; Eagle, Michelle; Hudson, Judith; Sarkozy, Anna; Vita, Gianluca; Charlton, Richard; Roberts, Mark; Straub, Volker; Barresi, Rita; Lochmüller, Hanns

    2009-01-01

    Mutations in the dysferlin gene lead to limb girdle muscular dystrophy 2B, Miyoshi myopathy and distal anterior compartment myopathy. A cohort of 36 patients affected by dysferlinopathy is described, in the first UK study of clinical, genetic, pathological and biochemical data. The diagnosis was established by reduction of dysferlin in the muscle biopsy and subsequent mutational analysis of the dysferlin gene. Seventeen mutations were novel; the majority of mutations were small deletions/insertions, and no mutational hotspots were identified. Sixty-one per cent of patients (22 patients) initially presented with limb girdle muscular dystrophy 2B, 31% (11 patients) with a Miyoshi phenotype, one patient with proximodistal mode of onset, one patient with muscle stiffness after exercise and one patient as a symptomatic carrier. A wider range of age of onset was noted than previously reported, with 25% of patients having first symptoms before the age of 13 years. Independent of the initial mode of presentation, in our cohort of patients the gastrocnemius muscle was the most severely affected muscle leading to an inability to stand on tiptoes, and lower limbs were affected more severely than upper limbs. As previous anecdotal evidence on patients affected by dysferlinopathy suggests good muscle prowess before onset of symptoms, we also investigated pre-symptomatic fitness levels of the patients. Fifty-three per cent of the patients were very active and sporty before the onset of symptoms which makes the clinical course of dysferlinopathy unusual within the different forms of muscular dystrophy and provides a challenge to understanding the underlying pathomechanisms in this disease. PMID:19528035

  14. Review of self-reported instruments that measure sleep dysfunction in patients suffering from temporomandibular disorders and/or orofacial pain.

    PubMed

    Sommer, Isabelle; Lavigne, Gilles; Ettlin, Dominik A

    2015-01-01

    Patients with temporomandibular disorders (TMD) and/or orofacial pain (OFP) frequently experience poor sleep quality or suffer from comorbid sleep disorders. Study results suggest that in chronic pain patients, an improvement in sleep quality critically influences the outcomes of interventions on mood and pain. Yet, only a few studies have systematically sought to evaluate the sleep quality of TMD/OFP patients. Standardized and validated self-reported instruments designed for screening sleep disturbances or for the evaluation of treatment outcomes in this population would therefore enhance evidence and improve treatment options. The objectives of the present study were: (1) to review the self-reported instruments that measure sleep dysfunction in studies on TMD/OFP patients, by conducting a systematic literature search; (2) to evaluate their clinimetric evidence; and (3) to provide guidance for future research using such instruments. A total of 26 papers, using eight different instruments, were identified. The most frequently used questionnaires and the only ones with good clinimetric properties were the Insomnia Severity Index followed by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. They were most reliable, valid and time-effective for measuring sleep dysfunctions in patients with TMD/OFP, with only a few practical constraints. Yet, in future studies, an assessment of the relationship between sleep disturbances and chronic pain will have to include instruments measuring the effect of mediator variables such as cognitive or emotional arousal. Research is required to clarify if existing self-reported questionnaires measuring these aspects will promote further insights or if there is a need for new instruments. This future research direction would blend into the overall biopsychosocial concept of TMD/OFP diagnoses and treatment. PMID:25547038

  15. Epidemiological evaluation quality of life in patients suffering from early rheumatoid arthritis: a pragmatic, prospective, randomized, blind allocation controlled of a modular program group intervention

    PubMed Central

    2015-01-01

    OBJECTIVES: Epidemiology has taken on new roles in the management of health care services. In this study, we developed a non-pharmacological self-management modular program group intervention and evaluated its efficacy as an adjunct therapy in patients suffering from early rheumatoid arthritis (RA). METHODS: Patients were randomized to either participate in a non-equivalent intervention group along with the standard of care or only receive standard-of-care treatment at a community rheumatology center. The outcomes measured were a pain visual analog scale (VAS), patient general health (GH) on a VAS, and the Short Form 36 Health Survey version 2 scale measuring quality of life. These parameters were evaluated in the first week to obtain baseline values, and at 20, 32, 48, and 60 weeks to evaluate the efficacy of the intervention group. RESULTS: The patients were randomized, with 100 patients in the intervention group and 106 in the control group. The intervention and control groups were similar with regard to the percentage of women (86% vs. 89.6%), tobacco usage (25% vs. 19.8%), mean age (42.6±13.2 years vs. 46.6±10.9 years), and disease duration (15.3±6.7 months vs. 14.5±6.6 months). The mean outcomes were significantly different between the two groups, and post-hoc pairwise analysis demonstrated significant deterioration in the control group in contrast to improvement in the intervention group at the second, third, fourth, and fifth evaluations. Improvements were often seen as early as the 12-week and 24-week follow-up visits. CONCLUSIONS: Epidemiology contributes to the evaluation of how well specific therapies or other health interventions prevent or control health problems. The modular program group intervention implemented in this study appears to be a suitable and feasible method to facilitate much more comprehensive management of early RA in socioeconomically challenged communities. PMID:26552423

  16. Are physicians' ratings of pain affected by patients' physical attractiveness?

    PubMed

    Hadjistavropoulos, H D; Ross, M A; von Baeyer, C L

    1990-01-01

    The degree to which physical attractiveness and nonverbal expressions of pain influence physicians' perceptions of pain was investigated. Photographs of eight female university students were represented in four experimental conditions created by the manipulation of cosmetics, hairstyles, and facial expressions: (a) attractive-no pain, (b) attractive-pain, (c) unattractive-no pain, and (d) unattractive-pain. Each photograph was accompanied by a brief description of the patient's pain problem that was standard across conditions. Medical residents (N = 60) viewed the photographs and rated each patient's pain, distress, negative affective experience, health, personality, blame for the situation, and the physician's own solicitude for the patient. The results showed that physicians' ratings of pain were influenced both by attractiveness of patients and by nonverbal expressions of pain. Unattractive patients, and patients who were expressing pain, were perceived as experiencing more pain, distress, and negative affective experiences than attractive patients and patients who were not expressing pain. Unattractive patients also received higher ratings of solicitude on the doctor's part and lower ratings of health than attractive patients. Physician's assessments of pain appear to be influenced by the physical attractiveness of the patient. PMID:2367884

  17. Nietzsche and the dilemma of suffering.

    PubMed

    Johnston, J S; Johnston, C

    1999-01-01

    In this paper, we attempt to view a long-held assumption in nursing as mistaken. That is, that patient suffering is something to be overcome. Utilizing Nietzsche's statements on Amor Fati, we carefully examine the cultural assumptions behind our denigration of suffering, look at specific nursing examples of this situation, and attempt the beginnings of a discourse on what it would take for nurses to overcome their own predetermined views of suffering in order to better help their patients "own" their own suffering. PMID:11833584

  18. [Effect of treatment with selenium electrophoresis on biochemical indices in patients suffering from ischaemic cardiac disease with a stable stenocardia of tension].

    PubMed

    Kurtsikidze, I

    2006-08-01

    Disturbances in lipid metabolism, intensification of lipid peroxidize oxidation and functions of sympatho-adrenal system play an important role in the development and progressing of ischaemic cardiac disease. As a result of investigations it has been established that microelement--selenium has an antiatherogenic action and suppresses peroxidize oxidation of lipids. The effect of treatment with selenium electrophoresis in patients suffering from ischaemic cardiac disease with a stable stenocardia of tension has been studied. Total of 76 patients with ICS:SST of I-II functional classes (FC) have been investigated. It has been established that treatment with selenium electrophoresis provokes a reduction of overall cholesterol, triglycerides and beta-lipoproteins content in blood serum, as well as a decrease of cholesterol amount in beta-lipoproteins, lipoproteins of low and very low density and diene conjugates in blood serum and adrenaline and norepinephrine excretion with urine; increase of lipoprotein amount of high density in blood serum, activity of catalase and selenium excretion with urine. Above-said positive changes in biochemical data were more pronounced for the ICS:SST of the first FC. PMID:16980743

  19. A Comparative Study on the Effectiveness of Positive Psychotherapy and Group Cognitive-Behavioral Therapy for the Patients Suffering From Major Depressive Disorder

    PubMed Central

    Asgharipoor, Negar; Asgharnejad Farid, Aliasghar; Arshadi, Hamidreza; Sahebi, Ali

    2012-01-01

    Objective: Aim of this experimental study is evaluating the effectiveness of two different approaches towards the treatment of major depressive disorder (MDD): Positive-oriented psychotherapy and group cognitive-behavior therapy. Methods: Eighteen out-patients suffering from major depression were randomly divided into two groups to be treated according to either of these two approaches. Both groups undertook the treatments for 12 weeks. All the subjects were tested by Beck Depression Inventory, Subjective Wellbeing Scale, Oxford test of Happiness, and the scale of Subjective Units of Distress before and after the treatments. Results: The results show significant differences between the two groups in terms of the variables of happiness and mental distress, suggesting that effectiveness of positive psychotherapy is more than cognitive-behavioral therapy in increasing happiness. These two approaches were significantly different in neither decreasing the acuteness of depression symptoms nor increasing subjective wellbeing. Conclusion: As a whole, the results of this comparative study indicate that positive psychotherapy is more effective in increasing happiness among MDD patients. PMID:24644480

  20. Rethinking Suffering: Allowing for Suffering that is Intrinsic at End of Life.

    PubMed

    Rattner, Maxxine; Berzoff, Joan

    2016-01-01

    The dilemma so central to the work of providers of palliative and end-of-life care is the paradox of their professional and ethical duty to try to relieve suffering and the limitations of so doing. While the capacity to sit with suffering at the end of life is critical to clinical work, the idea that some intrinsic suffering cannot necessarily always be relieved may model for patients and families that suffering can be borne. Clinicians who encounter unrelievable suffering may feel a sense of failure, helplessness, moral distress, and compassion fatigue. While tolerating suffering runs counter to the aims of palliative care, acknowledging it, bearing it, and validating it may actually help patients and families to do the same. "Sitting with suffering" signals a paradigm shift within the discipline of palliative care, as it asks clinicians to rethink their role in being able to relieve some forms of psychosocial suffering intrinsic to dying. PMID:27462954

  1. Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura.

    PubMed

    Paterna, S; Di Pasquale, P; D'Angelo, A; Seidita, G; Tuttolomondo, A; Cardinale, A; Maniscalchi, T; Follone, G; Giubilato, A; Tarantello, M; Licata, G

    2000-01-01

    Many authors have reported an association between the angiotensin-converting enzyme (ACE)-D allele and coronary heart disease and other cardiovascular diseases. The mechanism underlying the positive associations between the ACE-D alleles and diseases are not yet clear. Previous reports showed an association between migraine without aura and ACE-D allele polymorphism. The study is aimed to evaluate if the DD genotype could also be associated with the frequency and duration of migraine without aura. In 302 patients suffering from migraine without aura (at least for 1 year), with no history of cardiovascular diseases and major risk factors for ischemic events, the genotypes of the ACE gene, plasma ACE activity, and the frequency (weekly) and duration of migraine attacks were evaluated. No drugs were given before (4 weeks) and during the study. The same evaluations were performed in 201 subjects without migraine. The molecular biologist and the physician evaluating the patient data were blinded to the clinical history and ACE-DD gene determination. Genotypes were determined by polymerase chain reaction amplification. Plasma ACE activity was performed by the HPLC method. The groups were similar for sex, age and smoking habit (migraines: 302 patients (200 F/102 M), mean age 37.8 +/- 8.2 years; control: 201 subjects (127 F/74 M), mean age 37.5 +/- 9.3 years). Patients with migraine without aura showed higher incidence of the ACE-DD gene (48.34%) than control subjects (37.32%), p < 0.05. The frequency of migraine (average attacks per week) was higher in patients with DD (2.11 +/- 1.9) than in patients with ID (1.54 +/- 1. 44), p < 0.05. No difference in duration of migraine attacks (hours per week) was observed. Plasma ACE activity was increased in patients with the ACE-DD gene. Our data suggest that ACE-DD gene polymorphism could have an important role in determining migraine attacks and the frequency of these attacks. Further data are needed through further studies

  2. Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease.

    PubMed

    Kałka, D; Domagała, Z; Rakowska, A; Womperski, K; Franke, R; Sylwina-Krauz, E; Stanisz, J; Piłot, M; Gebala, J; Rusiecki, L; Pilecki, W

    2016-01-01

    Up to 40% of cases of erectile dysfunction (ED) originate from vascular disturbances associated with atherosclerotic disease, leading to the previously proven concomitance between ischaemic heart disease (IHD) and ED. The aim of this study was to evaluate patients' knowledge about modifiable risk factors for ED. The evaluated group of patients was composed of 502 male patients undergoing cardiac rehabilitation and receiving treatment for IHD. The patients' knowledge of risk factors for ED linked to IHD was assessed with an original survey. The presence of ED was assessed using an abridged version of the International Index of Erectile Function-5 questionnaire. Increase in leisure-time physical activity was estimated using a leaflet based on the Framingham questionnaire. In all, 189 participants were unable to name any modifiable ED risk factors, and only 31 patients knew all 6 of them. The most frequently mentioned ED risk factor was smoking, whereas the least frequently mentioned was sedentary lifestyle. Awareness of smoking as an ED risk factor was closely related to the patients' level of education, place of residence, smoking and underlying ED in the individual patient. The ability to classify diabetes as a risk factor for ED was significantly related to the patients' level of education, place of residence, and the prevalence of diabetes in the evaluated group of respondents. The same relations were observed regarding hyperlipidaemia. Awareness of the negative impact a sedentary lifestyle has on the erectile process was found to be closely related to the patients' age, as well as their level of education. The performed study demonstrates the poor knowledge of IHD patients about the modifiable risk factors for ED. The factor that patients are the least aware of is sedentary lifestyle, which, simultaneously, is the risk factor that most frequently affects the respondents. PMID:26631924

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

    PubMed Central

    Jimenez-Rodríguez, Irene; Garcia-Leiva, Juan Miguel; Jimenez-Rodriguez, Beatriz M; Condés-Moreno, Emilia; Rico-Villademoros, Fernando; Calandre, Elena P

    2014-01-01

    Fibromyalgia is associated with an increased rate of mortality from suicide. In fact, this disease is associated with several characteristics that are linked to an increased risk of suicidal behaviors, such as being female and experiencing chronic pain, psychological distress, and sleep disturbances. However, the literature concerning suicidal behaviors and their risk factors in fibromyalgia is sparse. The objectives of the present study were to evaluate the prevalence of suicidal ideation and the risk of suicide in a sample of patients with fibromyalgia compared with a sample of healthy subjects and a sample of patients with chronic low-back pain. We also aimed to evaluate the relevance of pain intensity, depression, and sleep quality as variables related to suicidal ideation and risks. Logistic regression was applied to estimate the likelihood of suicidal ideation and the risk of suicide adjusted by age and sex. We also used two logistic regression models using age, sex, pain severity score, depression severity, sleep quality, and disease state as independent variables and using the control group as a reference. Forty-four patients with fibromyalgia, 32 patients with low-back pain, and 50 controls were included. Suicidal ideation, measured with item 9 of the Beck Depression Inventory, was almost absent among the controls and was low among patients with low-back pain; however, suicidal ideation was prominent among patients with fibromyalgia (P<0.0001). The risk of suicide, measured with the Plutchik Suicide Risk Scale, was also higher among patients with fibromyalgia than in patients with low-back pain or in controls (P<0.0001). The likelihood for suicidal ideation and the risk of suicide were higher among patients with fibromyalgia (odds ratios of 26.9 and 48.0, respectively) than in patients with low-back pain (odds ratios 4.6 and 4.7, respectively). Depression was the only factor associated with suicidal ideation or the risk of suicide. PMID:24790444

  4. Addition of methylphenidate to intensive dialectical behaviour therapy for patients suffering from comorbid borderline personality disorder and ADHD: a naturalistic study.

    PubMed

    Prada, Paco; Nicastro, Rosetta; Zimmermann, Julien; Hasler, Roland; Aubry, Jean-Michel; Perroud, Nader

    2015-09-01

    Attention deficit hyperactivity disorder (ADHD) is frequently comorbid with borderline personality disorder (BPD). However, few studies have examined how comorbid BPD-ADHD patients, treated or not with methylphenidate (MPH), respond to psychotherapy compared to non-comorbid BPD patients. In this perspective, we used a naturalistic study to compare, during a month-long intensive dialectical behaviour therapy (DBT), the clinical course of BPD patients and comorbid BPD-ADHD patients who were treated or untreated with MPH. Out of the 158 BPD patients recruited, 59 had adult ADHD as a comorbidity; among these, 29 underwent a treatment with MPH or des-methylphenidate, while the 30 others did not. MPH treatment was given non-randomly and only when ADHD was considered to be hampering the capacity of the subjects to follow the therapy. Patients completed the following forms upon admission and after 1 month of treatment: the adult ADHD Self-Report Scale (ASRS v.1.1), the Barratt Impulsiveness Scale (BIS-10), the State-Trait Anger Expression (STAXI), the Beck Depression Inventory II (BDI-II), and the Beck Hopelessness Scale. At baseline, comorbid BPD-ADHD patients showed significantly higher impulsiveness than BPD patients. In the entire sample, there was a significant decrease in all dimensions ranging from small to large effect sizes during the 4-week intensive DBT. BPD-ADHD patients who were undergoing MPH treatment showed a significantly improved response to DBT treatment for Trait-State Anger scores, motor impulsiveness, depression severity, and ADHD severity, when compared to those without stimulant medication. This study outlines the importance of systematically screening BPD patients for ADHD, since a MPH-based treatment will improve the symptoms of patients who are comorbid for BPD and ADHD. Due to the non-random allocation of subjects, more severely affected patients were more readily placed on MPH; this suggests that the more severe the ADHD symptoms, the greater

  5. Control of hair growth using long-pulsed alexandrite laser is an efficient and cost effective therapy for patients suffering from recurrent pilonidal disease.

    PubMed

    Khan, Muhammad Adil Abbas; Javed, Ammar Asrar; Govindan, Karthikeyan Srinivasan; Rafiq, Sadia; Thomas, Kay; Baker, Lynne; Kenealy, John

    2016-07-01

    Pilonidal sinus (PNS) and its surgical management have a profound impact on hospital resources in terms of finances and productive man-hours. Surgical treatment has been the mainstay of treatment of both acute and chronic pilonidal sinus but recurrence is common. The control of hair growth in the sinus region plays an important role in preventing recurrence. Here, we discuss our experience of treating 19 patients suffering from recurrent pilonidal sinus with laser depilation and its long-term cost effectiveness. This is a retrospective study on patients who had recurrence of pilonidal sinus following multiple surgical treatments. They were treated using long-pulsed alexandrite laser for depilation in the sinus area, an outpatient procedure. Their clinical characteristics and outcomes were then evaluated. There was a significant reduction in hair density after laser treatment (p < 0.001). The disease-free period after laser treatment was significantly longer than that one after surgical treatment (p < 0.001). The average cost of repeated surgical treatment per disease-free month was significantly higher than that of laser treatment (p < 0.001). Evidence suggests the role of natal cleft hair growth in the evolution of the pilonidal disease; therefore, control of hair growth should be considered as an adjunct to the initial treatment via surgery. Compared to surgical treatment of recurrences, laser depilation is an efficient and cost-effective method of preventing recurrence and reducing morbidity and loss of man-hours. We suggest that laser depilation of the pilonidal sinus should be funded by clinical commissioning groups. PMID:27003897

  6. New evidence for gait abnormalities among Parkinson's disease patients who suffer from freezing of gait: insights using a body-fixed sensor worn for 3 days.

    PubMed

    Weiss, Aner; Herman, Talia; Giladi, Nir; Hausdorff, Jeffrey M

    2015-03-01

    Previous studies conducted in laboratory settings suggest that the gait pattern in between freezing of gait (FOG) episodes is abnormal among patients with Parkinson's disease (PD) who suffer from FOG (i.e., "freezers"), compared to those who do not (i.e., "non-freezers"). We evaluated whether long-term recordings also reveal gait alterations in freezers and if these features were related to freezing severity and its impact on daily function. 72 patients with PD wore a 3-D accelerometer for 3 days. Acceleration-derived gait features included quantity (e.g., the amount of walking) and quality measures (e.g., gait variability). The New FOG-Questionnaire evaluated the subject's perceptions of FOG severity and its impact. Age, gender, and disease duration were similar (p > 0.19) in the 28 freezers and 44 non-freezers. Walking quantity was similar in the two groups, while freezers walked with higher gait variability (i.e., larger anterior-posterior power spectral density width; p = 0.003) and lower gait consistency (i.e., lower vertical stride regularity; p = 0.007). Group differences were observed when comparing the typical (i.e., median), best, and worst performance among the multiple walking bouts measured. Vertical and medio-lateral gait consistency were associated with the impact of FOG on daily living (r < -0.39, p < 0.044). The present findings demonstrate that freezers have altered gait variability and consistency during spontaneous community ambulation, even during optimal performance, and that these measures are associated with the impact of FOG on daily function. Long-term recordings may provide new insights into PD and augment the monitoring of FOG and its response to therapy. PMID:25069586

  7. [Temporal meaning of suffering].

    PubMed

    Porée, J

    2015-09-01

    If we had to find a few simple words to express what a suffering human being experiences, no matter what ills are causing the suffering and no matter what circumstances underlie the ills themselves, we could unmistakably say that it is the experience of not being able to go on like this. Suffering can be described, in this same sense, as an alteration in temporality. However, describing suffering as such only makes sense if we already have a conception of normal temporality. Yet for this, philosophical tradition offers not one but four competing conceptions. In the present article, we begin by briefly presenting these different conceptions. We then show how each one sheds light, by way of contrast, on a phenomenon whose meaning thus appears to be essentially negative. But does this phenomenon have a negative meaning only? Doesn't it correspond as much to a transformation as an alteration of temporality? This is what we will strive to establish in the third part of the article by relating suffering to hope, in a paradoxical sense of the term. Of the four conceptions of time likely to shed a contrasting light on the upheavals that suffering introduces into our life experience, the one described by Aristotle in Physics is historically the first. In particular, the notion of succession originates therein. But this conception does not account for what makes time the unit of a past, a present, and a future. In Book XI of Confessions, St. Augustine situated this unit not in nature but in the human mind. Hence, his definition of time as a distension of the soul and the necessary division into physical time and psychic time it entails. Husserl's Lessons on the phenomenology of the consciousness of internal time lend credit to this division, but they illuminate only the internal constitution of the "present", which is at the heart of the psychological conception of time. In Being and Time, Heidegger breaks away from this long-standing tradition; in his view, physical time

  8. Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis

    PubMed Central

    Rosemann, Thomas; Joos, Stefanie; Koerner, Thorsten; Szecsenyi, Joachim; Laux, Gunter

    2006-01-01

    Background Chronic diseases like osteoarthritis (OA) substantially affect different dimensions of quality of life (QoL). The aim of the study was to reveal possible factors which mainly influence general practitioners (GPs) assessment of patients' QoL. Methods 220 primary care patients with OA of the knee or the hip treated by their general practitioner for at least one year were included. All GPs were asked to assess patients' QoL based on the patients' history, actual examination and existing x-rays by means of a visual analog scale (VAS scale), resulting in values ranging from 0 to 10. Patients were asked to complete the McMaster Universities Osteoarthritis Index (WOMAC) and the Arthritis Impact Measurement Scale2 Short Form (AIMS2-SF) questionnaire. Results Significant correlations were revealed between "GP assessment" and the AIMS2-SF scales "physical" (rho = 0.495) and "symptom" (rho = 0.598) as well as to the "pain" scale of the WOMAC (rho = 0.557). A multivariate ordinal regression analysis revealed only the AIMS2-SF "symptom" scale (coefficient beta = 0.2588; p = 0.0267) and the x-ray grading according to Kellgren and Lawrence as significant influence variables (beta = 0.6395; p = 0.0004). Conclusion The results of the present study suggest that physicians' assessment of patients' QoL is mainly dominated by physical factors, namely pain and severity of x-ray findings. Our results suggest that socioeconomic and psychosocial factors, which are known to have substantial impact on QoL, are underestimated or missed. Moreover, the overestimation of x-ray findings, which are known to be less correlated to QoL, may cause over-treatment while important and promising targets to increase patients' QoL are missed. PMID:16438717

  9. Nocturnal melatonin secretion in multiple sclerosis patients with affective disorders.

    PubMed

    Sandyk, R; Awerbuch, G I

    1993-02-01

    The pineal gland has been implicated recently in the pathogenesis of multiple sclerosis (MS), a chronic demyelinating disease of CNS. Since nocturnal melatonin secretion is low in some groups of patients with mental depression, we predicted lower melatonin secretion in MS patients with history of affective illness compared to those without psychiatric disorders. To test this hypothesis, we studied single nocturnal plasma melatonin levels and the incidence of pineal calcification (PC) on CT scan in a cohort of 25 MS patients (4 men, 21 women; mean age = 39.4 years, SD = 9.3), 15 of whom had a history of coexisting psychiatric disorders with predominant affective symptomatology. Other factors that may be related to depression such as vitamin B12, folic acid, zinc, magnesium, and homocysteine, were also included in the analysis. Neither any of the metabolic factors surveyed nor the incidence of PC distinguished the psychiatric from the control group. However, the mean melatonin level in the psychiatric patients was significantly lower than in the control group. Since low melatonin secretion in patients with depression may be related to a phase-advance of the circadian oscillator regulating the offset of melatonin secretion, we propose that the depression of MS likewise may reflect the presence of dampened circadian oscillators. Furthermore, since exacerbation of motor symptoms in MS patients may be temporally related to worsening of depression, we propose that circadian phase lability may also underlie the relapsing-remitting course of the disease. Consequently, pharmacological agents such as lithium or bright light therapy, which have been shown to phase-delay circadian rhythms, might be effective in the treatment of affective symptoms in MS as well as preventing motor exacerbation and hastening a remission from an acute attack. PMID:8063528

  10. Clinical factors affecting quality of life of patients with asthma

    PubMed Central

    Uchmanowicz, Bartosz; Panaszek, Bernard; Uchmanowicz, Izabella; Rosińczuk, Joanna

    2016-01-01

    Background In recent years, there has been increased interest in the subjective quality of life (QoL) of patients with bronchial asthma. QoL is a significant indicator guiding the efforts of professionals caring for patients, especially chronically ill ones. The identification of factors affecting the QoL reported by patients, despite their existing condition, is important and useful to provide multidisciplinary care for these patients. Aim To investigate the clinical factors affecting asthma patients’ QoL. Methods The study comprised 100 patients (73 female, 27 male) aged 18–84 years (mean age was 45.7) treated in the Allergy Clinic of the Wroclaw Medical University Department and Clinic of Internal Diseases, Geriatrics and Allergology. All asthma patients meeting the inclusion criteria were invited to participate. Data on sociodemographic and clinical variables were collected. In this study, we used medical record analysis and two questionnaires: the Asthma Quality of Life Questionnaire (AQLQ) to assess the QoL of patients with asthma and the Asthma Control Test to measure asthma control. Results Active smokers were shown to have a significantly lower QoL in the “Symptoms” domain than nonsmokers (P=0.006). QoL was also demonstrated to decrease significantly as the frequency of asthma exacerbations increased (R=−0.231, P=0.022). QoL in the domain “Activity limitation” was shown to increase significantly along with the number of years of smoking (R=0.404; P=0.004). Time from onset and the dominant symptom of asthma significantly negatively affected QoL in the “Activity limitation” domain of the AQLQ (R=−0.316, P=0.001; P=0.029, respectively). QoL scores in the “Emotional function” and “Environmental stimuli” subscale of the AQLQ decreased significantly as time from onset increased (R=−0.200, P=0.046; R=−0.328, P=0.001, respectively). Conclusion Patients exhibiting better symptom control have higher QoL scores. Asthma patients’ Qo

  11. Patterns of Emotion Attribution are Affected in Patients with Schizophrenia.

    PubMed

    Romero-Ferreiro, María Verónica; Aguado, Luis; Rodriguez-Torresano, Javier; Palomo, Tomás; Rodriguez-Jimenez, Roberto

    2015-01-01

    Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η 2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (p s < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η 2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states. PMID:26255714

  12. Factors Affecting Hemodialysis Patients' Satisfaction with Their Dialysis Therapy

    PubMed Central

    Al Eissa, M.; Al Sulaiman, M.; Jondeby, M.; Karkar, A.; Barahmein, M.; Shaheen, F. A. M.; Al Sayyari, A.

    2010-01-01

    Aim. To assess the degree of satisfaction among hemodialysis patients and the factors influencing this satisfaction. Methods. Patients were recruited from 3 Saudi dialysis centers. Demographic data was collected. Using 1 to 10 Likert scale, the patients were asked to rate the overall satisfaction with, and the overall impact of, their dialysis therapy on their lives and to rate the effect of the dialysis therapy on 15 qualities of life domains. Results. 322 patients were recruited (72.6% of the total eligible patients). The mean age was 51.7 years (±15.4); 58% have been on dialysis for >3 years. The mean Charlson Comorbidity Index was 3.2 (±2), and Kt/V was 1.3 (±0.44). The mean satisfaction score was (7.41 ± 2.75) and the mean score of the impact of the dialysis on the patients' lives was 5.32 ± 2.55. Male patients reported worse effect of dialysis on family life, social life, energy, and appetite. Longer period since the commencement of dialysis was associated with adverse effect on finances and energy. Lower level of education was associated with worse dialysis effect on stress, overall health, sexual life, hobbies, and exercise ability. Conclusion. The level of satisfaction is affected by gender, duration on dialysis, educational level, and standard of care given. PMID:21152200

  13. Factors affecting medication adherence in patients with hypertension.

    PubMed

    Karakurt, Papatya; Kaşikçi, Mağfiret

    2012-12-01

    The aim of this study descriptive study was to evaluate concordance with medication and those factors that affect the use of medicine in patients with hypertension. Data were collected using a questionnaire completed by 750 patients with hypertension between December 25, 2003, and April 30, 2004, in an outpatient hypertension clinic in Erzincan, Turkey. It was found that 57.9% of the patients did not use their medicines as prescribed. Forgetfulness, aloneness, and negligence were ranked as the top three reasons for this non-concordance, accounting for almost half (49.3%) of all patients with hypertension studied; price (expensive medicines) accounted for another quarter (26.5%). A statistically significant relationship with non-concordance was found for age, education level and profession. Patients' lack of knowledge related to the complications of hypertension was also found to have a statistically significant relationship with not taking medicines as prescribed. Gender, location of residence and salary were not found to be statistically related to concordance. These results indicate the need to educate patients with hypertension on how to use their medicine regularly and indicate also the target populations for this. PMID:23127428

  14. [Comparative characteristic of blood vessels filling, venous drainage and venous congestion in patients with autonomic vascular dystonia and arterial hypertention who have suffered from Chernobyl accident (according to the data of rheoencephalography and rheovasculagraphy)].

    PubMed

    Vereskun, S B

    2004-01-01

    Reliable differences in venous drainage and venous congestion and blood vessels filling of cerebral hemispheres in patients with vegetovascular dystonic and arterial hypertention who have suffered from Chernobyl accident have been detected by means of impedance tetrapolar plethysmography (rheoanalyzer PA5-01). PMID:15724601

  15. Comparable low-level mosaicism in affected and non affected tissue of a complex CDH patient.

    PubMed

    Veenma, Danielle; Beurskens, Niels; Douben, Hannie; Eussen, Bert; Noomen, Petra; Govaerts, Lutgarde; Grijseels, Els; Lequin, Maarten; de Krijger, Ronald; Tibboel, Dick; de Klein, Annelies; Van Opstal, Dian

    2010-01-01

    In this paper we present the detailed clinical and cytogenetic analysis of a prenatally detected complex Congenital Diaphragmatic Hernia (CDH) patient with a mosaic unbalanced translocation (5;12). High-resolution whole genome SNP array confirmed a low-level mosaicism (20%) in uncultured cells, underlining the value of array technology for identification studies. Subsequently, targeted Fluorescence In-Situ Hybridization in postmortem collected tissues demonstrated a similar low-level mosaicism, independently of the affected status of the tissue. Thus, a higher incidence of the genetic aberration in affected organs as lung and diaphragm cannot explain the severe phenotype of this complex CDH patient. Comparison with other described chromosome 5p and 12p anomalies indicated that half of the features presented in our patient (including the diaphragm defect) could be attributed to both chromosomal areas. In contrast, a few features such as the palpebral downslant, the broad nasal bridge, the micrognathia, microcephaly, abnormal dermatoglyphics and IUGR better fitted the 5p associated syndromes only. This study underlines the fact that low-level mosaicism can be associated with severe birth defects including CDH. The contribution of mosaicism to human diseases and specifically to congenital anomalies and spontaneous abortions becomes more and more accepted, although its phenotypic consequences are poorly described phenomena leading to counseling issues. Therefore, thorough follow-up of mosaic aberrations such as presented here is indicated in order to provide genetic counselors a more evidence based prediction of fetal prognosis in the future. PMID:21203572

  16. [Familial incidence of affective diseases in patients with anorexia nervosa].

    PubMed

    Herpertz-Dahlmann, B

    1988-03-01

    Analysis of family history information about first-, second- and third-degree relatives of 45 anorectic patients and 38 control subjects with different types of neurosis showed significantly more depression and eating disorders in the families of the anorectic group. Our data revealed the same prevalence of psychiatric disorders in general for both groups; the alcoholism rate was higher in the anorectic group without a statistic significance. These findings might provide further evidence of a possible genetic relationship between anorexia nervosa and affective illness. PMID:3388987

  17. ASXL1 but Not TET2 Mutations Adversely Impact Overall Survival of Patients Suffering Systemic Mastocytosis with Associated Clonal Hematologic Non-Mast-Cell Diseases

    PubMed Central

    Damaj, Gandhi; Joris, Magalie; Chandesris, Olivia; Hanssens, Katia; Soucie, Erinn; Canioni, Danielle; Kolb, Brigitte; Durieu, Isabelle; Gyan, Emanuel; Livideanu, Cristina; Chèze, Stephane; Diouf, Momar; Garidi, Reda; Georgin-Lavialle, Sophie; Asnafi, Vahid; Lhermitte, Ludovic; Lavigne, Christian; Launay, David; Arock, Michel; Lortholary, Olivier

    2014-01-01

    Systemic mastocytosis with associated hematologic clonal non-mast cell disease (SM-AHNMD) is a rare and heterogeneous subtype of SM and few studies on this specific entity have been reported. Sixty two patients with Systemic mastocytosis with associated hematologic clonal non-mast cell disease (SM-AHNMD) were presented. Myeloid AHNMD was the most frequent (82%) cases. This subset of patients were older, had more cutaneous lesions, splenomegaly, liver enlargement, ascites; lower bone mineral density and hemoglobin levels and higher tryptase level than lymphoid AHNMD. Defects in KIT, TET2, ASXL1 and CBL were positive in 87%, 27%, 14%, and 11% of cases respectively. The overall survival of patients with SM-AHNMD was 85.2 months. Within the myeloid group, SM-MPN fared better than SM-MDS or SM-AML (p = 0.044,). In univariate analysis, the presence of C-findings, the AHNMD subtypes (SM-MDS/CMML/AML versus SM-MPN/hypereosinophilia) (p = 0.044), Neutropenia (p = 0.015), high monocyte level (p = 0.015) and the presence of ASXL1 mutation had detrimental effects on OS (p = 0.007). In multivariate analysis and penalized Cox model, only the presence of ASXL1 mutation remained an independent prognostic factor that negatively affected OS (p = 0.035). SM-AHNMD is heterogeneous with variable prognosis according to the type of the AHNMD. ASXL1 is mutated in a subset of myeloid AHNMD and adversely impact on OS. PMID:24465546

  18. Evaluation of macrophage antiviral activity in patients affected by neoplasia.

    PubMed

    Merendino, R A; Iannello, D; Arena, A; Bonina, L; Greco, V; Mesiti, M; Chillemi, S; Mastroeni, P

    1988-01-01

    The intrinsic antiviral activity of macrophages has been studied in healthy donors and in patients affected by breast cancer and melanoma. In vitro differentiated macrophages from blood-derived monocytes were infected with measles virus, herpes simplex virus type 2 and adenovirus 17. The challenge was carried out with different multiplicities of infection and the synthesis of virus was tested by evaluating the single cycle growth curve in 24 h. The results obtained show that the restriction of virus infectivity by macrophages is strongly influenced by the multiplicity of infection. This was particularly evident with the adenovirus 17. Moreover, macrophages from patients with melanoma and breast cancer showed an impairment of the intrinsic antiviral activity in comparison with normal subjects. PMID:2842553

  19. Identification of mutations in Colombian patients affected with Fabry disease.

    PubMed

    Uribe, Alfredo; Mateus, Heidi Eliana; Prieto, Juan Carlos; Palacios, Maria Fernanda; Ospina, Sandra Yaneth; Pasqualim, Gabriela; da Silveira Matte, Ursula; Giugliani, Roberto

    2015-12-15

    Fabry Disease (FD) is an X-linked inborn error of glycosphingolipid catabolism, caused by a deficiency of the lisosomal α-galactosidase A (AGAL). The disorder leads to a vascular disease secondary to the involvement of kidney, heart and the central nervous system. The mutation analysis is a valuable tool for diagnosis and genetic counseling. Although more than 600 mutations have been identified, most mutations are private. Our objective was to describe the analysis of nine Colombian patients with Fabry disease by automated sequencing of the seven exons of the GLA gene. Two novel mutations were identified in two patients affected with the classical subtype of FD, in addition to other 6 mutations previously reported. The present study confirms the heterogeneity of mutations in Fabry disease and the importance of molecular analysis for genetic counseling, female heterozygotes detection as well as therapeutic decisions. PMID:26297554

  20. Endocrinological disorders affecting neurosurgical patients: An intensivists perspective

    PubMed Central

    Bajwa, Sukhminder Jit Singh; Haldar, Rudrashish

    2014-01-01

    Management of critically ill neurosurgical patients is often complicated by the presence or development of endocrinological ailments which complicate the clinical scenario and adversely affect the prognosis of these patients. The anatomical proximity to the vital centers regulating the endocrinological physiology and alteration in the neurotransmitter release causes disturbances in the hormonal homeostasis. This paves the way for development of diverse disorders where single or multiple hormones may be involved which can have deleterious effect on the different organ system. Understanding and awareness of these disorders is important for the treating intensivist to recognize these changes early in their course, so that appropriate and timely therapeutic measures can be initiated along with the treatment of the primary malady. PMID:25364671

  1. Factors affecting medication discontinuation in patients with overactive bladder symptoms

    PubMed Central

    Shim, Eun-Jung; Kim, Young-Mi; Kim, Donguk

    2015-01-01

    Objective To find out the factors affecting medication discontinuation in patients with overactive bladder (OAB) symptoms. Methods The clinical data of 125 patients with OAB symptoms who had taken antimuscarinics and behavioral therapy were retrospectively reviewed. Antimuscarinics related outcomes were evaluated by an independent observer with telephone interview. All patients were asked about duration of medication and reason of continuation or discontinuation of antimuscarinics. To determine pre-treatment factors predicting self-report discontinuation of antimuscarinics, variables of only those with P-values <0.25 on the univariate analysis were included in the Cox proportional hazard modeling. Results Mean follow-up was 39.6 months and the proportion of discontinuation of antimuscarinics was 60.0% (75/125). The mean duration of medication was 21.2 months in the continuation group and 3.3 months in the discontinuation group. The reasons of discontinuation of antimuscarinics were improved OAB symptoms (46.7%), tolerable OAB symptoms (33.3%), no change of OAB symptoms (1.3%), side-effects (8.0%) and no desire to take long-term medication (10.7%). The variables affecting remaining cumulative probability of antimuscarinics were age, history of anti-incontinence surgery or vaginal surgery, and having stress predominant urinary incontinence on urodynamic study. Conclusion The lower rate of cumulative continuation of antimuscarinics encourages us to give a more detailed counseling and education to the patients with OAB symptoms before prescription. And explorations about newer agent and non-pharmacologic treatment with good efficacy and lower side-effects are needed. PMID:26623416

  2. Psychiatric Morbidity and Other Factors Affecting Treatment Adherence in Pulmonary Tuberculosis Patients

    PubMed Central

    Pachi, Argiro; Bratis, Dionisios; Moussas, Georgios; Tselebis, Athanasios

    2013-01-01

    As the overall prevalence of TB remains high among certain population groups, there is growing awareness of psychiatric comorbidity, especially depression and its role in the outcome of the disease. The paper attempts a holistic approach to the effects of psychiatric comorbidity to the natural history of tuberculosis. In order to investigate factors associated with medication nonadherence among patients suffering from tuberculosis, with emphasis on psychopathology as a major barrier to treatment adherence, we performed a systematic review of the literature on epidemiological data and past medical reviews from an historical perspective, followed by theoretical considerations upon the relationship between psychiatric disorders and tuberculosis. Studies reporting high prevalence rates of psychiatric comorbidity, especially depression, as well as specific psychological reactions and disease perceptions and reviews indicating psychiatric complications as adverse effects of anti-TB medication were included. In sum, data concerning factors affecting medication nonadherence among TB patients suggested that better management of comorbid conditions, especially depression, could improve the adherence rates, serving as a framework for the effective control of tuberculosis, but further studies are necessary to identify the optimal way to address such issues among these patients. PMID:23691305

  3. Rosa damascena oil improves SSRI-induced sexual dysfunction in male patients suffering from major depressive disorders: results from a double-blind, randomized, and placebo-controlled clinical trial

    PubMed Central

    Farnia, Vahid; Shirzadifar, Mehdi; Shakeri, Jalal; Rezaei, Mansour; Bajoghli, Hafez; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Background A substantial disadvantage of psychopharmacological treatment of major depressive disorder (MDD) with selective serotonin-reuptake inhibitors (SSRIs) is the impact on sexual dysfunction. The aim of the present study was to investigate whether the oil of Rosa damascena can have a positive influence on SSRI-induced sexual dysfunction (SSRI-I SD) of male patients who are suffering from MDD and are being treated with SSRIs. Method In a double-blind, randomized, and placebo-controlled clinical trial, a total of 60 male patients treated with an SSRI and suffering from MDD (mean age =32 years) and SSRI-I SD were randomly assigned to take either verum (R. damascena oil) or a placebo. Patients completed self-ratings of depression and sexual function at baseline, at 4 weeks later, and at the end of the study, 8 weeks after it started. Results Over time, sexual dysfunction improved more in the verum group than in the control group. Improvements were observed in the verum group from week 4 to week 8. Self-rated symptoms of depression reduced over time in both groups, but did so more so in the verum group than in the control group. Conclusion This double-blind, randomized, and placebo-controlled clinical trial showed that the administration of R. damascena oil ameliorates sexual dysfunction in male patients suffering from both MDD and SSRI-I SD. Further, the symptoms of depression reduced as sexual dysfunction improved. PMID:25834441

  4. The relief of existential suffering.

    PubMed

    Kissane, David W

    2012-10-22

    Advanced and progressive illnesses bring existential suffering to patients as an inevitable consequence of the disease and its treatment. Physicians need a typology of existential distress to aid its recognition and improved management. The major forms of existential challenge include (1) death anxiety, (2) loss and change, (3) freedom with choice or loss of control, (4) dignity of the self, (5) fundamental aloneness, (6) altered quality of relationships, (7) our search for meaning, and (8) mystery about what seems unknowable. An adaptive response to each challenge promotes equanimity, peace, and fulfillment while sustaining engagement with life, creativity, and joy. Physicians can do much to nurture courage and maintain each person's sense of meaning, value, and purpose. PMID:22945389

  5. Encounter with Suffering.

    ERIC Educational Resources Information Center

    Kapor-Stanulovic, Nila

    1999-01-01

    Outlines lessons learned during many missions undertaken in countries of the former Soviet Union and former Yugoslavia that were designed to set up psychosocial assistance programs to teach coping skills to children adversely affected by armed conflicts and the socioeconomic transition process from a planned to a market economy. (SM)

  6. Systematic screening for mutations in the human serotonin 1F receptor gene in patients with bipolar affective disorder and schizophrenia

    SciTech Connect

    Shimron-Abarbanell, D.; Harms, H.; Erdmann, J.; Propping, P.; Noethen, M.M.

    1996-04-09

    Using single strand conformational analysis we screened the complete coding sequence of the serotonin 1F (5-HT{sub 1F}) receptor gene for the presence of DNA sequence variation in a sample of 137 unrelated individuals including 45 schizophrenic patients, 46 bipolar patients, as well as 46 healthy controls. We detected only three rare sequence variants which are characterized by single base pair substitutions, namely a silent T{r_arrow}A transversion in the third position of codon 261 (encoding isoleucine), a silent C{r_arrow}T transition in the third position of codon 176 (encoding histidine), and a C{r_arrow}T transition in position -78 upstream from the start codon. The lack of significant mutations in patients suffering from schizophrenia and bipolar affective disorder indicates that the 5-HT{sub 1F} receptor is not commonly involved in the etiology of these diseases. 12 refs., 1 fig., 2 tabs.

  7. Factors Affecting Patients Undergoing Cosmetic Surgery in Bushehr, Southern Iran

    PubMed Central

    Salehahmadi, Zeinab; Rafie, Seyyed Reza

    2012-01-01

    BACKGROUND Although, there have been extensive research on the motivations driving patient to undergo cosmetic procedures, there is still a big question mark on the persuasive factors which may lead individuals to undergo cosmetic surgery. The present study evaluated various factors affecting patients undergoing cosmetic surgery in Bushehr, Southern Iran. METHODS From 24th March 2011 to 24th March 2012, eighty-one women and 20 men who wished to be operated in Fatemeh Zahra Hospital in Bushehr, Southern Iran and Pars Clinic, Iran were enrolled by a simple random sampling method. They all completed a questionnaire to consider reasons for cosmetic procedures. The collected data were statistically analyzed. RESULTS Demographical, sociological and psychological factors such as age, gender, educational level, marital status, media, perceived risks, output quality, depression and self-improvement were determined as factors affecting tendency of individuals to undergo cosmetic surgery in this region. Trend to undergo cosmetic surgery was more prevalent in educational below bachelor degree, married subjects, women population of 30-45 years age group. Education level, age, marital status and gender were respectively the influential factors in deciding to undergo cosmetic surgery. Among the socio-psychological factors, self-improvement, finding a better job opportunity, rivalry, media, health status as well as depression were the most persuasive factors to encourage people to undergo cosmetic surgery too. Cost risk was not important for our samples in decision making to undergo cosmetic surgery. CONCLUSION We need to fully understand the way in which the combination of demographic, social and psychological factors influence decision-making to undergo cosmetic surgery. PMID:25734051

  8. Glycomic Characterization of Induced Pluripotent Stem Cells Derived from a Patient Suffering from Phosphomannomutase 2 Congenital Disorder of Glycosylation (PMM2-CDG)*

    PubMed Central

    Thiesler, Christina T.; Cajic, Samanta; Hoffmann, Dirk; Thiel, Christian; van Diepen, Laura; Hennig, René; Sgodda, Malte; Weiβmann, Robert; Reichl, Udo; Steinemann, Doris; Diekmann, Ulf; Huber, Nicolas M. B.; Oberbeck, Astrid; Cantz, Tobias; Kuss, Andreas W.; Körner, Christian; Schambach, Axel; Rapp, Erdmann; Buettner, Falk F. R.

    2016-01-01

    PMM2-CDG, formerly known as congenital disorder of glycosylation-Ia (CDG-Ia), is caused by mutations in the gene encoding phosphomannomutase 2 (PMM2). This disease is the most frequent form of inherited CDG-diseases affecting protein N-glycosylation in human. PMM2-CDG is a multisystemic disease with severe psychomotor and mental retardation. In order to study the pathophysiology of PMM2-CDG in a human cell culture model, we generated induced pluripotent stem cells (iPSCs) from fibroblasts of a PMM2-CDG-patient (PMM2-iPSCs). Expression of pluripotency factors and in vitro differentiation into cell types of the three germ layers was unaffected in the analyzed clone PMM2-iPSC-C3 compared with nondiseased human pluripotent stem cells (hPSCs), revealing no broader influence of the PMM2 mutation on pluripotency in cell culture. Analysis of gene expression by deep-sequencing did not show obvious differences in the transcriptome between PMM2-iPSC-C3 and nondiseased hPSCs. By multiplexed capillary gel electrophoresis coupled to laser induced fluorescence detection (xCGE-LIF) we could show that PMM2-iPSC-C3 exhibit the common hPSC N-glycosylation pattern with high-mannose-type N-glycans as the predominant species. However, phosphomannomutase activity of PMM2-iPSC-C3 was 27% compared with control hPSCs and lectin staining revealed an overall reduced protein glycosylation. In addition, quantitative assessment of N-glycosylation by xCGE-LIF showed an up to 40% reduction of high-mannose-type N-glycans in PMM2-iPSC-C3, which was in concordance to the observed reduction of the Glc3Man9GlcNAc2 lipid-linked oligosaccharide compared with control hPSCs. Thus we could model the PMM2-CDG disease phenotype of hypoglycosylation with patient derived iPSCs in vitro. Knock-down of PMM2 by shRNA in PMM2-iPSC-C3 led to a residual activity of 5% and to a further reduction of the level of N-glycosylation. Taken together we have developed human stem cell-based cell culture models with stepwise

  9. Glycomic Characterization of Induced Pluripotent Stem Cells Derived from a Patient Suffering from Phosphomannomutase 2 Congenital Disorder of Glycosylation (PMM2-CDG).

    PubMed

    Thiesler, Christina T; Cajic, Samanta; Hoffmann, Dirk; Thiel, Christian; van Diepen, Laura; Hennig, René; Sgodda, Malte; Weiβmann, Robert; Reichl, Udo; Steinemann, Doris; Diekmann, Ulf; Huber, Nicolas M B; Oberbeck, Astrid; Cantz, Tobias; Kuss, Andreas W; Körner, Christian; Schambach, Axel; Rapp, Erdmann; Buettner, Falk F R

    2016-04-01

    PMM2-CDG, formerly known as congenital disorder of glycosylation-Ia (CDG-Ia), is caused by mutations in the gene encoding phosphomannomutase 2 (PMM2). This disease is the most frequent form of inherited CDG-diseases affecting protein N-glycosylation in human. PMM2-CDG is a multisystemic disease with severe psychomotor and mental retardation. In order to study the pathophysiology of PMM2-CDG in a human cell culture model, we generated induced pluripotent stem cells (iPSCs) from fibroblasts of a PMM2-CDG-patient (PMM2-iPSCs). Expression of pluripotency factors andin vitrodifferentiation into cell types of the three germ layers was unaffected in the analyzed clone PMM2-iPSC-C3 compared with nondiseased human pluripotent stem cells (hPSCs), revealing no broader influence of the PMM2 mutation on pluripotency in cell culture. Analysis of gene expression by deep-sequencing did not show obvious differences in the transcriptome between PMM2-iPSC-C3 and nondiseased hPSCs. By multiplexed capillary gel electrophoresis coupled to laser induced fluorescence detection (xCGE-LIF) we could show that PMM2-iPSC-C3 exhibit the common hPSC N-glycosylation pattern with high-mannose-type N-glycans as the predominant species. However, phosphomannomutase activity of PMM2-iPSC-C3 was 27% compared with control hPSCs and lectin staining revealed an overall reduced protein glycosylation. In addition, quantitative assessment of N-glycosylation by xCGE-LIF showed an up to 40% reduction of high-mannose-type N-glycans in PMM2-iPSC-C3, which was in concordance to the observed reduction of the Glc3Man9GlcNAc2 lipid-linked oligosaccharide compared with control hPSCs. Thus we could model the PMM2-CDG disease phenotype of hypoglycosylation with patient derived iPSCsin vitro Knock-down ofPMM2by shRNA in PMM2-iPSC-C3 led to a residual activity of 5% and to a further reduction of the level of N-glycosylation. Taken together we have developed human stem cell-based cell culture models with stepwise reduced

  10. Neurophysiologic studies in nightmare sufferers.

    PubMed

    Newell, S A; Padamadan, H; Drake, M E

    1992-10-01

    Nightmares have long attracted neurologic and psychiatric attention, yet little is known of their pathophysiology. We recorded 17-channel electroencephalograms (EEGs), brainstem auditory evoked potentials (BAEPs), long-latency auditory event-related potentials (AEPs), and overnight cassette sleep EEGs (AEEGs) in 10 individuals with recurrent nightmares. They were all nocturnal sleepers, took no medications, do not abuse alcohol or drugs, and had no known medical or psychiatric illnesses. Five patients were being evaluated for other complaints, 3 reported disturbed nocturnal sleep and daytime sleepiness, and 2 sought attention chiefly for nightmares. All 10 patients had normal EEGs and BAEPs. BAEP latencies did not differ significantly from control subjects. Latencies and amplitudes of AEPs were not significantly different in nightmare sufferers and controls, but the former had higher amplitude N100, P160, and N200. Those patients with sleep complaints had on overnight AEEG, less sleep, decreased slow-wave sleep, and more awakenings than those without sleep complaints, but nightmares did not occur during the AEEG recordings. PMID:1395059

  11. Interventions That Affect Gastrointestinal Motility in Hospitalized Adult Patients

    PubMed Central

    Asrani, Varsha M.; Yoon, Harry D.; Megill, Robin D.; Windsor, John A.; Petrov, Maxim S.

    2016-01-01

    Abstract Gastrointestinal (GI) dysmotility is a common complication in acute, critically ill, postoperative, and chronic patients that may lead to impaired nutrient delivery, poor clinical, and patient-reported outcomes. Several pharmacological and nonpharmacological interventions to treat GI dysmotility were investigated in dozens of clinical studies. However, they often yielded conflicting results, at least in part, because various (nonstandardized) definitions of GI dysmotility were used and methodological quality of studies was poor. While a universally accepted definition of GI dysmotility is yet to be developed, a systematic analysis of data derived from double-blind placebo-controlled randomized trials may provide robust data on absolute and relative effectiveness of various interventions as the study outcome (GI motility) was assessed in the least biased manner. To systematically review data from double-blind placebo-controlled randomized trials to determine and compare the effectiveness of interventions that affect GI motility. Three electronic databases (MEDLINE, SCOPUS, and EMBASE) were searched. A random effects model was used for meta-analysis. The summary estimates were reported as mean difference (MD) with the corresponding 95% confidence interval (CI). A total of 38 double-blind placebo-controlled randomized trials involving 2371 patients were eligible for inclusion in the systematic review. These studies investigated a total of 20 different interventions, of which 6 interventions were meta-analyzed. Of them, the use of dopamine receptor antagonists (MD, −8.99; 95% CI, −17.72 to −0.27; P = 0.04) and macrolides (MD, −26.04; 95% CI, −51.25 to −0.82; P = 0.04) significantly improved GI motility compared with the placebo group. The use of botulism toxin significantly impaired GI motility compared with the placebo group (MD, 5.31; 95% CI, −0.04 to 10.67; P = 0.05). Other interventions (dietary factors, probiotics, hormones) did

  12. Factors Affecting Exercise Test Performance in Patients After Liver Transplantation

    PubMed Central

    Kotarska, Katarzyna; Wunsch, Ewa; Jodko, Lukasz; Raszeja-Wyszomirska, Joanna; Bania, Izabela; Lawniczak, Malgorzata; Bogdanos, Dimitrios; Kornacewicz-Jach, Zdzislawa; Milkiewicz, Piotr

    2016-01-01

    Background Cardiovascular diseases are a leading cause of morbidity and mortality in solid organ transplant recipients. In addition, low physical activity is a risk factor for cardiac and cerebrovascular complications. Objectives This study examined potential relationships between physical activity, health-related quality of life (HRQoL), risk factors for cardiovascular disease, and an exercise test in liver-graft recipients. Patients and Methods A total of 107 participants (62 men/45 women) who had received a liver transplantation (LT) at least 6 months previously were evaluated. Physical activity was assessed using three different questionnaires, while HRQoL was assessed using the medical outcomes study short form (SF)-36 questionnaire, and health behaviors were evaluated using the health behavior inventory (HBI). The exercise test was performed in a standard manner. Results Seven participants (6.5%) had a positive exercise test, and these individuals were older than those who had a negative exercise test (P = 0.04). A significant association between a negative exercise test and a higher level of physical activity was shown by the Seven-day physical activity recall questionnaire. In addition, HRQoL was improved in various domains of the SF-36 in participants who had a negative exercise test. No correlations between physical activity, the exercise test and healthy behaviors, as assessed via the HBI were observed. Conclusions Exercise test performance was affected by lower quality of life and lower physical activity after LT. With the exception of hypertension, well known factors that affect the risk of coronary artery disease had no effect on the exercise test results. PMID:27226801

  13. Obesity Adversely Affects Survival in Pancreatic Cancer Patients

    PubMed Central

    McWilliams, Robert R.; Matsumoto, Martha E.; Burch, Patrick A.; Kim, George P.; Halfdanarson, Thorvardur R.; de Andrade, Mariza; Reid-Lombardo, Kaye; Bamlet, William R.

    2010-01-01

    Purpose Higher body-mass index (BMI) has been implicated as a risk factor for developing pancreatic cancer, but its effect on survival has not been thoroughly investigated. We assessed the association of BMI with survival in a sample of pancreatic cancer patients and utilized epidemiologic and clinical information to understand the contribution of diabetes and hyperglycemia. Methods A survival analysis using Cox proportional hazards by usual adult BMI was performed on 1,861 unselected patients with pancreatic adenocarcinoma; analyses were adjusted for covariates that included clinical stage, age, and sex. Secondary analyses incorporated self reported diabetes and fasting blood glucose in the survival model. Results BMI as a continuous variable was inversely associated with survival from pancreatic adenocarcinoma [hazard ratio 1.019 for each increased unit of BMI (kg/m2), p < 0.001] after adjustment for age, stage, and sex. In analysis by National Institutes of Health BMI category, BMI of 30–34.99 kg/m2 (HR 1.14, 95% confidence interval 0.98–1.33), 35–39.99 kg/m2 (HR 1.32, 95% CI 1.08–1.62), and ≥40 (HR 1.60, 95% CI 1.26–2.04) were associated with decreased survival compared to normal BMI of 18,5–24.99 kg/m2 (overall trend test p<0.001). Fasting blood glucose and diabetes did not affect the results. Conclusions Higher BMI is associated with decreased survival in pancreatic cancer. Although the mechanism of this association remains undetermined, diabetes and hyperglycemia do not appear to account for the observed association. PMID:20665496

  14. [WHO AFFECTS THE PATIENT, DR. GOOGLE OR THE DOCTOR?].

    PubMed

    Mishali, Moshe; Avrech, Tova

    2015-09-01

    In the last decade the World Wide Web has become one of the prime sources for medical data searches. The abundance of information and emphasis on consumer communication, which are the main characteristics of the new generation of the web named "Web 2.0", enable users to engage and educate others by sharing and collaborating knowledge. It also enables them to receive medical information based on the experience of other patients, while the duration of the traditional physician's visit has shortened. However, using Web 2.0 for health collaboration has drawbacks as well: When alternative ways of "knowing" replace objective medical facts, there is danger of misinformation and truth "flattening". This article examines the distribution of medical misinformation online: Its characteristics, the nature of the messages presented online and the means that might help protect users and patients from it. The authors hold positions in the Israeli Dairy Board (IDB): Dr. Averch manages the health field on the IDB, and the findings in this article are based on research that she is leading as part of this position, and Dr. Mishali is a trained psychologist, and acts as a strategic consultant for IDB in the field of coping with the opposition to milk and its products. In this article it is initially shown how the characteristics of information distribution in general help spreading medical misinformation online: The decline of doctors' authority as sole providers of medical information, disillusionment and suspicion towards science and the notion of expertise, and the emergence of new ways to evaluate information, based on community ties. The nature of this pseudo-medical information will then be discussed, including the range of the phenomenon and the probability of users to be affected by it. Furthermore, we will raise specific tactics in which anti-establishment messages are portrayed; examples will be given of the use of emotion evoking content in the anti-establishment messages

  15. Factors That Affect Patient Attitudes toward Infection Control Measures.

    ERIC Educational Resources Information Center

    Jones, Daniel J.; And Others

    1991-01-01

    A study investigated patient attitudes toward different disease control measures taken in dental school clinics (n=272 patients) and private practices (n=107 patients). Variables examined included sex, age, educational background, and knowledge of infectious diseases. Patients tended to accept the control measures being used in each context. (MSE)

  16. In patients suffering from idiopathic central serous chorioretinopathy, anxiety scores are higher than in healthy controls, but do not vary according to sex or repeated central serous chorioretinopathy

    PubMed Central

    Bazzazi, Nooshin; Ahmadpanah, Mohammad; Akbarzadeh, Siamak; Seif Rabiei, Mohammad Ali; Holsboer-Trachsler, Edith; Brand, Serge

    2015-01-01

    Introduction Idiopathic central serous chorioretinopathy (CSCR) is a relatively common ophthalmic disorder characterized by the development of a serous detachment of the sensory retina. Psychophysiological factors may trigger or maintain CSCR, though, surprisingly, the association between CSCR and anxiety has yet to be studied. The aims of the present study were threefold: to determine whether 1) Iranian patients with CSCR have higher scores for anxiety, 2) anxiety is lower, if CSCR has been experienced twice, and whether 3) anxiety scores differ between sexes. Methods A total of 30 patients with CSCR and 30 healthy age-and sex-matched controls took part in the study. A brief face-to-face interview was conducted covering demographic variables and history and occurrence of CSCR and assessing anxiety. Results Compared to healthy controls, anxiety was significantly higher in both first-time and second-time CSCR patients. In CSCR patients, anxiety scores did not differ between sexes. Conclusion Higher anxiety scores were observed in Iranian patients with CSCR, irrespective of whether this was the first or second occurrence of CSCR. This suggests there is no psychological adaptation in terms of reduced anxiety among patients with repeated CSCR. PMID:25995637

  17. A panel study to evaluate quality of life assessments in patients suffering from allergic rhinitis after treatment with a Chinese herbal nasal drop.

    PubMed

    Chui, Shiu Hon; Shek, Siu Lam; Fong, Ming Yiu; Szeto, Yim Tong; Chan, Kelvin

    2010-04-01

    Allergic rhinitis impairs quality of life (QOL). To assess the changes in QOL of patients with perennial allergic rhinitis (PAR) after treatment with Allergic Rhinitis Nose Drops (ARND), 35 patients were divided into 2 groups in a randomized, double-blinded and placebo-controlled study, with a cross-over arrangement over 7 weeks, applying ARND or placebo. Group A (n = 20) started with ARND first for 2 weeks followed by a 3-week washout before placebo for the last 2 weeks, while Group B (n = 15) started with placebo first and finished with ARND after washout. The changes in Clinical Symptoms Score (CSS) and QOL were observed. A decrease in CSS was observed in patients of both groups after treatment with ARND, but no change was observed with the placebo. Group A patients also showed significant improvements in complexion and sleep (P < 0.05 for both) after treatment with ARND, but no change with the placebo. Group B patients showed significant improvements in appetite and digestion (P < 0.01) as well as joy (P < 0.05) after cross-over treatment with ARND, but no change with the placebo. ARND may have a therapeutic effect by relieving clinical symptoms and improving the QOL in patients with PAR. PMID:20014162

  18. Health care interactional suffering in palliative care.

    PubMed

    Beng, Tan Seng; Guan, Ng Chong; Jane, Lim Ee; Chin, Loh Ee

    2014-05-01

    A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care. PMID:23689367

  19. Role of BiPAP applied through endotracheal tube in unconscious patients suffering from acute exacerbation of COPD: a pilot study

    PubMed Central

    Rawat, Jagdish; Sindhwani, Girish; Biswas, Debasis; Dua, Ruchi

    2012-01-01

    Background and objectives Mechanical ventilation is the recommended treatment in unconscious patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) and hypercapenic respiratory failure. But, in resource-poor countries, many of these patients are not able to afford this treatment due to financial constraints. The main aim of this study was to evaluate the usefulness, safety and cost-effectiveness of bilevel positive airway pressure (BiPAP) applied via endotracheal tube in such patients. Methods Twenty patients with acute exacerbation of COPD and altered sensorium, who were unable to afford ventilatory support, were intubated and BiPAP therapy was provided to these patients through the endotracheal tube. The outcome of these patients was studied. Results The BiPAP success rate and hospital mortality were 85% (17/20) and 15% (3/20) respectively. BiPAP failure was associated with high sequential organ failure assessment (SOFA) score at the time of admission (P = 0.002). Improvement in Glasgow coma scale (GCS) score (P < 0.001), pH (P = 0.001), PaCO2 (partial pressure of carbon dioxide) (P < 0.001), respiratory rate (P < 0.001), and SOFA score (P = 0.001) was observed among the responders following 2 hours of therapy. Only one of the responders developed aspiration pneumonitis, as a complication. The daily cost of BiPAP therapy was 8.75 times lower than the average cost of mechanical ventilation. Conclusion This pilot study reveals that this treatment modality could be a safe, cost-effective and efficacious method of treatment in unconscious patients with acute exacerbation of COPD. PMID:22665995

  20. Risk scores and geriatric profile: can they really help us in anticoagulation decision making among older patients suffering from atrial fibrillation?

    PubMed Central

    Maes, Frédéric; Dalleur, Olivia; Henrard, Séverine; Wouters, Dominique; Scavée, Christophe; Spinewine, Anne; Boland, Benoit

    2014-01-01

    Objectives Anticoagulation for the prevention of cardio-embolism is most frequently indicated but largely underused in frail older patients with atrial fibrillation (AF). This study aimed at identifying characteristics associated with anticoagulation underuse. Methods A cross-sectional study of consecutive geriatric patients aged ≥75 years, with AF and clear anticoagulation indication (CHADS2 [Congestive heart failure, Hypertension, Age >75, Diabetes mellitus, and prior Stroke or transient ischemic attack] ≥2) upon hospital admission. All patients benefited from a comprehensive geriatric assessment. Their risks of stroke and bleeding were predicted using CHADS2 and HEMORR2HAGES (Hepatic or renal disease, Ethanol abuse, Malignancy, Older (age >75 years), Reduced platelet count or function, Rebleed risk, Hypertension (uncontrolled), Anemia, Genetic factors, Excessive fall risk, and Stroke) scores, respectively. Results Anticoagulation underuse was observed in 384 (50%) of 773 geriatric patients with AF (median age 85 years; female 57%, cognitive disorder 33%, nursing home 20%). No geriatric characteristic was found to be associated with anticoagulation underuse. Conversely, anticoagulation underuse was markedly increased in the patients treated with aspirin (odds ratio [OR] [95% confidence interval]: 5.3 [3.8; 7.5]). Other independent predictors of anticoagulation underuse were ethanol abuse (OR: 4.0 [1.4; 13.3]) and age ≥90 years (OR: 2.0 [1.2; 3.4]). Anticoagulation underuse was not inferior in patients with a lower bleeding risk and/or a higher stroke risk and underuse was surprisingly not inferior either in the AF patients who had previously had a stroke. Conclusion Half of this geriatric population did not receive any anticoagulation despite a clear indication, regardless of their individual bleeding or stroke risks. Aspirin use is the main characteristic associated with anticoagulation underuse. PMID:25053883

  1. Status of antioxidant enzyme: glutathione peroxidase and total polyphenol level in plasma of Tunisian patients suffering from colorectal and gastric cancer: interaction with clinical outcome.

    PubMed

    Baroudi, Olfa; Younes, Sonia Ben; Mézlini, Amel; Bignon, Yves Jean; Medimeg, Imen; Uhrhammer, Nancy; Gaiied, Amel Ben Ammar E L; Ellouz, Soufia Chabchoub

    2013-12-01

    In our case-control study, we measure the antioxidant status by dosing enzymes involved in oxidant stress in plasma of patients with colorectal and gastric cancer, and in the second step, we investigate the impact of chemotherapy before and after surgery on plasma antioxidant status and polyphenols in patients. Blood serum was collected from patients with stomach and colorectal cancer before conventional treatment, and glutathione peroxidase (GSHPX) enzyme activities and total polyphenols were determined by spectrophotometric methods. In our study, we found a significant decrease in glutathione peroxidase activity in plasma of patients compared with controls (P = 0.02), although we did not find a significant association between total polyphenols and 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) or ABTS in plasma of colorectal and stomach cancer compared with control; furthermore, we observed no significant difference in the average plasma polyphenols in patients treated with chemotherapy before and after surgery. We have shown the decrease in GSHPX activity in plasma of cases with colorectal and gastric cancer, and this decrease reflects that the oxidative stress is associated with tumor tract and related to oxidative metabolism; however, no association was found between total polyphenols and ABTS in our study. PMID:24072511

  2. Bed bugs reproductive life cycle in the clothes of a patient suffering from Alzheimer’s disease results in iron deficiency anemia

    PubMed Central

    Sabou, Marcela; Gallo Imperiale, Delphine; Andrès, Emmanuel; Abou-Bacar, Ahmed; Foeglé, Jacinthe; Lavigne, Thierry; Kaltenbach, Georges; Candolfi, Ermanno

    2013-01-01

    We report the case of an 82-year-old patient, hospitalized for malaise. Her clothes were infested by numerous insects and the entomological analysis identified them as being Cimex lectularius (bed bugs). The history of the patient highlighted severe cognitive impairment. The biological assessment initially showed a profound microcytic, aregenerative, iron deficiency anemia. A vitamin B12 deficiency due to pernicious anemia (positive intrinsic factor antibodies) was also highlighted, but this was not enough to explain the anemia without macrocytosis. Laboratory tests, endoscopy and a CT scan eliminated a tumor etiology responsible for occult bleeding. The patient had a mild itchy rash which was linked to the massive colonization by the bed bugs. The C. lectularius bite is most often considered benign because it is not a vector of infectious agents. Far from trivial, a massive human colonization by bed bugs may cause such a hematic depletion that severe microcytic anemia may result. PMID:23673315

  3. [Impact of dietotherapy with enterosorbent of marine origin on the indices of mineral and lipid metabolism for patients suffering from kidney diseases].

    PubMed

    Rudichenko, E V; Gvozdenko, T A; Antoniuk, M V

    2005-01-01

    It is described the effectiveness of application of dietotherapy including enterosorbent of marine origin at the stage of rehabilitation of patients having kidneys pathology. Application of this enterosorbent favors the positive clinic-biochemical dynamics with correction of electrolyte and lipid imbalance. PMID:16265914

  4. ‘Islamic fatalism’: life and suffering among Bangladeshi psychiatric patients and their families in London – an interview study 2

    PubMed Central

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in eastern London demonstrated frequent appeals to God and deprecation of personal agency. This paper offers an interpretation of this apparent ‘fatalism’, which argues for the logical downplaying of human agency and ambition in archaic Arabia, contemporary rural Sylhet and among first generation Sylheti migrants in London. PMID:24670160

  5. Successful Allogeneic Hematopoietic Stem Cell Transplantation of a Patient Suffering from Type II Congenital Dyserythropoietic Anemia A Rare Case Report from Western India

    PubMed Central

    Modi, Gaurang; Shah, Sandip; Panchal, Harsha; Patel, Apurva; Uparkar, Urmila; Anand, Asha; Parikh, Sonia; Patel, Kinnari; Shah, Kamlesh; Revannasiddaiah, Swaroop

    2015-01-01

    The most frequent form of congenital dyserythropoiesis (CDA) is congenital dyserythropoietic anemia II (CDA II). CDA II is a rare genetic anemia in humans, inherited in an autosomally recessive mode, characterized by hepatosplenomegaly normocytic anemia and hemolytic jaundice. Patients are usually transfusion-independent except in severe type. We are here reporting a case of severe transfusion-dependent type II congenital dyserythropoietic anemia in a 5-year-old patient who has undergone allogeneic hematopoietic stem cell transplantation (HSCT) at our bone marrow transplantation centre. Patient has had up until now more than 14 mL/kg/month of packed cell volume (PCV), which he required every 15 to 20 days to maintain his hemoglobin of 10 gm/dL and hematocrit of 30%. His pre-HSCT serum ferritin was 1500 ng/mL and he was on iron chelating therapy. Donor was HLA identical sibling (younger brother). The preparative regimen used was busulfan, cyclophosphamide, and antithymocyte globulin (Thymoglobulin). Cyclosporine and short-term methotrexate were used for graft versus host disease (GVHD) prophylaxis. Engraftment of donor cells was quick and the posttransplant course was uneventful. The patient is presently alive and doing well and he has been transfusion-independent for the past 33 months after HSCT. PMID:25692053

  6. [Potentials of infusion therapy in enhancing the detoxification effect of hemosorption in patients suffering from suppurative-septic complications of mechanical injury].

    PubMed

    Deriabin, I I; Trusov, A A; Rozhkov, A S; Shashkov, B V; Gard, I S

    1987-01-01

    Under study was the application of microvasoplegia as a method of preoperative management in fulfilling hemosorption in patients with pyo-septic complications of a severe mechanical trauma. The method of infusion and medicamentous therapy used before hemosorption is described. Laboratory examinations of the enzyme toxemia level have shown pathogenetic grounds of the complex method of treatment. Positive clinical results were obtained. PMID:3590549

  7. Unravelling the spirits' message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda.

    PubMed

    van Duijl, Marjolein; Kleijn, Wim; de Jong, Joop

    2014-01-01

    As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries. PMID:24940355

  8. Unravelling the spirits’ message: a study of help-seeking steps and explanatory models among patients suffering from spirit possession in Uganda

    PubMed Central

    2014-01-01

    As in many cultures, also in Uganda spirit possession is a common idiom of distress associated with traumatic experiences. In the DSM-IV and -5, possession trance disorders can be classified as dissociative disorders. Dissociation in Western countries is associated with complicated, time-consuming and costly therapies. Patients with spirit possession in SW Uganda, however, often report partial or full recovery after treatment by traditional healers. The aim of this study is to explore how the development of symptoms concomitant help-seeking steps, and explanatory models (EM) eventually contributed to healing of patients with spirit possession in SW Uganda. Illness narratives of 119 patients with spirit possession referred by traditional healers were analysed using a mixed-method approach. Treatments of two-thirds of the patients were unsuccessful when first seeking help in the medical sector. Their initially physical symptoms subsequently developed into dissociative possession symptoms. After an average of two help-seeking steps, patients reached a healing place where 99% of them found satisfactory EM and effective healing. During healing sessions, possessing agents were summoned to identify themselves and underlying problems were addressed. Often-mentioned explanations were the following: neglect of rituals and of responsibilities towards relatives and inheritance, the call to become a healer, witchcraft, grief, and land conflicts. The results demonstrate that traditional healing processes of spirit possession can play a role in restoring connections with the supra-, inter-, intra-, and extra-human worlds. It does not always seem necessary to address individual traumatic experiences per se, which is in line with other research in this field. The study leads to additional perspectives on treatment of trauma-related dissociation in Western countries and on developing effective mental health services in low -and middle-income countries. PMID:24940355

  9. HER2 and β-catenin protein location: importance in the prognosis of breast cancer patients and their correlation when breast cancer cells suffer stressful situations.

    PubMed

    Cuello-Carrión, F Darío; Shortrede, Jorge E; Alvarez-Olmedo, Daiana; Cayado-Gutiérrez, Niubys; Castro, Gisela N; Zoppino, Felipe C M; Guerrero, Martín; Martinis, Estefania; Wuilloud, Rodolfo; Gómez, Nidia N; Biaggio, Verónica; Orozco, Javier; Gago, Francisco E; Ciocca, Leonardo A; Fanelli, Mariel A; Ciocca, Daniel R

    2015-02-01

    In human breast cancer, β-catenin localization has been related with disease prognosis. Since HER2-positive patients are an important subgroup, and that in breast cancer cells a direct interaction of β-catenin/HER2 has been reported, in the present study we have explored whether β-catenin location is related with the disease survival. The study was performed in a tumor bank from patients (n = 140) that did not receive specific anti-HER2 therapy. The proteins were detected by immunohistochemistry in serial sections, 47 (33.5%) patients were HER2-positive with a long follow-up. HER2-positive patients that displayed β-catenin at the plasma membrane (completely surrounding the tumour cells) showed a significant better disease-free survival and overall survival than the patients showing the protein on other locations. Then we explored the dynamics of the co-expression of β-catenin and HER2 in human MCF-7 and SKBR3 cells exposed to different stressful situations. In untreated conditions MCF-7 and SKBR3 cells showed very different β-catenin localization. In MCF-7 cells, cadmium administration caused a striking change in β-catenin localization driving it from plasma membrane to cytoplasmic and perinuclear areas and HER2 showed a similar localization patterns. The changes induced by cadmium were compared with heat shock, H2O2 and tamoxifen treatments. In conclusion, this study shows the dynamical associations of HER2 and β-catenin and their changes in subcellular localizations driven by stressful situations. In addition, we report for the first time the correlation between plasma membrane associated β-catenin in HER2-positive breast cancer and survival outcome, and the importance of the protein localization in breast cancer samples. PMID:25636904

  10. Computerised brain electrical activity findings of parkinson patients suffering from hyperkinetic side effects (hypersensitive dopamine syndrome) and a review of possible sources.

    PubMed

    Fünfgeld, E W

    1995-01-01

    Among 2,000 Park. pat. hospitalised during the years 1988 till 1990 we found 61 pat. with hyperkinetic side-effects in the sequence of a long-term L-dopa treatment. 43 (mean age 64y.) had a complete clinical data set and hyperkinesia ratings (AIMS scale). Compared to the system's data base--none of these patients showed a strickly normal CEEG. Our standard parkinson treatment was established in 1986: L-dopa as low as possible, dopamine agonists low, amantadines as high as necessary, L-deprenyl till 10 mg and anticholinergics--no, if possible. Our pat. group got initially a mean of 508 mg L-dopa, at the end of the study 296 mg. Conventional EEG (Picker-Schwarzer) and CEEG data were recorded (Dynamic Brain Mapping, Itil). Clinical and CEEG follow-up investigations were done after 2 weeks and 2 years. At follow-up, a reduction of the hyperkinesias was found in 43 patients (AIMS scale). 28 pat. received an additional treatment with nootropic drugs, 15 pat. were without this additional therapy. The visually evaluated CEEG at the latter group showed an acceleration ("response") in 33%, but among the patients with nootropic drugs the acceleration was seen in 66%. In patients without nootropics the mean delta power increased, patients additionally treated showed a reduction of delta. In cases of high L-dopa dosage--associated with severe hyperkinetic side effects--more slow waves were registered. The non-nootropic treated patients were divided into two groups--non-responders and the responders: a) Non-responders (n = 10) showed a significant reduction of alpha and a significant increase of delta and theta, b) Responders (5 pat.) without nootropics had a significant reduction of theta and a increase of alpha, but the acceleration is less pronounced than in the responder group with nootropics. Without co-medication a high L-dopa dosage may provoke/facilitate an organic cerebral dysfunction. The nootropic-treated but non-responder group showed no significant changes (n = 13

  11. Hearing the patient's voice? Factors affecting the use of patient survey data in quality improvement

    PubMed Central

    Davies, E; Cleary, P

    2005-01-01

    Objective: To develop a framework for understanding factors affecting the use of patient survey data in quality improvement. Design: Qualitative interviews with senior health professionals and managers and a review of the literature. Setting: A quality improvement collaborative in Minnesota, USA involving teams from eight medical groups, focusing on how to use patient survey data to improve patient centred care. Participants: Eight team leaders (medical, clinical improvement or service quality directors) and six team members (clinical improvement coordinators and managers). Results: Respondents reported three types of barriers before the collaborative: organisational, professional and data related. Organisational barriers included lack of supporting values for patient centred care, competing priorities, and lack of an effective quality improvement infrastructure. Professional barriers included clinicians and staff not being used to focusing on patient interaction as a quality issue, individuals not necessarily having been selected, trained or supported to provide patient centred care, and scepticism, defensiveness or resistance to change following feedback. Data related barriers included lack of expertise with survey data, lack of timely and specific results, uncertainty over the effective interventions or time frames for improvement, and consequent risk of perceived low cost effectiveness of data collection. Factors that appeared to have promoted data use included board led strategies to change culture and create quality improvement forums, leadership from senior physicians and managers, and the persistence of quality improvement staff over several years in demonstrating change in other areas. Conclusion: Using patient survey data may require a more concerted effort than for other clinical data. Organisations may need to develop cultures that support patient centred care, quality improvement capacity, and to align professional receptiveness and leadership with

  12. [Successful delivery following subcutaneous heparin administration in a 7-weeks pregnant patient suffering from cerebral venous thrombosis due to secondary protein S deficiency].

    PubMed

    Nozaki, Hiroaki; Naruse, Satoshi; Koike, Tadashi; Okuizumi, Yuzuru; Fujita, Nobuya; Nagai, Hiroko

    2006-03-01

    A 25-year-old, 7-weeks pregnant woman was admitted to the Nagaoka Red Cross Hospital in a state of confusion, following fever, headache and vomiting. Brain CT and MRI showed swelling in the bilateral thalami, basal ganglia and splenium of corpus callosum, and thrombosis of the internal cerebral veins and straight sinus. Initial treatment by intravenous heparin and glycerol was successful, and she regained her consciousness, leaving antegrade amnesia and childish character change. Her free protein S antigen was 32% (normal 60-127) and subsequently rose to 70% after delivery. She was diagnosed as having secondary protein S deficiency associated with pregnancy. Because warfarin can be teratogenic, subcutaneous heparin injection was prescribed in order to prevent thrombosis and the patient subsequently had a successful delivery. This was the first case in Japanese of successful delivery after subcutaneous heparin treatment in a patient with cerebral venous thrombosis. PMID:16642938

  13. [Pulmonary tuberculosis after 11 years of observation in a patient suffering from advanced squamous lung cancer cured by radical radiotherapy--a case report].

    PubMed

    Mysiorski, Grzegorz; Marciniak, Marek; Rogowska, Danuta; Sedlaczek, Andrzej; Witkiewicz, Iwona; Tarnowska-Matusiak, Marzenna; Pankowski, Juliusz

    2003-01-01

    Advanced lung cancer is a neoplasm of a poor prognosis. The treatment may improve it to a certain degree but not satisfactory. A case of squamous- cell lung cancer, in a stage III B of TNM classification, which was by cured completely radiotherapy is described. The 11 years post-treatment observation was performed without any symptoms of recurrence. Actually patient is hospitalised due to active tuberculosis. No evidence for lung cancer was found until now. PMID:14587431

  14. Detection of abnormal resting-state networks in individual patients suffering from focal epilepsy: an initial step toward individual connectivity assessment

    PubMed Central

    Dansereau, Christian L.; Bellec, Pierre; Lee, Kangjoo; Pittau, Francesca; Gotman, Jean; Grova, Christophe

    2014-01-01

    The spatial coherence of spontaneous slow fluctuations in the blood-oxygen-level dependent (BOLD) signal at rest is routinely used to characterize the underlying resting-state networks (RSNs). Studies have demonstrated that these patterns are organized in space and highly reproducible from subject to subject. Moreover, RSNs reorganizations have been suggested in pathological conditions. Comparisons of RSNs organization have been performed between groups of subjects but have rarely been applied at the individual level, a step required for clinical application. Defining the notion of modularity as the organization of brain activity in stable networks, we propose Detection of Abnormal Networks in Individuals (DANI) to identify modularity changes at the individual level. The stability of each RSN was estimated using a spatial clustering method: Bootstrap Analysis of Stable Clusters (BASC) (Bellec et al., 2010). Our contributions consisted in (i) providing functional maps of the most stable cores of each networks and (ii) in detecting “abnormal” individual changes in networks organization when compared to a population of healthy controls. DANI was first evaluated using realistic simulated data, showing that focussing on a conservative core size (50% most stable regions) improved the sensitivity to detect modularity changes. DANI was then applied to resting state fMRI data of six patients with focal epilepsy who underwent multimodal assessment using simultaneous EEG/fMRI acquisition followed by surgery. Only patient with a seizure free outcome were selected and the resected area was identified using a post-operative MRI. DANI automatically detected abnormal changes in 5 out of 6 patients, with excellent sensitivity, showing for each of them at least one “abnormal” lateralized network closely related to the epileptic focus. For each patient, we also detected some distant networks as abnormal, suggesting some remote reorganization in the epileptic brain. PMID

  15. BCL-B (BCL2L10) is overexpressed in patients suffering from multiple myeloma (MM) and drives an MM-like disease in transgenic mice.

    PubMed

    Hamouda, Mohamed-Amine; Jacquel, Arnaud; Robert, Guillaume; Puissant, Alexandre; Richez, Valentine; Cassel, Romeo; Fenouille, Nina; Roulland, Sandrine; Gilleron, Jerome; Griessinger, Emmanuel; Dubois, Alix; Bailly-Maitre, Beatrice; Goncalves, Diogo; Mallavialle, Aude; Colosetti, Pascal; Marchetti, Sandrine; Amiot, Martine; Gomez-Bougie, Patricia; Rochet, Nathalie; Deckert, Marcel; Avet-Loiseau, Herve; Hofman, Paul; Karsenti, Jean-Michel; Jeandel, Pierre-Yves; Blin-Wakkach, Claudine; Nadel, Bertrand; Cluzeau, Thomas; Anderson, Kenneth C; Fuzibet, Jean-Gabriel; Auberger, Patrick; Luciano, Frederic

    2016-08-22

    Multiple myeloma (MM) evolves from a premalignant condition known as monoclonal gammopathy of undetermined significance (MGUS). However, the factors underlying the malignant transformation of plasmocytes in MM are not fully characterized. We report here that Eµ-directed expression of the antiapoptotic Bcl-B protein in mice drives an MM phenotype that reproduces accurately the human disease. Indeed, with age, Eµ-bcl-b transgenic mice develop the characteristic features of human MM, including bone malignant plasma cell infiltration, a monoclonal immunoglobulin peak, immunoglobulin deposit in renal tubules, and highly characteristic bone lytic lesions. In addition, the tumors are serially transplantable in irradiated wild-type mice, underlying the tumoral origin of the disease. Eµ-bcl-b plasmocytes show increased expression of a panel of genes known to be dysregulated in human MM pathogenesis. Treatment of Eµ-bcl-b mice with drugs currently used to treat patients such as melphalan and VELCADE efficiently kills malignant plasmocytes in vivo. Finally, we find that Bcl-B is overexpressed in plasmocytes from MM patients but neither in MGUS patients nor in healthy individuals, suggesting that Bcl-B may drive MM. These findings suggest that Bcl-B could be an important factor in MM disease and pinpoint Eµ-bcl-b mice as a pertinent model to validate new therapies in MM. PMID:27455953

  16. The crossroads of gastroenterology and psychiatry – what benefits can psychiatry provide for the treatment of patients suffering from gastrointestinal symptoms

    PubMed Central

    Klasa, Katarzyna; Mielimąka, Michał; Rutkowski, Krzysztof; Dembińska, Edyta; Müldner-Nieckowski, Łukasz; Cyranka, Katarzyna; Smiatek-Mazgaj, Bogna; Popiołek, Lech

    2015-01-01

    Introduction Gastrointestinal symptoms are very common in the general population. Many of them coincide with mental disorders (especially with neuroses, stress-related disorders, somatisation disorders, autonomic dysfunction, and anxiety) that are associated with psychological trauma, conflicts, and difficulties with interpersonal relationships. Aim Assessment of the association between gastrointestinal complaints and stressful situations in relationships, among patients admitted to day hospital for neurotic and behavioural disorders. Material and methods Analysis of the likelihood of co-occurrence of abdominal symptoms and stressful situations, reported by patients before admission, in a large group of subjects treated with psychotherapy. Results Gastrointestinal symptoms were highly prevalent in the studied group (they were reported by 40–50% of patients). The most common complaints in women were: loss of appetite (52%), nausea (49%), and constipation and flatulence (45%). In men the most prevalent symptoms were: loss of appetite (47%), heartburn (44%), and flatulence (43%). Functional gastrointestinal symptoms (especially vomiting in cases of nervousness in females or heartburn in males) were significantly associated with greater likelihood of current difficulties in interpersonal relationships, such as conflicts with partner/spouse or parent. Conclusions The results suggest that in many cases symptoms of anxiety disorders or somatisation disorders coexisted with irritable bowel syndrome and functional dyspepsia. PMID:26759629

  17. Implicit and Explicit Memory for Affective Passages in Temporal Lobectomy Patients

    ERIC Educational Resources Information Center

    Burton, Leslie A.; Rabin, Laura; Vardy, Susan Bernstein; Frohlich, Jonathan; Porter, Gwinne Wyatt; Dimitri, Diana; Cofer, Lucas; Labar, Douglas

    2008-01-01

    Eighteen temporal lobectomy patients (9 left, LTL; 9 right, RTL) were administered four verbal tasks, an Affective Implicit Task, a Neutral Implicit Task, an Affective Explicit Task, and a Neutral Explicit Task. For the Affective and Neutral Implicit Tasks, participants were timed while reading aloud passages with affective or neutral content,…

  18. Facial reactions in response to dynamic emotional stimuli in different modalities in patients suffering from schizophrenia: a behavioral and EMG study

    PubMed Central

    Sestito, Mariateresa; Umiltà, Maria Alessandra; De Paola, Giancarlo; Fortunati, Renata; Raballo, Andrea; Leuci, Emanuela; Maffei, Simone; Tonna, Matteo; Amore, Mario; Maggini, Carlo; Gallese, Vittorio

    2013-01-01

    Emotional facial expression is an important low-level mechanism contributing to the experience of empathy, thereby lying at the core of social interaction. Schizophrenia is associated with pervasive social cognitive impairments, including emotional processing of facial expressions. In this study we test a novel paradigm in order to investigate the evaluation of the emotional content of perceived emotions presented through dynamic expressive stimuli, facial mimicry evoked by the same stimuli, and their functional relation. Fifteen healthy controls and 15 patients diagnosed with schizophrenia were presented with stimuli portraying positive (laugh), negative (cry) and neutral (control) emotional stimuli in visual, auditory modalities in isolation, and congruently or incongruently associated. Participants where requested to recognize and quantitatively rate the emotional value of the perceived stimuli, while electromyographic activity of Corrugator and Zygomaticus muscles was recorded. All participants correctly judged the perceived emotional stimuli and prioritized the visual over the auditory modality in identifying the emotion when they were incongruently associated (Audio-Visual Incongruent condition). The neutral emotional stimuli did not evoke any muscle responses and were judged by all participants as emotionally neutral. Control group responded with rapid and congruent mimicry to emotional stimuli, and in Incongruent condition muscle responses were driven by what participants saw rather than by what they heard. Patient group showed a similar pattern only with respect to negative stimuli, whereas showed a lack of or a non-specific Zygomaticus response when positive stimuli were presented. Finally, we found that only patients with reduced facial mimicry (Internalizers) judged both positive and negative emotions as significantly more neutral than controls. The relevance of these findings for studying emotional deficits in schizophrenia is discussed. PMID:23888132

  19. The doctor's medicine and the ambiguity of amulets: life and suffering among Bangladeshi psychiatric patients and their families in London – an interview study – 1

    PubMed Central

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in London demonstrated simultaneous trust in psychiatrists as well as in the widespread use of healing amulets. At the same time, local Islamic clerics and traditional healers were seen by many with some degree of suspicion. The authors offer an interpretation in which local healers and their methods are regarded ambivalently: the more distant biomedical framework fits with the newer modernising ‘High’ Islam (literate, scripturalist, puritanical, unitarian, urban, clerical, perhaps masculinist), as opposed to Hindu-inflected traditional Sufi Islam in Bangladesh (peasant, popular, syncretic, saintly, magical, ecstatic and possibly more sympathetic to women's experience). PMID:23998259

  20. The doctor's medicine and the ambiguity of amulets: life and suffering among Bangladeshi psychiatric patients and their families in London--an interview study--1.

    PubMed

    Littlewood, Roland; Dein, Simon

    2013-01-01

    An interview study of 44 Bangladeshi patients and relatives in London demonstrated simultaneous trust in psychiatrists as well as in the widespread use of healing amulets. At the same time, local Islamic clerics and traditional healers were seen by many with some degree of suspicion. The authors offer an interpretation in which local healers and their methods are regarded ambivalently: the more distant biomedical framework fits with the newer modernising 'High' Islam (literate, scripturalist, puritanical, unitarian, urban, clerical, perhaps masculinist), as opposed to Hindu-inflected traditional Sufi Islam in Bangladesh (peasant, popular, syncretic, saintly, magical, ecstatic and possibly more sympathetic to women's experience). PMID:23998259

  1. Tracheal Decannulation Protocol in Patients Affected by Traumatic Brain Injury

    PubMed Central

    Zanata, Isabel de Lima; Santos, Rosane Sampaio; Hirata, Gisela Carmona

    2014-01-01

    Introduction The frequency of tracheostomy in patients with traumatic brain injury (TBI) contrasts with the lack of objective criteria for its management. The study arose from the need for a protocol in the decision to remove the tracheal tube. Objective To evaluate the applicability of a protocol for tracheal decannulation. Methods A prospective study with 20 patients, ranging between 21 and 85 years of age (average 33.55), 4 of whom were women (20%) and 16 were men (80%). All patients had been diagnosed by a neurologist as having TBI, and the anatomical region of the lesion was known. Patients were evaluated following criteria for tracheal decannulation through a clinical evaluation protocol developed by the authors. Results Decannulation was performed in 12 (60%) patients. Fourteen (70%) had a score greater than 8 on the Glasgow Coma Scale and only 2 (14%) of these were not able to undergo decannulation. Twelve (60%) patients maintained the breathing pattern with occlusion of the tube and were successfully decannulated. Of the 20 patients evaluated, 11 (55%) showed no signs suggestive of tracheal aspiration, and of these, 9 (82%) began training on occlusion of the cannula. The protocol was relevant to establish the beginning of the decannulation process. The clinical assessment should focus on the patient's condition to achieve early tracheal decannulation. Conclusion This study allowed, with the protocol, to establish six criteria for tracheal decannulation: level of consciousness, respiration, tracheal secretion, phonation, swallowing, and coughing. PMID:25992074

  2. Role of endovascular embolization in improving the quality of life in a patient suffering from complicated intralobar pulmonary sequestration - A case report.

    PubMed

    Ojha, Vineeta; Samui, Partha P; Dakshit, Debashis

    2015-01-01

    Intralobar pulmonary sequestration is a rare congenital malformation characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply and lacking normal communication with tracheobronchial tree. Recurrent pneumonia and massive hemoptysis are life threatening complications associated with it. Delay in the diagnosis and management can be fatal. We report here a case of intralobar pulmonary sequestration in a 18 year old female who presented with recurrent severe episodes of pneumonia and hemoptysis forcing her to drop out of school. The diagnosis was confirmed by CECT Thorax and CT Angiography. The patient was managed by minimally invasive endovascular treatment in the form of feeding artery embolization. She made a full recovery with satisfactory outcome. On subsequent follow up, there was no recurrence of symptoms and she is doing well socially and academically. The aim of this case report is to show feasibility and safety of embolization as a less-invasive management option for adult pulmonary sequestration complicated with hemoptysis and LRTIs and emphasize the importance of such minimally invasive technique to enhance the quality of life in such patients. PMID:26744646

  3. Clinical findings in patients with anorexia nervosa and affective illness in their relatives.

    PubMed

    Gershon, E S; Schreiber, J L; Hamovit, J R; Dibble, E D; Kaye, W; Nurnberger, J I; Andersen, A E; Ebert, M

    1984-11-01

    The most prevalent psychiatric disorders in the families of patients with anorexia nervosa are bipolar and unipolar major affective disorder. The presence of affective disorder, self-induced vomiting, or bulimia in the patient is not predictive of affective illness in the relatives. Thus these features do not define genetic heterogeneity within anorexia nervosa. There may be genetic factors shared between anorexia nervosa and affective disorders. PMID:6496786

  4. Proportionality, terminal suffering and the restorative goals of medicine.

    PubMed

    Jansen, Lynn A; Sulmasy, Daniel P

    2002-01-01

    Recent years have witnessed a growing concern that terminally ill patients are needlessly suffering in the dying process. This has led to demands that physicians become more attentive in the assessment of suffering and that they treat their patients as 'whole persons.' For the most part, these demands have not fallen on deaf ears. It is now widely accepted that the relief of suffering is one of the fundamental goals of medicine. Without question this is a positive development. However, while the importance of treating suffering has generally been acknowledged, insufficient attention has been paid to the question of whether different types of terminal suffering require different responses from health care professionals. In this paper we introduce a distinction between two types of suffering likely to be present at the end of life, and we argue that physicians must distinguish between these types if they are to respond appropriately to the suffering of their terminally ill patients. After introducing this distinction and explaining its basis, we further argue that the distinction informs a (novel) principle of proportionality, one that should guide physicians in balancing their competing obligations in responding to terminal suffering. As we explain, this principle is justified by reference to the interests terminally ill patients have in restoration, as well as in the relief of suffering, at the end of life. PMID:12516836

  5. Factors affecting patient outcome in primary cutaneous aspergillosis

    PubMed Central

    Tatara, Alexander M.; Mikos, Antonios G.; Kontoyiannis, Dimitrios P.

    2016-01-01

    Abstract Primary cutaneous aspergillosis (PCA) is an uncommon infection of the skin. There is a paucity of organized literature regarding this entity in regard to patient characteristics, associated Aspergillus species, and treatment modalities on outcome (disease recurrence, disease dissemination, and mortality). We reviewed all published reports of PCA from 1967 to 2015. Cases were deemed eligible if they included the following: patient baseline characteristics (age, sex, underlying condition), evidence of proven or probable PCA, primary treatment strategy, and outcome. We identified 130 eligible cases reported from 1967 to 2015. The patients were predominantly male (63.8%) with a mean age of 30.4 ± 22.1 years. Rates of PCA recurrence, dissemination, and mortality were 10.8%, 18.5%, and 31.5%, respectively. In half of the cases, there was an association with a foreign body. Seven different Aspergillus species were reported to cause PCA. Systemic antifungal therapy without surgery was the most common form of therapy (60% of cases). Disease dissemination was more common in patients with underlying systemic conditions and occurred on average 41.4 days after PCA diagnosis (range of 3–120 days). In a multivariate linear regression model of mortality including only patients with immunosuppressive conditions, dissemination and human immunodeficiency virus/acquired immune deficiency syndrome were statistically significantly associated with increased mortality. Nearly one-third of patients with PCA die with the disease. Dissemination and host status are critical in patient outcome. PMID:27367980

  6. [The formation of self-care in patients suffered from tetraplegia by dint of maxillofacial muscles and a tongue with use of electronic mechanical vehicle].

    PubMed

    Mironov, S P; Oganesian, O V; Kosik, A L

    2008-01-01

    Method for the restoration of self-service ability in patients with tetraplegia was proposed. The use of the elaborated computer controlled device in creases the efficacy of rehabilitation. A basic realization of technical facilities and software can be further developed. In particular, the plan is drawn to expand the software functional for the possibility of prompt input of the required word from the dictionary. Application of this technology has shown to give a possibility toa great number of handicapped people with limitations in using a computer and thus realizing their intellectual potential in education, work and leisure to restore their self-service ability. A significantsocial and economic effect from the introduction of this technology into practice is expected. PMID:18819355

  7. Successful treatment of fusarium solani ecthyma gangrenosum in a patient affected by leukocyte adhesion deficiency type 1 with granulocytes transfusions

    PubMed Central

    2010-01-01

    Background Ecthyma gangrenosum (EG) manifests as a skin lesion affecting patients suffering extreme neutropenia and is commonly associated with Pseudomonas aeruginosa in immunocompromised patients. Leukocyte adhesion deficiency I (LAD I) which count among primary immunodeficiency syndromes of the innate immunity, is an autosomal recessive disorder characterized in its severe phenotype by a complete defect in CD18 expression on neutrophils, delayed cord separation, chronic skin ulcers mainly due to recurrent bacterial and fungal infections, leucocytosis with high numbers of circulating neutrophils and an accumulation of abnormally low number of neutrophils at sites of infection. Case Presentation We report at our knowledge the first case of a child affected by LAD-1, who experienced during her disease course a multi-bacterial and fungal EG lesion caused by fusarium solani. Despite targeted antibiotics and anti-fungi therapy, the lesion extended for as long as 18 months and only massive granulocytes pockets transfusions in association with G-CSF had the capacity to cure this lesion. Conclusion We propose that granulocytes pockets transfusions will be beneficial to heal EG especially in severely immunocompromised patients. PMID:20929531

  8. Does a clerkship affect students' views of psychiatric patients?

    PubMed

    Fabrega, H

    1995-12-01

    This study deals with the views of medical students toward real psychiatric patients. The students answered seven questions about ten patients who had been interviewed by a senior faculty member. The interviews were recorded on audiovisual tapes. The questions dealt with different aspects of mental illness and included views on how laypersons would evaluate and respond to patients, what it would be like to care for the patients, and whether the patients were potentially dangerous. Answers to questions were correlated. Gender and the student's accuracy in rating psychopathology were used as independent variables to examine students' views and the possible change in these views as a result of participating in a 6-week psychiatric clerkship. The pattern of intercorrelations is reported and discussed. Negative views correlated with anticipated difficulty in caring for patients, and positive views correlated with a higher accuracy in rating psychopathology. In general, student views about mental illness were relatively impervious to the effect of a clerkship. Results are discussed in terms of prior research and knowledge about gender differences in interpersonal sensitivity. Some of the social implications of the results are discussed. PMID:8522934

  9. Discrimination and evocation of affectively intoned speech in patients with right parietal disease.

    PubMed

    Tucker, D M; Watson, R T; Heilman, K M

    1977-10-01

    Patients with right parietal disease have disturbed comprehension of affective speech. Ability to discriminate affective speech (make same/different discriminations) and ability to repeat emotionally bland sentences with affective tones were tested in three groups of subjects--patients with right parietal dysfunction and neglect, conduction aphasics with left hemispheric lesions, and patients without intracranial disease. Patients with right parietal dysfunction performed significantly poorer than did aphasic controls on both a recognition and discrimination task. Patients with right parietal dysfunction also scored poorer on the evocative task than the nonaphasic controls. PMID:561908

  10. A screening of skin changes, with special emphasis on neurochemical marker antibody evaluation, in patients claiming to suffer from "screen dermatitis" as compared to normal healthy controls.

    PubMed

    Johansson, O; Hilliges, M; Han, S W

    1996-10-01

    In the present study, facial skin from so-called "screen dermatitis" patients were compared with corresponding material from normal healthy volunteers. The aim of the study was to evaluate possible markers to be used for future double-blind or blind provocation investigations. Differences were found for the biological markers calcitonin gene-related peptide (CGRP), somatostatin (SOM), vasoactive intestinal polypeptide (VIP), peptide histidine isoleucine amide (PHI), neuropeptide tyrosine (NPY), protein S-100 (S-100), neuron-specific enolase (NSE), protein gene product (PGP) 9.5 and phenylethanolamine N-methyltransferase (PNMT). The overall impression in the blind-coded material was such that it turned out easy to blindly separate the two groups from each other. However, no single marker was 100% able to pin-point the difference, although some were quite powerful in doing so (CGRP, SOM, S-100). However, it has to be pointed out that we cannot, based upon the present results, draw any definitive conclusions about the cause of the changes observed. Whether this is due to electric or magnetic fields, a surrounding airborne chemical, humidity, heating, stress factors, or something else, still remains an open question. Blind or double-blind provocations in a controlled environment are necessary to elucidate possible underlying causes for the changes reported in this investigation. PMID:8981027

  11. Immediate effect of two yoga-based relaxation techniques on cognitive functions in patients suffering from relapsing remitting multiple sclerosis: A comparative study.

    PubMed

    Bhargav, Praerna; Bhargav, Hemant; Raghuram, Nagarathna; Garner, Christoph

    2016-06-01

    Cognitive impairment (CI) is an important feature of relapsing remitting multiple sclerosis (RRMS). Yogic relaxation techniques have been found useful in improving various cognitive domains in health and disease. Eighteen subjects (13 females) in the age range of 51.5 ± 12.72 years with the diagnosis of RRMS by a neurologist (McDonald Criteria 2010) since last 18.16 ± 12.59 years were recruited into the study from a neuro-rehabilitation centre in Germany. Assessments were done before and immediately after two randomly allocated 30-min sessions of yogic relaxation: Cyclic Meditation (CM) and SR (supine rest or shavasana). Assessments were done for attention, psychomotor performance, information processing speed, executive functions, and immediate and delayed recall using standard psychometric tools. RMANOVA was applied to analyse the data using SPSS version 10. Both CM and SR sessions improved scores on Digit Symbol Substitution Test (DSST) (p < 0.01) and Auditory Verbal Learning Test (AVLT) (p < 0.05). There was a significantly better performance in Trail Making Test (TMT)-A and forward digit span (FDS) after CM as compared to SR (p < 0.01). Yogic relaxation techniques may have an immediate enhancing effect on processing speed, psychomotor performance, and recall of RRMS patients. CM is better than SR in improving processing speed, short-term memory, and verbal working memory. PMID:27299568

  12. Understanding suffering: Utermohlen's self-portraits and Alzheimer's disease.

    PubMed

    Harrison, Elizabeth M

    2013-01-01

    Human suffering is a universal experience simply defined as, or associated with, physical or psychological pain and distress. Faculty seeks ways to help its students understand and ease their patients' suffering. The author uses Alzheimer's disease as an exemplar of suffering and describes a creative teaching strategy using 9 self-portraits that chronicle American-born artist William Utermohlen's deterioration from the disease. PMID:23222627

  13. Comparison of time-resolved autofluorescence in the eye-ground of healthy subjects and patients suffering from age-related macular degeneration

    NASA Astrophysics Data System (ADS)

    Schweitzer, Dietrich; Schweitzer, Frank; Hammer, Martin; Schenke, Stefan; Richter, Sandra

    2005-08-01

    Age-related macular degeneration (AMD) is the most frequent cause for blindness for person older than 65 years in western countries. Besides the subjective pain, it is also an economic problem in the ageing population. As the pathomechanism is unknown, no curative treatment is possible. International research for discovering of early age-related alterations at the fundus is directed on in vivo measurements of autofluorescence. One way is the measurement of fluorescence spectra. Unfortunately, any selective excitation of fluorophores is excluded by the absorption edge of the ocular media at 400 nm. Furthermore, the shape of fluorescence spectra is influenced by the spectral absorption of layers in front of the emitting fluorophore. Weakly emitting fluorophores are covered by intensive emitting substances. The most serious limitation in fluorescence measurements of the living human fundus is the maximal permissible exposure. For that reason, fluorescence spectra of the fundus can not be detected with a high spatial resolution. The detection of dynamic fluorescence provides substance-specific lifetimes Ti, amplitudes Ai, and information about the relative contribution Qi of components in fluorescence images. As these parameters are calculated for each image point, diagrams of Ti vs. Tj, Ai vs. Aj, and Qi vs. Qj can be drawn, in which specific clusters appear for healthy subjects or AMD - patients. The projection of lifetime - clusters onto corresponding axis represents histogram of the considered lifetime. The slope in the correlation between Ai and Aj can also be used as a discriminating mark. Considering image lines as intersection through characteristic anatomical structures (optic disc, macula) profiles of Ti, Ai, or Qi show changes of these parameters (e.g. depigmentation) as function of location, which might be specific for AMD.

  14. Quality of life in breast cancer sufferers.

    PubMed

    Shouman, Ahmed Essmat; Abou El Ezz, Nahla Fawzy; Gado, Nivine; Ibrahim Goda, Amal Mahmoud

    2016-08-01

    Purpose - The purpose of this paper is to measure health-related quality of life (QOL) among patients with early stage cancer breast under curative treatment at department of oncology and nuclear medicine at Ain Shams University Hospitals. Identify factors affecting QOL among these patients. Design/methodology/approach - A cross-sectional study measured QOL among early stage female breast cancer (BC) patients and determined the main factors affecting their QOL. Three interviewer administered questionnaires were used. Findings - The physical domain mostly affected in BC patients and the functional domain least. Socio-demographic factors that significantly affected BC patients QOL scores were patient age, education, having children and family income. Specific patient characteristics include caregiver presence - a factor that affected different QOL scores. Age at diagnosis, affection in the side of the predominant hand, post-operative chemotherapy and difficulty in obtaining the medication were the disease-related factors that affected QOL scores. Originality/value - The final model predicting QOL for early stage female BC patients included age, education and difficulty in obtaining the medication as determinants for total QOL score. Carer presence was the specific patient characteristic that affected different QOL scores. PMID:27477929

  15. Change in patient affect/defense ratio from early to late sessions in brief psychotherapy.

    PubMed

    Taurke, E A; Flegenheimer, W; McCullough, L; Winston, A; Pollack, J; Trujillo, M

    1990-09-01

    The current study examined changes in the ratio of patients' affective and defensive behaviors during the course of brief psychodynamic psychotherapy. Treatments of 16 patients were videotaped. For each patient, four sessions were evaluated with a minute-by-minute coding system of process variables. When patients were grouped according to outcome scores, significant differences between the high outcome and the average-to-low outcome groups emerged. During the early phase of treatment, patients in both groups showed an average of one affective response per five defensive responses. By the late phase of treatment, the high outcome patients showed a marked shift to one affective response per two defensive responses, while the low outcome patients remained the same. An incidental finding was a negative correlation between good outcome and the ratio of defensive behavior to total patient activity. PMID:2246376

  16. Factors affecting daily activities of patients with cerebral infarction

    PubMed Central

    Liu, Peng; Zhou, Cheng-ye; Zhang, Ying; Wang, Yun-feng; Zou, Chang-lin

    2010-01-01

    BACKGROUND: Stroke is the leading cause of death and long-term disability. This study was undertaken to investigate the factors influencing daily activities of patients with cerebral infarction so as to take interventional measures earlier to improve their daily activities. METHODS: A total of 149 patients with first-episode cerebral infarction were recruited into this prospective study. They were admitted to the Encephalopathy Center, Department of Neurology, the First Affiliated Hospital of Wenzhou Medical College in Zhejiang Province from August 2008 to December 2008. The baseline characteristics of the patients and cerebral infarction risk factors on the first day of admission were recorded. White blood cell (WBC) count, plasma glucose (PG), and many others of laboratory targets were collected in the next morning. Barthel index (BI) was calculated at 2 weeks and 3 months respectively after onset of the disease at the outpatient clinic or by telephone call. Lung infection, urinary tract infection and atrial fibrillation if any were recorded on admission. The National Institute of Health Stroke Scale (NIHSS) scores and the GCS scores were recorded within 24 hours on and after admission, at the second week, and at the third month after the onset of cerebral infarction respectively. RESULTS: The factors of BI at 2 weeks and 3 months after onset were the initial PG level, WBC count and initial NIHSS scores. Besides, urinary tract infection on admission was also the factor for BI at 3 months. CONCLUSION: Active measures should be taken to control these factors to improve the daily activities of patients with cerebral infarction. PMID:25214953

  17. Personalized symptoms forecasting for pollen-induced allergic rhinitis sufferers

    NASA Astrophysics Data System (ADS)

    Voukantsis, D.; Berger, U.; Tzima, F.; Karatzas, K.; Jaeger, S.; Bergmann, K. C.

    2015-07-01

    Hay fever is a pollen-induced allergic reaction that strongly affects the overall quality of life of many individuals. The disorder may vary in severity and symptoms depending on patient-specific factors such as genetic disposition, individual threshold of pollen concentration levels, medication, former immunotherapy, and others. Thus, information services that improve the quality of life of hay fever sufferers must address the needs of each individual separately. In this paper, we demonstrate the development of information services that offer personalized pollen-induced symptoms forecasts. The backbone of these services consists of data of allergic symptoms reported by the users of the Personal Hay Fever Diary system and pollen concentration levels (European Aeroallergen Network) in several sampling sites. Data were analyzed using computational intelligence methods, resulting in highly customizable forecasting models that offer personalized warnings to users of the Patient Hay Fever Diary system. The overall system performance for the pilot area (Vienna and Lower Austria) reached a correlation coefficient of r = 0.71 ± 0.17 (average ± standard deviation) in a sample of 219 users with major contribution to the Pollen Hay Fever Diary system and an overall performance of r = 0.66 ± 0.18 in a second sample of 393 users, with minor contribution to the system. These findings provide an example of combining data from different sources using advanced data engineering in order to develop innovative e-health services with the capacity to provide more direct and personalized information to allergic rhinitis sufferers.

  18. [Handicapped and chronically ill patients: special effect on the affected].

    PubMed

    Rinn, F

    1997-05-01

    The Bonn coalition government's determination to reduce incidental wage costs, to be realized by way of benefit cutbacks in the social insurance systems and social assistance domain as well as increasing the burdens on insurers through higher retention and cost sharing levels, has particularly serious implications for people with disabilities and chronic illness. Apart from facing numerous direct changes for the worse, they in addition are affected by restrictive regulations applicable generally, inter alia in the labour market or the health and pension insurance schemes; adverse effects, hence, accumulate and heighten out of proportion. The implications of the Bonn austerity legislation are dealt with in the present contribution on the examples of the health-care reform acts as well as the changes to the federal social assistance act, in as far as they affect the provision and care of disabled individuals in residential or community settings. Also dealt with are various problems arising due to the integration assistance/long-term care insurance overlap. PMID:9324712

  19. Impairment in cognitive and affective empathy in patients with brain lesions: anatomical and cognitive correlates.

    PubMed

    Shamay-Tsoory, S G; Tomer, R; Goldsher, D; Berger, B D; Aharon-Peretz, J

    2004-11-01

    The present study was designed to examine the degree of impairment in cognitive and affective empathy among patients with focal brain lesions, and the contribution of specific cognitive abilities (such as cognitive flexibility and processing of emotional information), to empathy. The cognitive and affective empathic response of patients with localized prefrontal lesions (n=36) was compared to responses of patients with parietal lesions (n=15) and healthy control subjects (n=19). Results indicate that patients with prefrontal lesions (especially those with lesions involving the orbitoprefrontal and medial regions) were significantly impaired in both cognitive and affective empathy as compared to parietal patients and healthy controls. When the damage was restricted to the prefrontal cortex, either left- or right-hemisphere lesions resulted in impaired empathy. However, when the lesion involved the right hemisphere, patients with parietal lesions were also impaired. The pattern of relationships between cognitive performance and empathy suggested dissociation between the cognitive correlates of affective and cognitive empathy. PMID:15590464

  20. Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?

    PubMed

    Clemens, Jeffrey; Gottlieb, Joshua D

    2014-04-01

    We investigate whether physicians' financial incentives influence health care supply, technology diffusion, and resulting patient outcomes. In 1997, Medicare consolidated the geographic regions across which it adjusts physician payments, generating area-specific price shocks. Areas with higher payment shocks experience significant increases in health care supply. On average, a 2 percent increase in payment rates leads to a 3 percent increase in care provision. Elective procedures such as cataract surgery respond much more strongly than less discretionary services. Non-radiologists expand their provision of MRIs, suggesting effects on technology adoption. We estimate economically small health impacts, albeit with limited precision. PMID:25170174

  1. Does varicocelectomy affect DNA fragmentation in infertile patients?

    PubMed Central

    Telli, Onur; Sarici, Hasmet; Kabar, Mucahit; Ozgur, Berat Cem; Resorlu, Berkan; Bozkurt, Selen

    2015-01-01

    Introduction: The aims of this study were to investigate the effect of varicocelectomy on DNA fragmentation index and semen parameters in infertile patients before and after surgical repair of varicocele. Materials and Methods: In this prospective study, 72 men with at least 1-year history of infertility, varicocele and oligospermia were examined. Varicocele sperm samples were classified as normal or pathological according to the 2010 World Health Organization guidelines. The acridine orange test was used to assess the DNA fragmentation index (DFI) preoperatively and postoperatively. Results: DFI decreased significantly after varicocelectomy from 34.5% to 28.2% (P = 0.024). In addition all sperm parameters such as mean sperm count, sperm concentration, progressive motility and sperm morphology significantly increased from 19.5 × 106 to 30.7 × 106, 5.4 × 106/ml to 14.3 × 106/ml, and 19.9% to 31.2% (P < 0.001) and 2.6% to 3.1% (P = 0.017). The study was limited by the loss to follow-up of some patients and unrecorded pregnancy outcome due to short follow-up. Conclusion: Varicocele causes DNA-damage in spermatozoa. We suggest that varicocelectomy improves sperm parameters and decreases DFI. PMID:25878412

  2. Diogenes syndrome in patients suffering from dementia

    PubMed Central

    Cipriani, Gabriele; Lucetti, Claudio; Vedovello, Marcella; Nuti, Angelo

    2012-01-01

    Diogenes syndrome (DS) is a behavioral disorder of the elderly. Symptoms include living in extreme squalor, a neglected physical state, and unhygienic conditions. This is accompanied by a self-imposed isolation, the refusal of external help, and a tendency to accumulate unusual objects. To explore the phenomenon of DS in dementia we searched for the terms: “Diogenes syndrome, self-neglect, dementia. ” It has long been understood that individuals with dementia often become shut-ins, living in squalor, in the Eastern Baltimore study, dementia was present in 15% of the elderly cases with moderate and severe social breakdown syndrome; twice as many as in the general population of the same age group. Researchers have underlined the frequent presence of DS (36%) in frontotemporal dementia (FTD): different neuropsychological modifications in FTD may contribute to symptoms of DS. The initial treatment should be a behavioral program, but there is not sufficient information regarding pharmacological treatment of the syndrome. PMID:23393422

  3. Risk Factors Predictive of Recurrence and Progression for Patients Who Suffered Initial Recurrence After Transurethral Resection of Stage pT1 Bladder Tumor in Chinese Population: A Retrospective Study

    PubMed Central

    Shen, Zhonghua; Xie, Linguo; Chen, Tao; Tian, Dawei; Liu, xiaoteng; Xu, Hao; Zhang, Yu; Wu, Zhouliang; Sha, Nan; Xing, Chen; Ding, Na; Hu, Hailong; Wu, Changli

    2016-01-01

    Abstract Bladder cancer is one of the most common malignancies worldwide and the stage pT1nonmuscle invasive bladder cancer (NMIBC) has a high probability of recurrence after initial diagnosis and treatment. However, risk factors predictive of repeated recurrence and progression of pT1 bladder tumors after primary relapse have not been uncovered. Thus, we conducted the retrospective study. A total of 418 patients who suffered initial recurrence after transurethral resection (TUR) of pT1 bladder tumor were selected for the analyses. Clinic information of the patients was retrieved from their medical records. Recurrence-free survival (RFS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Univariate and multivariate analyses were performed using a Cox proportional hazards regression model. The probability of recurrence and progression by multivariate analyses was used as a surrogate marker to construct receiver operating curve (ROC). Results showed that variables including time to prior recurrence time, prior treatment, number of tumor, tumor size, tumor grade, and time of instillation after surgery were associated with the repeated recurrence of pT1 bladder tumor (P < 0.05). The variables including time to prior recurrence time, tumor size, tumor grade, carcinoma in situ (CIS), and time of instillation after surgery were associated with progression of pT1 bladder tumor (P < 0.05). In the present study, the multivariate model showed an area under ROC (AUC) value of 0.754 and 0.798 for tumor recurrence and progression, respectively, which was more effective in prediction than a single risk factor. In conclusion, we have identified several risk factors relevant to RFS and PFS for patients who have had a history of recurrence of pT1 bladder tumor after TUR. These predictive factors may help urologists to stratify patients into distinct risk groups of recurrence and progression, which probably contributes to the individualized

  4. Identification of Risk Factors Affecting Impaired Fasting Glucose and Diabetes in Adult Patients from Northeast China

    PubMed Central

    Yin, Yutian; Han, Weiqing; Wang, Yuhan; Zhang, Yue; Wu, Shili; Zhang, Huiping; Jiang, Lingling; Wang, Rui; Zhang, Peng; Yu, Yaqin; Li, Bo

    2015-01-01

    Background: Besides genetic factors, the occurrence of diabetes is influenced by lifestyles and environmental factors as well as trace elements in diet materials. Subjects with impaired fasting glucose (IFG) have an increased risk of developing diabetes mellitus (DM). This study aimed to explore risk factors affecting IFG and diabetes in patients from Northeast China. Methods: A population-based, cross-sectional survey of chronic diseases and related risk factors was conducted in Jilin Province of Northeast China. All adult residents, aged 18–79, were invited to participate in this survey using the method of multistage stratified random cluster sampling. One hundred thirty-four patients with IFG or DM and 391 healthy control subjects were recruited. We compared demographic factors, body size measurements, healthy-related behaviors, and hair metallic element contents between IFG/diabetes patients and healthy individuals. Results: IFG/diabetes patients had a greater weight, waist, hip, and body mass index (BMI) than control subjects. Significant differences in the content of zinc (Zn), potassium (K), copper (Ca), and sodium (Na) as well as Cu/Zn ratios between IFG or DM patients and control subjects (p < 0.05) were also observed. Hair Cu, selenium (Se), and Na contents were positively correlated with blood glucose levels (Cu: rs = 0.135, p = 0.002; Se: rs = 0.110, p = 0.012; Na: rs = 0.091, p = 0.038). Polytomous logistic regression adjusting for age, sex, family history of diabetes and BMI, showed that subjects with high BMI were more likely to develop IFG and DM (IFG: OR = 1.15, OR 95% CI = 1.02–1.29; DM: OR = 1.15, OR 95% CI = 1.01–1.33). Moreover, rarely or never eating fruits was a risk factor for DM (OR = 5.46, OR 95% CI = 1.87–15.98) but not for IFG (OR = 1.70, OR 95% CI = 0.72–4.02). Subjects with abdominal obesity or DM history were more susceptible to DM (abdominal obesity: OR = 2.99, OR 95% CI = 1.07–8.37; DM history: OR = 2.69, OR 95% CI = 1

  5. Does tramadol affect coagulation status of patients with malignancy?

    PubMed Central

    Bilir, Ayten; Akay, Meltem Olga; Ceyhan, Dilek; Andıc, Neslihan

    2014-01-01

    Aim: The study investigated the direct effects of tramadol on the coagulation status of women with gynecologic malignancies in vitro. Materials and Methods: Citrated whole-blood samples from 21 patients with gynecologic tumors were spiked ex vivo with 2 or 6 μl/ml tramadol. Thrombelastography (TEG) analysis was performed using ROTEM® to assess clotting time (CT), clot formation time (CFT) and maximum clot formation (MCF). Results: In the INTEM assay, CT (P < 0.05) and CFT (P < 0.01) were significantly prolonged with tramadol at a 6 μl/ml concentration compared with baseline. There were no significant differences in MCF values between the baseline and the tramadol-treated samples (P > 0.05). Blood medicated with tramadol (6 μl/ml) clotted slowly (increased CT and CFT). Conclusion: The changes observed by TEG demonstrated that tramadol impairs hemostasis in a concentration-dependent manner in the whole blood of women with gynecologic malignancies in vitro. PMID:25097280

  6. Direct-to-consumer advertising affects provider / patient relationship.

    PubMed

    1998-12-01

    Family planning program clients are increasingly seeking oral contraceptive pills by brand name. Direct-to-consumer ads have spurred this recent increase in brand-specific requests for prescription drugs. While print consumer pitches for prescription drugs have been around for a long time, proposed guidance issued by the US Food and Drug Administration (FDA) in August 1997 allows pharmaceutical companies to more easily broadcast product claim commercials on television and radio. Now, half of all direct-to-consumer advertising dollars spent by pharmaceutical companies during January-February 1998 were directed to television ads, almost twice the share spent upon television last year. Last year, pharmaceutical companies spent more than $1 billion on direct-to-consumer advertising. The effects of this new policy are presenting in providers' offices. Before the FDA guidance, 41% of physicians participating in a national survey observed an increase in patients' requests for brand name drugs. However, since the change, 65% surveyed to date have observed an increase in such requests. With the increase in advertising comes a potential for violations of the US Food, Drug, and Cosmetic Act, which regulates provider and consumer prescription drug advertising. 125 companies were cited for violations in 1998, 6 specifically for violations connected with contraceptive information they disseminated. PMID:12321805

  7. Skepticism, empathy, and animal suffering.

    PubMed

    Aaltola, Elisa

    2013-12-01

    The suffering of nonhuman animals has become a noted factor in deciding public policy and legislative change. Yet, despite this growing concern, skepticism toward such suffering is still surprisingly common. This paper analyzes the merits of the skeptical approach, both in its moderate and extreme forms. In the first part it is claimed that the type of criterion for verification concerning the mental states of other animals posed by skepticism is overly (and, in the case of extreme skepticism, illogically) demanding. Resting on Wittgenstein and Husserl, it is argued that skepticism relies on a misguided epistemology and, thus, that key questions posed by it face the risk of absurdity. In the second part of the paper it is suggested that, instead of skepticism, empathy together with intersubjectivity be adopted. Edith Stein's take on empathy, along with contemporary findings, are explored, and the claim is made that it is only via these two methods of understanding that the suffering of nonhuman animals can be perceived. PMID:24096874

  8. Category fluency performance in patients with schizophrenia and bipolar disorder: The influence of affective categories.

    PubMed

    Rossell, Susan L

    2006-02-28

    Semantic fluency (SF) and phonological fluency (PF) were examined in large groups of schizophrenia patients, bipolar patients and controls. As well as standard SF categories (animals and food), fluency to two affective categories, happy and fear was measured, i.e. participants were asked to produce as many words as they could that resulted in or are associated with fear or happiness. Schizophrenia patients showed SF and PF deficits. Bipolar patients showed PF deficits. Thus, PF is argued to be a good cognitive marker in both disorders. Severity of delusions was related to SF performance in all patients. The patient groups showed different patterns on the affective categories compared to controls: the bipolar patients were better and produced more words, especially to the happiness category, and the schizophrenia patients were impaired and produced less words. The results suggest an interesting interaction between psychotic illnesses, fluency and emotion. PMID:16376054

  9. The Meaning Of Healing: Transcending Suffering

    PubMed Central

    Egnew, Thomas R.

    2005-01-01

    PURPOSE Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms beyond the physiological processes related to curing. The objective of this study was to determine a definition of healing that operationalizes its mechanisms and thereby identifies those repeatable actions that reliably assist physicians to promote holistic healing. METHODS This study was a qualitative inquiry consisting of in-depth, open-ended, semistructured interviews with Drs. Eric J. Cassell, Carl A. Hammerschlag, Thomas S. Inui, Elisabeth Kubler-Ross, Cicely Saunders, Bernard S. Siegel, and G. Gayle Stephens. Their perceptions regarding the definition and mechanisms of healing were subjected to grounded theory content analysis. RESULTS Healing was associated with themes of wholeness, narrative, and spirituality. Healing is an intensely personal, subjective experience involving a reconciliation of the meaning an individual ascribes to distressing events with his or her perception of wholeness as a person. CONCLUSIONS Healing may be operationally defined as the personal experience of the transcendence of suffering. Physicians can enhance their abilities as healers by recognizing, diagnosing, minimizing, and relieving suffering, as well as helping patients transcend suffering. PMID:15928230

  10. Interpersonal Effects of Suffering in Older Adult Caregiving Relationships

    PubMed Central

    Monin, Joan K.; Schulz, Richard

    2009-01-01

    Examining the interpersonal effects of suffering in the context of family caregiving is an important step to a broader understanding of how exposure to suffering affects humans. In this review article, we first describe existing evidence that being exposed to the suffering of a care recipient (conceptualized as psychological distress, physical symptoms, and existential/spiritual distress) directly influences caregivers’ emotional experiences. Drawing from past theory and research, we propose that caregivers experience similar, complementary, and/or defensive emotions in response to care recipient suffering through mechanisms such as cognitive empathy, mimicry, and conditioned learning, placing caregivers at risk for psychological and physical morbidity. We then describe how gender, relationship closeness, caregiving efficacy, and individual differences in emotion regulation moderate these processes. Finally, we provide directions for future research to deepen our understanding of interpersonal phenomena among older adults, and we discuss implications for clinical interventions to alleviate the suffering of both caregivers and care recipients. PMID:19739924

  11. Interpersonal effects of suffering in older adult caregiving relationships.

    PubMed

    Monin, Joan K; Schulz, Richard

    2009-09-01

    Examining the interpersonal effects of suffering in the context of family caregiving is an important step to a broader understanding of how exposure to suffering affects humans. In this review article, the authors first describe existing evidence that being exposed to the suffering of a care recipient (conceptualized as psychological distress, physical symptoms, and existential/spiritual distress) directly influences caregivers' emotional experiences. Drawing from past theory and research, the authors propose that caregivers experience similar, complementary, and/or defensive emotions in response to care recipient suffering through mechanisms such as cognitive empathy, mimicry, and conditioned learning, placing caregivers at risk for psychological and physical morbidity. The authors then describe how gender, relationship closeness, caregiving efficacy, and individual differences in emotion regulation moderate these processes. Finally, the authors provide directions for future research to deepen understanding of interpersonal phenomena among older adults, and they discuss implications for clinical interventions to alleviate the suffering of both caregivers and care recipients. PMID:19739924

  12. Cognitive Function in Adolescent Patients with Anorexia Nervosa and Unipolar Affective Disorders.

    PubMed

    Sarrar, Lea; Holzhausen, Martin; Warschburger, Petra; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Schneider, Nora

    2016-05-01

    Studies have shown impairments in cognitive function among adult patients with anorexia nervosa (AN) and affective disorders (AD). The association between cognitive dysfunctions, AN and AD as well as the specificity for these psychiatric diagnoses remains unclear. Therefore, we examined cognitive flexibility and processing speed in 47 female adolescent patients with AN, 21 female adolescent patients with unipolar affective disorders and 48 female healthy adolescents. All participants completed a neuropsychological test battery. There were no significant group differences regarding cognitive function, except for psychomotor processing speed with poorer performance in patients with AN. A further analysis revealed that all groups performed with the normal range, although patients with AN were over represented in the poorest performing quartile. We found no severe cognitive impairments in either patient group. Nevertheless, belonging to the AN group contributed significantly to poor performances in neuropsychological tasks. Therefore, we conclude that the risk for cognitive impairments is slightly higher for patients with AN. PMID:26695683

  13. Usefulness in clinical practice of a point-of-care rapid test for simultaneous detection of nontreponemal and Treponema pallidum-specific antibodies in patients suffering from documented syphilis.

    PubMed

    Guinard, Jérôme; Prazuck, Thierry; Péré, Hélène; Poirier, Claire; LeGoff, Jérôme; Boedec, Erwan; Guigon, Aurélie; Day, Nesrine; Bélec, Laurent

    2013-12-01

    The usefulness of a point-of-care immunochromatographic dual test for the simultaneous detection of both nontreponemal and Treponema pallidum-specific antibodies (Chembio Diagnostics Systems Inc., Medford, NY, USA) was assessed in various situations related to syphilis, by reference to conventional syphilis serology. Thawed sera were obtained from 100 adults including 36 primary syphilis, 6 secondary syphilis, 6 re-infection, 9 recently-treated syphilis, and 43 old syphilis. Doubtful reactivities for the treponemal line were considered positive; doubtful reactivities for the nontreponemal line were considered positive only when the treponemal line was present. The sensitivity, the specificity, and its concordance to gold standard serology of treponemal line were high, around 90%. The sensitivity of nontreponemal line was 96.3%, its specificity 76.7%, and its concordance 83.4%. In conclusion, the dual rapid test from Chembio Diagnostics Systems Inc. is useful for rapid point-of-care diagnosis in the various situations encountered with patients suffering from syphilis. PMID:23999937

  14. Understanding graft-versus-host disease. Preliminary findings regarding the effects of exercise in affected patients.

    PubMed

    Fiuza-Luces, Carmen; Garatachea, Nuria; Simpson, Richard J; Berger, Nathan A; Ramírez, Manuel; Lucia, Alejandro

    2015-01-01

    Advances in this century regarding allogeneic hematopoietic stem cell transplantation (allo-HSCT) have led to an expanding population of long-term survivors, many of whom suffer severe side effects, particularly those related to graft-versushost disease (GVHD), a potentially multi-systemic disorder caused by immunoeffector donor lymphocytes that destroy host tissues. The GVHD, especially in its chronic form (cGVHD), generates considerable morbidity and compromises the physical capacity of patients. We have reviewed the main pathophysiological aspects of the disease as well as the data available on the effects of exercise in GVHD, based on animal and human patient research. Although exercise training as an adjunct therapy to improve health outcomes after allo-HSCT shows promise (particularly, this lifestyle intervention can improve physical fitness and possibly immune function while attenuating fatigue), there is a need for more randomized control trials that focus specifically on GVHD. PMID:25826127

  15. Unmet Needs of Patients Feeling Severely Affected by Multiple Sclerosis in Germany: A Qualitative Study

    PubMed Central

    Golla, Heidrun; Strupp, Julia; Karbach, Ute; Kaiser, Claudia; Ernstmann, Nicole; Pfaff, Holger; Ostgathe, Christoph; Voltz, Raymond

    2014-01-01

    Abstract Background: The needs of patients feeling severely affected by multiple sclerosis (MS) have rarely been investigated. However this is essential information to know before care can be improved, including adding palliative care (PC) services where helpful. Since it remains unclear at what point specialized palliative care should begin for this patient group, this study focuses on needs in general. Objective: The objective was to explore the subjectively unmet needs of patients feeling severely affected by MS. Methods: The study used a qualitative cross-sectional approach for needs assessment. Fifteen patients self-reporting feeling severely affected by MS were recruited and interviewed using a combination of purposive and convenience sampling (five were accompanied by a caregiver relative). Interviews were recorded and transcribed verbatim, followed by qualitative content analysis. Results: Unmet needs were identified in the main categories “support of family and friends,” “health care services,” “managing everyday life,” and “maintaining biographical continuity.” Patients expressed the desire for more support from their families and to be viewed as distinct individuals. They see a substantial deficit in the physician-patient relationship and in the coordination of services. A decrease in expressed unmet needs was found for patients more severely affected and less socially integrated. Conclusions: To address the unmet needs of severely affected MS patients, health care services need to be improved and linked with existing PC services. Special attention is required to form supporting professional-patient relationships. Multiprofessional services should be accessible for patients, while integrating relatives. All services should have an individual approach to provide needs-tailored support. PMID:24527993

  16. The neuroanatomical basis of affective mentalizing in schizophrenia: comparison of patients with schizophrenia and patients with localized prefrontal lesions.

    PubMed

    Shamay-Tsoory, Simone G; Aharon-Peretz, Judith; Levkovitz, Yechiel

    2007-02-01

    Patients with schizophrenia show impaired emotional and social behavior, such as misinterpretation of social situations and lack of Theory of Mind (ToM). However, the neuroanatomical basis of impaired ToM and its nature in schizophrenia is still largely unknown. Based on previous findings, the present study suggests that impaired social cognition observed in schizophrenic patients may be similar to that observed in patients with prefrontal (PFC) damage due to impaired 'affective ToM' abilities, rather than to a general impairment in ToM. We examined the behavioral and neural mechanisms that underlie the social and communicative impairments observed in patients with schizophrenia and with PFC damage, by looking at differential patterns of ToM impairment in these individuals. The performance of 24 patients with schizophrenia was compared to the responses of patients with localized lesions in the ventromedial (VM) or dorsolateral PFC, patients with non-frontal lesions, and healthy control subjects. Patients with schizophrenia and those with VM lesions were impaired on 'affective ToM' tasks but not in cognitive ToM conditions. It was concluded that the pattern of mentalizing impairments in schizophrenia resembled those seen in patients with lesions of the frontal lobe, particularly with VM damage, providing support for the notion of a disturbance of the fronto-limbic circuits in schizophrenia. PMID:17182218

  17. A novel SMARCAL1 missense mutation that affects splicing in a severely affected Schimke immunoosseous dysplasia patient.

    PubMed

    Barraza-García, Jimena; Rivera-Pedroza, Carlos I; Belinchón, Alberta; Fernández-Camblor, Carlota; Valenciano-Fuente, Blanca; Lapunzina, Pablo; Heath, Karen E

    2016-08-01

    Schimke immunoosseous dysplasia (SIOD) is an autosomal recessive disease characterized by skeletal dysplasia, focal segmental glomerulosclerosis, renal failure and immunodeficiency. In this work, we report the molecular studies undertaken in a severely affected SIOD patient that died at six years old due to nephropathy. The patient was screened for mutations using a targeted skeletal dysplasias panel. A homozygous novel missense mutation was identified, c.1615C > G (p.[Leu539Val]) that was predicted as mildly pathogenic by in silico pathogenicity prediction tools. However, splicing prediction software suggested that this variant may create a new splicing donor site in exon 9, which was subsequently confirmed using a minigene assay in HEK293 cells. Thus, the splicing alteration, c.1615C > G; r.1615c > g, 1615_1644del; (p.[Leu539_Ile548del]), results in the loss of 10 amino acids of the HARP-ATPase catalytic domain and the RPA-binding domain. Several studies have demonstrated a weak genotype-phenotype correlation among such patients. Thus, the molecular characterization has helped us to understand why a predicted weakly pathogenic missense mutation results in severe SIOD and should be considered in similar scenarios. PMID:27282802

  18. EVASEP: A Noninterventional Study Describing the Perception of Neurologists, Patients, and Caregivers on Caregivers' Role in the Support of Patients Suffering from Multiple Sclerosis Treated with Subcutaneous Interferon Beta 1a

    PubMed Central

    Donzé, Cécile; Lenne, Bruno; Jean Deleglise, Anne-Sophie; Bellili, Yasmine; Hautecoeur, Patrick

    2016-01-01

    Background. The perception of the role of caregivers for people with multiple sclerosis (MS) is important but poorly studied, particularly in patients with low levels of disability. Objectives. To describe the perceptions of the role of caregivers from the perspective of the caregiver, the patient, and neurologists. Methods. This observational study was conducted in France on patients with relapsing remitting MS treated with subcutaneous (SC) interferon-β-1a (IFN-β-1a) for more than 24 months. Results. Caregiver, patients, and neurologists all considered providing moral support and fighting against the disease as the most important role of the care provider. Moral support was considered significantly more important by caregivers than the patients and neurologists (p = 0.002) and caregivers considered their role in helping patients to fight disease more important than did the neurologists (p = 0.006). Knowledge of disease and available treatments were less important among support providers than patients (p = 0.007 and p = 0.001). Conclusion. There are many unmet needs in the perception of the role of caregivers for people with MS which need to be addressed to deliver the most effective care package for patients and to support the needs of the support provider. PMID:27563466

  19. Prehension Kinematics, Grasping Forces, and Independent Finger Control in Mildly Affected Patients with Essential Tremor.

    PubMed

    Solbach, Kasja; Mumm, Mareike; Brandauer, Barbara; Kronenbürger, Martin; Hermsdörfer, Joachim; Timmann, Dagmar

    2016-08-01

    Although the pathophysiology of essential tremor (ET), one of the most common movement disorders, is not fully understood, evidence increasingly points to cerebellar involvement. To confirm this connection, we assessed the everyday hand and finger movements of patients with ET, as these movements are known to be affected in cerebellar diseases. In 26 mildly affected patients with ET (compared to age- and gender-matched controls), kinematic and finger force parameters were assessed in a precision grip. In a second task, independent finger movements were recorded. The active finger had to press and release against a force-sensitive keypad while the other fingers stayed inactive. Finally, control of grip force to movement-induced, self-generated load changes was studied. Transport and shaping components during prehension were significantly impaired in patients with ET compared to controls. No significant group differences were observed in independent finger movements and grip force adjustments to self-generated load force changes. However, in the latter two tasks, more severely affected ET patients performed worse than less affected. Although observed deficits in hand and finger movement tasks were small, they are consistent with cerebellar dysfunction in ET. Findings need to be confirmed in future studies examining more severely affected ET patients. PMID:26310449

  20. Talc pleurodesis as surgical palliation of patients with malignant pleural effusion. Analysis of factors affecting survival.

    PubMed

    Lumachi, Franco; Mazza, Francesco; Ermani, Mario; Chiara, Giordano B; Basso, Stefano M M

    2012-11-01

    Malignant pleural effusion (MPE) is common in most patients with advanced cancer, especially in those with lung cancer, metastatic breast carcinoma and lymphoma. This complication usually leads patients to suffer from significant dyspnea, which may impair their mobility and reduce their quality of life. In patients with MPE, several interventions have been shown to be useful for palliation of the symptoms, including talc pleurodesis. The aim of this study was to evaluate prognostic factors for survival of patients with symptomatic MPE who underwent palliative video-assisted thoracoscopic (VATS) talc pleurodesis. Thirty-five patients with MPE underwent VATS, evacuation of the pleural fluid and talc pleurodesis with large-particle talc. There were 22 (62.9%) males and 13 (37.1%) females, with an overall median age of 69 years (range 42-81 years). The main causes of MPE were non-small cell lung carcinoma, breast or ovarian cancer and malignant pleural mesothelioma. The age did not differ (p=0.88) between men (68.6±11.6 years) and women (68.0±8.7 years). The mean quantity of pleural effusion was 2005.7±1078.9 ml, while the overall survival was 11.2±8.9 months. We did not find any relationship between survival and gender (log-rank test, p=0.53) or underlying malignancy associated with MPE (p=0.89, 0.48 and 0.36 for secondary cancer, lung cancer and mesothelioma, respectively). Similarly, no correlation was found between survival and age of the patients (Cox's regression, p=0.44) or quantity of pleural effusion (p=0.88). Our results show that the prognosis of patients after talc pleurodesis is independent of age, gender, type of malignancy and amount of pleural effusion, thus, suggesting the utility of treating all patients with symptomatic MPE early. PMID:23155281

  1. An investigation on pharmacy functions and services affecting satisfaction of patients with prescriptions in community pharmacies.

    PubMed

    Sakurai, Hidehiko; Nakajima, Fumio; Tada, Yuichirou; Yoshikawa, Emi; Iwahashi, Yoshiki; Fujita, Kenji; Hayase, Yukitoshi

    2009-05-01

    Various functions expected by patient expects are needed with progress in the system for separation of dispensing and prescribing functions. In this investigation, the relationship between patient satisfaction and pharmacy function were analyzed quantitatively. A questionnaire survey was conducted in 178 community pharmacies. Questions on pharmacy functions and services totaled 87 items concerning information service, amenities, safety, personnel training, etc. The questionnaires for patients had five-grade scales and composed 11 items (observed variables). Based on the results, "the percentage of satisfied patients" was determined. Multivariate analysis was performed to investigate the relationship between patient satisfaction and pharmacy functions or services provided, to confirm patient's evaluation of the pharmacy, and how factors affected comprehensive satisfaction. In correlation analysis, "the number of pharmacists" and "comprehensive satisfaction" had a negative correlation. Other interesting results were obtained. As a results of factor analysis, three latent factors were obtained: the "human factor," "patients' convenience," and "environmental factor," Multiple regression analysis showed that the "human factor" affected "comprehensive satisfaction" the most. Various pharmacy functions and services influence patient satisfaction, and improvement in their quality increases patient satisfaction. This will result in the practice of patient-centered medicine. PMID:19420889

  2. Patients Respond More Positively to Physicians Who Focus on Their Ideal Affect

    PubMed Central

    Sims, Tamara; Tsai, Jeanne L.

    2014-01-01

    Previous findings suggest that patients choose physicians whose affective focus matches how they ideally want to feel (Sims et al., 2014). For instance, the more people wanted to feel excitement, the more likely they were to hypothetically choose a new physician who promoted excitement. What remains unknown is whether this match shapes how patients actually respond to physicians after being assigned to them (i.e., whether they adhere to physicians’ recommendations more and evaluate physicians more positively). To this end, community adults reported their global ideal affect and actual affect (how they ideally want to feel and actually feel during a typical week, respectively), and were randomly assigned to receive health recommendations from either a physician who expressed and promoted high arousal positive states (HAP) (e.g., excitement), or one who expressed and promoted low arousal positive states (LAP) (e.g., calm). For the next five days, participants reported their daily adherence to the recommendations and their daily ideal and actual affect. At the end of the week, participants evaluated their physician. As predicted, the more participants wanted to feel HAP, the more they adhered to the “HAP-focused” physician’s recommendations, and the more participants wanted to feel LAP, the more they adhered to the “LAP-focused” physician’s recommendations. Participants also evaluated their physician more positively when his affective focus matched their ideal affect. Neither global nor daily actual affect systematically predicted how patients responded to their physicians. These findings suggest that patients respond better to physicians whose affective focus matches their ideal affect. PMID:25313670

  3. Randomized controlled trial to evaluate the effects of ethyl-2-cyanoacrylate on pain intensity and quality of life in head and neck cancer patients suffering from cetuximab-induced rhagades during radioimmunotherapy: the support trial

    PubMed Central

    2014-01-01

    Background Cetuximab is a chimeric monoclonal antibody against the epidermal growth factor receptor (EGFR). Skin reactions are the most common side effects of cetuximab. Rhagades of the tips of the fingers and toes, the heels and especially the interphalangeal joints are one of the most frightening and painful dermatological side effects that may develop from EGFR-inhibitor therapy. Rhagades are characterized by pain, severe tenderness and poor healing response. They are challenging to treat. Thus, rhagades often poses the most significant threat to the quality of life (QoL) for these patients. Ethyl-2-cyanoacrylate (ECA), an ethyl ester of the 2-cyano-2-propenoic acid, is often used as adhesive in a variety of different work settings in industry, i.e. as a component in nail-care products such as nail glue. In addition, ECA is used for various medical indications, such as for liquid bandages and for suture-less surgery. Wound healing can be accelerated with ECA. The purpose of the SUPPORT trial is to investigate the efficacy of ECA for the treatment of cetuximab-induced rhagades and to assess the clinical usefulness of the SUPO score, a new classification system for rhagades induced by EGFR-inhibitor therapy. Methods/Design The SUPPORT trial is an open-label, prospective, randomized, national multicenter intervention study to evaluate the effectiveness of ECA versus the standard treatment of each institution on the pain intensity and QoL in patients with locally advanced head and neck cancer suffering from painful cetuximab-induced rhagades during radioimmunotherapy. Primary endpoint is the assessment of the pain intensity 24 hours after application of ECA or the standard treatment quantified by the visual analogue scale (VAS). Secondary endpoints are the evaluation of QoL assessed by the EORTC-QoL-C30 questionnaire and the Dermatological Life Quality Index (DLQI). Discussion During treatment with EGFR inhibitors it is necessary to recognize and manage side effects

  4. Factors affecting decision-making of patients choosing acupuncture in a public hospital

    PubMed Central

    Koh, Thean Howe Bryan; Kong, Keng He; Low, Yin Peng

    2015-01-01

    Background With increasing evidence to support its practice, acupuncture has been integrated within many hospitals around the world. The purpose of this study is to understand the factors affecting decision making of patients as they select acupuncture treatment for their medical conditions and symptoms within a public hospital. Methods A qualitative study consisting of in depth interviews with 14 patients was conducted. All patients attended an acupuncture clinic within a public hospital. Data collected was analysed via thematic analysis. Results Four main factor groups affecting decision making of patients were identified- factors affecting the level and value of patient-centric care, the confidence and trust patients place within the acupuncture service, the presence of collaborative efforts between acupuncturists and Western medicine practitioners, and the knowledge, culture and belief society has regarding the role of acupuncture and Western medicine. All participants interviewed had more than one factor group present as enablers toward their eventual selection of acupuncture for ailment management. It was also noted that although the majority of participants had sufficient knowledge regarding acupuncture, there were a select few who had misperceptions or no knowledge regarding certain aspects of acupuncture. Conclusions There may be certain patterns in the way patients choose to utilise acupuncture services in public hospitals. Further studies should also be carried out in other public hospitals to analyse the factor groups identified further. PMID:26697443

  5. Impairments of attention and effort among patients with major affective disorders.

    PubMed

    Cohen, R; Lohr, I; Paul, R; Boland, R

    2001-01-01

    Impairments of attention are common among people with major affective disorders, yet the influence of effortful task demands on attentional performance in unipolar and bipolar illness has been little studied. The authors compared psychiatric inpatients with primary diagnoses of unipolar or bipolar affective disorder (n=27) and age-matched normal control subjects (n=20) on a battery of eight neuropsychological tasks designed to measure different attentional functions. There were low-effort and high-effort versions of each task. Significant group differences were consistently observed on tasks demanding sustained and focused attention, but not on tasks requiring visual selective attention. Although affective disorder patients showed impairments on most tasks regardless of level of task effort, group differences were greatest on high-effort conditions. Results indicate that patients with major affective disorders show significant attentional impairments on most measures of effortful attention, and the magnitude of these impairments increases as the effortful demands of the task increase. PMID:11514646

  6. Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study

    PubMed Central

    Maseda, Ana; Balo, Aránzazu; Lorenzo–López, Laura; Lodeiro–Fernández, Leire; Rodríguez–Villamil, José Luis; Millán–Calenti, José Carlos

    2014-01-01

    Purpose Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and

  7. Seasonal difference in brain serotonin transporter binding predicts symptom severity in patients with seasonal affective disorder.

    PubMed

    Mc Mahon, Brenda; Andersen, Sofie B; Madsen, Martin K; Hjordt, Liv V; Hageman, Ida; Dam, Henrik; Svarer, Claus; da Cunha-Bang, Sofi; Baaré, William; Madsen, Jacob; Hasholt, Lis; Holst, Klaus; Frokjaer, Vibe G; Knudsen, Gitte M

    2016-05-01

    Cross-sectional neuroimaging studies in non-depressed individuals have demonstrated an inverse relationship between daylight minutes and cerebral serotonin transporter; this relationship is modified by serotonin-transporter-linked polymorphic region short allele carrier status. We here present data from the first longitudinal investigation of seasonal serotonin transporter fluctuations in both patients with seasonal affective disorder and in healthy individuals. Eighty (11)C-DASB positron emission tomography scans were conducted to quantify cerebral serotonin transporter binding; 23 healthy controls with low seasonality scores and 17 patients diagnosed with seasonal affective disorder were scanned in both summer and winter to investigate differences in cerebral serotonin transporter binding across groups and across seasons. The two groups had similar cerebral serotonin transporter binding in the summer but in their symptomatic phase during winter, patients with seasonal affective disorder had higher serotonin transporter than the healthy control subjects (P = 0.01). Compared to the healthy controls, patients with seasonal affective disorder changed their serotonin transporter significantly less between summer and winter (P < 0.001). Further, the change in serotonin transporter was sex- (P = 0.02) and genotype- (P = 0.04) dependent. In the patients with seasonal affective disorder, the seasonal change in serotonin transporter binding was positively associated with change in depressive symptom severity, as indexed by Hamilton Rating Scale for Depression - Seasonal Affective Disorder version scores (P = 0.01). Our findings suggest that the development of depressive symptoms in winter is associated with a failure to downregulate serotonin transporter levels appropriately during exposure to the environmental stress of winter, especially in individuals with high predisposition to affective disorders.media-1vid110.1093/brain/aww043_video_abstractaww043_video

  8. Impact of aerobic exercise training during chemotherapy on cancer related cognitive impairments in patients suffering from acute myeloid leukemia or myelodysplastic syndrome - Study protocol of a randomized placebo-controlled trial.

    PubMed

    Zimmer, P; Oberste, M; Bloch, W; Schenk, A; Joisten, N; Hartig, P; Wolf, F; Baumann, F T; Garthe, A; Hallek, M; Elter, T

    2016-07-01

    Cancer related cognitive impairments (CRCI) are frequently reported by patients prior to, during and after medical treatment. Although this cognitive decline severely affects patients' quality of life, little is known about effective treatments. Exercise programs represent a promising supportive strategy in this field. However, evidence is sparse and existing studies display methodological limitations. In the planned study, 83 men and women newly diagnosed with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) will be randomized into one of three treatment groups. During 4weeks of induction chemotherapy with Anthracycline and Cytarabin patients allocated to exercise group will cycle 3×/week for 30min at moderate to vigorous intensity on an ergometer. Patients allocated to placebo group will receive a supervised myofascial release training (3×/week, approx. 30min) and patients at control group will get usual care. As primary endpoints a cognitive test battery will be conducted measuring performances depending on verbal/spatial memory and executive functioning. Secondary endpoints will be self-perceived cognitive functioning, as well as neurotrophic and inflammatory serum markers. All assessments will be conducted immediately after hospitalization and before chemotherapy is commenced, immediately before discharge of hospital after 4-5weeks as well as before continuing medical treatment 3-4weeks after discharge. This will be the first study investigating the impact of an aerobic exercise training on CRCI in AML/MDS patients. We hope that the study design and the state-of-the-art assessments will help to increase knowledge about CRCI in general and exercise as potential treatment option in this under investigated population. PMID:27261170

  9. Impaired oculo-motor behaviour affects both reading and scene perception in neglect patients.

    PubMed

    Primativo, Silvia; Arduino, Lisa S; Daini, Roberta; De Luca, Maria; Toneatto, Carlo; Martelli, Marialuisa

    2015-04-01

    Unilateral spatial neglect (USN) is a common neuropsychological disorder following a right-sided brain lesion. Although USN is mostly characterized by symptoms involving the left hemispace, other symptoms are not left lateralized. Recently, it was shown that patients with neglect dyslexia, a reading disturbance that affects about 40% of USN patients, manifest a non-lateralized impairment of eye movement behaviour in association with their reading deficit when they read aloud and perform non-verbal saccadic tasks (Primativo et al., 2013). In the present paper, we aimed to demonstrate that the eye movement impairment shown by some USN patients reflects a more general oculo-motor disorder that is not confined to orthographic material, the horizontal axis or constrained saccadic tasks. We conjectured that inaccurate oculo-motor behaviour in USN patients indicates the presence of a reading deficit. With this aim we evaluated 20 patients, i.e., 10 right-sided brain-damaged patients without neglect and 10 patients affected by USN. On the basis of the patients' eye movement patterns during a scene exploration task, we found that 4 out of the 10 USN patients presented an abnormal oculo-motor pattern. These same four patients (but not the others) also failed in performing 5 different saccadic tasks and produced neglect dyslexia reading errors in both single words and texts. First, we show that a large proportion of USN patients have inaccurate eye movement behaviour in non-reading tasks. Second, we demonstrate that this exploratory deficit is predictive of the reading impairment. Thus, we conclude that the eye movement deficit prevents reading and impairs the performance on many other perceptual tests, including scene exploration. The large percentage of patients with impaired eye-movement pattern suggests that particular attention should be paid to eye movement behaviour during the diagnostic phase in order to program the best rehabilitation strategy for each patient. PMID

  10. Dialysis-related factors affecting quality of life in patients on hemodialysis.

    PubMed

    Anees, Muhammad; Hameed, Farooq; Mumtaz, Asim; Ibrahim, Muhammad; Saeed Khan, Muhammad Nasir

    2011-01-01

    INTRODUCTION. Treatment modalities for end-stage renal disease affect quality of life (QOL) of the patients. This study was conducted to assess the QOL of patients on hemodialysis and compare it with caregivers of these patients. Cause of ESRD and dialysis-related factors affecting QOL were also examined. MATERIALS AND METHODS. This cross-sectional study was conducted on patient on maintenance hemodialysis for more than 3 months at 3 dialysis centers of Lahore. Fifty healthy individuals were included as controls from among the patients' caregivers. The QOL index was measured using the World Health Organization QOL questionnaire, with higher scores corresponding to better QOL of patients. RESULTS. Eighty-nine patients (71.2%) were men, 99 (79.2%) were married, 75 (60.0%) were older than 45 years, and 77 (61.6%) were on dialysis for more than 8 months. Patients on hemodialysis had a poorer QOL as compared to their caregivers in all domains except for domain 4 (environment). There was no difference in the QOL between the three dialysis centers of the study, except for domain 3 (social relationship) of the patients at Mayo Hospital (a public hospital), which was significantly better. Nondiabetic patients had a better QOL in domain 1 (physical health) as compared to diabetic patients. Duration of dialysis had a reverse correlation with the overall QOL. CONCLUSIONS. We found that QOL of hemodialysis patients was poor as compared to caregivers of the patients, especially that of diabetics. Also, duration of dialysis had a reverse correlation with QOL. PMID:21189427

  11. Charting Phelan's 'To Suffer a Sea Change'.

    PubMed

    Winkelman, Megan; Ng, Jacqueline; Shafer, Audrey

    2015-12-01

    Physicians and healthcare workers usually perceive their medical record entries as documentation rather than construction. In the following article, we extract a medical record from a narrative, Peggy Phelan's pathography of glaucoma, 'To Suffer a Sea Change'. From information about encounters described by Phelan, an ophthalmologist reconstructs progress notes similar to those that would be key to a glaucoma patient's medical record. Rather than condemning the arcane pointilism of the medical record as a poverty of language, or isolating the pathography as an academic text, we hope to instead appreciate what their collaborative dialogue offers the study of disease. While the points of divergence between these texts will demonstrate failures in communication, they will also unearth an enriched dialogue. PMID:26179595

  12. Oral Myiasis Affecting Gingiva in a Child Patient: An Uncommon Case Report.

    PubMed

    Ali, Fareedi Mukram; Patil, Kishor; Kar, Sanjay; Patil, Atulkumar A; Ahamed, Shabeer

    2016-01-01

    Certain dipteran flies larvae causing invasion of the tissues and organs of the humans or other vertebrates are called as myiasis, which feed on hosts dead or living tissues. It is well documented in the skin and hot climate regions; underdeveloped countries are affected more commonly. Oral cavity is affected rarely and it can be secondary to serious medical conditions. Poor oral hygiene, alcoholism, senility, or suppurating lesions can be associated with the oral myiasis. Inflammatory and allergic reactions are the commonest clinical manifestations of the disease. In the present case, gingiva of maxillary anterior region was affected by larval infection in a 13-year-old mentally retarded patient. PMID:26881145

  13. Oral Myiasis Affecting Gingiva in a Child Patient: An Uncommon Case Report

    PubMed Central

    Ali, Fareedi Mukram; Patil, Kishor; Kar, Sanjay; Patil, Atulkumar A.; Ahamed, Shabeer

    2016-01-01

    Certain dipteran flies larvae causing invasion of the tissues and organs of the humans or other vertebrates are called as myiasis, which feed on hosts dead or living tissues. It is well documented in the skin and hot climate regions; underdeveloped countries are affected more commonly. Oral cavity is affected rarely and it can be secondary to serious medical conditions. Poor oral hygiene, alcoholism, senility, or suppurating lesions can be associated with the oral myiasis. Inflammatory and allergic reactions are the commonest clinical manifestations of the disease. In the present case, gingiva of maxillary anterior region was affected by larval infection in a 13-year-old mentally retarded patient. PMID:26881145

  14. [Effect of pharmacotherapy of affective disorders on the psycho-semantics of alcoholic patients].

    PubMed

    Krupitskiĭ, E M; Burakov, A M; Grinenko, A Ia; Borodkin, Iu S

    1995-01-01

    90 alcoholic patients (II stage of alcoholism) with secondary affective disorders (anxiety, depression) were divided into 4 groups. The patients of the first group received the GABA receptor ligand baclofen during 3 weeks. Sybazon preparation was used in the second group, while the patients of the third group were treated with amitriptyline. Placebo was applied in the forth group. The clinical psychological tests demonstrated that all drugs caused quite effective relief of affective disorders. Psychosemantic tests application showed that the pharmacotherapy caused positive changes in patients of 1-3 groups. These changes touched on both system of personal estimations and relations of personality to himself and to the world around i.e. psychosemantic sphere. Such changes in psychosemantic sphere were not observed in the 4-th group of patients (placebo). Besides it was revealed that each drug caused some specific changes in psychosemantic sphere. The result obtained were supposed to have some theoretical value in comprehension of brain-psychics relations as well as the applied significance for adequate choice of affective disorders pharmacotherapy of alcoholic patients. PMID:8788983

  15. Er:YAG Laser Dental Treatment of Patients Affected by Epidermolysis Bullosa

    PubMed Central

    Galeotti, Angela; D'Antò, Vincenzo; Gentile, Tina; Giancristoforo, Simona; Romeo, Umberto

    2014-01-01

    Aim. The purpose of this study was to evaluate the efficacy of Er:YAG laser used for treating hard dental tissue in patients with epidermolysis bullosa (EB). Methods. We report two cases of EB in which an Er:YAG laser was used for conservative treatments. In the first case, the Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to treat caries on a deciduous maxillary canine in an 8-year-old male patient affected by dystrophic EB. In the second case, we treated a 26-year-old female patient, affected by junctional EB, with generalized enamel hypoplasia, and an Er:YAG laser (2,940 μm, 265 mJ, 25 Hz) was used to remove the damaged enamel on maxillary incisors. Results. The use of the Er:YAG laser, with the appropriate energy, was effective in the selective removal of carious tissue and enamel hypoplasia. During dental treatment with the Er:YAG laser, patients required only a few interruptions due to the absence of pain, vibration, and noise. Conclusions. Laser treatment of hard dental tissues is a valuable choice for patients affected by EB since it is less invasive compared to conventional treatment, resulting in improved patient compliance. PMID:25431688

  16. Intermittent targeted therapies and stochastic evolution in patients affected by chronic myeloid leukemia

    NASA Astrophysics Data System (ADS)

    Pizzolato, N.; Persano Adorno, D.; Valenti, D.; Spagnolo, B.

    2016-05-01

    Front line therapy for the treatment of patients affected by chronic myeloid leukemia (CML) is based on the administration of tyrosine kinase inhibitors, namely imatinib or, more recently, axitinib. Although imatinib is highly effective and represents an example of a successful molecular targeted therapy, the appearance of resistance is observed in a proportion of patients, especially those in advanced stages. In this work, we investigate the appearance of resistance in patients affected by CML, by modeling the evolutionary dynamics of cancerous cell populations in a simulated patient treated by an intermittent targeted therapy. We simulate, with the Monte Carlo method, the stochastic evolution of initially healthy cells to leukemic clones, due to genetic mutations and changes in their reproductive behavior. We first present the model and its validation with experimental data by considering a continuous therapy. Then, we investigate how fluctuations in the number of leukemic cells affect patient response to the therapy when the drug is administered with an intermittent time scheduling. Here we show that an intermittent therapy (IT) represents a valid choice in patients with high risk of toxicity, despite an associated delay to the complete restoration of healthy cells. Moreover, a suitably tuned IT can reduce the probability of developing resistance.

  17. Factors affecting the use of antioxidant supplements in patients with late AMD

    PubMed Central

    Yu, Alice L; Paul, Tobias; Schaumberger, Markus; Welge-Lussen, Ulrich

    2014-01-01

    Background The purpose of this study was to assess the use of oral antioxidant supplements in patients with late age-related macular degeneration (AMD) and to identify influencing factors that may affect the use of such supplements. Methods The study included 47 patients with late AMD. Using a questionnaire, the patients were asked for their demographic, ophthalmologic, and systemic data, their source of recommendation of antioxidant use for AMD, and/or their reasons for nonuse. The demographic, ophthalmologic, and systemic information was correlated with use or nonuse of oral antioxidant supplements for AMD. Results Sixty-eight percent (32/47) of patients took antioxidant supplements for AMD and 32% (15/47) of patients did not. There were no statistically significant differences in demographic, ophthalmologic, and systemic parameters between patients with late AMD who used supplements and those who did not. Two thirds of patients with late AMD (66%, 31/47) reported being recommended oral antioxidant supplements for AMD by their ophthalmologist. Patients who did not use antioxidant supplements either did not obtain any recommendation or did not believe in their benefits. Conclusion This study shows that most patients with late AMD use antioxidant supplements despite the recommendation to do so being missing in the Age-Related Eye Disease Study. Our study emphasizes the importance of seeking further therapeutic options for patients with late AMD. PMID:25061269

  18. Spouses’ Cardiovascular Reactivity to Their Partners’ Suffering

    PubMed Central

    Schulz, Richard; Martire, Lynn M.; Jennings, J. Richard; Lingler, Jennifer Hagerty; Greenberg, Martin S.

    2010-01-01

    A laboratory study of older adults with osteoarthritis and their spouses was conducted to examine the unique influence of exposure to suffering on caregivers’ risk for impaired psychological and physical health. Spouses’ blood pressure (BP) and heart rate (HR) were monitored during 2 tasks designed to capture their partners’ suffering. First, spouses watched their partners (and a stranger) carry heavy logs across an 8-ft space for 3 min, a task that elicited pain expression. Second, spouses spoke about their partners’ suffering (and also about a typical meal with their partners). Results showed that spouses’ BP and HR increased when watching and talking about their partners’ suffering, and exposure to a partner’s suffering was more physiologically stressful than to a stranger’s suffering. These findings suggest that heightened physiological stress caused by exposure to a loved one’s suffering may be one pathway to caregivers’ increased risk for cardiovascular disease. PMID:20067977

  19. Neuropsychological performance and affective temperaments in Euthymic patients with bipolar disorder type II.

    PubMed

    Romero, Ester; Holtzman, Jessica N; Tannenhaus, Lucila; Monchablon, Romina; Rago, Carlo Mario; Lolich, Maria; Vázquez, Gustavo H

    2016-04-30

    Affective temperament has been suggested as a potential mediator of the effect between genetic predisposition and neurocognitive functioning. As such, this report seeks to assess the extent of the correlation between affective temperament and cognitive function in a group of bipolar II subjects. 46 bipolar II outpatients [mean age 41.4 years (SD 18.2); female 58.9%] and 46 healthy controls [mean age 35.1 years (SD 18); female 56.5%] were evaluated with regard to their demographic and clinical characteristics, affective temperament, and neurocognitive performance. Crude bivariate correlation analyses and multiple linear regression models were constructed between five affective temperament subscales and eight neurocognitive domains. Significant correlations were identified in bipolar patients between hyperthymic temperament and verbal memory and premorbid IQ; cyclothymic temperament and attention; and irritable temperament, attention, and verbal fluency. In adjusting for potential confounders of the relationship between temperament and cognitive function, the strongest mediating factors among the euthymic bipolar patients were found to be residual manic and depressive symptoms. It is therefore concluded that affective temperaments may partially influence the neurocognitive performance of both healthy controls and euthymic patients with bipolar disorder type II in several specific domains. PMID:27086230

  20. Transcriptional regulation differs in affected facioscapulohumeral muscular dystrophy patients compared to asymptomatic related carriers

    PubMed Central

    Arashiro, Patricia; Eisenberg, Iris; Kho, Alvin T.; Cerqueira, Antonia M. P.; Canovas, Marta; Silva, Helga C. A.; Pavanello, Rita C. M.; Verjovski-Almeida, Sergio; Kunkel, Louis M.; Zatz, Mayana

    2009-01-01

    Facioscapulohumeral muscular dystrophy (FSHD) is a progressive muscle disorder that has been associated with a contraction of 3.3-kb repeats on chromosome 4q35. FSHD is characterized by a wide clinical inter- and intrafamilial variability, ranging from wheelchair-bound patients to asymptomatic carriers. Our study is unique in comparing the gene expression profiles from related affected, asymptomatic carrier, and control individuals. Our results suggest that the expression of genes on chromosome 4q is altered in affected and asymptomatic individuals. Remarkably, the changes seen in asymptomatic samples are largely in products of genes encoding several chemokines, whereas the changes seen in affected samples are largely in genes governing the synthesis of GPI-linked proteins and histone acetylation. Besides this, the affected patient and related asymptomatic carrier share the 4qA161 haplotype. Thus, these polymorphisms by themselves do not explain the pathogenicity of the contracted allele. Interestingly, our results also suggest that the miRNAs might mediate the regulatory network in FSHD. Together, our results support the previous evidence that FSHD may be caused by transcriptional dysregulation of multiple genes, in cis and in trans, and suggest some factors potentially important for FSHD pathogenesis. The study of the gene expression profiles from asymptomatic carriers and related affected patients is a unique approach to try to enhance our understanding of the missing link between the contraction in D4Z4 repeats and muscle disease, while minimizing the effects of differences resulting from genetic background. PMID:19339494

  1. Does Intellectual Disability Affect the Development of Dental Caries in Patients with Cerebral Palsy?

    ERIC Educational Resources Information Center

    Moreira, Rafaela Nogueira; Alcantara, Carlos Eduardo Pinto; Mota-Veloso, Isabella; Marinho, Sandra Aparecida; Ramos-Jorge, Maria L.; Oliveira-Ferreira, Fernanda

    2012-01-01

    The aim of this study was to evaluate if the severity of intellectual disability is a factor that affects the development of dental cavities in patients with cerebral palsy. This cross-sectional study was conducted on 165 individuals who were selected from a physical rehabilitation center, a special public school and a regular public school. Of…

  2. Complex treatment of trophic affections with vascular patients using monochromatic red light and hyperbaric oxygenation

    NASA Astrophysics Data System (ADS)

    Babkina, Zinaida M.; Vasilyev, Mikhail V.; Zakharov, Vyacheslav P.; Nikolayev, Viktor V.; Babkin, Vasily I.; Samoday, Valery G.; Zon, Boris A.; Pakhomov, Gennady V.; Naskidashvili, Vasily I.; Kumin, Anatoly A.

    1996-11-01

    Monochromatic red light irradiation therapy of trophic skin affections with vascular patients permits to receive positive results with small wounds. A combination of monochromatic red light and hyperbaric oxygenation is most perspective when conducting a complex therapy of trophic wounds not more than 40 mm2 and allows to diminish time of treatment almost two times.

  3. Influence of Sex on Suicidal Phenotypes in Affective Disorder Patients with Traumatic Childhood Experiences

    PubMed Central

    Carlberg, Laura; Swoboda, Patrick; Ludwig, Birgit; Koller, Romina; Kapusta, Nestor D.; Aigner, Martin; Haslacher, Helmuth; Schmöger, Michaela; Kasper, Siegfried; Schosser, Alexandra

    2015-01-01

    Objectives In the current study, we aimed to investigate the impact of childhood trauma on suicidal behaviour phenotypes in a group of patients with diagnosed affective disorder (unipolar or bipolar affective disorder). Patients and Methods Patients with and without a history of childhood abuse, measured by Childhood Trauma Questionnaire (CTQ), were assessed to explore risks for suicidal behaviour (including suicide attempt, self-harm and non-suicidal self-injury). The tested sample consisted of 258 patients (111 males and 147 females, in-patients and out-patients at the Department of Psychiatry and Psychotherapy, Medical University of Vienna and University Hospital Tulln, Lower Austria). Psychiatric diagnoses were derived from the SCAN (Schedules for Clinical Assessment in Neuropsychiatry) interview. In addition, patients were administered the Lifetime Parasuicidal Count (LPC), Suicidal Behaviour Questionnaire (SBQ-R), and Viennese Suicide Risk Assessment Scale (VISURIAS) questionnaires. Results In contrast to male suicide attempters, female suicide attempters showed both significantly higher total CTQ scores (p<0.001), and higher CTQ subscores (emotional, physical and sexual abuse, as well as emotional and physical neglect) in comparison to the non-suicidal control group. Besides, females with a history of self-harming behaviour (including suicidal intention) and Non-Suicidal-Self Injury (NSSI) had significantly higher CTQ total scores (p<0.001) than the control group. Conclusion These findings suggest gender differences in suicidal behaviour after being exposed to childhood trauma. PMID:26366559

  4. Predicting self-care with patients and family members' affective states and family functioning.

    PubMed

    Musci, E C; Dodd, M J

    1990-01-01

    People with cancer manage the side effects of treatment with the assistance of their family members. This study was designed to describe self-care behaviors (SCBs) initiated by patients and their family members and to determine the relationship between patients and family members' affective states and family functioning and SCBs. Using a longitudinal design, 42 patients and 40 family members were followed during 3 cycles of chemotherapy (12-16 weeks). The patients completed measures of affective state (POMS) each cycle; patients and family members completed a family functioning measure (F-COPES) at second cycle only; and the patients reported in an SCB log on an ongoing basis. The overall pattern of SCBs corroborated previous findings. The average number of SCBs initiated was 1.4 per side effect. Depression and vigor significantly predicted SCBs at Cycle 1 only. The severity of side effects consistently predicted SCB over the 3 cycles (r 2 = -0.39 to -0.46). Patients who experienced more severe side effects were at risk of diminished self-care. PMID:2342973

  5. Sociodemographic factors affecting the quality of life of patients with asthma

    PubMed Central

    Uchmanowicz, Bartosz; Panaszek, Bernard; Uchmanowicz, Izabella; Rosińczuk, Joanna

    2016-01-01

    Background In recent years, there has been an increased interest in the subjective quality of life (QoL) of patients with bronchial asthma. Patients diagnosed with asthma experience a number of problems with regard to everyday activities and functions, which adversely affects their health-related QoL. Aim The aim of this study is to analyze the sociodemographic factors affecting the QoL of patients with asthma. Patients and methods The study comprised of 100 patients (73 females and 27 males) aged 18–84 years (mean age 45.7 years) treated in the Department and Clinic of Internal Diseases, Geriatrics and Allergology, Wroclaw Medical University. All patients with asthma who met the inclusion criteria participated in the study. We used medical record analysis and two questionnaires: the asthma quality of life questionnaire (AQLQ) and the asthma control test. Up-to-date sociodemographic data were collected from all participants, including sex, age, marital status, education, and sources of income. Results The sociodemographic variables that correlated positively with QoL in all domains of the AQLQ were professional activity and higher education level of respondents. Factors that negatively influenced the AQLQ domains were older age and lack of professional activity. Conclusion This study shows that age, physical work, and lack of professional activity decreased the QoL in this patient group. It was found that higher education contributes to better QoL scores. PMID:27051276

  6. Not only headache: higher degree of sexual pain symptoms among migraine sufferers.

    PubMed

    Ifergane, Gal; Ben-Zion, Itzhak Z; Plakht, Ygal; Regev, Keren; Wirguin, Itzhak

    2008-04-01

    Chronic illness and chronic pain can have profound negative effects on relationship and sexual satisfaction, yet the influence of migraine on sexuality has not been previously evaluated. To assess sexual functions in subjects with migraine compared to those with no migraine. We evaluated female university students using the Israeli sexual behavior inventory (ISBI). Migraine was diagnosed according to self-reported symptoms according to the IHS criteria. Several dimensions of female sexuality--desire, orgasm, sexual avoidance, interpersonal sexual relationship, health influence, satisfaction and pain were evaluated using a structured questionnaire. Thirty-three (23.9%) of the participants met the IHS criteria for episodic migraine with and without aura. Sexual activity, desire, orgasm and satisfaction from sexual life did not differ significantly between migraine sufferers and non-sufferers. Migraine patients reported lower ISBI scores, higher health influence on sexual life, higher levels of sexual pain and lower sexual satisfaction. Migraine negatively affected the sexual life of sufferers. Sexual pain disorder is more common among migraine sufferers compared to non-migraineurs. PMID:18317864

  7. Longer resistance of some DNA traits from BT176 maize to gastric juice from gastrointestinal affected patients.

    PubMed

    Ferrini, A M; Mannoni, V; Pontieri, E; Pourshaban, M

    2007-01-01

    The presence of antibiotic resistance marker genes in genetically engineered plants is one of the most controversial issues related to Genetically Modified Organism (GMO)-containing food, raising concern about the possibility that these markers could increase the pool of antibiotic resistance genes. This study investigates the in vitro survival of genes bla and cryIA(b) of maize Bt176 in human gastric juice samples. Five samples of gastric juice were collected from patients affected by gastro-esophageal reflux or celiac disease and three additional samples were obtained by pH modification with NaHCO3. DNA was extracted from maize Bt176 and incubated with samples of gastric juices at different times. The survival of the target traits (bla gene, whole 1914 bp gene cry1A(b), and its 211 bp fragment) was determined using PCR. The stability of the target genes was an inverse function of their lengths in all the samples. Survival in samples from untreated subjects was below the normal physiological time of gastric digestion. On the contrary, survival time in samples from patients under anti-acid drug treatment or in samples whose pH was modified, resulted strongly increased. Our data indicate the possibility that in particular cases the survival time could be so delayed that, as a consequence, some traits of DNA could reach the intestine. In general, this aspect must be considered for vulnerable consumers (people suffering from gastrointestinal diseases related to altered digestive functionality, physiological problems or drug side-effects) in the risk analysis usually referred to healthy subjects. PMID:17346434

  8. Suffering, Meaning, and Healing: Challenges of Contemporary Medicine

    PubMed Central

    Egnew, Thomas R.

    2009-01-01

    This essay explores the thesis that changes in contemporary society have transformed the work of doctoring and challenge doctors to be physician-healers. Medical advances in the prevention and management of acute disease have wrought a growing population of chronically ill patients whose care obliges physicians to become holistic healers. Holistic healing involves the transcendence of suffering. Suffering arises from perceptions of a threat to the integrity of person-hood, relates to the meaning patients ascribe to their illness experience, and is conveyed as an intensely personal narrative. Physician-healers use the power of the doctor-patient relationship to help patients discover or create new illness narratives with fresh meanings that reconnect them to the world and to others and thereby transcend suffering and experience healing. Physician-healers equipped with the attitudes, skills, and knowledge to assist patients to transcend suffering are indispensable if contemporary medicine is to maintain its tradition as a healing profession. In the process, physicians may discover meaningful connections with patients that bring new and refreshing perspectives to their work. PMID:19273873

  9. Pathological display of affect in patients with depression and right frontal brain damage. An alternative mechanism.

    PubMed

    Ross, E D; Stewart, R S

    1987-03-01

    Two patients are reported with the acute onset of pathological crying following right inferior frontal brain damage. Both had severe endogenous depression and neither had pseudobulbar palsy. These and other cases argue that two organic brain diseases--one structural and the other "physiopharmacological"--may interact to produce pathological display of affect that cannot be accounted for by traditional neurological explanations. A pharmacological mechanism for the rapid amelioration of pathological affect by tricyclic medications and its possible relationship to the newly discovered descending motor systems of the brain that use norepinephrine and serotonin as neurotransmitters is offered. These cases also suggest that pathological affect is a valuable clinical indicator of an underlying major depression in some brain-injured patients. PMID:3819712

  10. Symptom Interval and Patient Delay Affect Survival Outcomes in Adolescent Cancer Patients

    PubMed Central

    Jin, Song Lee; Hahn, Seung Min; Kim, Hyo Sun; Shin, Yoon Jung; Kim, Sun Hee; Lee, Yoon Sun; Lyu, Chuhl Joo

    2016-01-01

    Purpose Unique features of adolescent cancer patients include cancer types, developmental stages, and psychosocial issues. In this study, we evaluated the relationship between diagnostic delay and survival to improve adolescent cancer care. Materials and Methods A total of 592 patients aged 0–18 years with eight common cancers were grouped according to age (adolescents, ≥10 years; children, <10 years). We retrospectively reviewed their symptom intervals (SIs, between first symptom/sign of disease and diagnosis), patient delay (PD, between first symptom/sign of disease and first contact with a physician), patient delay proportion (PDP), and overall survival (OS). Results Mean SI was significantly longer in adolescents than in children (66.4 days vs. 28.4 days; p<0.001), and OS rates were higher in patients with longer SIs (p=0.001). In children with long SIs, OS did not differ according to PDP (p=0.753). In adolescents with long SIs, OS was worse when PDP was ≥0.6 (67.2%) than <0.6 (95.5%, p=0.007). In a multivariate analysis, adolescents in the long SI/PDP ≥0.6 group tended to have a higher hazard ratio (HR, 6.483; p=0.069) than those in the long SI/PDP <0.6 group (HR=1, reference). Conclusion Adolescents with a long SI/PDP ≥0.6 had lower survival rates than those with a short SI/all PDP or a long SI/PDP <0.6. They should be encouraged to seek prompt medical assistance by a physician or oncologist to lessen PDs. PMID:26996554

  11. Metabolic issues in patients affected by schizophrenia: clinical characteristics and medical management

    PubMed Central

    Ventriglio, Antonio; Gentile, Alessandro; Stella, Eleonora; Bellomo, Antonello

    2015-01-01

    Patients affected by psychotic disorders are more likely to develop high rates of co-morbidities, such as obesity, type 2 diabetes, dyslipidemias, hypertension, metabolic syndrome, myocardial infarction, stroke etc., in the long-term. These morbidities have a significant impact on the life-expectancy of these patients. Patients with chronic psychoses show a 2–3-fold increased risk of death mostly from cardiovascular and metabolic diseases. Although there may be an independent link, between schizophrenia and metabolic conditions the cardio-metabolic risk is mostly related to an unhealthy lifestyle and the usage of antipsychotic agents (especially Second Generation Antipsychotics or atypical) even when these remain effective treatments in the management of major psychoses. Recently, many international organizations have developed screening and monitoring guidelines for the control of modifiable risk factors in order to reduce the rate of co-morbidity and mortality among patients affected by schizophrenia. This paper is a review of current knowledge about the metabolic issues of patients affected by schizophrenia and describes clinical characteristics and medical management strategies for such conditions. PMID:26388714

  12. Behavior, affect, and cognition among psychogenic pain patients in group expressive psychotherapy.

    PubMed

    Corbishley, M A; Hendrickson, R; Beutler, L E; Engle, D

    1990-08-01

    In an exploratory study, the authors examined the cognitions, affect, and behaviors reported by eight female depressed chronic pain patients during experiential therapy sessions that focused on anger and depression. Subjects appeared to fit previously developed psychologic profiles of patients with chronic pain disorder: they presented as conscientious, compliant, passive, and rule-bound, viewing life and emotional expression as dangerous, avoiding conflict and risk, denying their own emotional needs. Their reports were compared with the self-reported affect behavior and cognitions of eight depressed female patients without chronic pain, under similar therapeutic conditions. Considerable differences in style and content were found. Implications of these findings for clinical practice are discussed. PMID:2384704

  13. [Body and finitude--listening to suffering as a working tool in an oncological institution].

    PubMed

    e Castro-Arantes, Juliana de Miranda; Lo Bianco, Anna Carolina

    2013-09-01

    Based on the day-to-day care of patients in the Pain Clinic of a Brazilian cancer hospital (INCA), this article seeks to examine the consequences upon the psychic dimension of the fact of pain being intimately linked to the body. Almost always profoundly affected by the illness, the concept of the subject's own body deeply modifies this identification. This not only causes suffering, but also prejudices oncological treatment. Conceptualizing the body from a psychoanalytical standpoint, this article emphasizes the importance of language and the spoken word in its constitution, as the body perceived by psychoanalysis does not coincide with the biological body. The importance of listening to what the patients say is therefore seen as an important tool in the work of professionals in an oncological institution. Two possible positions regarding professionals dealing with the imminence of death and the finitude of life are then outlined. The first is refraining from being affected by the finite and perishable dimension of life, feeling pity for the patients, resigning and distancing oneself from their predicament. The second involves listening to the patients with compassion, acknowledging the inexorable finitude common to all, such that they may not suffer alone and share some of the horror they are experiencing. PMID:23989557

  14. Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments.

    PubMed

    Vigil, Jacob M; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S; Strenth, Chance; Parshall, Mark; Cichowski, Sara B

    2016-04-01

    Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment.The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses.A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, <1% American Indian/Alaska Native, and 1% mixed ethnicity. After controlling for demographic characteristics of nurses and patients, African-American, Hispanic, and mixed-ethnicity patients reported higher average PI scores but lower HRs and RRs than NHW patients. NHW patients received higher priority ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans).This study provides evidence for systemic differences in how patients' vital signs are applied for determining ESI scores for different ethnic groups. Additional

  15. Myasthenia gravis in patients with thymoma affects survival rate following extended thymectomy

    PubMed Central

    ZHANG, ZHEFENG; CUI, YOUBIN; JIA, RUI; XUE, LEI; LIANG, HUAGANG

    2016-01-01

    Thymomas are the most common adult tumors in the anterior mediastinal compartment, and a significant amount of thymomas are complicated by myasthenia gravis (MG). Extended thymectomy (ET) is the primary treatment method for thymomas and is used to completely resect possible ectopic thymus to avoid recurrence. Studies on the effect of MG in thymoma patients following ET are limited. The aim of the present study was to determine whether the presence of MG affects the prognosis of patients with thymoma. The present study consisted of 104 patients with thymoma that underwent ET; 61 men (58.7%) and 43 women (41.3%) (mean age, 54.6 years). In total, 38 patients had MG (36.5%). MG was most frequently observed in World Health Organization (WHO) classification type B2 thymoma compared with other types of thymoma. During the 5-year follow-up period, 11 patients succumbed to a recurrence of thymoma or respiratory failure due to MG. The overall 5-year survival rate in patients without MG or with MG was 89.1 and 76.0%, respectively. The overall survival (OS) rate in patients with Masaoka stages I + II and III + IV was 90.0 and 68.0%, respectively. The OS rate in patients with WHO type A + AB + B1 and type B2 + B3 was 96.9 and 76.8%, respectively. The patients with MG (P=0.026), Masaoka stages III + IV (P=0.008) and WHO type B2 + B3 (P=0.032) had a poorer prognosis compared with patients without these characteristics. Furthermore, multivariate analysis by Cox regression revealed that age [P=0.032; relative risk (RR)=1.097; 95% confidence interval (CI)=1.097–1.192] and MG (P=0.042; RR=0.167; 95% CI=0.037–0.940) significantly affected OS rate. In summary, ET is a reliable method for the treatment of thymoma. Long-term survival is expected for patients at early Masaoka stages, and for patients without MG. The prognosis of patients with thymomas with MG is poorer compared with patients without MG. The present findings provide useful information for the future management of

  16. Relationship of Negative Affect and Outcome of an Opioid Therapy Trial Among Low Back Pain Patients

    PubMed Central

    Jamison, Robert N.; Edwards, Robert R.; Liu, Xiaoxia; Ross, Edgar L.; Michna, Edward; Warnick, Meredith; Wasan, Ajay D.

    2013-01-01

    Objectives Patients with chronic noncancer pain frequently report symptoms of depression and anxiety (negative affect), which are associated with higher ratings of pain intensity and a greater likelihood of being prescribed chronic opioid therapy. The purpose of this secondary analysis was to test the hypothesis that initial levels of negative affect can predict treatment-related outcomes in a double-blind, placebo-controlled study of extended-release (ER) hydromorphone among opioid-tolerant patients with chronic low back pain. Methods Four hundred fifty-nine (N = 459) patients participated in the titration/conversion phase of a multicenter study, of which 268 were randomized to receive once-daily hydromorphone or placebo. All patients completed the Hospital Anxiety and Depression Scale (HADS) at baseline and were divided evenly into Low (N = 157), Moderate (N = 155), and High (N = 147) negative affect groups based on their scores. Group differences in numerical pain intensity measures at home and in the clinic, Roland–Morris Disability ratings, and measures of symptoms from the Subjective Opiate Withdrawal Scale (SOWS) throughout the trial were analyzed. Results Two hundred sixty-eight of the initial 459 subjects who entered the 2 to 4-week titration/conversion phase (pretreatment) were successfully randomized to either placebo or ER hydromorphone; a total of 110 patients then completed this double-blind phase of the study. Those in the Moderate and High negative affect groups tended to drop out more often during the titration/conversion phase because of the adverse effects or lack of efficacy of their prescribed opioid than those in the Low negative mood group (P < 0.05). Overall, those patients in the Moderate and High groups reported significantly higher pain intensity scores in at-home and in-clinic pain intensity ratings (P < 0.05), greater disability on the Roland–Morris Scale (P < 0.01), and more withdrawal symptoms on the SOWS (P < 0.05) than those in

  17. Cultural meaning of cancer suffering.

    PubMed

    Ozkan, Sedat; Ozkan, Mine; Armay, Zeynep

    2011-10-01

    It is not possible to understand the cancer experience independent from the specific culture. The history, culture, related values, and traditions shape the experience of Turkish cancer patients. This article aims to review the current Turkish literature on the psychological and psychosocial effects of cancer and its related burden. The psychological and psychosocial burden of cancer is discussed. The review clearly documents that an interdisciplinary approach that combines oncologic and psychiatric treatments is required for decreasing the emotional, physiological, and social burden of cancer in Turkey. PMID:21952563

  18. Underlying personality differences between alcohol/substance-use disorder patients with and without an affective disorder.

    PubMed

    Janowsky, D S; Hong, L; Morter, S; Howe, L

    1999-01-01

    The Myers-Briggs Type Indicator (MBTI), a popular personality test, was used to profile the personalities of in-patient alcoholics/substance-use disorder patients who had, and those who did not have, a concurrent affective disorder diagnosis. The MBTI divides individuals into eight categories: Extroverts and Introverts, Sensors and Intuitives, Thinkers and Feelers, and Judgers and Perceivers. Alcohol/substance-use disorder patients with no affective disorder differed from a normative population only in being significantly more often Sensing and significantly less often Intuitive single-factor types. The Extroverted/Sensing/ Feeling/Judging four-factor type was also significantly over-represented in this group, compared to a normative population. In contrast, mood-disordered alcohol/substance-use disorder patients were significantly more often Introverted, Sensing, Feeling, and Perceiving and significantly less often Extroverted, Intuitive, Thinking, and Judging single-factor types. They were also significantly more often Introverted/Sensing/ Feeling/Perceiving and Introverted/Intuitive/Feeling/Perceiving four-factor types. 'Pure' alcohol/ substance-use disorder patients differed from alcohol/substance-use disorder patients with a mood disorder in that they were significantly more often Extroverted and Thinking and significantly less often Introverted and Feeling single-factor types; and significantly less often were an Introverted/Sensing/ Feeling/Perceiving four-factor type. The above results may have psychogenetic, diagnostic, and psychotherapeutic implications. PMID:10414613

  19. Patient Ethnicity Affects Triage Assessments and Patient Prioritization in U.S. Department of Veterans Affairs Emergency Departments

    PubMed Central

    Vigil, Jacob M.; Coulombe, Patrick; Alcock, Joe; Kruger, Eric; Stith, Sarah S.; Strenth, Chance; Parshall, Mark; Cichowski, Sara B.

    2016-01-01

    Abstract Ethnic minority patients receive lower priority triage assignments in Veteran's Affairs (VA) emergency departments (EDs) compared to White patients, but it is currently unknown whether this disparity arises from generalized biases across the triage assessment process or from differences in how objective and/or subjective institution-level or person-level information is incorporated into the triage assessment process, thus contributing to disparate treatment. The VA database of electronic medical records of patients who presented to the VA ED from 2008 to 2012 was used to measure patient ethnicity, self-reported pain intensity (PI) levels, heart rate (HR), respiratory rate (RR), and nurse-provided triage assignment, the Emergency Severity Index (ESI) score. Multilevel, random effects linear modeling was used to control for demographic and clinical characteristics of patients as well as age, gender, and experience of triage nurses. A total of 359,642 patient/provider encounters between 129,991 VA patients and 774 nurses were included in the study. Patients were 61% non-Hispanic White [NHW], 28% African-American, 7% Hispanic, 2% Asian-American, <1% American Indian/Alaska Native, and 1% mixed ethnicity. After controlling for demographic characteristics of nurses and patients, African-American, Hispanic, and mixed-ethnicity patients reported higher average PI scores but lower HRs and RRs than NHW patients. NHW patients received higher priority ESI ratings with lower PI when compared against African-American patients. NHW patients with low to moderate HRs also received higher priority ESI scoring than African-American, Hispanic, Asian-American, and Mixed-ethnicity patients; however, when HR was high NHWs received lower priority ESI ratings than each of the minority groups (except for African-Americans). This study provides evidence for systemic differences in how patients’ vital signs are applied for determining ESI scores for different ethnic groups

  20. Demographic factors affecting quality of life of hemodialysis patients – Lahore, Pakistan

    PubMed Central

    Anees, Muhammad; Malik, Muzammil Riaz; Abbasi, Tanzeel; Nasir, Zeeshan; Hussain, Yasir; Ibrahim, Muhamamd

    2014-01-01

    Objective: The objective of the study was to determine the demographic factors affecting Quality Of Life (QOL) of hemodialysis (HD) patients. Methods: This observational study was conducted at Shalamar Hospital, Lahore. Patients of End Stage Renal Disease (ESRD) and on maintenance HD for more than three months were included during the period March to June 2012. Patient of ESRD not on dialysis and Acute Renal Failure were excluded. One hundred and twenty five patients who fulfilled the criteria were included. Demographic data containing age, sex, residence, socio economic status, education, mode of traveling for dialysis, total time consumed in dialysis were collected by the investigators. QOL index was measured using 26 items, WHO QOL BREF. Results: There were 89(71.2%) male and 36(28.8%) female patients. Environmental domain score was highest (p=0.000) than all other domains in HD Patients. In overall analysis age, marital status and total time consumed in getting HD effect QOL significantly (p=<0.05). In domain wise analysis, male has better QOL in social relationship domain than female. Age has negative relationship with physical health and psychological health domain. QOL of unmarried and literate patients is significantly better (p=<0.05) in physical health domain. Employed patients have better QOL in physical, psychological and social relationship domain (p=<0.05) than unemployed patients. Patients of residence of rural areas have better QOL in physical and environment domain. Financial status of HD patients affect QOL in social domain. Distance covered to reach hospital effect QOL in psychological domain (p=<0.05). Patients traveling in private transport have better QOL in environmental domain (p=<0.05). Total time consumed in getting HD effect social relation in QOL (p=<0.05). According to linear regression model, marital status is positive predictor and unemployment is negative predictor of QOL in physical health domain. Age is negative predictor of QOL in

  1. Somatic focus/awareness: Relationship to negative affect and pain in chronic pain patients

    PubMed Central

    O’Brien, Erin M.; Atchison, James W.; Gremillion, Henry A.; Waxenberg, Lori B.; Robinson, Michael E.

    2009-01-01

    Somatic focus refers to the tendency to notice and report physical symptoms, and has been investigated in relation to chronically painful conditions. This study investigated the relationship between somatic focus, as measured by the Pennebaker Inventory of Limbic Languidness (PILL), negative affect and pain. A secondary purpose of the present study was to examine sex differences in these relationships. Participants included 280 chronic pain patients (69.6% females, 88.9% Caucasian), who completed a battery of self-report measures on somatic focus, pain, negative affect, coping, and dysfunction. Results for the overall sample revealed that the PILL shares considerable variance with measures of negative affect, particularly with the physiological components of anxiety and depression. When the results were analyzed separately for male and female patients, it was found that several components of negative affect and cognitive factors play a stronger role in predicting somatic focus among men compared to women. Additional analyses then examined whether somatic focus was predictive of male and female patients’ pain reports. Results indicated that somatic focus explained a small, but unique amount of variance in female patients’ pain reports, which differed from the relationship observed among male patients. PMID:17524684

  2. Affective disorders in patients with HIV infection: impact of antiretroviral therapy.

    PubMed

    Arendt, Gabriele

    2006-01-01

    At the beginning of the AIDS pandemic, affective disorders (such as depressed mood) were seen in a considerable number of HIV-1-infected individuals. These disorders were a result of the poor physical condition of the patients, brain involvement by the virus (e.g. encephalopathy) or a reaction to disadvantageous living conditions (losing friends, jobs, etc.). In the era of highly active antiretroviral therapy (HAART), mental illness related to physical weakness is declining, as is the incidence of HIV-1-associated encephalopathy. However, depressed mood and fatigue caused by efavirenz (a standard component of HAART) is becoming increasingly important, particularly in individuals who are infected long-term with HIV-1. Whatever the cause of affective disorders, their presence has been shown to negatively influence adherence to HAART and HIV-1 disease progression. Specialist knowledge of HIV-1 infection, and HAART and its psychiatric complications (particularly in subgroups of patients such as drug abusers and older people), is needed to care adequately for patients. Furthermore, prospective studies are needed to more fully differentiate between the various aetiologies of affective disorders seen in individuals living with HIV/AIDS and to determine their incidence and prevalence. Such information is important to ensure that affective disorders are recognised and adequately treated, which will in turn improve the efficacy of HAART. PMID:16734500

  3. Affective temperaments and psychopathological dimensions of personality in bipolar and cyclothymic patients.

    PubMed

    Harnic, Désirée; Pompili, Maurizio; Mazza, Marianna; Innamorati, Marco; Di Nicola, Marco; Catalano, Valeria; Bruschi, Angelo; Del Bono, Diletta; Forte, Alberto; Lester, David; Girardi, Paolo; Bria, Pietro; Janiri, Luigi

    2013-01-01

    The aims of the study were: (1) to study possible associations between temperament, personality dimensions, and psychopathological variables in a clinical sample of euthymic patients with bipolar disorder (BD) and cyclothymia; and (2) to assess how Cloninger's temperament and personality dimensions were associated with affective temperaments. Participants, consisting of 60 patients with BD (type I or II) and cyclothymia in the euthymic phase, completed Akiskal's Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Cloninger's Temperament and Character Inventory-revised version (TCI-R). The diagnostic groups differed in past hospitalization, for age at onset of the disorder, and on two affective temperaments: the TEMPS-A Hyperthymia, and the TEMPS-A Irritability. There were six significant associations between affective temperaments and Cloninger's personality dimensions, ranging from 0.26 to 0.54. The measures of Akiskal and of Cloninger tap common behavioral features in patients with bipolar disorder and cyclothymia, yet the differences indicate that the two measures are not redundant. BD and cyclothymic patients differed significantly in temperament and personality, differences that may have important implications for treatment. PMID:23398272

  4. Prognostic Value of Affective Symptoms in First-Admission Psychotic Patients

    PubMed Central

    Arrasate, Marta; González-Ortega, Itxaso; García-Alocén, Adriana; Alberich, Susana; Zorrilla, Iñaki; González-Pinto, Ana

    2016-01-01

    Background: Very little research has been conducted in patients with first-episode psychosis using a dimensional approach. Affective dimensional representations might be useful to predict the clinical course and treatment needs in such patients. Methods: Weincluded 112 patients with first-episode psychosis in a longitudinal-prospective study with a five-year follow-up (N = 82). Logistic analyses were performed to determine the predictive factors associated with depressive, manic, activation, and dysphoric dimensions. Results: High scores on the depressive dimension were associated with the best prognosis. On the other hand, high scores on the activation dimension and the manic dimension were associated with a poorer prognosis in terms of relapses. Only the dysphoric dimension was not associated with syndromic or functional prognosis. Conclusion: Ourresults suggest that the pattern of baseline affective symptoms helps to predict the course of psychotic illness. Therefore, the systematic assessment of affective symptoms would enable us to draw important conclusions regarding patients’ prognosis. Interventions for patients with high scores on manic or activation dimensions could be beneficial in decreasing relapses in first-episode psychosis. PMID:27376266

  5. Factors That Affect the Rehabilitation Duration in Patients With Congenital Muscular Torticollis

    PubMed Central

    Jung, Ah Young; Lee, Sung Hoon; Nam, Doo Hyeon; Cheon, Ji Hwan; Kim, Hyo Jung

    2015-01-01

    Objective To determine which factors affect the rehabilitation duration in patients with congenital muscular torticollis (CMT) and to predict the duration of rehabilitation and prognosis. Methods One hundred and eighteen patients (79 males and 39 females) who were diagnosed with CMT and received physical therapy were enrolled in this study. We retrospectively reviewed the information in terms of sex, gestational age, birth weight, methods of delivery, fetal presentation, age at diagnosis, the affected sternocleidomastoid (SCM) muscle site, SCM muscle thickness, ratio of muscle thickness on the affected side to that on the unaffected side (called the 'abnormal/normal [A/N] ratio'), and range of motion for cervical rotation and side bending. Results The SCM muscle thickness and A/N ratio had a positive linear relationship with the rehabilitation duration. Patients who were in the breech position needed longer rehabilitation. The birth weight and age at diagnosis were negatively correlated with the rehabilitation duration. However, the cervical range of motion, mass site, sex, gestational age, and methods of delivery were not correlated with the rehabilitation duration. Conclusion Patients with a thicker SCM, lower birth weight, and history of breech delivery had a longer rehabilitation duration. PMID:25750867

  6. Bisphosphonate-related osteonecrosis of the jaws: a case series of 25 patients affected by osteoporosis.

    PubMed

    Manfredi, M; Merigo, E; Guidotti, R; Meleti, M; Vescovi, P

    2011-03-01

    Bisphosphonates (BPs) are used to treat metabolic bone diseases, such as osteoporosis. In this study the occurrence of bisphosphonates-related osteonecrosis of the jaws (BRONJ) is reported in 25 patients who received BP therapy for osteoporosis with different drug schedules. From June 2005 to May 2009, 25 patients affected by BRONJ were observed. A history of oral surgery was reported for 18 patients (72%). Of the 22 patients treated by the authors, 20 (91%) recorded healing improvement with a mean follow-up of 16.6 months, with particular regard for those treated with oral surgery and laser applications (10/22, 45%) who were all characterised by complete mucosal healing over time. The risk of developing BRONJ in patients treated with BP for osteoporosis is lower than in cancer patients, but is not negligible. It is advisable for the prescribing physician to recommend a dental check-up prior to treatment, at least for patients who have not been to the dentist in the last 12 months. An early surgical and possible laser-assisted approach for patients who develop BRONJ is recommended. PMID:21163625

  7. Collectivism and the meaning of suffering.

    PubMed

    Sullivan, Daniel; Landau, Mark J; Kay, Aaron C; Rothschild, Zachary K

    2012-12-01

    People need to understand why an instance of suffering occurred and what purpose it might have. One widespread account of suffering is a repressive suffering construal (RSC): interpreting suffering as occurring because people deviate from social norms and as having the purpose of reinforcing the social order. Based on the theorizing of Emile Durkheim and others, we propose that RSC is associated with social morality-the belief that society dictates morality-and is encouraged by collectivist (as opposed to individualist) sentiments. Study 1 showed that dispositional collectivism predicts both social morality and RSC. Studies 2-4 showed that priming collectivist (vs. individualist) self-construal increases RSC of various types of suffering and that this effect is mediated by increased social morality (Study 4). Study 5 examined behavioral intentions, demonstrating that parents primed with a collectivist self-construal interpreted children's suffering more repressively and showed greater support for corporal punishment of children. PMID:23046067

  8. Epidemiological aspects of rheumatoid arthritis patients affected by oral bisphosphonate-related osteonecrosis of the jaws

    PubMed Central

    2012-01-01

    This literature review aims to evaluate the epidemiologic profile of patients with rheumatoid arthritis (RA) that developed a bisphosphonate-related osteonecrosis that affect the jaws (BRONJ), including demographic aspects, as well as clinical and therapeutic issues. A search of PUBMED/MEDLINE, Scopus, and Cochrane databases from January 2003 to September 2011 was conducted with the objective of identifying publications that contained case reports regarding oral BRONJ in RA patients. Patients with RA who develop oral BRONJ are usually women above 60 years taking steroids and long-term alendronate. Most of them have osteoporosis, and lesions, triggered by dental procedures, are usually detected at stage II in the mandible. Although there is no accepted treatment protocol, these patients seem to have better outcomes with conservative approaches that include antibiotic therapy, chlorhexidine, and drug discontinuation. PMID:22376948

  9. Service Design Attributes Affecting Diabetic Patient Preferences of Telemedicine in South Korea

    PubMed Central

    Chon, YuCheong; Lee, Jongsu; Choi, Ie-Jung; Yoon, Kun-Ho

    2011-01-01

    Abstract Objective Attempts to introduce telemedicine in South Korea have failed mostly, leaving critical questions for service developers and providers about whether patients would be willing to pay for the service and how the service should be designed to encourage patient buy-in. In this study, we explore patients' valuations and preferences for each attribute of telemedicine service for diabetes management and evaluate patient willingness to pay for specific service attributes. Materials and Methods We conducted a conjoint survey to collect data on patients' stated preferences among telemedicine service alternatives. The alternatives for diabetes-related service differed in 10 attributes, including those related to price, type of service provider, and service scope. To estimate the relative importance of attributes, patients' willingness to pay for each attribute, and their probable choice of specific alternatives, we used a rank-ordered logit model. A total of 118 respondents participated in the survey. Results All 10 attributes significantly affected patients' valuations and preferences, and demographic and disease characteristics, such as existence of complications and comorbidities, significantly affected patients' valuations of the attributes. Price was the most important attribute, followed by comprehensive scope of service, the availability of mobile phone-based delivery, and large general-hospital provided services. Conclusions The study findings have significant implications for adoption policy and strategy of telemedicine in diabetes management care. Further, the methodology presented in this study can be used to draw knowledge needed to formulate effective policy for adoption of the necessary technology and for the design of services that attract potential beneficiaries. PMID:21631382

  10. Facial affect recognition in early and late-stage schizophrenia patients.

    PubMed

    Romero-Ferreiro, María Verónica; Aguado, Luis; Rodriguez-Torresano, Javier; Palomo, Tomás; Rodriguez-Jimenez, Roberto; Pedreira-Massa, José Luis

    2016-04-01

    Prior studies have shown deficits in social cognition and emotion perception in first-episode psychosis (FEP) and multi-episode schizophrenia (MES) patients. These studies compared patients at different stages of the illness with only a single control group which differed in age from at least one clinical group. The present study provides new evidence of a differential pattern of deficit in facial affect recognition in FEP and MES patients using a double age-matched control design. Compared to their controls, FEP patients only showed impaired recognition of fearful faces (p=.007). In contrast to this, the MES patients showed a more generalized deficit compared to their age-matched controls, with impaired recognition of angry, sad and fearful faces (ps<.01) and an increased misattribution of emotional meaning to neutral faces. PANSS scores of FEP patients on Depressed factor correlated positively with the accuracy to recognize fearful expressions (r=.473). For the MES group fear recognition correlated positively with negative PANSS factor (r=.498) and recognition of sad and neutral expressions was inversely correlated with disorganized PANSS factor (r=-.461 and r=-.541, respectively). These results provide evidence that a generalized impairment of affect recognition is observed in advanced-stage patients and is not characteristic of the early stages of schizophrenia. Moreover, the finding that anomalous attribution of emotional meaning to neutral faces is observed only in MES patients suggests that an increased attribution of salience to social stimuli is a characteristic of social cognition in advanced stages of the disorder. PMID:26874869

  11. Demographic and Clinical Findings in Pediatric Patients Affected by Organic Acidemia

    PubMed Central

    NAJAFI, Reza; HASHEMIPOUR, Mahin; MOSTOFIZADEH, Neda; GHAZAVI, Mohammadreza; NASIRI, Jafar; SHAHSANAI, Armindokht; FAMORI, Fatemeh; NAJAFI, Fatemeh; MOAFI, Mohammad

    2016-01-01

    Objective Metabolic disorders, which involve many different organs, can be ascribed to enzyme deficiency or dysfunction and manifest with a wide range of clinical symptoms. This study evaluated some of the demographic and clinical findings in pediatric patients affected by organic acidemia. Materials & Methods This cross-sectional study was part of a larger study conducted in patients with metabolic disorders during a period of 7 years from 2007 to 2014 in Isfahan Province, Iran. Our study covered a wide range of cases from newborn infants (one-week old) to adolescents (children up to the age of 17 years). This study evaluated patients’ demographic information, history of disease, developmental and educational status, clinical and general conditions. Phone and in-person interviews were used to gather information. Results Out of 5100 patients screened in this study, 392 patients were affected by one of the different metabolic disorders and 167 individuals were diagnosed as organic acidemia. Propionic acidemia/methyl malonic acidemia (PA/MMA) was the most prevalent form of this metabolic disorder. The frequency of consanguinity was 84.7% in the group of patients. The mortality rate was 18.8% in patients with organic academia. Conclusion Each of the metabolic diseases, as a separate entity, is rare; nevertheless, in aggregate they have a somewhat high overall prevalence. These diseases result in mental and developmental disorders in the absence of quick diagnosis and initiation of treatment. Furthermore, more mutations should be identified in societies affected by consanguinity. Further research should also be conducted to determine worthwhile and more-efficient screening methods as well as long term neurological prognosis. PMID:27247587

  12. Factors Affecting Adherence to Osteoporosis Medications: A Focus Group Approach Examining Viewpoints of Patients and Providers

    PubMed Central

    Iversen, Maura D; Vora, Ruchita R; Servi, Amber; Solomon, Daniel H

    2011-01-01

    This is a qualitative study using a focus group approach, conducted to determine factors influencing adherence to osteoporosis medications among older adults. Thirty-two patients aged 65 to 85 years from the greater Boston area who were prescribed an osteoporosis medication, 11 general medicine physicians and 1 nurse practitioner were recruited from Boston based hospitals affiliated with a large healthcare system. Focus groups consisting of 6 to 8 subjects including males and females were held separately for providers and patients and conducted until thematic saturation was reached. Responses were obtained from patients and providers during the focus group interviews conducted by a trained focus group moderator. All interviews were audio taped and transcribed by a medical transcriptionist. According to patients, factors affecting adherence to osteoporosis drugs included lack of knowledge about osteoporosis, dissatisfaction with their doctor visits, side effects, and difficulty or failure to remember instructions for taking medications. Physicians reported lack of patient knowledge, structural barriers, medication side effects, and the inability to track patients’ adherence to their medications as barriers to adherence. This study identifies the extent of and reasons for non-adherence as perceived by patients and providers, and provides insights into strategies to modify treatment plans to address non-adherence. The results from this study were used to develop a RCT to conduct and evaluate patient and physician targeted interventions to improve adherence to osteoporosis medications and to examine cost effectiveness of alternative strategies. PMID:21937896

  13. Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study

    PubMed Central

    Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen

    2016-01-01

    Background: Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. Materials and Methods: This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Results: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. Conclusions: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals. PMID:27186203

  14. Analysis of factors affecting hemorrhagic diathesis and overall survival in patients with acute promyelocytic leukemia

    PubMed Central

    Lee, Ho Jin; Kim, Dong Hyun; Lee, Seul; Koh, Myeong Seok; Kim, So Yeon; Lee, Ji Hyun; Lee, Suee; Oh, Sung Yong; Han, Jin Yeong; Kim, Hyo-Jin; Kim, Sung-Hyun

    2015-01-01

    Background/Aims: This study investigated whether patients with acute promyelocytic leukemia (APL) truly fulfill the diagnostic criteria of overt disseminated intravascular coagulation (DIC), as proposed by the International Society on Thrombosis and Haemostasis (ISTH) and the Korean Society on Thrombosis and Hemostasis (KSTH), and analyzed which component of the criteria most contributes to bleeding diathesis. Methods: A single-center retrospective analysis was conducted on newly diagnosed APL patients between January 1995 and May 2012. Results: A total of 46 newly diagnosed APL patients were analyzed. Of these, 27 patients (58.7%) showed initial bleeding. The median number of points per patient fulfilling the diagnostic criteria of overt DIC by the ISTH and the KSTH was 5 (range, 1 to 7) and 3 (range, 1 to 4), respectively. At diagnosis of APL, 22 patients (47.8%) fulfilled the overt DIC diagnostic criteria by either the ISTH or KSTH. In multivariate analysis of the ISTH or KSTH diagnostic criteria for overt DIC, the initial fibrinogen level was the only statistically significant factor associated with initial bleeding (p = 0.035), but it was not associated with overall survival (OS). Conclusions: Initial fibrinogen level is associated with initial presentation of bleeding of APL patients, but does not affect OS. PMID:26552464

  15. Systematic review of telemedicine services for patients affected by chronic obstructive pulmonary disease (COPD).

    PubMed

    Bartoli, Laura; Zanaboni, Paolo; Masella, Cristina; Ursini, Niccoló

    2009-11-01

    The aim of the present study was to conduct a systematic literature review focused on telemedicine services for patients affected by chronic obstructive pulmonary disease (COPD). In particular, it addresses (1) which telemedicine applications and related organizational models have been adopted for patients affected by COPD and (2) the impact of these applications. A computerized literature search was performed utilizing MEDLINE and Cochrane Library databases, selecting articles published between 1996 and 2008 using the following combination of keywords: [COPD] AND [telemedicine OR telehealth OR ehealth OR telecare] and after exclusions, 40 articles were considered. The adoption of telemedicine inevitably resulted in the reconfiguration of the existing practices and sociomaterial relationships. These organizational changes must be understood and addressed. PMID:19919194

  16. Complementary and Alternative Medicine Use Among Cancer Patients and Determination of Affecting Factors: A Questionnaire Study.

    PubMed

    Üstündağ, Sema; Demir Zencirci, Ayten

    2015-01-01

    This descriptive and cross-sectional study was conducted to determine the use and effects of complementary and alternative medicine on cancer patients receiving chemotherapy. The research was conducted in Daytime Chemotherapy Unit of the College District Outpatients in the Ankara Numune Education and Research Hospital and comprised 397 patients in the oncology outpatients. Written informed consents were obtained from all participants. Among the participants, 52.6% were women, 85.1% married, 10.6% illiterate, 41.1% housewife, and 8.8% civil servants. Among the patients participated in the study, 27.7% had cancer in the family, 22.6% had gastrointestinal cancer, and 22.1% had breast cancer. Most of the patients (92.2%) resorted to religious and cultural approaches, and some patients (33.8%) used nutritional and herbal products besides medical treatment. The nutritional and herbal products used as remedy included stinging nettle (22.3%), fennel flower (20.1%), and herbal products that were advertised by herbalists in media (9.7%). It was determined that most of the patients resorting to complementary or alternative medicine were women (52.6%), housewife (51.5%), and patients with a history of cancer in the family (37.7%). Complementary and alternative medicine use as a remedy for cure is common among patients in Turkey. But when it is considered that many of these products had the potential to negatively affect cancer therapy, it is crucial that nurses providing care to cancer patients should be well informed about complementary therapies, be aware of the potential risks and benefits, and communicate openly with patients on their health care choices. PMID:26465625

  17. [THE ANALYSIS OF INDICATORS OF MINERAL METABOLISM IN PATIENTS WITH DEGENERATIVE DYSTROPHIC AFFECTIONS OF JOINTS].

    PubMed

    Gasanova, A G; Matveeva, E L; Spirkina, E S

    2015-12-01

    The analysis of indicators of mineral metabolism in patients with degenerative dystrophic affections of joints demonstrated that under development of osteoarthrosis process the alteration of indicators of concentration of electrolytes in blood serum, urine and synovial fluid occurs. The stage II of process is characterized by maximal alterations of indicators. The indicator of relationship between concentration of phosphate-ion and index of phosphatases of blood serum turned out the significant coefficient of correlation. PMID:27032248

  18. Risk factors affecting the survival rate in patients with symptomatic pericardial effusion undergoing surgical intervention

    PubMed Central

    Mirhosseini, Seyed Mohsen; Fakhri, Mohammad; Mozaffary, Amirhossein; Lotfaliany, Mojtaba; Behzadnia, Neda; Ansari Aval, Zahra; Ghiasi, Seyed Mohammad Saeed; Boloursaz, Mohammad Reza; Masjedi, Mohammad Reza

    2013-01-01

    OBJECTIVES The optimal management and treatment of pericardial effusion are still controversial. There is limited data related to the risk factors affecting survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion who underwent surgical interventions. METHODS From 2004 to 2011, we retrospectively analysed 153 patients who underwent subxiphoid pericardial window as their surgical intervention to drain pericardial effusions at the National Research Institute of Tuberculosis and Lung diseases (NRITLD). To determine the effects of risk factors on survival rate, demographic data, clinical records, echocardiographic data, computed tomographic and cytopathological findings and also operative information of patients were recorded. Patients were followed annually until the last clinical follow-up (August 2011). To determine the prognostic factors affecting survival, both univariate analysis and multivariate Cox proportional hazards model were utilized. RESULTS There were 89 men and 64 women with a mean age of 50.3 ± 15.5 years. The most prevalent symptom was dyspnoea. Concurrent malignancies were present in 66 patients. Lungs were the most prevalent primary site for malignancy. The median duration of follow-up was 15 (range 1–85 months). Six-month, 1-year and 18-month survival rates were 85.6, 61.4 and 36.6%, respectively. In a multivariate analysis, positive history of lung cancer (hazard ratio [HR] 2.894, 95% confidence interval [CI] 1.362–6.147, P = 0.006) or other organ cancers (HR 2.315, 95% CI 1.009–50311, P = 0.048), presence of a mass in the computed tomography (HR 1.985, 95% CI 1.100–3.581, P = 0.023), and echocardiographic findings compatible with tamponade (HR 1.745, 95% CI 1.048–2.90 P = 0.032) were the three independent predictors of postoperative death. CONCLUSIONS In the surgical management of pericardial effusion, patients with underlying

  19. Fibrillin levels in a severely affected Marfan syndrome patient with a null allele

    SciTech Connect

    Boxer, M.; Withers, A.P.; Al-Ghaban, Z. |

    1994-09-01

    Marfan syndrome is an autosomal dominantly inherited connective tissue disorder characterized by defects in the cardiovascular, skeletal and ocular systems. A patient was first examined in 1992 having survived an acute sortic dissection with subsequent composite repair and insertion of a prosthetic aortic valve. Clinical examination revealed arachnodactyly, narrow, high arched palate with dental crowding, an arm span exceeding her height by 10.5 cm, joint laxity and bilateral lens subluxation. Analysis of the family showed affected members in three generations and the fibrillin gene, FBN1, was shown to segregate with the disease when using polymorphic markers including an RsaI polymorphism in the 3{prime}-untranslated region of the gene. Analysis of patient mRNA for this RsaI polymorphism by RT-PCR (reverse transcriptase-PCR) amplification and restriction enzyme digestion of the PCR products showed that the copy of the gene segregating with the disease was not transcribed. No low level expression of this allele was observed despite RT-PCR amplification incorporating radioactively labelled dCTP, thus revealing a null allele phenotype. Western blotting analysis of fibrillin secreted by the patient`s dermal fibroblasts using fibrillin-specific antibodies showed only normal sized fibrillin protein. However, immunohistochemical studies of the patient`s tissue and fibroblasts showed markedly lowered levels in staining of microfibrillar structures compared with age-matched controls. This low level of expression of the protein affected in Marfan syndrome in a patient with such severe clinical manifestations is surprising since current understanding would suggest that this molecular phenotype should lead to a mild clinical disorder.

  20. Minimally invasive prosthetic procedures in the rehabilitation of a bulimic patient affected by dental erosion

    PubMed Central

    Derchi, Giacomo; Peñarrocha, David; Barone, Antonio; Covani, Ugo

    2015-01-01

    The population affected by dental erosion due to bulimia is generally very young. This population group has a high aesthetic requirement; the dentition in these patients is severely damaged, especially in the anterior maxillary quadrant. In terms of treatment, it is still controversial whether an adhesive rehabilitation is preferable to a longer-lasting but more aggressive conventional treatment, such as full-crown coverage of the majority of teeth. This case report describes the prosthetic rehabilitation of a young female patient previously affected by bulimia nervosa and presenting erosion of the maxillary teeth. The prosthetic rehabilitation was performed through indirect adhesive restorations of the anterior teeth and direct restorations of the posterior teeth. A clinical follow-up after 4 years showed that the occlusion remained satisfactorily restored. Posterior direct composite resin restorations and anterior indirect adhesive composite restorations proved to be an effective time and money-saving procedure to rehabilitate patients affected by dental erosion. Adhesive rehabilitation provides a functional and good aesthetic result while preserving tooth structure. Key words:Bulimia, dental erosion, composite resin, veneers. PMID:25810832

  1. [The psychological suffering of elderly people].

    PubMed

    Hazif-Thomas, Cyril

    2013-01-01

    The psychological suffering of elderly people consists of several components. It arises from contact with the reality which the elderly invariably face in their lives: bereavements, necessary changes after the loss of a loved one, alteration of the quality of life. The caregiver must therefore understand this suffering in order for a quality help relationship to be established. PMID:23785854

  2. Applications of Text Messaging, and Bibliotherapy for Treatment of Patients Affected by Depressive Symptoms

    PubMed Central

    Taleban, Roya; Zamani, Ahmadreza; Moafi, Mohammad; Jiryaee, Nasrin; Khadivi, Reza

    2016-01-01

    Background: Intensity of depressive symptoms could be exacerbated due to the paucity of appropriate treatments. We assessed the effectiveness of bibliotherapy and text messaging, which aimed at amelioration of patient's behavior and consciousness, which could lead to suicide prevention. Methods: This was a randomized clinical trial implemented in rural health centers of Isfahan district (Iran). Health centers were assigned in three trials consisting of the booklet, text messaging, and control groups. Each group consisted of 70 patients. Inclusion criteria were being affected by depressive symptom, <18 years, and cell phone accessibility. Mental retardation, drug and alcohol abuse, visual disability, dementia, suicide attempt history, electrotherapy, and receiving psychological interventions were our not met criteria. Our patient outcomes comprised intensity of depressive symptom and treatment compliance. The first two trials were requested to study instructive booklets in 30 days while the second cohort was demanded to study the booklet in accordance with the daily delivered text messaging. Results: Out of 210 individuals, 198 patients finished this study. The intensity of depressive symptom was significantly affected through time and group factors as well as time-group interaction (F = 12.30, P < 0.001). Based on treatment compliance, the interactive effect of group factor and the time factor was statistically significant. Conclusions: It seems that bibliotherapy could efficiently decrease the intensity of depressive symptoms. Nevertheless, in comparison with our booklet trial, the text messaging group achieved neither durable nor significant success; thus, bibliotherapy could be utilized as a complementary methodology aiming depression treatment. PMID:27076884

  3. A survey of methicillin-resistant Staphylococcus aureus affecting patients in England and Wales.

    PubMed

    Kerr, S; Kerr, G E; Mackintosh, C A; Marples, R R

    1990-07-01

    For a six-month period between October 1987 and March 1988, 660 isolates of methicillin-resistant Staphylococcus aureus (MRSA) from 570 patients were sent to the Staphylococcus Reference Laboratory at Colindale to supplement the National reporting survey of MRSA in England and Wales. The isolates were characterized by phage typing, antibiotic susceptibility and by selected biochemical tests. Patient details were also surveyed. Fourteen strains affected more than one hospital and were called multi-hospital epidemic strains. One strain, EMRSA-1, accounted for more than 40% of isolates and of patients. Other epidemic strains were defined. Ten additional strains were restricted to single hospitals. Only 25 primary isolates were non-typable but 67 sporadic typable strains occurred. The patients affected were approximately equally either infected or colonized. The sexes were represented equally. Orthopaedic and geriatric wards were over-represented. Epidemic strains were clumping factor positive while some sporadic strains were weak producers. Urea alkalinization and protein A production could supplement phage typing and antibiotic resistance in strain recognition. PMID:1974905

  4. Correlation Between the Clinical Parameters and Tissue Phenotype in Patients Affected by Deep-Infiltrating Endometriosis.

    PubMed

    Vinci, Giovanna; Arkwright, Sylviane; Audebourg, Anne; Radenen, Brigitte; Chapron, Charles; Borghese, Bruno; Dousset, Bertrand; Mehats, Celine; Vaiman, Daniel; Vacher-Lavenu, Marie-Cécile; Gogusev, Jean

    2016-09-01

    The current study aimed to identify and validate an applicable immunohistochemistry panel including Ki-67, c-MYC, estrogen receptor-α (ER-α), and progesterone receptor isoforms A/B (PR-A/B) in correlation with clinicopathological parameters in patients affected by deep infiltrating endometriosis. Tissue microarrays were prepared from a cohort of 113 patients. Phenotypic profile of the panel molecules was evaluated in glands and stroma in parallel with microvessels and stroma density measurements. Principal component analysis was performed on 8 immunohistochemical variables, 2 histological variables, and 8 subgroups of clinical parameters. The immunohistochemical profiling showed consistent Ki-67 immunostaining in 17.9% of the samples and c-MYC in 83.1%, while intense ER-α immunoreactivity was detected in 84% of the samples and PR-A/B isoforms in 24.1% of them. The combination of clinical parameters and tissue phenotype allowed a stratification of endometriosis-affected patients. Such novel phenotypical and clinical correlation could be helpful in the future studies for a better stratification of the disease aiming at a personalized patient care. PMID:26994067

  5. Proposal for a recovery prediction method for patients affected by acute mediastinitis

    PubMed Central

    2012-01-01

    Background An attempt to find a prediction method of death risk in patients affected by acute mediastinitis. There is not such a tool described in available literature for that serious disease. Methods The study comprised 44 consecutive cases of acute mediastinitis. General anamnesis and biochemical data were included. Factor analysis was used to extract the risk characteristic for the patients. The most valuable results were obtained for 8 parameters which were selected for further statistical analysis (all collected during few hours after admission). Three factors reached Eigenvalue >1. Clinical explanations of these combined statistical factors are: Factor1 - proteinic status (serum total protein, albumin, and hemoglobin level), Factor2 - inflammatory status (white blood cells, CRP, procalcitonin), and Factor3 - general risk (age, number of coexisting diseases). Threshold values of prediction factors were estimated by means of statistical analysis (factor analysis, Statgraphics Centurion XVI). Results The final prediction result for the patients is constructed as simultaneous evaluation of all factor scores. High probability of death should be predicted if factor 1 value decreases with simultaneous increase of factors 2 and 3. The diagnostic power of the proposed method was revealed to be high [sensitivity =90%, specificity =64%], for Factor1 [SNC = 87%, SPC = 79%]; for Factor2 [SNC = 87%, SPC = 50%] and for Factor3 [SNC = 73%, SPC = 71%]. Conclusion The proposed prediction method seems a useful emergency signal during acute mediastinitis control in affected patients. PMID:22574625

  6. Psychosocial Functioning in Depressive Patients: A Comparative Study between Major Depressive Disorder and Bipolar Affective Disorder

    PubMed Central

    Mittal, Pankaj Kumar; Swami, Mukesh Kumar

    2014-01-01

    Introduction. Major depressive disorder (MDD) and bipolar affective disorder (BAD) are among the leading causes of disability. These are often associated with widespread impairments in all domains of functioning including relational, occupational, and social. The main aim of the study was to examine and compare nature and extent of psychosocial impairment of patients with MDD and BAD during depressive phase. Methodology. 96 patients (48 in MDD group and 48 in BAD group) were included in the study. Patients were recruited in depressive phase (moderate to severe depression). Patients having age outside 18–45 years, psychotic symptoms, mental retardation, and current comorbid medical or axis-1 psychiatric disorder were excluded. Psychosocial functioning was assessed using Range of Impaired Functioning Tool (LIFE-RIFT). Results. Domains of work, interpersonal relationship, life satisfaction, and recreation were all affected in both groups, but the groups showed significant difference in global psychosocial functioning score only (P = 0.031) with BAD group showing more severe impairment. Conclusion. Bipolar depression causes higher global psychosocial impairment than unipolar depression. PMID:24744917

  7. The early course of affective and cognitive symptoms in de novo patients with Parkinson's disease.

    PubMed

    Spalletta, Gianfranco; Robinson, Robert G; Cravello, Luca; Pontieri, Francesco E; Pierantozzi, Mariangela; Stefani, Alessandro; Long, Jeffrey D; Caltagirone, Carlo; Assogna, Francesca

    2014-06-01

    Neuropsychiatric and cognitive symptoms are common in patients with Parkinson's disease (PD) from the early stage of the disease but their course is still unclear. In this study we investigated prospectively the progression of affective and cognitive symptoms and disorders in de novo idiopathic PD patients. Twenty-four de novo drug naïve PD patients underwent a comprehensive neurological, psychopathological and neuropsychological evaluation at the first diagnostic visit (OFF), after 4-6 months when the antiparkinsonian therapy regimen was stabilized (ON-1), and at one year following the ON-1 follow-up visit (ON-2). Generalized least squares analysis revealed a significant improvement over time in the depressive mood, short and long term episodic verbal memory, visual memory, and the motor symptoms. Pairwise comparisons showed a significant change from OFF to ON-1 for all the aforementioned variables, except for short term episodic verbal memory which approached significance. A significant improvement from ON-1 to ON-2, however, was shown for short term episodic verbal memory. An ancillary analysis indicated that overall level and change in a number of cognitive variables, but not depression, was conditional upon age of onset, education, and sometime gender. In conclusion, early stage PD is not associated with affective and cognitive deterioration. On the contrary, very specific neuropsychiatric and cognitive symptoms may improve. This study provides Class III evidence that antiparkinsonian treatment commonly used in the clinical practice improves memory performance and depression severity in de novo patients with PD. PMID:24695996

  8. Nickel allergy: what it is and how it can affect our patient care.

    PubMed

    Hannah, Janet

    2012-01-01

    Nickel allergy is the second most common form of allergic contact dermatitis skin allergy, second only to poison ivy. There is no cure for a nickel allergy. The best treatment is to avoid contact with all products known to have nickel content. Because nickel is present in a vast amount of items used every day in the gastroenterology endoscopy setting, it is not possible to have a nickel-free environment. Nurses need to be aware of items in their facility, which could affect the nickel-allergic patient in an adverse way. The focus should be to limit patient exposure as much as possible. This article provides an overview of nickel allergy and areas of risk for patients in the gastroenterology endoscopy setting. PMID:22847285

  9. Factors affecting effectiveness of vaccination against hepatitis B virus in hemodialysis patients

    PubMed Central

    Eleftheriadis, Theodoros; Pissas, Georgios; Antoniadi, Georgia; Liakopoulos, Vassilios; Stefanidis, Ioannis

    2014-01-01

    Hepatitis B virus (HBV) is a major global health problem. Despite the success of the general measures against blood transmitted infections in hemodialysis (HD) units, the prevalence of HBV infection among the HD patients is still high. Thus vaccination against HBV is indicating in this population. However, compared with the general population the seroprotection achieved in HD patients remains relatively low, at about 70%. In this review patient, HD procedure and vaccine-associated factors that affect the efficacy of HBV vaccination are analyzed. Also alternative routes of HBV vaccine administration as well as new and more immunogenic vaccine formulations are discussed. However, besides scientific progress, vigilance of HD physicians and staff regarding the general measures against the transmission of blood borne infections and the vaccination against HBV is also required for reducing the prevalence of this viral infection. PMID:25232238

  10. Factors affecting effectiveness of vaccination against hepatitis B virus in hemodialysis patients.

    PubMed

    Eleftheriadis, Theodoros; Pissas, Georgios; Antoniadi, Georgia; Liakopoulos, Vassilios; Stefanidis, Ioannis

    2014-09-14

    Hepatitis B virus (HBV) is a major global health problem. Despite the success of the general measures against blood transmitted infections in hemodialysis (HD) units, the prevalence of HBV infection among the HD patients is still high. Thus vaccination against HBV is indicating in this population. However, compared with the general population the seroprotection achieved in HD patients remains relatively low, at about 70%. In this review patient, HD procedure and vaccine-associated factors that affect the efficacy of HBV vaccination are analyzed. Also alternative routes of HBV vaccine administration as well as new and more immunogenic vaccine formulations are discussed. However, besides scientific progress, vigilance of HD physicians and staff regarding the general measures against the transmission of blood borne infections and the vaccination against HBV is also required for reducing the prevalence of this viral infection. PMID:25232238

  11. Factors affecting response to medical management in patients of filarial chyluria: A prospective study

    PubMed Central

    Goyal, Neeraj Kumar; Goel, Apul; Sankhwar, Satyanarayan; Singh, Vishwajeet; Ali, Wahid; Natu, S. M.; Singh, Bhupendra Pal; Sinha, Rahul Janak; Dalela, Divakar

    2014-01-01

    Introduction: Filarial chyluria is a common problem in filarial endemic countries. Its management begins with medical therapy but some patients progress to require surgery. The present study aimed to determine factors affecting response to medical management in patients of filarial chyluria. Materials and Methods: This prospective study conducted between August 2008 and November 2012, included conservatively managed patients of chyluria. Demographic profile, clinical presentation, treatment history and urinary triglycerides (TGs) and cholesterol levels at baseline were compared between the responders and non-responders. Apart from the clinical grade of chyluria, hematuria was evaluated as an independent risk factor. Results: Out of the 222 patients (mean age, 37.99 ± 13.29 years, 129 males), 31 patients failed to respond while 35 had a recurrence after initial response; the overall success rate being 70.3% at a mean follow-up of 25 months. No difference was observed in demographics, clinical presentation, presence of hematuria, disease duration and mean urinary TGs loss between responders and non-responders. On multivariate analysis, patients with treatment failure were found to have a higher-grade disease (14.3% Grade-I, 36.6% Grades-II and 60% Grade-III), higher number of pretreatment courses (1.59 ± 1.08 vs. 1.02 ± 0.79) and heavier cholesterol (26.54 ± 23.46 vs. 8.81 ± 8.55 mg/dl) loss at baseline compared with responders (P < 0.05). Conclusion: Conservative management has a success rate in excess of 70%, not affected by the disease chronicity, previous episodes and recurrent nature. However, higher-grade disease, extensive pre-treatment with drugs and higher urinary cholesterol loss at baseline are the predictors of poor response. Hematuria is not an independent poor risk factor for conservative management. PMID:24497677

  12. A new mechanical arm trainer to intensify the upper limb rehabilitation of severely affected patients after stroke: design, concept and first case series.

    PubMed

    Hesse, S; Schmidt, H; Werner, C; Rybski, C; Puzich, U; Bardeleben, A

    2007-12-01

    Description and case series on a new mechanical arm trainer with three degrees of freedom (DoF), the REHA-SLIDE (RS), for stroke rehabilitation are presented. Similar to a rolling pin, it consists of two handles at either side of a connecting rod, the handles are bilaterally moved forward and backward, sideways, and rotated, the base plate is inclinable. A computer mouse attached to the rod enables playing games offering computer-biofeedback. Two patients, 6 and 5 weeks after a first-time supratentorial stroke, suffering from a flaccid non-functional upper extremity have been studied. Interventions performed were additional 30 min of RS-training every workday for 6 weeks; one session included 400 repetitions evenly distributed between the forward backward movement and drawing a circle clock- and counter clockwise. Afterwards the patients could play games. Upper extremity portion of the Fugl-Meyer Motor Assessment Score (FM, 0-66), and muscle strength by a Medical Research Council (MRC) sum score (0-45), the FM assessment was blinded. In the 2 patients, the FM (0-66) improved from 7 to 37, and from 17 to 43, their initial (terminal) MRC sum scores were 6 (36) and 13 (31). With the REHA-Slide (RS), severely affected patients practiced a bilateral 3 DoF movement. No conclusions can be drawn so far and a controlled clinical study must be the next step. PMID:18084168

  13. [Supporting carers of persons suffering from an eating disorder].

    PubMed

    Zitarosa, Dino; de Zwaan, Martina; Pfeffer, Meike; Graap, Holmer

    2012-01-01

    The purpose of this article is to describe the background and procedure of a skills training program provided for carers of patients suffering from anorexia or bulimia nervosa. Caring for someone suffering from an eating disorder is associated with psychological distress and may lead to unhelpful interactive behaviours that maintain the illness. Recent investigations in supporting carers, especially skills sharing workshops that target interpersonal maintaining factors are described. A 5-session training concept in teaching basic skills and information about eating disorders to carers in order to improve caregiving burden and reduce interpersonal maintaining factors like expressed emotions (EE) is currently examined in our department. Design and content will be described in detail. Carers' and sufferers' perceptions of the impact of the sessions and acceptance of the provided skills training are reported. PMID:22814922

  14. Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review

    PubMed Central

    Santaguida, Pasqualina L.; Hawker, Gillian A.; Hudak, Pamela L.; Glazier, Richard; Mahomed, Nizar N.; Kreder†, Hans J.; Coyte, Peter C.; Wright, James G.

    2008-01-01

    Background Total joint arthroplasty is a highly efficacious and cost-effective procedure for moderate to severe arthritis in the hip and knee. Although patient characteristics are considered to be important determinants of who receives total joint arthroplasty, no systematic review has addressed how they affect the outcomes of total joint arthroplasty. This study addresses how patient characteristics influence the outcomes of hip and knee arthroplasty in patients with osteoarthritis. Methods We searched 4 bibliographic databases (MEDLINE 1980–2001, CINAHL 1982–2001, EMBASE 1980–2001, HealthStar 1998–1999) for studies involving more than 500 patients with osteoarthritis and 1 or more of the following outcomes after total joint arthroplasty: pain, physical function, postoperative complications (short-and long-term) and time to revision. Prognostic patient characteristics of interest included age, sex, race, body weight, socioeconomic status and work status. Results Sixty-four of 14 276 studies were eligible for inclusion and had extractable data. Younger age (variably defined) and male sex increased the risk of revision 3-fold to 5-fold for hip and knee arthroplasty. The influence of weight on the risk of revision was contradictory. Mortality was greatest in the oldest age group and among men. Function for older patients was worse after hip arthroplasty (particularly in women). Function after knee arthroplasty was worse for obese patients. Conclusion Although further research is required, our findings suggest that, after total joint arthroplasty, younger age and male sex are associated with increased risk of revision, older age and male sex are associated with increased risk of mortality, older age is related to worse function (particularly among women), and age and sex do not influence the outcome of pain. Despite these findings, all subgroups derived benefit from total joint arthroplasty, suggesting that surgeons should not restrict access to these

  15. Obstructive sleep apnea affects the clinical outcomes of patients undergoing percutaneous coronary intervention

    PubMed Central

    Zhang, Jun-jie; Gao, Xiao-fei; Ge, Zhen; Jiang, Xiao-Min; Xiao, Ping-xi; Tian, Nai-liang; Kan, Jing; Lee, Chi-Hang; Chen, Shao-Liang

    2016-01-01

    Background There is a paucity of evidence regarding the association between obstructive sleep apnea (OSA) and patients undergoing percutaneous coronary intervention (PCI) for coronary artery disease. We sought to investigate whether OSA affects the clinical outcomes of patients undergoing PCI. Patients and methods All enrolled individuals treated with PCI were evaluated for OSA by polysomnography. The primary end point was defined as major adverse cardiac events (MACEs) at 2 years, including cardiac death, myocardial infarction (MI), and/or target vessel revascularization. Results A total of 340 consecutive patients undergoing PCI were assigned to the OSA (n=152, apnea–hypopnea index ≥15) and non-OSA (n=188, apnea–hypopnea index <15) groups. The incidence of OSA in patients with coronary artery disease undergoing PCI was 44.7%. Patients in the OSA group had more three-vessel disease (34.9%), increased number of total implanted stents (3.3±2.0), and longer total stent length (83.8±53.1 mm) when compared to the non-OSA group (23.4%, P=0.020; 2.8±1.9, P=0.007; 68.7±48.4, P=0.010). After a median follow-up of 2 years, the incidence of MACEs was significantly higher in patients with OSA (25.0% vs 16.0%, P=0.038), mainly driven by the increased periprocedural MI (19.2% vs 11.2%, P=0.038) in the OSA group. By Cox regression multivariable analysis, the independent predictor of MACEs was OSA (hazard ratio: 1.962, 95% confidence interval: 1.036–3.717, P=0.039). Conclusion There was a high prevalence of moderate-to-severe OSA in patients undergoing PCI, and OSA was associated with significantly increased MACE rate, mainly due to the increase in periprocedural MI rate. PMID:27284240

  16. Measuring the Experience and Perception of Suffering

    PubMed Central

    Schulz, Richard; Monin, Joan K.; Czaja, Sara J.; Lingler, Jennifer H.; Beach, Scott R.; Martire, Lynn M.; Dodds, Angela; Hebert, Randy S.; Zdaniuk, Bozena; Cook, Thomas B.

    2010-01-01

    Purpose: Assess psychometric properties of scales developed to assess experience and perception of physical, psychological, and existential suffering in older individuals. Design and Methods: Scales were administered to 3 populations of older persons and/or their family caregivers: individuals with Alzheimer’s disease (AD) and their family caregivers (N = 105 dyads), married couples in whom 1 partner had osteoarthritis (N = 53 dyads), and African American and Hispanic caregivers of care recipients with AD (N = 121). Care recipients rated their own suffering, whereas caregivers provided ratings of perceived suffering of their respective care recipients. In addition, quality of life, health, and functional status data were collected from all respondents via structured in-person interviews. Results: Three scales showed high levels of internal consistency, test–retest reliability, and convergent and discriminant validity. The scales were able to discriminate differences in suffering as a function of type of disease, demonstrated high intra-person correlations and moderately high inter-person correlations and exhibited predicted patterns of association between each type of suffering and indicators of quality of life, health status, and caregiver outcomes of depression and burden. Implications: Suffering is an important but understudied domain. This article provides valuable tools for assessing the experience and perception of suffering in humans. PMID:20478899

  17. Suffering, justice, and the politics of becoming.

    PubMed

    Connolly, W E

    1996-09-01

    To suffer is to undergo, to bear, to endure. Suffering exists on the underside of agency; it is as important to ethics as agency. The experience of suffering is never entirely captured by the ethical, political, medical and spiritual categories in which it is represented. Perhaps an engagement with suffering can open up hidden connections between these domains. After examining John Caputo and Friedrich Nietzsche comparatively on the relation between suffering and ethics, this essay explores the relation of the "politics of becoming" to suffering. The politics of becoming is a paradoxical process by which a new cultural identity is drawn into being and yet is irreducible to the energies and motives that spurred its initiators to action. To exemplify and think the politics of becoming is to call into question the sufficiency of existing paradigms of morality. A critical examination of the Rawlsian model of justice brings out, for example, the insufficiency of justice to the politics of becoming. It suggests the need, first, to pursue an "ethics of engagement" between several parties drawing upon a variety of sources of ethical inspiration and, second, to cultivate "critical responsiveness" to new social movements that struggle to place new identities onto the cultural register. If the latter movements sometimes modify general understandings of suffering, identity, justice and medical practice they also indicate the role cultural thinkers can play in re-examining periodically established codes of interaction between these domains. PMID:8899281

  18. Cardiac Affection in Type 1 Diabetic Patients in Relation to Omentin

    PubMed Central

    Dayem, Soha M. Abd El; Battah, Ahmed A.; Shehaby, Amal El

    2015-01-01

    AIM: To evaluate cardiac affection in type 1 diabetes in relation to Omentin. PATIENTS AND METHODS: Sixty two diabetics and 30 volunteer of the same age and sex were included as a control group. Blood sample was taken for assessment of omentin and oxidized low density lipoprotein (OxLDL), glycosylated hemoglobin (HbA1) and lipid profile. Urine sample was taken for assessment of albumin/creatinine ratio. 24 hour holter was also done. T-test, simple correlation followed by stepwise multiple regression analysis was used for analysis of data. RESULTS: Parameters of 24 hour holter were significantly lower in diabetics. Omentin was significantly lower, while OxLDL were significantly higher than controls. RMSSD, ST deviation and OxLDL were the parameters related to omentin by stepwise multiple regression analysis in diabetics. CONCLUSION: Diabetic patients had a cardiac autonomic neuropathy. A significant reduction of omentin and elevation OxLDL imply that they influence glucose metabolism in type 1 diabetes. Omentin had a significant relation to 24 hr holter which may reflect its role in cardiac affection. Omentin and OxLDL had a role in renal affection.

  19. Affective instability and suicidal ideation and behavior in patients with borderline personality disorder.

    PubMed

    Links, Paul S; Eynan, Rahel; Heisel, Marnin J; Barr, Aiala; Korzekwa, Marilyn; McMain, Shelley; Ball, Jeffrey S

    2007-02-01

    This study employed an Experience Sampling Methodology (ESM) to test whether various elements of affective instability can predict future suicide ideation in patients with borderline personality disorder (BPD) and a history of recurrent suicidal behavior. Eighty-two individuals with BPD and a history of recurrent suicidal behavior were followed prospectively for one month during which time they recorded their current mood states, 6 times daily over three weeks. Accounting for a set of robust suicide risk factors in multiple regression analyses, only negative mood intensity was significantly related to intensity of self-reported suicide ideation and to number of suicidal behaviors over the past year. Other elements of affective instability examined (e.g., mood amplitude, dyscontrol, and reactivity) were not associated with future suicide ideation or with recent suicidal behavior. Affective instability in patients with BPD is highly variable from one individual to another and is characterized by high levels of intense negative mood. These negative mood states, versus other aspects of mood variability, seem to be more closely tied to the occurrence of suicidal ideation and behavior. PMID:17373891

  20. Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries

    PubMed Central

    2016-01-01

    Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients. PMID:26841885

  1. Review on the Eyedrop Self-Instillation Techniques and Factors Affecting These Techniques in Glaucoma Patients

    PubMed Central

    Kayikcioglu, Ozcan; Bilgin, Sinan; Uyar, Murat

    2016-01-01

    Objective. This study aims to evaluate eyedrop self-installation techniques and factors affecting these techniques in glaucoma patients. Methods. Researchers directly observed eyedrop instillation procedures of 66 glaucoma patients. Contact with periocular tissues and instillation onto ocular surface or conjunctival fornices were considered. Correlations of instillation patterns with patient characteristics including age, gender, intraocular pressure, cup-to-disc ratio, visual field loss, and total intake of glaucoma medication and handgrip strength score were searched. Results. The average handgrip strength in the instillation without periocular contact group was 66.4 ± 19.7 kg, while the average handgrip strength score was 55.9 ± 20.9 kg in the instillation with contact group. The difference between the two groups was statistically significant (p = 0.039). No statistically significant correlation was found between handgrip strength and the mean number of glaucoma medications, c/d, intraocular pressure (p > 0.05). Also there was no significant relation between mean handgrip strength score and the severity of the visual field defect (p = 0.191). Conclusion. Patients especially with severe glaucomatous damage should be adequately instructed about the proper techniques for self-instillation of eyedrops and motivated to use a proper technique. Also, it is possible to suggest that patients with a higher handgrip strength, indicating the well-being of general health, may be doing better in properly instilling glaucoma eyedrops. PMID:27119046

  2. Locomotor micro-activities associated with therapeutic responses in patients with seasonal affective disorders

    PubMed Central

    Ohashi, Kyoko; Yamamoto, Yoshiharu; Teicher, Martin H.

    2015-01-01

    Background Psychomotor retardation, leaden paralysis and fatigue are often used to describe patients with depressive disorders. However, there is limited understanding of their meaning and how they are objectively manifested in the physical world. Patients with seasonal affective disorder (SAD) are characteristically hypoactive, and experience restoration in energy during effective treatment with bright light. In this study, we attempt to identify quantitative metrics of psychomotor activity that correspond to the clinical perceptions of hypoactivity and to the early activating effects of treatment. Methods Novel means of assessing the microstructure of activity was employed using wavelets and Hurst exponents to indicate the proclivity of subjects to persist at higher and lower levels of activity. This was assesed using actigraphs in 16 unmedicated patients with SAD before and following two weeks of bright light therapy. Results Two weeks of phototherapy had no significant effect on mean levels of diurnal activity, but altered the microstructure of the activity. Specifically, phototherapy produced a significant reduction in inertial resistance in patients who had a 50% or greater reduction in Hamilton Depression scores (n=8), as reflected in reduced tendency to persist at low levels of activity. There was also a strong correlation between ratings of fatigue and measures of persistence at high versus low activity in initial responders, but not in initial non-responders. Conclusion These findings suggest that light therapy alters the nature of diurnal activity troughs in early responsive patients, reducing their tendency to persist at low levels, possibly reflecting an alleviation of psychomotor retardation. PMID:27135034

  3. Does Time Affect Patient Satisfaction and Health-Related Quality of Life After Reduction Mammoplasty?

    PubMed Central

    Cohen, Wess A.; Homel, Peter

    2016-01-01

    Objective: A total of 62,611 patients with breast hypertrophy underwent breast reduction surgery in 2013 in the United States to improve their symptoms and health-related quality of life. While multiple studies utilizing various outcome instruments demonstrate the efficacy of reductive surgery, it is presently unknown how the postoperative course affects patient satisfaction and health-related quality of life as measured by the BREAST-Q. Our objective was to determine the temporal relationship of patient satisfaction and health-related quality of life after reduction mammoplasty. Methods: Patients prospectively completed the BREAST-Q reduction mammoplasty module at 3 time points during their treatment: preoperatively, at less than 3 months postoperatively, and at more than 3 months (<12 months) postoperatively. A single surgeon (N.P.P.) performed all of the breast reduction procedures. Results: Each time point contained 20 questionnaires. Mean preoperative BREAST-Q scores were significantly lower than scores at the less than 3-month postoperative time point for the scales Satisfaction With Breasts, Psychosocial Well-being, Sexual Well-being, and Physical Well-being (P < .001). There was no significant difference in BREAST-Q scores between the postoperative time points in these measures. Conclusion: Breast reduction surgery offers a vast improvement in patients’ satisfaction and health-related quality of life that is maintained throughout the postoperative period. These findings can assist surgeons in managing patient expectations after reduction mammoplasty and help improve the probability of obtaining prior authorization for insurance coverage. PMID:26819650

  4. Does labelling a rare cancer diagnosis 'good' affect the patient's experience of treatment and recovery?

    PubMed

    Ridgway, E; Grose, J; Charles, A; Hewett, J; Jarvis, M; Benjamin, S

    2016-05-01

    Doctors sometimes tell patients with rare but highly treatable cancers that they have 'good' cancer which some patients have found unhelpful, but this has been little explored. The aim of this study was to explore how patients reacted to being told they had a 'good' cancer. Qualitative interviews were carried out with 25 people with rare but prognostically favourable cancers who had received treatment at two hospitals within a cancer network. Results showed that despite good treatment outcomes, patients are still very shocked to hear the word cancer and react in similar ways to those with other forms of cancer. The potential effects of treatment should be recognised as having a detrimental effect on patient well-being whatever the prognosis. We should therefore avoid using 'good' and 'cancer' in the same sentence. In addition, the impact on all family members should not be underestimated. The data can be used to improve clinical practice and improve support for people affected by cancer. PMID:25335904

  5. Outcomes and Risk Factors Affecting Mortality in Patients Who Underwent Colorectal Emergency Surgery

    PubMed Central

    Oh, Nam Ho

    2016-01-01

    Purpose Emergency colorectal surgery has a high risk of mortality and morbidity because of incomplete bowel preparation, bacterial proliferation, and contamination. In this study, we investigated the outcomes and the risk factors affecting mortality in patients who had undergone emergency surgery for the treatment of various colorectal diseases. Methods This study is a retrospective analysis of prospectively collected data to survey the clinical results for patients who had undergone emergency colorectal surgery from January 2014 to December 2014. We analyzed various clinicopathologic factors, which were divided into 3 categories: preoperative, intraoperative, and postoperative. Results A total of 50 patients had undergone emergency colorectal surgery during the time period covered by this study. Among them, 10 patients (20%) died during the postoperative period. A simple linear regression analysis showed that the risk factors for mortality were old age, preoperative hypotension, and a high American Society of Anesthesiologist (ASA) score. Moreover, a multiple linear regression analysis showed a high ASA score and preoperative hypotension to be independent risk factors. Conclusion In this study, emergency colorectal surgery showed a relatively high mortality rate. Furthermore, the independent risk factors for mortality were preoperative hypotension and high ASA score; thus, patients with these characteristics need to be evaluated more carefully and receive better care if the mortality rate is to be reduced.

  6. Factors Affecting Hemodialysis Adequacy in Cohort of Iranian Patient with End Stage Renal Disease

    PubMed Central

    Shahdadi, Hosein; Balouchi, Abbas; Sepehri, Zahra; Rafiemanesh, Hosein; Magbri, Awad; Keikhaie, Fereshteh; Shahakzehi, Ahmad; Sarjou, Azizullah Arbabi

    2016-01-01

    Background: There are many factors that can affect dialysis adequacy; such as the type of vascular access, filter type, device used, and the dose, and rout of erythropoietin stimulation agents (ESA) used. The aim of this study was investigating factors affecting Hemodialysis adequacy in cohort of Iranian patient with end stage renal disease (ESRD). Methods: This is a cross-sectional study conducted on 133 Hemodialysis patients referred to two dialysis units in Sistan-Baluchistan province in the cities of Zabol and Iranshahr, Iran. We have looked at, (the effects of the type of vascular access, the filter type, the device used, and the dose, route of delivery, and the type of ESA used) on Hemodialysis adequacy. Dialysis adequacy was calculated using kt/v formula, two-part information questionnaire including demographic data which also including access type, filter type, device used for hemodialysis (HD), type of Eprex injection, route of administration, blood groups and hemoglobin response to ESA were utilized. The data was analyzed using the SPSS v16 statistical software. Descriptive statistical methods, Mann-Whitney statistical test, and multiple regressions were used when applicable. Results: The range of calculated dialysis adequacy is 0.28 to 2.39 (units of adequacy of dialysis). 76.7% of patients are being dialyzed via AVF and 23.3% of patients used central venous catheters (CVC). There was no statistical significant difference between dialysis adequacy, vascular access type, device used for HD (Fresenius and B. Braun), and the filter used for HD (p> 0.05). However, a significant difference was observed between the adequacy of dialysis and Eprex injection and patients’ time of dialysis (p <0.05). Conclusion: Subcutaneous ESA (Eprex) injection and dialysis shift (being dialyzed in the morning) can have positive impact on dialysis adequacy. Patients should be educated on the facts that the type of device used for HD and the vascular access used has no

  7. Emotion Risk-Factor in Patients With Cardiac Diseases: The Role of Cognitive Emotion Regulation Strategies, Positive Affect and Negative Affect (A Case-Control Study)

    PubMed Central

    Bahremand, Mostafa; Alikhani, Mostafa; Zakiei, Ali; Janjani, Parisa; Aghaei, Abbas

    2016-01-01

    Application of psychological interventions is essential in classic treatments for patient with cardiac diseases. The present study compared cognitive emotion regulation strategies, positive affect, and negative affect for cardiac patients with healthy subjects. This study was a case-control study. Fifty subjects were selected using convenient sampling method from cardiac (coronary artery disease) patients presenting in Imam Ali medical center of Kermanshah, Iran in the spring 2013. Fifty subjects accompanied the patients to the medical center, selected as control group, did not have any history of cardiac diseases. For collecting data, the cognitive emotion regulation questionnaire and positive and negative affect scales were used. For data analysis, multivariate analysis of variance (MANOVA) was applied using the SPSS statistical software (ver. 19.0). In all cognitive emotion regulation strategies, there was a significant difference between the two groups. A significant difference was also detected regarding positive affect between the two groups, but no significant difference was found regarding negative affect. We found as a result that, having poor emotion regulation strategies is a risk factor for developing heart diseases. PMID:26234976

  8. Visualization of nasal airflow patterns in a patient affected with atrophic rhinitis using particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Garcia, G. J. M.; Mitchell, G.; Bailie, N.; Thornhill, D.; Watterson, J.; Kimbell, J. S.

    2007-10-01

    The relationship between airflow patterns in the nasal cavity and nasal function is poorly understood. This paper reports an experimental study of the interplay between symptoms and airflow patterns in a patient affected with atrophic rhinitis. This pathology is characterized by mucosal dryness, fetor, progressive atrophy of anatomical structures, a spacious nasal cavity, and a paradoxical sensation of nasal congestion. A physical replica of the patient's nasal geometry was made and particle image velocimetry (PIV) was used to visualize and measure the flow field. The nasal replica was based on computed tomography (CT) scans of the patient and was built in three steps: three-dimensional reconstruction of the CT scans; rapid prototyping of a cast; and sacrificial use of the cast to form a model of the nasal passage in clear silicone. Flow patterns were measured by running a water-glycerol mixture through the replica and evaluating the displacement of particles dispersed in the liquid using PIV. The water-glycerol flow rate used corresponded to an air flow rate representative of a human breathing at rest. The trajectory of the flow observed in the left passage of the nose (more affected by atrophic rhinitis) differed markedly from what is considered normal, and was consistent with patterns of epithelial damage observed in cases of the condition. The data are also useful for validation of computational fluid dynamics predictions.

  9. Predictors of suicide attempts in 3.322 patients with affective disorders and schizophrenia spectrum disorders.

    PubMed

    Gallego, Juan A; Rachamallu, Vivekananda; Yuen, Eunice Y; Fink, Sabina; Duque, Laura M; Kane, John M

    2015-08-30

    This study explores risk factors for suicide attempts using the electronic health records of 3322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior. PMID:26077849

  10. Predictors of Suicide Attempts in 3.322 Patients with Affective Disorders and Schizophrenia Spectrum Disorders

    PubMed Central

    Yuen, Eunice Y.; Fink, Sabina; Duque, Laura M.; Kane, John M.

    2015-01-01

    This study explores risk factors for suicide attempts using the electronic health records of 3,322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior. PMID:26077849

  11. Leptin Receptor Gene Polymorphism may Affect Subclinical Atherosclerosis in Patients with Acromegaly

    PubMed Central

    Turgut, Sebahat; Topsakal, Senay; Ata, Melek Tunç; Herek, Duygu; Akın, Fulya; Özkan, Şeyma; Turgut, Günfer

    2016-01-01

    Background: Acromegaly is associated with increased morbidity and mortality related to cardiovascular diseases. Leptin (LEP) and Leptin Receptor (LEPR) gene polymorphisms can increase cardiovascular risks. The aim of this study was to investigate association between the frequencies of LEP and LEPR gene polymorphisms and subclinical atherosclerosis in acromegalic patients. Methods: Forty-four acromegalic patients and 30 controls were admitted to study. The polymorphisms were identified by using polymerase chain reaction from peripheral blood samples. The levels of systolic and diastolic blood pressure, BMI, fasting plasma glucose, fasting insulin, IGF-I, GH, IGFBP3, leptin, triglyceride, carotid Intima Media Thickness (cIMT) and HDL and LDL cholesterol concentrations were evaluated. Results: There was statistically significant difference between the LEPR genotypes of acromegalic patients (GG 11.4%, GA 52.3%, and AA 36.4%) and controls (GG 33.3%, GA 50%, and AA 16.7%) although their LEP genotype distribution was similar. In addition, the prevalence of the LEPR gene G and A alleles was significantly different between patients and controls. No significant difference was found among the G(-2548) A leptin genotypes of groups in terms of the clinical parameters. cIMT significantly increased homozygote LEPR GG genotype group compared to AA subjects in patients. But the other parameters were not different between LEPR genotypes groups of patients and controls. Conclusion: It can be said that the LEPR gene polymorphism may affect cIMT in patients. The reason is that LEPR GG genotype carriers may have more risk than other genotypes in the development of subclinical atherosclerosis in acromegaly. PMID:27563428

  12. Patient characteristics affecting stroke identification by emergency medical service providers in Brooklyn, New York.

    PubMed

    Sharma, Mohit; Helzner, Elizabeth; Sinert, Richard; Levine, Steven Richard; Brandler, Ethan Samuel

    2016-03-01

    Early identification of stroke should begin in the prehospital phase because the benefits of thrombolysis and clot extraction are time dependent. This study aims to identify patient characteristics that affect prehospital identification of stroke by Long Island college hospital (LICH) emergency medical services (EMS). All suspected strokes brought to LICH by LICH ambulances from January 1, 2010 to December 31, 2011 were included in the study. We compared prehospital care report-based diagnosis against the get with the guidelines (GWTG) database. Age-adjusted logistic regression models were used to study that the effect of individual patient characteristics have on EMS providers' diagnosis. Included in the study were 10,384 patients with mean age 43.9 years. Of whom, 75 had a GWTG cerebrovascular diagnosis: 53 were ischemic strokes, 7 transient ischemic attacks, 3 subarachnoid hemorrhage, and 12 intercerebral bleeds. LICH EMS correctly identified 44 of 75 GWTG strokes. Fifty-one patients were overcalled as stroke by the EMS. Overall EMS sensitivity was 58.7 % and specificity was 99.5 %. Dispatcher call type of altered mental status, stroke, unconsciousness, and increasing prehospital blood pressure quartile were found to be significantly predictive of a true stroke diagnosis. Patients with a past medical history and EMS providers' impression of seizures were more likely to be overcalled as a stroke in the field. More than a third of actual stroke patients were missed in the field in our study. Our results show that the patients' past medical history, dispatcher collected information and prehospital vital sign measurements are associated with a true diagnosis of stroke. PMID:26553585

  13. Nightmares in Patients With Psychosis: The Relation With Sleep, Psychotic, Affective, and Cognitive Symptoms

    PubMed Central

    Sheaves, Bryony; Onwumere, Juliana; Keen, Nadine; Stahl, Daniel; Kuipers, Elizabeth

    2015-01-01

    Objective: To examine the prevalence of nightmares in people with psychosis and to describe the link between nightmares and sleep quality, psychotic, affective, and cognitive symptoms. Methods: Forty participants with psychotic symptoms completed an assessment of nightmares, sleep quality, positive symptoms of psychosis, affect, posttraumatic stress, social functioning, and working memory. Results: Among the patients, 55% reported weekly distressing nightmares. Experience of more frequent nightmares was related to poorer sleep quality and sleep efficiency. More distressing nightmares were positively associated with greater delusional severity, depression, anxiety, stress, and difficulties with working memory. Conclusions: Nightmares might be common in those with psychosis and are associated with increased day- and nighttime impairment. Future research should investigate treatments for nightmares, for people presenting with psychotic symptoms. PMID:26454557

  14. Affect is central to patient safety: the horror stories of young anaesthetists.

    PubMed

    Iedema, Rick; Jorm, Christine; Lum, Martin

    2009-12-01

    This paper analyses talk produced by twenty-four newly qualified anaesthetists. Data were collected from round table discussions at the Young Fellows Conference of the Australia and New Zealand College of Anaesthetists 2006. The talk consisted to an important extent of narratives about experiences of horror. The paper isolates three themes: the normalization of horror, the functionalisation of horror for pedagogic purposes, and the problematization of horror. The last theme provides a springboard into our argument that confronting the affect invested in coping with medical-clinical failure is central to enabling young doctors, and clinicians generally, to address and resolve such adverse events. We conclude that the negotiation of affect through shared or 'dialogic' narrative is central to enabling doctors to deal with adverse events on a personal level, and to enabling them at a collective level to become attentive to threats to patients' safety. PMID:19846244

  15. Prevalence of Isolated Atrial Amyloidosis in Young Patients Affected by Congestive Heart Failure

    PubMed Central

    Millucci, Lia; Ghezzi, Lorenzo; Bernardini, Giulia; Braconi, Daniela; Tanganelli, Piero; Santucci, Annalisa

    2012-01-01

    Atrial natriuretic peptide (ANP), whose amyloid is responsible of isolated atrial amyloidosis (IAA), is known to play an important role in the pathophysiology of congestive heart failure (CHF). We provide here the microscopic examination of atrial biopsies from 36 young (mean 40 years) CHF patients distinguished in idiopathic dilated cardiomyopathy (DC) affected and hypertrophic Cardiomyopathy (HC) affected, endorsing the presumptive association of early CHF with IAA. We utilized a multiple method, using Congo red (CR) staining, CR fluorescence (CRF), and immunohistochemistry to assess the presence of IAA in CHF. Immunostaining showed a moderate deposition of IAA in the atrium surrounding working myocardium with small intracellular deposits. Our findings suggest a monitoring of young CHF cases for the development of IAA. Our study also demonstrated how the concurrent use of immunohistochemistry, CR, and CRF may greatly enhance the detection of low-grade amyloid deposits. PMID:22536133

  16. Prevalence of isolated atrial amyloidosis in young patients affected by congestive heart failure.

    PubMed

    Millucci, Lia; Ghezzi, Lorenzo; Bernardini, Giulia; Braconi, Daniela; Tanganelli, Piero; Santucci, Annalisa

    2012-01-01

    Atrial natriuretic peptide (ANP), whose amyloid is responsible of isolated atrial amyloidosis (IAA), is known to play an important role in the pathophysiology of congestive heart failure (CHF). We provide here the microscopic examination of atrial biopsies from 36 young (mean 40 years) CHF patients distinguished in idiopathic dilated cardiomyopathy (DC) affected and hypertrophic Cardiomyopathy (HC) affected, endorsing the presumptive association of early CHF with IAA. We utilized a multiple method, using Congo red (CR) staining, CR fluorescence (CRF), and immunohistochemistry to assess the presence of IAA in CHF. Immunostaining showed a moderate deposition of IAA in the atrium surrounding working myocardium with small intracellular deposits. Our findings suggest a monitoring of young CHF cases for the development of IAA. Our study also demonstrated how the concurrent use of immunohistochemistry, CR, and CRF may greatly enhance the detection of low-grade amyloid deposits. PMID:22536133

  17. Does organizational culture affect out-patient DNA (did not attend) rates?

    PubMed

    Jackson, S

    1997-01-01

    Government interest in health service "did not attend" (DNA) rates was seen to occur by accident, following which efforts to reduce DNAs have tended to concentrate on operational rather than strategic issues. Considers the effect hospital culture has had on DNA rates from an organizational and patient perspective. Identifies some of the key cultural issues that impacted on DNA rates by utilizing observation and telephone survey research methods. Concludes that, in the main, the lack of customer-oriented organizational culture was seen to affect DNA rates adversely within one NHS provider trust. PMID:10179096

  18. Autonomic dysreflexia: one more way EMS can positively affect patient survival.

    PubMed

    Tomassoni, Paul J; Campagnolo, Denise I

    2003-12-01

    Autonomic dysreflexia is a life-threatening medical condition that affects people with spinal cord injuries above T6. Caused by the division of the autonomic nervous system, it can result in disastrous hypertension. Although complicated in nature, AD can be quickly treated and reversed by prehospital providers. The prompt emptying of a patient's bladder and/or bowels will resolve most occurrences. Other factors that can't be resolved in the prehospital setting may cause AD. In these situations, quickly transport the patient to a definitive care facility and consider the use of antihypertensive agents. Bladder catheterization and digital bowel emptying are not everyday EMS skills. They are, however, skills within the range of EMS abilities. Providers should contact their medical directors or training supervisors to obtain the training necessary to carry out both techniques. Having these skills will arm you with the necessary abilities to mitigate an episode of autonomic dysreflexia. PMID:14699347

  19. Late-onset Tay-Sachs disease: the spectrum of peripheral neuropathy in 30 affected patients.

    PubMed

    Shapiro, Barbara E; Logigian, Eric L; Kolodny, Edwin H; Pastores, Gregory M

    2008-08-01

    Late-onset Tay-Sachs (LOTS) disease is a chronic, progressive, lysosomal storage disorder caused by a partial deficiency of beta-hexosaminidase A (HEXA) activity. Deficient levels of HEXA result in the intracellular accumulation of GM2-ganglioside, resulting in toxicity to nerve cells. Clinical manifestations primarily involve the central nervous system (CNS) and lower motor neurons, and include ataxia, weakness, spasticity, dysarthria, dysphagia, dystonia, seizures, psychosis, mania, depression, and cognitive decline. The prevalence of peripheral nervous system (PNS) involvement in LOTS has not been well documented, but it has traditionally been thought to be very low. We examined a cohort of 30 patients with LOTS who underwent clinical and electrophysiologic examination, and found evidence of a predominantly axon loss polyneuropathy affecting distal nerve segments in the lower and upper extremities in eight patients (27%). PMID:18642377

  20. Development of the Adolescent Cancer Suffering Scale

    PubMed Central

    Khadra, Christelle; Le May, Sylvie; Tremblay, Isabelle; Dupuis, France; Cara, Chantal; Mercier, Geneviève; Vachon, Marie France; Fiola, Jacinthe Lachance

    2015-01-01

    BACKGROUND: While mortality due to pediatric cancer has decreased, suffering has increased due to complex and lengthy treatments. Cancer in adolescence has repercussions on personal and physical development. Although suffering can impede recovery, there is no validated scale in French or English to measure suffering in adolescents with cancer. OBJECTIVE: To develop an objective scale to measure suffering in adolescents with cancer. METHODS: A methodological design for instrument development was used. Following a MEDLINE search, semistructured interviews were conducted with adolescents 12 to 19 years of age who had undergone four to six weeks of cancer treatment, and with a multidisciplinary cohort of health care professionals. Adolescents with advanced terminal cancer or cognitive impairment were excluded. Enrollment proceeded from the hematology-oncology department/clinic in Montreal, Quebec, from December 2011 to March 2012. Content validity was assessed by five health care professionals and four adolescents with cancer. RESULTS: Interviews with 19 adolescents and 16 health care professionals identified six realms of suffering: physical, psychological, spiritual, social, cognitive and global. Through iterative feedback, the Adolescent Cancer Suffering Scale (ACSS) was developed, comprising 41 questions on a four-point Likert scale and one open-ended question. Content validity was 0.98, and inter-rater agreement among professionals was 88% for relevance and 86% for clarity. Adolescents considered the scale to be representative of their suffering. CONCLUSIONS: The ACSS is the first questionnaire to measure suffering in adolescents with cancer. In future research, the questionnaire should be validated extensively and interventions developed. Once validated, the ACSS will contribute to promote a holistic approach to health with appropriate intervention or referral. PMID:26252665

  1. Alcohol consumption and hangover patterns among migraine sufferers

    PubMed Central

    Zlotnik, Yair; Plakht, Ygal; Aven, Anna; Engel, Yael; Am, Neta Bar; Ifergane, Gal

    2014-01-01

    Aims: Alcohol hangover is a poorly understood cluster of symptoms occurring following a heavy consumption of alcohol. The term “delayed alcohol-induced headache” is often used synonymously. Our objective was to compare alcohol hangover symptoms in migraine sufferers and nonsufferers. Materials and Methods: In this cross-sectional study, university students were asked to fill structured questionnaires assessing headache history, alcoholic consumption, and hangover symptoms (using the Hangover Symptom Scale (HSS)). Subjects were classified as suffering from migraine with or without aura and nonsufferers according the International Classification of Headache Disorders 2nd Edition (ICHD-II). The 13 hangover symptoms were divided by the researches into migraine-like and other nonmigraine-like symptoms. Results: Hangover symptoms among 95 migraine sufferers and 597 nonsufferers were compared. Migraine sufferers consumed less alcohol compared with the nonsufferers (mean drinks/week 2.34 ± 4.11 vs. 2.92 ± 3.58, P = 0.038) and suffered from higher tendency to migraine-like symptoms after drinking (mean 2.91 ± 3.43 vs. 1.85 ± 2.35, P = 0.002) but not to other hangover symptoms (mean 5.39 ± 6.31 vs. 4.34 ± 4.56, P = 0.1). Conclusions: Migraine sufferers consume less alcohol, especially beer and liquors, and are more vulnerable to migraine-like hangover symptoms than nonsufferers. The finding that the tendency to develop migraine attacks affects the hangover symptomatology may suggest a similarity in pathophysiology, and possibly in treatment options. PMID:24966549

  2. Affective responses after different intensities of exercise in patients with traumatic brain injury

    PubMed Central

    Rzezak, Patricia; Caxa, Luciana; Santolia, Patricia; Antunes, Hanna K. M.; Suriano, Italo; Tufik, Sérgio; de Mello, Marco T.

    2015-01-01

    Background: Patients with traumatic brain injury (TBI) usually have mood and anxiety symptoms secondary to their brain injury. Exercise may be a cost-effective intervention for the regulation of the affective responses of this population. However, there are no studies evaluating the effects of exercise or the optimal intensity of exercise for this clinical group. Methods: Twelve male patients with moderate or severe TBI [mean age of 31.83 and SD of 9.53] and 12 age- and gender-matched healthy volunteers [mean age of 30.58 and SD of 9.53] participated in two sessions of exercise of high and moderate-intensity. Anxiety and mood was evaluated, and subjective assessment of experience pre- and post-exercise was assessed. A mixed between and within-subjects general linear model (GLM) analysis was conducted to compare groups [TBI, control] over condition [baseline, session 1, session 2] allowing for group by condition interaction to be determined. Planned comparisons were also conducted to test study hypotheses. Results: Although no group by condition interaction was observed, planned comparisons indicated that baseline differences between patients and controls in anxiety (Cohens’ d = 1.80), tension (d = 1.31), depression (d = 1.18), anger (d = 1.08), confusion (d = 1.70), psychological distress (d = 1.28), and physical symptoms (d = 1.42) disappear after one session of exercise, independently of the intensity of exercise. Conclusion: A single-section of exercise, regardless of exercise intensity, had a positive effect on the affective responses of patients with TBI both by increasing positive valence feelings and decreasing negative ones. Exercise can be an easily accessible intervention that may alleviate depressive symptoms related to brain injury. PMID:26161074

  3. Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease.

    PubMed

    Jang, Ki Ung; Yu, Chang Sik; Lim, Seok-Byung; Park, In Ja; Yoon, Yong Sik; Kim, Chan Wook; Lee, Jong Lyul; Yang, Suk-Kyun; Ye, Byong Duk; Kim, Jin Cheon

    2016-07-01

    In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease.We included 394 patients (69.3% male) who underwent small bowel resection for Crohn disease between 1991 and 2012. Patients who were classified as underweight (body mass index < 17.5) or at high risk of nutrition-related problems (modified nutritional risk index < 83.5) were regarded as having a poor nutritional status. Preliminary remnant small bowel length cut-offs were determined using receiver operating characteristic curves. Variables associated with poor nutritional status were assessed retrospectively using Student t tests, chi-squared tests, Fisher exact tests, and logistic regression analyses.The mean follow-up period was 52.9 months and the mean patient ages at the time of the last bowel surgery and last follow-up were 31.2 and 35.7 years, respectively. The mean remnant small bowel length was 331.8 cm. Forty-three patients (10.9%) underwent ileostomy, 309 (78.4%) underwent combined small bowel and colon resection, 111 (28.2%) had currently active disease, and 105 (26.6%) underwent at least 2 operations for recurrent disease. The mean body mass index and modified nutritional risk index were 20.6 and 100.8, respectively. The independent factors affecting underweight status were remnant small bowel length ≤240 cm (odds ratio: 4.84, P < 0.001), ileostomy (odds ratio: 4.70, P < 0.001), and currently active disease (odds ratio: 4.16, P < 0.001). The independent factors affecting high nutritional risk were remnant small bowel length ≤230 cm (odds ratio: 2.84, P = 0.012), presence of ileostomy (odds ratio: 3.36, P = 0.025), and currently active disease (odds ratio: 4.90, P < 0.001).Currently active disease, ileostomy, and remnant small

  4. Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality

    PubMed Central

    Levent, Dalar; Emel, Eryüksel; Pelin, Uysal; Turkay, Akbaş; Aybüke, Kekeçoğlu

    2016-01-01

    Background One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and PaO2/FIO2 levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate. PMID:27433176

  5. Factors affecting disability in patients attending the internal medicine departments of general hospitals.

    PubMed

    Sata, M; Yoshitake, K; Utsunomiya, H; Hatada, K; Ohtsuka, T; Sugasaki, H; Nakane, Y

    1999-12-01

    The aim of this study was to investigate the effect of sociodemographic factors, physical factors and mental factors on the physical and social disability of patients attending outpatient clinics of general hospitals. Physical and psychiatric morbidity in 1580 consecutive patients attending the internal medicine department of general hospitals was assessed using a stratified two-stage sampling design method. Of the total, 336 patients completed the second stage interview composed of Primary Care Version of Composite International Diagnostic Interview and Groningen Social Disability Schedule to assess sociodemographic, physical and mental factors. In this study, restricted activity days, disability days and Brief Disability Questionnaire were used for the assessment of physical disability, and Groningen Social Disability Schedule was used for social disability. Sociodemographic, physical and mental factors were all related to disability. Among sociodemographic factors, unemployment was associated with physical disability and social disability mildly. Among physical factors, the severity of physical disease was not associated with disability and medically explained somatic symptoms were associated with disability. Furthermore, the mental factor was more strongly associated with physical and social disability. It could be said that the mental factor is more strongly associated with physical and social disability than sociodemographic or physical factors. In addition, even mild mental symptoms not leading to ICD-10 mental disorders affected disability. From the viewpoint of the patients' burden, it is important to assess the mental symptoms as well as physical status in outpatient clinics of internal medicine or primary care. PMID:10687740

  6. Medicus Deus: a review of factors affecting hospital library services to patients between 1790–1950

    PubMed Central

    Perryman, Carol

    2006-01-01

    Question: What are some of the historical societal, medical, and public health trends leading to today's provision of hospital library services to patients? Data Sources: Literature from the archives of the Bulletin of the Medical Library Association and other library sources, medical journals, primary historical documents, and texts from the history of medicine form the core of this review. Study Selection: The period of review extends from about 1790 through 1950 and focuses solely on trends in the United States. Of primary concern are explicitly documented examples that appear to illustrate the patient-physician relationship and those between librarians and their patient-patrons during the earliest years of the profession's development. Data Extraction: An historical timeline was created to allow the identification of major trends that may have affected library services. Multiple literature searches were conducted using library, medical, and health anthropology resources. When possible, primary sources were preferred over reviews. Main Results: Juxtapositioning historical events allows the reader to obtain an overview of the roots of consumer health services in medical libraries and to consider their potential legacy in today's health care libraries. Conclusion: This review article highlights early developments in hospital library service to patients. Further research is needed to verify a preliminary conclusion that in some medical library settings, services to the general public are shaped by the broader health care environment as it has evolved. PMID:16888658

  7. Annual change in spirometric parameters among patients affected in Bhopal gas disaster: A retrospective observational study

    PubMed Central

    De, Sajal

    2013-01-01

    Background: The involvement of respiratory system due to inhalation of methyl isocyanate (MIC) during Bhopal gas disaster was particularly severe. We retrospectively evaluated the annual changes in spirometric parameters among those who were affected in this disaster (exposed survivors) and had respiratory symptoms. Materials and Methods: Spirometry reports of exposed survivors that were carried out in our institution were retrospectively reviewed and we identified 252 subjects who had performed spirometry at least twice with interval of more than one year. The annual changes in spirometric indices of them were calculated. Results: The average age of study population was 55.7 years and 72% were male. Annual decline of FEV1 ≥ 40 ml/yr was observed among 48% exposed survivors. The mean annual decline of FEV1 among symptomatic exposed survivors with initial normal spirometry was 91 ml (95% CI: 52 ml to 130 ml) and this was more than the patients with initial obstructive pattern. Among fifty four patients with initial normal spirometry, ten patients (18.5%) developed obstructive and two patients (5%) developed restrictive lung function abnormalities during follow up spirometry. Conclusion: The exposed survivors with chronic respiratory symptoms had accelerated decline in lung function and they are at higher risk of developing obstructive lung function. PMID:23741089

  8. Factors affecting nurses' intent to assess for depression in heart failure patients.

    PubMed

    Lea, Patricia

    2014-01-01

    The association between depression and cardiovascular disease has been well established and has been shown to decrease patients' quality of life and increase the risk of mortality, frequency and duration of hospitalization, and health care costs. The inpatient setting provides a potentially valuable opportunity to assess and treat depression among patients with acute cardiac illness, allowing for daily monitoring of treatment side effects. Although systematic depression screening appears to be feasible, efficient, and well accepted on inpatient cardiac units, the current lack of consistent inpatient assessment for depression in heart failure patients suggests the presence of barriers influencing the effective diagnosis and treatment of depression among inpatients with heart failure. The theory of planned behavior describes the cognitive mechanism by which behavioral intent is formed, giving some insight into how nurses' attitudes and beliefs affect their performance of routine depression screening. In addition, application of this cognitive theory suggests that nurses may be influenced to adopt more positive attitudes and beliefs about depression through educational intervention, leading to greater likelihood of routine assessment for depression, ultimately leading to more timely diagnosis and treatment and improved patient outcomes. PMID:25280199

  9. Investigation of patient, tumour and treatment variables affecting residual motion for respiratory-gated radiotherapy

    NASA Astrophysics Data System (ADS)

    George, R.; Ramakrishnan, V.; Siebers, J. V.; Chung, T. D.; Keall, P. J.

    2006-10-01

    Respiratory gating can reduce the apparent respiratory motion during imaging and treatment; however, residual motion within the gating window remains. Respiratory training can improve respiratory reproducibility and, therefore, the efficacy of respiratory-gated radiotherapy. This study was conducted to determine whether residual motion during respiratory gating is affected by patient, tumour or treatment characteristics. The specific aims of this study were to: (1) identify significant characteristics affecting residual motion, (2) investigate time trends of residual motion over a period of days (inter-session) and (3) investigate time trends of residual motion within the same day (intra-session). Twenty-four lung cancer patients were enrolled in an Institutional Review Board (IRB)-approved protocol. For approximately five sessions, 331 four-minute, respiratory motion traces were acquired with free breathing, audio instructions and audio-visual biofeedback for each patient. The residual motion was quantified by the standard deviation of the displacement within the gating window. The generalized linear model was used to obtain coefficients for each variable within the model and to evaluate the clinical and statistical significance. The statistical significance was determined by a p-value <0.05, while effect sizes of >=0.1 cm (one standard deviation) were considered clinically significant. This data analysis was applied to patient, tumour and treatment variables. Inter- and intra-session variations were also investigated. The only variable that was significant for both inhale- and exhale-based gating was disease type. In addition, visual-training displacement, breathing type and Karnofsky performance status (KPS) values were significant for inhale-based gating, and dose-per-fraction was significant for exhale-based gating. Temporal respiratory variations within and between sessions were observed for individual patients. However inter- and intra-session analyses did

  10. Changes in plantar load distribution and gait pattern following foot drop correction in leprosy affected patients.

    PubMed

    Karmakar, Mrinmoy; Joshua, Jerry; Mahato, Nidhu

    2015-09-01

    This study was done to compare the changes in plantar load (weight distribution) and gait patterns before and after tibialis posterior transfer surgery in people affected by leprosy. Changes in gait patterns were observed and proportionate changes in plantar load were quantified using data captured by a baropodometer. All the eight patients who underwent tibialis posterior transfer surgery in 2013 in our hospital were included in the study. In addition to the regular pre-operative and post-operative assessments, the patients also underwent baropodometric evaluation. There was a significant change in plantar load at the heel, lateral border and forefoot. Using the foot pressure scan, it was noted that the progression of the centre of mass (displayed graphically as 'the gait line') was also affected by the altered pattern of weight distribution. This study reiterates the importance of tibialis posterior transfer because: it restores the normal gait pattern of 1, 2, 3 (where 1 is heel strike, 2 is mid foot contact and 3 is forefoot contact) and provides a more uniform distribution of planter load. PMID:26665356

  11. Obesity affects the chondrocyte responsiveness to leptin in patients with osteoarthritis

    PubMed Central

    2010-01-01

    clearly showed that characteristics of OA patients and more expecially obesity may affect the responsiveness of cultured chondrocytes to leptin. In addition, the BMI-dependent effect of leptin for the expression of TIMP-2 and MMP-13 may explain why obesity is associated with an increased risk for OA. PMID:20534145

  12. Components of self-esteem in affective patients and non-psychiatric controls.

    PubMed

    Serretti, Alessandro; Olgiati, Paolo; Colombo, Cristina

    2005-09-01

    Decrease in self-esteem (SE) is found in all mood disorders during inter-episode phases. This trait was associated with relapse and suicidality but its genetic basis is still undefined, probably because SE has multiple components. The aim of the current study was to ascertain which of those components were altered in a sample of affective patients. Three hundred and thirty-one outpatients with bipolar (N=199) and major depressive MD (N=132) disorders in remission for at least three months and one hundred controls completed the Rosenberg Self-esteem Scale (RSE; [Rosenberg, M., 1965. The measurement of self-esteem, Society and the Adolescent Self-Image. Princeton University Press, pp.16-36]). Principal component analysis was performed to identify RSE factor structure. Extracted factors were compared across case and control groups in the whole sample (N=431) and in a sub-sample (N=301) with low self-esteem (RSE <20). PCA yielded a two-factor solution with self-confidence (SC) and self-deprecation (SD) that was largely consistent with the existing literature. Such factors were both associated with lower scores in affective patients than controls (SC: F=52, p<0.01; SD: F=43, p<0.01). However in the low RSE group only self-confidence was found to be decreased in subjects with mood disorders (SC: F=13.8, p<0.01; SD: F=0.05, p=0.9). These findings suggest that self-esteem deficit in affective disorders might involve specific components. Implications for research and clinical practice are discussed. PMID:16040127

  13. Physician, Patient and Contextual Factors Affecting Treatment Decisions in Older Adults with Cancer: A Literature Review

    PubMed Central

    Tariman, J. D.; Berry, D. L.; Cochrane, B.; Doorenbos, A.; Schepp, K.

    2010-01-01

    Purpose/Objectives To review physician, patient, and contextual factors that affect treatment decision-making in older adults diagnosed with cancer and relate these factors to theoretical models of decision-making. Data Sources PubMed (1966-April 2010), PsycINFO (1967-April 2010) and CINAHL (1982-April 2010) databases were searched to access relevant medical, psychological and nursing literature. Data Synthesis Physician factors in treatment decisions include physician personal beliefs and values, expertise, practice type, perception of lowered life expectancy, medical factors, power, and communication style. Patient factors include personal beliefs and values, ethnicity, decisional control preferences, previous health-related experience, perception of the decision-making process, and personal factors. Contextual factors include availability of caregiver, lack of insurance, poor financial status, and geographical barrier. The interplay of physician, patient, and contextual factors are not well understood. Existing models of decision-making are not sufficient to explicate TDM process in older adults diagnosed with cancer. Conclusions Clinical studies in older adult patient population using a longitudinal and prospective design are needed to examine real-time interplay of patient, physician, and contextual factors and to better understand how these divergent factors influenced actual treatment decisions. Implications for Nursing Oncology nurses can advocate for a patient’s autonomy during TDM by coaching them to seek evidence-based discussion of various treatment options, benefits and risks assessments, and truthful discussion of the probability of success for each treatment option from their physicians. Oncology nurses must promote an informed treatment decisions that are consistent with a patient’s personal preference and values within the limits of the patient’s personal contexts. PMID:22201670

  14. An examination of auditory processing and affective prosody in relatives of patients with auditory hallucinations

    PubMed Central

    Tucker, Rachel; Farhall, John; Thomas, Neil; Groot, Christopher; Rossell, Susan L.

    2013-01-01

    Research on auditory verbal hallucinations (AVHs) indicates that AVH schizophrenia patients show greater abnormalities on tasks requiring recognition of affective prosody (AP) than non-AVH patients. Detecting AP requires accurate perception of manipulations in pitch, amplitude and duration. Schizophrenia patients with AVHs also experience difficulty detecting these acoustic manipulations; with a number of theorists speculating that difficulties in pitch, amplitude and duration discrimination underlie AP abnormalities. This study examined whether both AP and these aspects of auditory processing are also impaired in first degree relatives of persons with AVHs. It also examined whether pitch, amplitude and duration discrimination were related to AP, and to hallucination proneness. Unaffected relatives of AVH schizophrenia patients (N = 19) and matched healthy controls (N = 33) were compared using tone discrimination tasks, an AP task, and clinical measures. Relatives were slower at identifying emotions on the AP task (p = 0.002), with secondary analysis showing this was especially so for happy (p = 0.014) and neutral (p = 0.001) sentences. There was a significant interaction effect for pitch between tone deviation level and group (p = 0.019), and relatives performed worse than controls on amplitude discrimination and duration discrimination. AP performance for happy and neutral sentences was significantly correlated with amplitude perception. Lastly, AVH proneness in the entire sample was significantly correlated with pitch discrimination (r = 0.44) and pitch perception was shown to predict AVH proneness in the sample (p = 0.005). These results suggest basic impairments in auditory processing are present in relatives of AVH patients; they potentially underlie processing speed in AP tasks, and predict AVH proneness. This indicates auditory processing deficits may be a core feature of AVHs in schizophrenia, and are worthy of further study as a potential endophenotype

  15. Tufted hair folliculitis in a patient affected by pachydermoperiostosis: case report and videodermoscopic features.

    PubMed

    Baroni, Adone; Romano, Francesca

    2011-01-01

    A 25-year-old man presented with Touraine-Solente-Golé syndrome (primary pachydermoperiostosis), with an area of inflammatory dermatosis (12-month evolution) of the scalp at the cranial vertex. The patient presented with arthropathy, clubbing of the digits, diffuse periostosis, pachydermia of the hands and feet, and periosteal hyperostosis of the knee. Facial seborrhea and sebaceous gland hyperplasia were evident (Figure 1A and 1B and Figure 2A and 2B). Examination of the scalp revealed an erythematous pruritic plaque with erosions, crusts, and pustules, on which multiple tufts of 10 to 20 normal-looking hairs emerged from single follicular openings (Figure 3A). Slight pressure on the perifollicular areas resulted in the discharge of purulent material through the dilated follicular openings. Cervical and occipital lymph nodes were not enlarged, and the patient was in generally good health. Routine laboratory findings were normal. Immunologic studies, including a screening for antinuclear antibody, complement, and immunoglobulins, were normal. Both potassium hydroxide staining and fungal culture were negative. Bacteriologic culture of purulent material taken from the affected area was positive for Staphylococcus aureus. Videodermoscopy of the lesion showed rarefied interfollicular twisted red loops centered around actively affected follicles and white dots with absence of normal vascular pattern (Figure 3B). These dermoscopy patterns are markers for folliculitis decalvans, of which tufted hair folliculitis (THF) is a clinical variant. Histologic examination showed hair plugging, a dense perifollicular infiltrate of plasma cells, lymphocytes, neutrophils, and large areas of scarring and fibrosis, which would confirm suspected THE THF was diagnosed on the grounds of clinical, microbiologic, histologic, and videodermoscopy data. The patient was treated with amoxicillin 875 mg plus clavulanic acid 125 mg twice daily and topical nadifloxacin 1% twice daily for 20 days

  16. Factors affecting the outcome of related allogeneic hematopoietic cell transplantation in patients with Fanconi Anemia.

    PubMed

    Ayas, Mouhab; Siddiqui, Khawar; Al-Jefri, Abdullah; El-Solh, Hassan; Al-Ahmari, Ali; Khairy, Ashraf; Markiz, Samer; Shahin, Hasan; Al-Musa, Abdulrahman; Al-Seraihy, Amal

    2014-10-01

    Hematopoietic cell transplantation (HCT) can cure bone marrow failure in patients with Fanconi Anemia (FA), and it is generally accepted that these patients should receive low-intensity conditioning because of the underlying DNA repair defect in their cells. Outcomes for recipients of matched related HCT have generally been favorable, but only a few studies have scrutinized the factors that may affect the eventual outcome of these patients. This retrospective analysis of 94 pediatric patients with FA who underwent related HCT at King Faisal Specialist Hospital & Research Center was carried out to attempt to identify factors that may affect outcome. Results showed overall survival (OS) probabilities of 92.5%, 89%, and 86% at 1, 5, and 10 years, respectively. In univariate analysis, use of higher dose cyclophosphamide (CY) (60 mg/kg) conditioning was associated with a better 10-year OS than lower dose CY (20 mg/kg) conditioning (91% versus 82%, respectively; P = .035), and use of radiation-containing regimens was associated with a significantly lower 10-year OS than nonradiation regimens (76% versus 91%, respectively; P = .005). Of the 4 regimens used in this study, the fludarabine-based regimen was associated with the highest survival (95.2%; P = .034). The use of the higher dose CY (60 mg/kg) was associated with a significantly increased incidence of hemorrhagic cystitis (HC) (20% versus 5.6% respectively; P = .049). Three patients (3%) developed squamous cell carcinoma (2 oropharyngeal and 1 genitourinary), at 9.4, 5.4, and 13.3 years after HCT; 2 of them had radiation-containing conditioning. In conclusion, our data suggest that although using a higher dose CY (60 mg/kg) conditioning regimen may be associated with better survival, it is also associated with a significantly increased risk of HC. The addition of fludarabine to the low-dose CY (20 mg/kg) is associated with the best survival. On the other hand, radiation-containing regimens are associated with

  17. Factors Affecting Survival in Patients with Lung Metastases from Colorectal Cancer. A Short Meta-analysis.

    PubMed

    Lumachi, Franco; Chiara, Giordano B; Tozzoli, Renato; Del Conte, Alessandro; Del Contea, Alessandro; Basso, Stefano M M

    2016-01-01

    Liver and pulmonary metastases (PMs) are relatively common in patients with colorectal cancer. The majority of metastases are suitable for surgical resection, and the effectiveness of metastasectomy is usually assessed based on overall survival (OS). Metastasectomy provides a mean 5-year OS rate of approximately 50%, but the results are better in patients with liver metastases compared to those with PMs. Unfortunately, the presence of bilateral or multiple PMs represents a relative contraindication to surgical metastasectomy. Unresectable PMs can be safely treated with percutaneous radiofrequency ablation or radiotherapy, but the reported results vary widely. Several clinical prognostic factors affecting OS after metastasectomy have been reported, such as number of PMs, hilar or mediastinal lymph node involvement, disease-free interval, age and gender, resection margins, size of the metastases, neoadjuvant chemotherapy administration, and histological type of the primary cancer. The accurate evaluation of all clinical prognostic factors, circulating and immunohistochemical markers, and the study of gene mutational status will lead to a more accurate selection of patients scheduled to metastasectomy, with the aim of improving outcome. PMID:26722023

  18. Factors Affecting Graft Survival among Patients Receiving Kidneys from Live Donors: A Single-Center Experience

    PubMed Central

    Ghoneim, Mohamed A.; Bakr, Mohamed A.; Refaie, Ayman F.; Akl, Ahmed I.; Shokeir, Ahmed A.; Shehab El-Dein, Ahmed B.; Ammar, Hesham M.; Ismail, Amani M.; Sheashaa, Hussein A.; El-Baz, Mahmoud A.

    2013-01-01

    Introduction. The aim of this report is to study the graft and patient survival in a large cohort of recipients with an analysis of factors that may affect the final outcomes. Methods. Between March 1976 and March 2008, 1967 consecutive live-donor renal transplants were carried out. Various variables that may have an impact on patients and/or graft survival were studied in two steps. Initially, a univariate analysis was carried out. Thereafter, significant variables were embedded in a stepwise regression analysis. Results. The overall graft survival was 86.7% and 65.5%, at 5 and 10 years, respectively. The projected half-life for grafts was 17.5 years and for patients was 22 years. Five factors had an independent negative impact on graft survival: donor's age, genetic considerations, the type of primary immunosuppression, number of acute rejection episodes, and total steroid dose during the first 3 months after transplantation. Conclusions. Despite refinements in tissue matching techniques and improvements in immunosuppression protocols, an important proportion of grafts is still lost following living donor kidney transplantation, presumably due to chronic allograft nephropathy. PMID:23878820

  19. Activation of less affected corticospinal tract and poor motor outcome in hemiplegic pediatric patients: a diffusion tensor tractography imaging study

    PubMed Central

    Kim, Jin Hyun; Son, Su Min

    2015-01-01

    The less affected hemisphere is important in motor recovery in mature brains. However, in terms of motor outcome in immature brains, no study has been reported on the less affected corticospinal tract in hemiplegic pediatric patients. Therefore, we examined the relationship between the condition of the less affected corticospinal tract and motor function in hemiplegic pediatric patients. Forty patients with hemiplegia due to perinatal or prenatal injury (13.7 ± 3.0 months) and 40 age-matched typically developing controls were recruited. These patients were divided into two age-matched groups, the high functioning group (20 patients) and the low functioning group (20 patients) using functional level of hemiplegia scale. Diffusion tensor tractography images showed that compared with the control group, the patient group of the less affected corticospinal tract showed significantly increased fiber number and significantly decreased fractional anisotropy value. Significantly increased fiber number and significantly decreased fractional anisotropy value in the low functioning group were observed than in the high functioning group. These findings suggest that activation of the less affected hemisphere presenting as increased fiber number and decreased fractional anisotropy value is related to poor motor function in pediatric hemiplegic patients. PMID:26889198

  20. War, suffering and modern German history.

    PubMed

    Hansen, Randall

    2011-01-01

    This introduction proceeds in five steps. First, it briefly considers the etymology of the term "suffering," as well as the way in which scholars from different disciplines have approached it conceptually and empirically. Second, drawing on the contributions to this issue, it raises general themes emerging from the study of the Thirty Years, Franco-Prussian and First World Wars, with particular attention to gender, the disabled, and Jewish-German veterans. Finally, it considers the most politically contested field of German suffering - the Second World War - and reflects on how that suffering can be narrated and understood without running into the intellectual dead ends of either self-pity or collective guilt. PMID:22141173

  1. Diabetes may affect intracranial aneurysm stabilization in older patients: Analysis based on intraoperative findings

    PubMed Central

    Song, Jihye; Shin, Yong Sam

    2016-01-01

    Background: Only a small proportion of aneurysms progress to rupture. Previous studies have focused on predicting the rupture risk of intracranial aneurysms. Atherosclerotic aneurysm wall appears resistant to rupture. The purpose of this study was to evaluate clinical and morphological factors affecting atherosclerosis of an aneurysm and identify the parameters that predict aneurysm stabilization. Methods: We conducted a retrospective analysis of 253 consecutive patients with 291 unruptured aneurysms who underwent clipping surgery in a single institution between January 2012 and October 2013. Aneurysms were categorized based on intraoperative video findings and assessed morphologic and demographic data. Aneurysms which had the atherosclerotic wall without any super thin and transparent portion were defined as stabilized group and the others as a not-stabilized group. Results: Of the 207 aneurysms, 176 (85.0%) were assigned to the not-stabilized group and 31 (15.0%) to the stabilized group. The relative proportion of stabilized aneurysms increased significantly as the age increased (P < 0.001). Univariate logistic analysis showed that age ≥65 years (P < 0.001), hypertension (P = 0.012), diabetes (P = 0.007), and height ≥3 mm (P = 0.007) were correlated with stabilized aneurysms. Multivariate logistic analysis showed that age ≥65 years (P = 0.009) and hypertension (P = 0.041) were strongly correlated with stable aneurysms. In older patients (≥65 years of age), multivariate logistic regression revealed that only diabetes was associated with stabilized aneurysms (P = 0.027). Conclusions: In patients ≥65 years of age, diabetes mellitus may highly predict the stabilized aneurysms. These results provide useful information in determining treatment and follow-up strategies, especially in older patients. PMID:27313965

  2. Which Factors Affect Dental Esthetics and Smile Attractiveness in Orthodontically Treated Patients?

    PubMed Central

    Heravi, Farzin; Rashed, Roozbeh; Zarrabi, Mohammad Javad; Setayesh, Yasin

    2015-01-01

    Objectives: This study aimed to find the factors that affect dental esthetics and smile attractiveness in orthodontically treated patients according to laypeople’s judgment, and to determine whether there is any relationship between dental and smile esthetics. Materials and Methods: Using the Q-sort technique, 60 laypersons (30 males, 30 females) rated dental and smile photographs of 48 orthodontically treated patients based on their degree of attractiveness. Dental and smile parameters of each rated image were measured by Smile Analyzer software. The Student’s t-test and chi-square test were used to compare dental and smile parameters between attractive and unattractive images. The logistic regression was used to assess which variables predicted dental and smile esthetics in treated individuals. Results: The philtral to commissural height ratio and gingival display were significantly different in attractive and unattractive smiles (P=0.003 and P=0.02, respectively). None of the dental variables were found to be a determinant of dental esthetics at the end of the orthodontic treatment (P>0.05). According to the judgment of all raters (female and male) and the male raters’ judgment, smile attractiveness could be predicted by philtral to commissural height ratio and buccal corridor ratio (P<0.05). There was no statistically significant relationship between dental esthetics and smile attractiveness in orthodontically treated patients (P>0.05). Conclusion: The philtral to commissural height ratio and buccal corridor ratio can be considered as predictors of smile attractiveness in orthodontically treated patients. Achieving dental esthetics at the end of orthodontic treatment does not guarantee smile attractiveness. PMID:26877739

  3. Seropositivity for West Nile Virus Antibodies in Patients Affected by Myasthenia Gravis

    PubMed Central

    Greco, Marilena; Cofano, Pietro; Lobreglio, Giambattista

    2016-01-01

    Background Myasthenia gravis (MG) is an autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal muscles. Specific auto-antibodies against acetylcholine receptor (AChR) are present in the majority of MG patients, although the main cause behind its development still remains unclear. Recently MG development following West Nile virus (WNV) infection has been described in patients without any earlier evidence of MG. It is known that infectious agents trigger immune response and occasionally initiate autoimmune disease. WNV, the causative agent of both benign illness and neuroinvasive disease, has become endemic in many countries in all continents. Methods In the present study, 29 patients (15 males and 14 females, 19 - 78 years old) with confirmed diagnosis of MG and elevated levels of AChR autoantibodies were screened for the presence of serum anti-WNV antibodies and compared to a similar population affected by different autoimmune diseases. Indirect immunofluorescent antibody technique was used to evaluate the reaction of patients’ sera on cells infected by WNV. Results Positive fluorescent signals for anti-WNV IgG were obtained in 17% of MG patients, although no clinical manifestations related to WNV infection were reported. These results are in agreement with previous data and appear of great interest in the understanding of the pathogenic autoimmune mechanisms at the bases of MG development. Conclusion As already observed in other human autoimmune diseases, pathogen-triggered autoimmunity could be involved in MG by breaking immunological self-tolerance through possible mechanisms of molecular mimicry between virus proteins and AChR subunits. In predisposed individuals, WNV infection could also represent an additional risk factor to initiate MG. PMID:26858791

  4. Are preoperative sex-related differences of affective symptoms in primary brain tumor patients associated with postoperative histopathological grading?

    PubMed

    Richter, Andre; Jenewein, J; Krayenbühl, N; Woernle, C; Bellut, D

    2016-01-01

    Our objective was to explore the impact of the histopathological tumor type on affective symptoms before surgery among male and female patients with supratentorial primary brain tumors. A total of 44 adult patients were included in the study. Depression and anxiety were measured using the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory. Additionally, clinical interviews, including the Hamilton Depression Rating Scale (HDRS), were conducted. The general function of patients was measured with the Karnofsky Performance Status scale (KPS). All measures were obtained before surgery and therefore before the final histopathological diagnosis. All self-rating questionnaires but not the HDRS, showed significantly higher scores in female patients. The functional status assessed with the KPS was lower in female patients and correlated to the somatic part of the BDI. We further found a tendency for higher HDRS scores in male patients with a WHO grade 4 tumor stage compared to female patients. This finding was supported by positive correlations between HDRS scores and WHO grade in male and negative correlations between HDRS scores and WHO grade in female patients. In conclusion the preoperative evaluation of affective symptoms with self-rating questionnaires in patients with brain tumors may be invalidated by the patient’s functional status. Depression should be explored with clinical interviews in these patients. Sex differences of affective symptoms in this patient group may also be related to the malignancy of the tumor, but further studies are needed to disentangle this relationship. PMID:26468140

  5. Specificity of Affective Instability in Patients With Borderline Personality Disorder Compared to Posttraumatic Stress Disorder, Bulimia Nervosa, and Healthy Controls

    PubMed Central

    Santangelo, Philip; Mussgay, Lutz; Sawitzki, Günther; Trull, Timothy J.; Reinhard, Iris; Steil, Regina; Klein, Christoph; Bohus, Martin; Ebner-Priemer, Ulrich W.

    2014-01-01

    Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses. PMID:24661176

  6. Long-term perspectives for 46,XY patients affected by complete androgen insensitivity syndrome or congenital micropenis.

    PubMed

    Wisniewski, Amy B; Migeon, Claude J

    2002-08-01

    Controversy concerning optimal treatment for individuals affected by syndromes of abnormal sex differentiation can best be resolved with knowledge about long-term medical, surgical, and psychosexual outcomes of patients. Follow-up information has recently been gathered on older cohorts of the following patient groups: (1) those affected by complete androgen insensitivity syndrome (CAIS) raised female and (2) those affected by congenital micropenis raised male or female. As a group, women with CAIS were satisfied with their female gender and sexual function. However, a need for better patient education was identified for this specific population. Most patients with congenital micropenis, whether raised male or female, were satisfied with their gender. Regardless of sex of rearing, dissatisfaction with the appearance and function of the genitalia as judged by both physicians and subjects was evident. For patients with congenital micropenis, male sex of rearing was concluded to be optimal because genital reconstructive surgery is not required with this choice. PMID:12428209

  7. The effects of physical environments in medical wards on medication communication processes affecting patient safety.

    PubMed

    Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

    2014-03-01

    Physical environments of clinical settings play an important role in health communication processes. Effective medication management requires seamless communication among health professionals of different disciplines. This paper explores how physical environments affect communication processes for managing medications and patient safety in acute care hospital settings. Findings highlighted the impact of environmental interruptions on communication processes about medications. In response to frequent interruptions and limited space within working environments, nurses, doctors and pharmacists developed adaptive practices in the local clinical context. Communication difficulties were associated with the ward physical layout, the controlled drug key and the medication retrieving device. Health professionals should be provided with opportunities to discuss the effects of ward environments on medication communication processes and how this impacts medication safety. Hospital administrators and architects need to consider health professionals' views and experiences when designing hospital spaces. PMID:24486620

  8. Affection of Fundamental Brain Activity By Using Sounds For Patients With Prosodic Disorders: A Pilot Study

    NASA Astrophysics Data System (ADS)

    Imai, Emiko; Katagiri, Yoshitada; Seki, Keiko; Kawamata, Toshio

    2011-06-01

    We present a neural model of the production of modulated speech streams in the brain, referred to as prosody, which indicates the limbic structure essential for producing prosody both linguistically and emotionally. This model suggests that activating the fundamental brain including monoamine neurons at the basal ganglia will potentially contribute to helping patients with prosodic disorders coming from functional defects of the fundamental brain to overcome their speech problem. To establish effective clinical treatment for such prosodic disorders, we examine how sounds affect the fundamental activity by using electroencephalographic measurements. Throughout examinations with various melodious sounds, we found that some melodies with lilting rhythms successfully give rise to the fast alpha rhythms at the electroencephalogram which reflect the fundamental brain activity without any negative feelings.

  9. Affective behavior in patients with localized cortical excisions: role of lesion site and side.

    PubMed

    Kolb, B; Taylor, L

    1981-10-01

    The perception of emotion in verbal and facial expression, and the spontaneous production of conversational speech were studied in patients with unilateral focal excisions of frontal, temporal, or parieto-occipital cortex. Lesions of the left hemisphere impaired the matching of verbal descriptions to appropriate verbal categories of emotional states, whereas with lesions of the right hemisphere, the matching of different faces displaying similar emotional states was impaired. The effects of lesions of both left and right hemisphere occurred regardless of the locus of the lesion. On the other hand, frontal-lobe lesions had differential effects upon unsolicited talking; lesions of the left frontal lobe virtually abolished this behavior, whereas lesions of the right frontal lobe produced excessive talking. These data suggest that the nature of the behavioral stimulus as well as the locus and side of damage must be considered in the study of the neural basis of affective behavior. PMID:7280683

  10. Birthdates of patients affected by mental illness and solar activity: A study from Italy

    NASA Astrophysics Data System (ADS)

    Ventriglio, Antonio; Borelli, Albacenzina; Bellomo, Antonello; Lepore, Alberto

    2011-04-01

    PurposeThis epidemiologic study tested an hypothesized association between the year of birth of persons with major mental illnesses and solar activity over the past century. MethodsWe collected data on diagnoses and birthdates of psychiatric patients born between 1926 and 1975 (N = 1954) in south Italy for comparison to yearly solar activity as registered by the International Observatories. ResultsWe found a strong inverse correlation between high solar activity (HSA) and incidence of schizophrenia and bipolar disorder in a 20-year period whereas the incidence of non-affective/non-psychotic disorders was moderately associated with HSA in the same period. ConclusionsInterpretation of the observed correlations between HSA during years of birth and the incidence of mental illnesses remains unclear, but the findings encourage further study.

  11. Deficits of Affect Mentalization in Patients with Drug Addiction: Theoretical and Clinical Aspects

    PubMed Central

    Savov, Svetoslav; Atanassov, Nikola

    2013-01-01

    Traditionally treated with wariness, drug addictions have provoked a serious interest in psychodynamically oriented clinicians in recent decades. This paper discusses the development of contemporary psychodynamic conceptualizations of addictions, focusing specifically on mentalization-based theories. The concept of mentalization refers to a complex form of self-regulation which includes attribution of psychological meaning to one's own behavior and affective states, as well as those of the others. We hypothesize that drug-addicted patients have severe impairments in mentalizing, associated with developmental deficits, characteristic for the borderline personality disorder and psychosomatic conditions. Psychodynamic models of mentalization and their corresponding research operationalizations are reviewed, and implications for a contemporary understanding of drug addictions and psychotherapy are drawn. The authors propose that mentalization-oriented theories provide an adequate conceptualization, which is open to empirical testing and has clear and pragmatic guidelines for treatment. PMID:25969831

  12. Diversity of the Genes Implicated in Algerian Patients Affected by Usher Syndrome.

    PubMed

    Abdi, Samia; Bahloul, Amel; Behlouli, Asma; Hardelin, Jean-Pierre; Makrelouf, Mohamed; Boudjelida, Kamel; Louha, Malek; Cheknene, Ahmed; Belouni, Rachid; Rous, Yahia; Merad, Zahida; Selmane, Djamel; Hasbelaoui, Mokhtar; Bonnet, Crystel; Zenati, Akila; Petit, Christine

    2016-01-01

    Usher syndrome (USH) is an autosomal recessive disorder characterized by a dual sensory impairment affecting hearing and vision. USH is clinically and genetically heterogeneous. Ten different causal genes have been reported. We studied the molecular bases of the disease in 18 unrelated Algerian patients by targeted-exome sequencing, and identified the causal biallelic mutations in all of them: 16 patients carried the mutations at the homozygous state and 2 at the compound heterozygous state. Nine of the 17 different mutations detected in MYO7A (1 of 5 mutations), CDH23 (4 of 7 mutations), PCDH15 (1 mutation), USH1C (1 mutation), USH1G (1 mutation), and USH2A (1 of 2 mutations), had not been previously reported. The deleterious consequences of a missense mutation of CDH23 (p.Asp1501Asn) and the in-frame single codon deletion in USH1G (p.Ala397del) on the corresponding proteins were predicted from the solved 3D-structures of extracellular cadherin (EC) domains of cadherin-23 and the sterile alpha motif (SAM) domain of USH1G/sans, respectively. In addition, we were able to show that the USH1G mutation is likely to affect the binding interface between the SAM domain and USH1C/harmonin. This should spur the use of 3D-structures, not only of isolated protein domains, but also of protein-protein interaction interfaces, to predict the functional impact of mutations detected in the USH genes. PMID:27583663

  13. JAK2 inhibitors do not affect stem cells present in the spleens of patients with myelofibrosis.

    PubMed

    Wang, Xiaoli; Ye, Fei; Tripodi, Joseph; Hu, Cing Siang; Qiu, Jiajing; Najfeld, Vesna; Novak, Jesse; Li, Yan; Rampal, Raajit; Hoffman, Ronald

    2014-11-01

    Dysregulation of Janus kinase (JAK)-signal transducer and activator of transcription signaling is central to the pathogenesis of myelofibrosis (MF). JAK2 inhibitor therapy in MF patients results in a rapid reduction of the degree of splenomegaly, yet the mechanism underlying this effect remains unknown. The in vitro treatment of splenic and peripheral blood MF CD34(+) cells with the JAK1/2/3 inhibitor, AZD1480, reduced the absolute number of CD34(+), CD34(+)CD90(+), and CD34(+)CXCR4(+) cells as well as assayable hematopoietic progenitor cells (HPCs) irrespective of the JAK2 and calreticulin mutational status. Furthermore, AZD1480 treatment resulted in only a modest reduction in the proportion of HPCs that were JAK2V617F(+) or had a chromosomal abnormality. To study the effect of the drug on MF stem cells (MF-SCs), splenic CD34(+) cells were treated with AZD1480 and transplanted into immunodeficient mice. JAK2 inhibitor therapy did not affect the degree of human cell chimerism or the proportion of malignant donor cells. These data indicate that JAK2 inhibitor treatment affects a subpopulation of MF-HPCs, while sparing another HPC subpopulation as well as MF-SCs. This pattern of activity might account for the reduction in spleen size observed with JAK2 inhibitor therapy as well as the rapid increase in spleen size observed frequently with its discontinuation. PMID:25193869

  14. JAK2 inhibitors do not affect stem cells present in the spleens of patients with myelofibrosis

    PubMed Central

    Wang, Xiaoli; Ye, Fei; Tripodi, Joseph; Hu, Cing Siang; Qiu, Jiajing; Najfeld, Vesna; Novak, Jesse; Li, Yan; Rampal, Raajit

    2014-01-01

    Dysregulation of Janus kinase (JAK)–signal transducer and activator of transcription signaling is central to the pathogenesis of myelofibrosis (MF). JAK2 inhibitor therapy in MF patients results in a rapid reduction of the degree of splenomegaly, yet the mechanism underlying this effect remains unknown. The in vitro treatment of splenic and peripheral blood MF CD34+ cells with the JAK1/2/3 inhibitor, AZD1480, reduced the absolute number of CD34+, CD34+CD90+, and CD34+CXCR4+ cells as well as assayable hematopoietic progenitor cells (HPCs) irrespective of the JAK2 and calreticulin mutational status. Furthermore, AZD1480 treatment resulted in only a modest reduction in the proportion of HPCs that were JAK2V617F+ or had a chromosomal abnormality. To study the effect of the drug on MF stem cells (MF-SCs), splenic CD34+ cells were treated with AZD1480 and transplanted into immunodeficient mice. JAK2 inhibitor therapy did not affect the degree of human cell chimerism or the proportion of malignant donor cells. These data indicate that JAK2 inhibitor treatment affects a subpopulation of MF-HPCs, while sparing another HPC subpopulation as well as MF-SCs. This pattern of activity might account for the reduction in spleen size observed with JAK2 inhibitor therapy as well as the rapid increase in spleen size observed frequently with its discontinuation. PMID:25193869

  15. Measuring the Experience and Perception of Suffering

    ERIC Educational Resources Information Center

    Schulz, Richard; Monin, Joan K.; Czaja, Sara J.; Lingler, Jennifer H.; Beach, Scott R.; Martire, Lynn M.; Dodds, Angela; Hebert, Randy S.; Zdaniuk, Bozena; Cook, Thomas B.

    2010-01-01

    Purpose: Assess psychometric properties of scales developed to assess experience and perception of physical, psychological, and existential suffering in older individuals. Design and Methods: Scales were administered to 3 populations of older persons and/or their family caregivers: individuals with Alzheimer's disease (AD) and their family…

  16. Is Pain Suffering? A Case Study

    ERIC Educational Resources Information Center

    Black, Helen K.

    2007-01-01

    In this article, the case study of an elderly woman shows how bodily pain and suffering meld in her narrative, not as the subjective and objective sides of the same event, but as distinct experiences in which both constructs emerge separately or come together based on the meaning she imputes to the event. The case study shows the clear…

  17. Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.

    PubMed

    Jena, Anupam B; Schoemaker, Lena; Bhattacharya, Jay

    2014-10-01

    In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency. We found that the duty-hour reforms did not adversely affect hospital mortality and length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during their own residency. However, assessment of the impact of the duty-hour reforms on other clinical outcomes is needed. PMID:25288430

  18. Characterization of the CYP21 gene 5' flanking region in patients affected by 21-OH deficiency.

    PubMed

    Bobba, A; Marra, E; Lattanzio, P; Iolascon, A; Giannattasio, S

    2000-05-01

    In order to test the hypothesis that mutations in the 5' non-coding region of CYP21 gene could contribute to the various spectrum of disease presentation due to 21-OH deficiency, the 400bp nucleotide sequence upstream of the ATG codon of CYP21 gene has been characterized in 28 CAH patients who have previously been genotyped by screening for the ten most frequent CYP21 mutations. Six specific sequence variations (-4C-->T, -73C-->T, -295T-->C, -294A-->C, -283A-->G, -281T-->G) have been identified in this region of CYP21 gene in 3 out of 28 21-OH deficient patients for whom the coding region mutations have been previously identified. Three of these mutations, -295T-->C, -294A-->C, -283A-->G, are apparently generated by a gene-conversion event, thus giving first evidence that this mechanism also applies to the 5' untranslated region of CYP21 gene in 21-OH deficiency. Four other sequence changes, identified at nucleotide position -279, -331, -350 and -353, could be referred to as normal since they are present also in healthy subjects. It may not be excluded that some of the newly-identified single nucleotide changes in the regulatory region could have a modulatory effect on the CYP21 gene transcriptional activity thus affecting the clinical outcome. PMID:10790214

  19. MIR137 variants identified in psychiatric patients affect synaptogenesis and neuronal transmission gene sets.

    PubMed

    Strazisar, M; Cammaerts, S; van der Ven, K; Forero, D A; Lenaerts, A-S; Nordin, A; Almeida-Souza, L; Genovese, G; Timmerman, V; Liekens, A; De Rijk, P; Adolfsson, R; Callaerts, P; Del-Favero, J

    2015-04-01

    Sequence analysis of 13 microRNA (miRNA) genes expressed in the human brain and located in genomic regions associated with schizophrenia and/or bipolar disorder, in a northern Swedish patient/control population, resulted in the discovery of two functional variants in the MIR137 gene. On the basis of their location and the allele frequency differences between patients and controls, we explored the hypothesis that the discovered variants impact the expression of the mature miRNA and consequently influence global mRNA expression affecting normal brain functioning. Using neuronal-like SH-SY5Y cells, we demonstrated significantly reduced mature miR-137 levels in the cells expressing the variant miRNA gene. Subsequent transcriptome analysis showed that the reduction in miR-137 expression led to the deregulation of gene sets involved in synaptogenesis and neuronal transmission, all implicated in psychiatric disorders. Our functional findings add to the growing data, which implicate that miR-137 has an important role in the etiology of psychiatric disorders and emphasizes its involvement in nervous system development and proper synaptic function. PMID:24888363

  20. Efficacy and Factors Affecting Outcome of Gemcitabine Concurrent Chemoradiotherapy in Patients With Locally Advanced Pancreatic Cancer

    SciTech Connect

    Huang, P.-I.; Chao, Yee; Li, C.-P.; Lee, R.-C.; Chi, K.-H.; Shiau, C.-Y.; Wang, L.-W.; Yen, S.-H.

    2009-01-01

    Purpose: To evaluate the efficacy and prognostic factors of gemcitabine (GEM) concurrent chemoradiotherapy (CCRT) in patients with locally advanced pancreatic cancer. Methods and Materials: Between January 2002 and December 2005, 55 patients with locally advanced pancreatic cancer treated with GEM (400 mg/m{sup 2}/wk) concurrently with radiotherapy (median dose, 50.4 Gy; range, 26-61.2) at Taipei Veterans General Hospital were enrolled. GEM (1,000 mg/m{sup 2}) was continued after CCRT as maintenance therapy once weekly for 3 weeks and repeated every 4 weeks. The response, survival, toxicity, and prognostic factors were evaluated. Results: With a median follow-up of 10.8 months, the 1- and 2-year survival rate was 52% and 19%, respectively. The median overall survival (OS) and median time to progression (TTP) was 12.4 and 5.9 months, respectively. The response rate was 42% (2 complete responses and 21 partial responses). The major Grade 3-4 toxicities were neutropenia (22%) and anorexia (19%). The median OS and TTP was 15.8 and 9.5 months in the GEM CCRT responders compared with 7.5 and 3.5 months in the nonresponders, respectively (both p < 0.001). The responders had a better Karnofsky performance status (KPS) (86 {+-} 2 vs. 77 {+-} 2, p = 0.002) and had received a greater GEM dose intensity (347 {+-} 13 mg/m{sup 2}/wk vs. 296 {+-} 15 mg/m{sup 2}/wk, p = 0.02) than the nonresponders. KPS and serum carbohydrate antigen 19-9 were the most significant prognostic factors of OS and TTP. Conclusion: The results of our study have shown that GEM CCRT is effective and tolerable for patients with locally advanced pancreatic cancer. The KPS and GEM dose correlated with response. Also, the KPS and CA 19-9 level were the most important factors affecting OS and TTP.

  1. Factors affecting carisoprodol metabolism in pain patients using urinary excretion data.

    PubMed

    Tse, Stephanie A; Atayee, Rabia S; Ma, Joseph D; Best, Brookie M

    2014-04-01

    Carisoprodol is a skeletal muscle relaxant prescribed to treat pain. Carisoprodol is metabolized to meprobamate, an active metabolite with anxiolytic effects, by the genetically polymorphic CYP2C19 enzyme. Concomitant use of CYP2C19 substrates or inhibitors may alter carisoprodol metabolism, with therapeutic and/or toxic implications for effectively treating patients with pain. This was a retrospective analysis of urinary excretion data collected from patients with pain from March 2008 to May 2011. Carisoprodol and meprobamate urine concentrations were measured by liquid chromatography-tandem mass spectrometry, and the metabolic ratio (MR) of meprobamate to carisoprodol concentrations was determined in 14,965 subjects. The MR geometric mean and 95% confidence interval (95% CI) of the young group (105, 95% CI = 99.1-113) were ∼47.4% higher than the middle-aged group (71.9, 95% CI = 70-73.8) and nearly two times higher than the elderly group (54.4, 95% CI = 51.3-57.6). Females had a 20.7% higher MR compared with males. No significant change in the MR was observed with overall CYP2C19 inhibitor or substrate use. However, evaluation of individual inhibitors showed co-administration with esomeprazole or fluoxetine was associated with a 31.8 and 24.6% reduction in MR, respectively, compared with controls (P < 0.05). Omeprazole did not significantly affect the MR. Patient-specific factors such as age, sex and co-medications may be important considerations for effective carisoprodol therapy. PMID:24488112

  2. [A case of narcolepsy with increased cataplectic attacks after suffering from cerebrovascular disease].

    PubMed

    Miura, H; Nakajima, S; Nakamura, H; Ichinowatari, N

    1990-06-01

    It is well known that narcoleptic patients have DR2 and DQw-1 on HLA typing. The development of narcolepsy is considered to depend on the two factors; genetic predispositions and exogenous factors such as head trauma, encephalitis, etc., mainly affecting the brainstem or diencephalon. We reported a 46-year-old man who had occasional sleep attacks after suffering from left thalamic hemorrhage and pontine vascular disorders. Rehabilitation was markedly disturbed due to frequent episodes of cataplectic attacks which was triggered by emotional lability such as laughing, anxiety, and excitement. HLA type examination showed both DR-2 and DQw-1 loci in the proband and his four other siblings. His elder brother also suffered from mild excessive daytime sleepiness during his younger age, but it subsided gradually. Analysis of overnight polysomnography in the patient revealed remarkable paradoxical alpha-blocking and frequent sleep onset REM stages as typically observed in narcoleptic patients. MRI examination showed multiple small hemorrhages and infarctions in the pontine tegmentum, in addition to the left thalamic hemorrhage and multiple subcortical ischemic lesions. Concerning the mechanism of frequent cataplexy in this patient, it is postulated that increased emotional incontinence might have stimulated the descending reticular system in the brainstem which in turn may inhibit anterior horn motor cell activities. Methylphenidate was initially given to the patient, resulting in some relief of attacks, and addition of imipramine dramatically suppressed cataplectic attacks. Imipramine is considered to inhibit the excitatory afferent pathway to the brainstem suppressing the hyperactivity of descending motor inhibitory system due to its anti-muscarinergic action. PMID:2225662

  3. Adverse childhood experiences associate to reduced glutamate levels in the hippocampus of patients affected by mood disorders.

    PubMed

    Poletti, Sara; Locatelli, Clara; Falini, Andrea; Colombo, Cristina; Benedetti, Francesco

    2016-11-01

    Adverse childhood experiences (ACE) can possibly permanently alter the stress response system, affect the glutamatergic system and influence hippocampal volume in mood disorders. The aim of the study is to investigate the association between glutamate levels in the hippocampus, measured through single proton magnetic resonance spectroscopy (1H-MRS), and ACE in patients affected by mood disorders and healthy controls. Higher levels of early stress associate to reduced levels of Glx/Cr in the hippocampus in depressed patients but not in healthy controls. Exposure to stress during early life could lead to a hypofunctionality of the glutamatergic system in the hippocampus of depressed patients. Abnormalities of glutamatergic signaling could then possibly underpin the structural and functional abnormalities observed in patients affected by mood disorders. PMID:27449360

  4. Volumetric analysis of the diagonal band of Broca in patients with schizophrenia and affective disorders: A post-mortem study.

    PubMed

    Brisch, Ralf; Bernstein, Hans-Gert; Dobrowolny, Henrik; Krzyżanowska, Marta; Jankowski, Zbigniew; Bogerts, Bernhard; Gos, Tomasz

    2016-05-01

    The human diagonal band of Broca is connected to other parts of the limbic system, such as the hippocampus, that are involved in the pathology of schizophrenia. This study aimed to characterize the volume and anterior-to-posterior distance of the human diagonal band of Broca (vertical limb) from post-mortem brains obtained from three groups: healthy control subjects (N = 17), patients with schizophrenia (N = 26), and patients with affective disorders (N = 12). There were no significant differences in the volume or anterior-to-posterior distance in the patients with schizophrenia or affective disorders compared with the healthy control subjects. To date, this is the first post-mortem investigation measuring the volume and the anterior-to-posterior distance of the diagonal band of Broca (vertical limb) in patients with schizophrenia or affective disorders compared with healthy control subjects. Clin. Anat. 29:466-472, 2016. © 2015 Wiley Periodicals, Inc. PMID:26457806

  5. Plasma fibrin clot phenotype independently affects intracoronary thrombus ultrastructure in patients with acute myocardial infarction.

    PubMed

    Zalewski, Jaroslaw; Bogaert, Jan; Sadowski, Marcin; Woznicka, Olga; Doulaptsis, Konstantinos; Ntoumpanaki, Maria; Ząbczyk, Michal; Nessler, Jadwiga; Undas, Anetta

    2015-06-01

    Determinants of intracoronary thrombus (ICT) composition in patients with ST-elevation myocardial infarction (STEMI) are largely unknown. We sought to investigate whether plasma fibrin phenotype and platelet reactivity affect ICT ultrastructure. We assessed the content of fibrin, platelets and erythrocytes including polyhedrocytes by scanning electron microscopy on the surface and inside ICT aspirated from 80 STEMI patients within 12 hours since chest pain onset. Plasma fibrin clot permeability (Ks), which indicates the average pore size, lysis time (t50 %), platelet reactivity index (PRI) and ADP-induced platelet aggregation (ADP5, 20µM) were evaluated on admission. All patients received aspirin and 45 (56.3 %) 600 mg of clopidogrel, 80 (60-120) min prior to aspiration. Higher content of fibrin (61.6 vs 34.3 %, P< 0.0001) and platelets (8.2 vs 4.8 %, P=0.018) and lower erythrocyte content (15.8 vs 42.9 %, P< 0.0001) were found on ICT surface compared with its inner part. After adjustment for fibrinogen, in both ICT parts fibrin content was correlated with Ks (r≤-0.55, P< 0.0001) and t50 % (r≥ 0.29, P≤ 0.02) but not with PRI and ADP5,20µM. Polyhedrocytes were observed in 16 (20 %) patients and their large amount expressed as ≥ 50 % fields of view covered by polyhedrocytes was associated with the lower PRI values (40 vs 69 %, P=0.015), but not Ks or t50 %. By multivariate regression, Ks (β=-0.62, P< 0.0001), clopidogrel pretreatment (β=-0.36, P< 0.001), ischemia time (β=0.19, P=0.044) and family history (β=0.18, P=0.049) independently predicted fibrin content in the whole ICT (R²=0.65, P< 0.0001). Formation of denser plasma fibrin clots is independently associated with high fibrin content within the ICT in STEMI. PMID:25739375

  6. Reciprocal Suffering: Caregiver Concerns During Hospice Care

    PubMed Central

    Wittenberg-Lyles, Elaine; Demiris, George; Oliver, Debra Parker; Burt, Stephanie

    2010-01-01

    Context For many hospice caregivers, the constancy and difficulty of caregiving impact their physical quality of life and cause depression, psychological distress, guilt, loneliness, and restrictions on social activities. Objectives Deviating from traditional unidimensional research on hospice caregivers, this study explored the transactional nature of reciprocal suffering by examining caregiver concerns through four dimensions: physical, psychological, social, and spiritual. Methods Researchers analyzed audiotapes of intervention discussions between hospice caregivers and research social workers. Results Results indicated that of the 125 pain talk utterances, the majority referenced psychological concern (49%), followed by physical (28%), social (22%), and spiritual (2%). Reflections on concerns revealed a global perspective of caregiving, which highlighted the patient’s needs juxtaposed to the caregiver’s recognized limitations. Conclusion By examining the reciprocal nature of suffering for caregivers, this study reinforced the need for assessing caregivers in hospice care, with specific emphasis on the importance of providing caregiver education on pain management. PMID:21146356

  7. Self-consciousness and animal suffering.

    PubMed

    Morton, D B

    2000-04-01

    Animals with relatively highly developed brains are likely to experience some degree of self-awareness and the ability to think. As well as being interesting in its own right, self-consciousness matters from an ethical point of view, since it can give rise to forms of suffering above and beyond the immediate physical sensations of pain or distress. This article surveys the evidence for animal self-consciousness and its implications for animal welfare. PMID:11190233

  8. Immunological fluctuations during intrathecal immunotherapy in three patients affected by CNS tumours disseminating via CSF.

    PubMed

    Salmaggi, A; Dufour, A; Silvani, A; Ciusani, E; Nespolo, A; Boiardi, A

    1994-07-01

    The immunological therapy of cancer has been proposed in a number of neoplasms (Borden, Sondel, 1989; Foon, 1989; Rosenberg, 1992) and has recently been adopted in the treatment of Central Nervous System (CNS) tumors in combination with conventional surgical and radiotherapeutical approach. In this context, loco-regional administration of immunomodulating agents (for instance in post-surgical cavity) allows to achieve much higher in situ concentrations than by systemic route. Since these treatments have potential adverse effects, careful assessment of clinical and immunological parameters in phase I trials is needed. CNS tumors disseminating via Cerebrospinal Fluid (CSF) pathways offer a stimulating opportunity for intrathecal immunotherapy. In this context, alpha-IFN and IL2 (alone or in combination with LAK cells) have been employed either loco-regionally or intrathecally (Merchant, Mc Vicar, Merchant & Young, 1992; Schiller, Hank, Storer, Borchert, Moore, Albertini, Bechhofer, Wesley, Brown, Bastin & Sondel, 1993). The rationale for the use of both these substances includes the known anti-tumor action of alpha-IFN (Mahaley, Urso, Whaley, Blue, Williams, Guaspari & Selker, 1985; Nagai, 1988) and the ability of r-IL2 to generate activated cells effective in lysing tumor cell targets (Hayes, Moore, Pierz, Chen, Da Rosso, Nirenberg & Allen, 1993). We treated 3 patients (2 affected by disseminating cerebellar medulloblastoma, 1 by disseminating thalamic glioblastoma) by intrathecal r-IL2 via recervoir. In the first 2 patients, this treatment was preceded by alpha-IFN (also intrathecally). Monitoring of immunological effects of the treatment schedule involved kinetics of CSF and serum TNF-alpha, IL2s and IL2R during the first day of r-IL2 treatment, as well as on day +2 and +4 of both r-IL2 cycles, and assessment of CSF cells, protein and CSF and PB NK cell activity and CD3-CD56+ cells during the course of all treatment cycles. We also assessed clinical and

  9. Variants on the promoter region of PTEN affect breast cancer progression and patient survival

    PubMed Central

    2011-01-01

    Introduction The PTEN gene, a regulator of the phosphatidylinositol-3-kinase (PI3K)/Akt oncogenic pathway, is mutated in various cancers and its expression has been associated with tumor progression in a dose-dependent fashion. We investigated the effect of germline variation in the promoter region of the PTEN gene on clinical characteristics and survival in breast cancer. Methods We screened the promoter region of the PTEN gene for germline variation in 330 familial breast cancer cases and further determined the genotypes of three detected PTEN promoter polymorphisms -903GA, -975GC, and -1026CA in a total of 2,412 breast cancer patients to evaluate the effects of the variants on tumor characteristics and disease outcome. We compared the gene expression profiles in breast cancers of 10 variant carriers and 10 matched non-carriers and performed further survival analyses based on the differentially expressed genes. Results All three promoter variants associated with worse prognosis. The Cox's regression hazard ratio for 10-year breast cancer specific survival in multivariate analysis was 2.01 (95% CI 1.17 to 3.46) P = 0.0119, and for 5-year breast cancer death or distant metastasis free survival 1.79 (95% CI 1.03 to 3.11) P = 0.0381 for the variant carriers, indicating PTEN promoter variants as an independent prognostic factor. The breast tumors from the promoter variant carriers exhibited a similar gene expression signature of 160 differentially expressed genes compared to matched non-carrier tumors. The signature further stratified patients into two groups with different recurrence free survival in independent breast cancer gene expression data sets. Conclusions Inherited variation in the PTEN promoter region affects the tumor progression and gene expression profile in breast cancer. Further studies are warranted to establish PTEN promoter variants as clinical markers for prognosis in breast cancer. PMID:22171747

  10. Exercise testing in the clinical management of patients affected by pulmonary arterial hypertension.

    PubMed

    Paolillo, Stefania; Farina, Stefania; Bussotti, Maurizio; Iorio, Annamaria; PerroneFilardi, Pasquale; Piepolil, Massimo F; Agostoni, Piergiuseppe

    2012-10-01

    Patients affected by pulmonary arterial hypertension (PAH) show a reduced exercise tolerance with early occurrence of dyspnoea and fatigue. The origin of functional capacity limitation is multifactorial and several mechanisms have been proposed, including right heart failure, which leads to a limited increase in cardiac output during exercise, and hyperventilation with a reduced perfusion of properly ventilated alveoli. In addition, abnormalities in arterial blood gases are observed, with the occurrence of hypoxemia and hypocapnia, related to an abnormal ventilation/perfusion match, gas diffusion abnormalities, low mixed venous oxygen saturation and to the development of intra- and extra-pulmonary right-to-left shunts. At present, the 6-minute walking test is the most used method to assess exercise tolerance in PAH; it is also useful to monitor the response to therapy and provides prognostic information. However, the assessment of functional capacity by cardiopulmonary exercise test (CPET) seems to be more complete, because CPET allows for discrimination between the metabolic, cardiovascular and pulmonary components of exercise limitation. Moreover, CPET estimates the severity of disease and assesses patients' prognosis and response to therapy. In PAH, a typical CPET-response is observed, characterized by a severe reduction in peak VO2, work rate, O2 pulse and anaerobic threshold and by a marked increase in VE/VCO2 slope and in the dead space to tidal volume ratio. However, the use of CPET should be limited to experienced centres. This review will focus on resting lung function and exercise tolerance tests, showing that CPET can provide the physiological explanation of functional limitation in PAH. PMID:23126000

  11. Dysautonomia Differentially Influences the Effect of Affective Pain Perception on Quality of Life in Parkinson's Disease Patients

    PubMed Central

    Rada, D.; Seco, J.; Tijero, B.; Abecia, L. C.; Gómez-Esteban, J. C.

    2016-01-01

    Background. Our aim was to evaluate the real effect of dysautonomic symptoms on the influence of affective pain perception on quality of life in PD patients. Methods. An observational cross-sectional study was carried out using 105 Parkinson's disease (PD) patients of the Movement Disorders Unit, Hospital de Cruces (Bilbao, Spain) [men 59 (56.2%), women 46 (43.85%)]. Statistical analysis was made in order to evaluate the possible association of pain with life quality. Results. Quality of life measured by PDQ-39 (Parkinson's Disease Questionnaire for quality of life) was statistically associated with affective dimension of pain (PRIA, affective pain rating index). However, the influence of this dimension on PDQ-39 was different in the specific case of PD patients that experimented a high score (>12) in SCOPA-AUT (Scale for Outcomes in PD-Autonomic scale). Conclusions. These results confirm the effect of affective perception of pain in life quality of PD patients, indicating the critical role of autonomic symptoms in the modulation of the influence of pain on quality of life and showing the possible utility of dysautonomia as clinical prognostic indicator of quality of life in PD patients affected by pain. PMID:27239367

  12. Dysautonomia Differentially Influences the Effect of Affective Pain Perception on Quality of Life in Parkinson's Disease Patients.

    PubMed

    Rada, D; Seco, J; Echevarría, E; Tijero, B; Abecia, L C; Gómez-Esteban, J C

    2016-01-01

    Background. Our aim was to evaluate the real effect of dysautonomic symptoms on the influence of affective pain perception on quality of life in PD patients. Methods. An observational cross-sectional study was carried out using 105 Parkinson's disease (PD) patients of the Movement Disorders Unit, Hospital de Cruces (Bilbao, Spain) [men 59 (56.2%), women 46 (43.85%)]. Statistical analysis was made in order to evaluate the possible association of pain with life quality. Results. Quality of life measured by PDQ-39 (Parkinson's Disease Questionnaire for quality of life) was statistically associated with affective dimension of pain (PRIA, affective pain rating index). However, the influence of this dimension on PDQ-39 was different in the specific case of PD patients that experimented a high score (>12) in SCOPA-AUT (Scale for Outcomes in PD-Autonomic scale). Conclusions. These results confirm the effect of affective perception of pain in life quality of PD patients, indicating the critical role of autonomic symptoms in the modulation of the influence of pain on quality of life and showing the possible utility of dysautonomia as clinical prognostic indicator of quality of life in PD patients affected by pain. PMID:27239367

  13. Injustice, suffering, difference: how can community health nursing address the suffering of others?

    PubMed

    Drevdahl, Denise J

    2013-01-01

    Social justice brings to life the purpose of public health-improving a population's overall health and well-being. Critiques of the concept demonstrate that social justice is inconsistently defined and rarely is acted upon, and continuation of these injustices constitutes a form of suffering. Seeing one's self as disconnected from others makes their suffering normal. Viewing others from an ethical, moral, and human rights perspective helps one understand that the well-being of the self and the individual rests on the well-being of the collective other; this obligates each person to ameliorate and, if possible, prevent the suffering of others. PMID:23384067

  14. Psychosocial outcome following genetic risk counselling for familial colorectal cancer. A comparison of affected patients and family members.

    PubMed

    Keller, M; Jost, R; Haunstetter, C M; Sattel, H; Schroeter, C; Bertsch, U; Cremer, F; Kienle, P; Tariverdian, M; Kloor, M; Gebert, J; Brechtel, A

    2008-11-01

    Few studies have reported prospective data on psychosocial outcomes after genetic counselling in families with suspected hereditary non-polyposis colorectal cancer (HNPCC). This prospective study examines the impact of multidisciplinary risk counselling on the psychosocial outcome of 139 affected cancer patients and 233 family members without cancer at risk for HNPCC. Participants completed questionnaires specific to HNPCC before and 8 weeks after attending the familial cancer clinic. Affected patients' levels of distress were closely related to their health status and exceeded that of unaffected individuals, as did worry regarding their relatives' risk. A significant reduction in general anxiety (Hospital Anxiety and Depression Scale), distress specific to familial CRC (Impact of Events Scale) and general cancer worry (Distress Hereditary Disorder) was demonstrated after counselling in both affected patients and unaffected individuals. Reduction in distress was more pronounced in affected patients given a high risk of HNPCC compared with those at intermediate risk. Among unaffected individuals, distress declined regardless of what clinical risk they were assigned. Their perceptions of risk and cancer-related threat declined, while confidence in effective surveillance increased. These results suggest the beneficial effects of multidisciplinary counselling even when high-risk information is conveyed. A patient's previous cancer experience is likely to contribute to clinically relevant distress (15% of those patients), indicating the need for appropriate counselling. PMID:18954412

  15. Mental suffering and the DSM-5: a critical review.

    PubMed

    Vanheule, Stijn; Devisch, Ignaas

    2014-12-01

    The definition of mental disorder included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), indicates that mental disorders are usually associated with significant distress. However, the handbook is vague with respect to whether distress is crucial to the diagnosis of mental disorders, and a conceptual framework on the precise nature of distress is lacking. As a result, it remains vague how the term 'distress' is to be taken into account in actual diagnostic situations: the DSM-5 provides no operational framework for diagnosing distress. The authors argue that the work of Georges Canguilhem, who focuses on the topic of abnormality and pathology, and Paul Ricoeur's philosophical reflections on the theme of mental suffering may provide a structure for conceptualizing and evaluating distress. Ricoeur's phenomenological model of mental suffering is discussed. Here, mental suffering can be thought of in terms of the relationship between self and other, and also in terms of the continuum made up by, what he terms, languishing and acting. Ricoeur suggests that distress is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Consequently, diagnosticians should describe and document how individuals experience subjective distress. On a practical level, this means that clinicians' ideas about patients' distress should be embedded in case formulations. A detailed evaluation of an individual's pathos-experience should be made before conclusions are drawn with regard to diagnosis. PMID:24815177

  16. Descriptions of suffering in connection with life values. Healthy individuals' reflections in interviews.

    PubMed

    Graneheim, U H; Lindahl, E; Kihlgren, M

    1997-01-01

    Nine semistructured interviews with attendant questions were conducted with the purpose of elucidating how healthy individuals describe suffering and life values in their reflections upon active euthanasia. In order to find the intended meaning in utterances, the interviews were interpreted step by step. The point of departure was the following question: What expressions of suffering and what expressions of life values can be found in the text? A connection was found between the interviewees' descriptions of suffering and life values in their reflections upon active euthanasia. The interviewees who considered close relations to be a value of life expressed suffering as dependence, compassion, violation, abandonment and feelings of guilt, while those to whom health was a value of life expressed suffering as torment, dependence, physical pain, feebleness, hopelessness and dying. Those who saw autonomy as a value of life expressed suffering as dependence and violation and those to whom doing good was a value of life expressed suffering as compassion. When organizing health care and deciding about the response to suffering, it seems important to strive for a response built upon the individual patient's description of suffering and life values. PMID:9349055

  17. Measuring Beliefs about Suffering: Development of the Views of Suffering Scale

    PubMed Central

    Hale-Smith, Amy; Park, Crystal L.; Edmondson, Donald

    2013-01-01

    Efforts to measure religion have intensified and many specific dimensions have been identified. However, although belief is a core dimension of all world religions, little attention has been given to assessment of religious beliefs. In particular, one essential set of religious beliefs, those concerning the reasons for human suffering, has remained virtually unexamined in spite of the potential clinical relevance of these beliefs. To fill the need for a measure of people’s beliefs about suffering, we developed the Views of Suffering Scale (VOSS). Analyses identified factors related to traditional Christian teachings, unorthodox theistic beliefs, karma, and randomness. Internal consistency and test-retest reliability for VOSS subscale scores were good (α’s and r’s ≥ .70). Comparisons to measures of related constructs suggest that the VOSS scores demonstrate good convergent validity. One subscale score was modestly correlated with social desirability related to image management, and seven were positively correlated to self-deceptive enhancement. These preliminary studies suggest that the VOSS differentiates religious perspectives on suffering among a sample of US university students, though more research is needed to confirm its utility in diverse populations. The VOSS provides a valid way to measure individuals’ beliefs about suffering, allowing for inquiry into the factors that lead to various beliefs about suffering and the roles of these beliefs in adjusting to stressful life events. PMID:22369650

  18. LITHIUM PROPHYLAXIS IN AFFECTIVE DISORDER

    PubMed Central

    Rao, A. Venkoba; Hariharasubramanian, N.; Devi, S. Parvathi; Sugumar, A.; Srinivasan, V.

    1982-01-01

    SUMMARY Out of 108 patients on the rolls in the Lithium clinic, Madurai Medical College and Govt. Rajaji Hospital, Madurai, India, 47 patients suffering from affective disorders receiving lithium continuously for more than three years were analysed with a view to study the recurrences. Thirteen suffered no relapses while on lithium while nineteen experienced them while on lithium. Four were free from recurrences after lithium was withdrawn- Seven defaulted but suffered recurrences while in four the drug was withdrawn and in both the groups remission was achieved with re-administration of lithium. The study reveals that lithium besides averting the recurrences can reduce the frequency, number, duration, intensity of episodes and improve the amenability to drugs. Among the symptoms, suicidal ideas and behaviour and insight were found to be influenced favourably by lithium. Among the factors that help favourable response to lithium were a positive family history of affective disorder, in the first degree relatives and lesser frequency and number of episodes in the pre-lithium period. A reappraisal of the natural history of the illness is called for in the light of lithium prophylaxis of manic depressive psychosis. PMID:21965880

  19. A steroid-induced bilateral avascular necrosis of the femoral head in an underage patient affected by multiple sclerosis

    PubMed Central

    Carulli, Christian; Nistri, Lorenzo; Bracco, Laura; Giannini, Marta; Amato, Maria Pia

    2015-01-01

    Summary Patients affected by Multiple Sclerosis are often treated by pulsed intravenous corticosteroids to manage acute relapses with positive outcomes. The intravenous administration is frequently associated to avascular necrosis of several bones, particularly the femur. The present report regards a case of an underage MS patient with a bilateral ANFH secondary to pulsed administrations of steroids, managed by a conservative approach on a hip, and by a novel surgical technique on the contralateral side. PMID:26811707

  20. A steroid-induced bilateral avascular necrosis of the femoral head in an underage patient affected by multiple sclerosis.

    PubMed

    Carulli, Christian; Nistri, Lorenzo; Bracco, Laura; Giannini, Marta; Amato, Maria Pia

    2015-01-01

    Patients affected by Multiple Sclerosis are often treated by pulsed intravenous corticosteroids to manage acute relapses with positive outcomes. The intravenous administration is frequently associated to avascular necrosis of several bones, particularly the femur. The present report regards a case of an underage MS patient with a bilateral ANFH secondary to pulsed administrations of steroids, managed by a conservative approach on a hip, and by a novel surgical technique on the contralateral side. PMID:26811707

  1. Occupational Stress: Preventing Suffering, Enhancing Wellbeing †

    PubMed Central

    Quick, James Campbell; Henderson, Demetria F.

    2016-01-01

    Occupational stress is a known health risk for a range of psychological, behavioral, and medical disorders and diseases. Organizations and individuals can mitigate these disorders through preventive stress management and enhanced wellbeing. This article addresses, first, the known health risk evidence related to occupational stress; second, the use of preventive stress management in organizations as the framework for intervention; and third, the emerging domain of enhancing wellbeing, which strengthens the individual. Premature death and disability along with chronic suffering from occupational stress are not inevitable, despite being known outcome risks. PMID:27136575

  2. Estimating postoperative survival of gastric cancer patients and factors affecting it in Iran: Based on a TNM-7 Staging System.

    PubMed

    Zeraati, Hojjat; Amiri, Zohreh

    2016-02-01

    Recently, reports have shown that gastric cancer has high abundance in Iran and is at the second level in men, and fourth in total. This study aimed to determine the 5-year survival of gastric cancer patients and to investigate factors affecting the performance, based on TNM-7 staging system. In this study, we investigated 760 patients with gastric cancer since the beginning of 1993 to the end of 2006 in the Iran Cancer Institute who underwent surgery. Survival of these patients was determined after surgery, and the effects of demographic characteristics such as age (during operation), sex, and information on diseases such as cancer site, pathologic type, stage of disease progress (Stage), metastasis and sites of metastases were evaluated. The 5 -year survival probability of patients was 28 %, and median survival time was 25.69 months. Univariate tests showed that sex, cancer site, and pathologic type have no significant effects on patient's survival. But the probability of 5-year survival significantly decreases with increasing age, and as it is expected, those with metastases were significantly less likely to have 5-year survival, and disease stage was significantly effective on patients' life (P<0.001). Simultaneous evaluation of different variables' effects on the probability of survival using the multiple Cox proportional hazards models showed that age and stage disease variables were effective on the survival of patients. The 5-year survival of patients with gastric cancer is low in Iran, although it is improved compared to the past. It seems that one of the main reasons for low survival rate of these patients is a late referral of patients for diagnosis and treatment. Most patients refer in the final stages of the disease, at this stage most patients are affected by lymph nodes metastases, liver and as the result, their treatment will be more difficult. PMID:26997598

  3. Sensitivity of ovarian cancer cells to acetaminophen reveals biological pathways that affect patient survival

    PubMed Central

    BUSH, STEPHEN H.; TOLLIN, SHARON; MARCHION, DOUGLAS C.; XIONG, YIN; ABBASI, FOROUGH; RAMIREZ, INGRID J.; ZGHEIB, NADIM BOU; BOAC, BERNADETTE; JUDSON, PATRICIA L.; CHON, HYE SOOK; WENHAM, ROBERT M.; APTE, SACHIN M.; CUBITT, CHRISTOPHER L.; BERGLUND, ANDERS E.; HAVRILESKY, LAURA J.; LANCASTER, JOHNATHAN M.

    2016-01-01

    Experimental and epidemiological data support the potential activity of acetaminophen against ovarian cancer (OVCA). In this study, we sought to confirm the activity of acetaminophen in OVCA cell lines and to investigate the molecular basis of response. A total of 16 OVCA cell lines underwent pretreatment (baseline) genome-wide expression measurements and were then treated with and analyzed for acetaminophen sensitivity. Pearson's correlation analysis was performed to identify genes that were associated with OVCA acetaminophen response. The identified genes were subjected to pathway analysis, and the expression of each represented pathway was summarized using principal component analysis. OVCA acetaminophen response pathways were analyzed in 4 external clinico-genomic datasets from 820 women for associations with overall survival from OVCA. Acetaminophen exhibited antiproliferative activity against all tested OVCA cell lines, with half maximal inhibitory concentration values ranging from 63.2 to 403 µM. Pearson's correlation followed by biological pathway analysis identified 13 pathways to be associated with acetaminophen sensitivity (P<0.01). Associations were observed between patient survival from OVCA and expression of the following pathways: Development/angiotensin signaling via β-arrestin (P=0.04), protein folding and maturation/angiotensin system maturation (P=0.02), signal transduction/c-Jun N-terminal kinase (JNK) pathway (P=0.03) and androstenedione and testosterone biosynthesis and metabolism (P=0.02). We confirmed that acetaminophen was active against OVCA cells in vitro. Furthermore, we identified 4 molecular signaling pathways associated with acetaminophen response that may also affect overall survival in women with OVCA, including the JNK pathway, which has been previously implicated in the mechanism of action of acetaminophen and is predictive of decreased survival in women with OVCA. PMID:26998291

  4. Event-Related Potentials Reveal Preserved Attention Allocation but Impaired Emotion Regulation in Patients with Epilepsy and Comorbid Negative Affect

    PubMed Central

    De Taeye, Leen; Pourtois, Gilles; Meurs, Alfred; Boon, Paul; Vonck, Kristl; Carrette, Evelien; Raedt, Robrecht

    2015-01-01

    Patients with epilepsy have a high prevalence of comorbid mood disorders. This study aims to evaluate whether negative affect in epilepsy is associated with dysfunction of emotion regulation. Event-related potentials (ERPs) are used in order to unravel the exact electrophysiological time course and investigate whether a possible dysfunction arises during early (attention) and/or late (regulation) stages of emotion control. Fifty epileptic patients with (n = 25) versus without (n = 25) comorbid negative affect plus twenty-five matched controls were recruited. ERPs were recorded while subjects performed a face- or house-matching task in which fearful, sad or neutral faces were presented either at attended or unattended spatial locations. Two ERP components were analyzed: the early vertex positive potential (VPP) which is normally enhanced for faces, and the late positive potential (LPP) that is typicall