Average Symptom Score Research Articles

The SQ tree sublingual immunotherapy tablet is effective and well tolerated in children-A pivotal phase III trial.

Allergic rhinitis and/or conjunctivitis (AR/C) induced by tree pollen is common and negatively impacts quality of life in children and adolescents. This phase III trial investigated the efficacy and safety of the SQ tree SLIT-tablet in a paediatric population (5-17 years) with moderate-to-severe AR/C induced by pollen from birch and trees in the birch homologous group. Nine hundred and fifty-two subjects were randomized (1:1) to daily treatment with SQ tree SLIT-tablet or placebo for up to 52 weeks and had free access to AR/C symptom-relieving medications. The primary endpoint was the average total combined score (TCS); sum of average daily symptom score (DSS) and average daily medication score (DMS) during the birch pollen season (BPS). Key secondary endpoints included average DSS and DMS during BPS and average TCS, DSS and DMS during tree pollen season (TPS). SQ tree SLIT-tablet demonstrated a statistically significant and clinically relevant treatment effect compared with placebo for the TCS during BPS with an absolute treatment difference of 1.29 (95% CI: 0.58, 2.00; p = .0004) and a relative reduction of 21.9% (95% CI: 10.6, 31.9). Results were substantiated by reductions in both DSS and DMS versus placebo during the BPS and in DSS, DMS and TCS during the TPS. Treatment was generally well tolerated. Most treatment-related adverse events were mild or moderate local administration site reactions. This is the first paediatric trial to provide robust evidence of efficacy and safety of the SQ tree SLIT-tablet in tree pollen-induced AR/C in a paediatric population (5-17 years).

Quality of Life and Symptoms of Hospitalized Hematological Cancer Patients

Patients with hematological malignancies undergo intensive treatment and prolonged hospitalization, thus having a variety of physical and psychosocial symptoms and worse quality of life (QOL). This study aimed to assess the QOL and investigate the symptoms of hospitalized hematological cancer patients. A cross-sectional study was conducted in the hematology clinics and day units of two general hospitals of Heraklion, Crete. Adult patients with hematological malignancy and an adequate understanding of the Greek language participated. A demographic questionnaire, the European Organization for Research and Treatment for Cancer quality assessment questionnaire (EORTC QLQ-C30), and the MD Anderson Symptom Inventory (MDASI) were used. The sample consisted of 120 patients—42.5% were women, with a mean age of 65.6 years. The mean time from diagnosis was 33 months. The global health status of QoL had an average value of 47.1. The highest levels of QOL were found in the subscale of cognitive function (72.8) and the lowest in the role function (46.1). For the EORTC QLQ-C30 symptoms scale, the lowest score was found in nausea-vomiting (11.0) and the highest in fatigue (59.1). In the MDASI, in part I (core symptoms), higher levels but also medium intensities were reported at fatigue (78.3%, mean 3.5), drowsiness (65.0, mean 3.3), and distress (65.8%, mean 2.8). In part II, enjoyment of life (85.8%, mean 5.1) had the highest, and relation with other people (67.5%, mean 3.7) had the lowest scores. The increase in the severity of the core symptoms (part I) was related to females (rho = 0.193, p <0.05) and comorbidities (rho = 0.220, p < 0.05). It was also associated with a significant decrease in all functional domains and increased fatigue (rho = 0.571, p < 0.05) in the EORTC QLQ-C30 questionnaire. The increased global health status was related to males (rho = −0.185, p < 0.05) and physical functioning with younger age (rho = −0.331, p < 0.05), higher education (rho = 0.239, p < 0.05), fewer months from diagnosis (rho = −0.199, p < 0.05), and low comorbidity (rho = −0.209, p < 0.05). Finally, multiple linear regression analysis revealed that the total average symptom score of the MDASI was the most significant factor influencing the global health status of the EORTC QLQ-C30 (β = −4.91, p < 0.001). The increased global health status of the EORTC QLQ C30 was not significantly related (p > 0.05) to the social characteristics of the patients, such as education or employment, which requires further validation. The QoL of hematological cancer patients significantly decreases during treatments due to a considerable number of symptoms that must be taken into consideration for high-quality, individualized care.

EMDR–Teens–cPTSD: Efficacy of Eye Movement Desensitization and Reprocessing in Adolescents with Complex PTSD Secondary to Childhood Abuse: A Case Series

Background: Mental healthcare for children and adolescents with a history of childhood abuse constitutes a major public health issue. Indeed, abuse exposes children to severe and complex post-traumatic stress disorder (cPTSD) but also to neurodevelopmental and psychological repercussions impacting the developmental trajectory. Trauma-focused care is essential to avoid the chronicization of symptoms and disorders. Objective: The aim of this prospective case series study was to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) on complex post-traumatic symptoms and associated psychiatric disorders in adolescents with a history of abuse. Method: Twenty-two adolescents, aged 12 to 17, who had been abused during childhood were included. All adolescents met ICD-11 criteria for complex PTSD. Subjective measures of PTSD and associated psychiatric disorders were taken before (T0) and after 3 months of EMDR therapy (T1). Results: The average PTSD symptom score on the CPTS-RI significantly decreased from 40.2 to 34.4 after EMDR, indicating improvement in post-traumatic symptoms. A significant decrease in the average depression score (CDI from 18.2 at T0 to 10.6 at T1), anxiety score (R–CMAS from 21.3 at T0 to 13.3 at T1), emotional regulation score (ALS from 29 at T0 to 10.8 at T1), insomnia score (ISI from 18.5 at T0 to T1 of 9.2 at T1), and harmful use of alcohol and drugs score (ADOSPA from 2.3 at T0 to 0.3 at T1) was observed after EMDR therapy, as well as an increase in quality of life (CBCL 4–16 score from 57.9 at T0 to 77.4 at T1). Conclusions: The results of this study are encouraging and suggest that EMDR may be effective in the symptom management reducing post-traumatic symptoms and certain comorbid disorders frequently seen in adolescents who have experienced childhood abuse. Further research is needed on adolescent populations suffering from cPTSD (e.g., randomized controlled trials with control groups and other therapies or evaluating the action of the different phases of the study).

Personality Correlates of Certain Clinical Characteristics of Patients With Psychotic Disorders

Abstract: Our study aimed to link personality traits (Big Five plus proneness to psychotic-like experiences and behaviors, conceptualized as Disintegration) with clinical characteristics (gender, age, density of episodes, average antipsychotic doses, functionality, and symptom scores). We analyzed 137 patients with psychotic disorders (ICD-10: F20–F29) who had at least one psychotic episode, with illness duration ≤10 years, in remission. Canonical correlation analysis revealed that (1) Psychotic fragility (defined by high density of illness episodes, older age, and more severe symptoms) is associated with high Disintegration and Neuroticism; (2) Disorder severity (high antipsychotic doses, dysfunctionality, severe symptoms, younger age) is linked to low Agreeableness and Openness; and (3) Well-functioning patients (better functionality, milder symptoms) are predicted by a resilient personality profile. These findings deepen our understanding of personality–psychopathology relationships.

Depressive Symptoms and Gut Microbiota after Bowel Preparation and Colonoscopy: A Pre-Post Intervention Study.

Mechanical bowel preparation (MBP) is essential for visualisation of the colon during colonoscopy. Previous studies have identified changes in gut microbiota composition after MBP and colonoscopy. Considering the gut microbiota is increasingly implicated in psychiatry, we explored the potential impact of this intervention on mood and the microbiota-gut-brain axis. We conducted a pre-post intervention study in adults, with timepoints of one week before and one month after MBP and colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores. We examined changes in average anxiety, stress, and quality of life scores and gut microbiota composition using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and gut microbiota and conducted post hoc analyses to explore potential effect modifiers. Average depressive symptom scores decreased one month post-procedure compared to baseline (n = 59; adjusted β = -0.64; 95%CI: -1.18, -0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (β = 1.78; 95%CI: 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Reduced alpha diversity, modest effects on beta-diversity, and increases in health-associated genera were observed one month post-procedure. Increases in the CLR-transformed abundances of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. There is preliminary evidence of a potential mental health effect of MBP and colonoscopy, particularly for those with IBS, which may be associated with changes to the gut microbiota. Further research is required to confirm these findings and their clinical relevance.

Effect of Topical (0.03%) Tacrolimus Eye Ointment in the Management of Vernal Keratoconjunctivitis

Background: Vernal keratoconjunctivitis (VKC) is a chronic, severe ocular inflammatory disorder predominantly affecting children and young adults. Current treatments, including antihistamines and corticosteroids, can have significant side effects, particularly with long-term use. Tacrolimus, a macrolide immunosuppressant, has emerged as a promising alternative due to its ability to inhibit T-cell proliferation and cytokine release, key factors in VKC pathogenesis. Objective: To determine the efficacy and safety of 0.03% tacrolimus eye ointment in the management of vernal keratoconjunctivitis compared to standard steroid-based treatment. Methods: This quasi-experimental study was conducted at the Department of Ophthalmology, Pak-Emirates Military Hospital, Rawalpindi, from January 2022 to May 2024. A total of 40 patients (80 eyes) diagnosed with VKC were included. Patients aged 5 to 60 years with bilateral VKC and no prior treatment in the last month were enrolled. Exclusion criteria included concurrent eye infections, use of contact lenses, systemic comorbidities, and previous ocular surgeries. The intervention group received 0.03% tacrolimus ointment twice daily for two months, followed by once daily for two months, and then on alternate days for the final two months. The control group received a combination of 0.1% fluorometholone eye drops, 0.3% tobramycin/0.1% dexamethasone ointment, and 0.1% olopatadine, with steroid tapering after two weeks. Patients were followed up at two weeks, one month, three months, and six months. The primary outcome was the change in symptom and sign scores from baseline to six months. Data were analyzed using SPSS version 25, with statistical significance set at p≤0.05. Results: The median age of the study population was 15.50 years (IQR: 10.00), with 57.4% female. The tacrolimus group showed significant improvement in eye discharge (p=0.033), itching (p=0.004), lacrimation (p=0.008), and foreign body sensation (p=0.015) compared to the control group. The average symptom score decreased more significantly in the tacrolimus group (p<0.001). Clinical signs such as punctate keratitis (p=0.031) and papillae (p=0.018) also showed greater resolution in the tacrolimus group, with a significant reduction in the average sign score (p=0.009). Conclusion: Topical 0.03% tacrolimus eye ointment is an effective and safe treatment for VKC, providing superior symptom relief and clinical improvement compared to standard steroid-based therapy. It offers a promising alternative for long-term management of VKC, with fewer side effects than traditional corticosteroids.

A Tale of 2 Experiences: Navigating End-of-Life Care With a History of Incarceration.

The adverse health effects of incarceration are well-documented, affecting individuals throughout their life course. However, the influence of a history of incarceration on end-of-life (EOL) experiences remains unexplored. This study aims to examine how prior incarceration affects individuals' experiences and care needs as they approach the EOL. Leveraging the Health and Retirement Study, we conducted secondary analyses on 1710 individuals who participated between 2012 and 2018. Through retrospective cohort analysis, we explored the association between incarceration history and EOL care, focusing on pain and symptom burden. Analyses showed that individuals with a history of incarceration experienced significantly higher levels of pain (65% reported "moderate" or "severe" pain) compared tononincarceratedindividuals (50%; adjusted odds ratio = 1.45, 95% confidence interval [CI]: 1.22-1.71, p < .001). Additionally, the symptom burden index revealed that formerly incarcerated individuals had a higher average symptom score (2.8 vs 2.1; β = 0.7, 95% CI: 0.5-0.9, p < .001), indicating a greater range of symptoms in their final year of life. These disparities persisted after adjusting for demographic, health, and socioeconomic variables. This study reveals that a history of incarceration significantly affects EOL experiences, with formerly incarcerated individuals facing higher levels of pain and a greater symptom burden compared tononincarceratedindividuals. This underscores the need for tailored palliative care to address the unique needs of this vulnerable population. This research highlights a critical area for intervention and calls for healthcare systems to adapt their practices to better serve those with incarceration histories.

The Significance of Off-Season Tailor-Made Baseline Measurements in the Assessment of Post-Concussion in University Athletes.

This study aimed to investigate the significance of baseline measurements for amateur team athletes playing contact and collision team sports with a specific focus on the Sports Concussion Assessment Tool (SCAT) to improve concussion management. Symptoms of sports-related concussions (SRCs) can be diverse and long-lasting and include cognitive impairment, sleep disturbances, and vestibular dysfunction. Therefore, comprehensive baseline data are essential to preventing recurrent concussions and secondary injuries. This study was conducted during the 2023 off-season and evaluated the baseline condition of 65 male university rugby players using the SCAT5, which includes self-reported symptoms, and the modified Balance Error Scoring System (mBESS). The athletes were assessed for the presence or absence of SRC, and the mean values were compared using the Mann-Whitney U test. Among the participants, 35.38% (23/65) reported symptoms, with an average of 1.5 ± 2.8 symptoms per player and an average symptom score of 2.66 ± 5.93. In the mBESS, no errors were observed in the tandem stance test; however, 72.31% (47/65) made errors in the single-leg stance test on the non-dominant foot, with an average of 1.7 ± 1.5 errors. Many athletes self-reported symptoms and balance errors, even during asymptomatic periods before experiencing concussion, indicating unresolved issues. In the injury history survey, the baseline evaluations and injury histories of the participants classified into the SRC and non-SRC groups were compared. In the mBESS single-leg stance test (non-dominant foot), 84.21% (32/38) of the SRC group participants made errors, with an average score of 2.13 ± 1.52, whereas 55.55% (15/27) of the non-SRC group participants made errors, with an average score of 1.15 ± 1.35, showing a significant difference (p = 0.007). Additionally, significant differences were observed in the average number of ankle sprains (p = 0.027) and fractures (p = 0.048) between patients with and without a history of SRC. These findings indicate that athletes may have underlying issues even during normal periods before concussion. Moreover, the results highlighted the impact of previous concussions on motor control and injury risk. This underscores the importance of preseason baseline measurements using the SCAT to identify at-risk athletes and implement preventive measures. These findings align with the recommendations of the 6th International Conference on Concussion in Sport and suggest further refinement of concussion assessment tools.

Socioeconomic and gender disparities in depression among elderly Chinese individuals

The positive relationship between socioeconomic status (SES) and health is well established in Western societies. However, while research mainly focuses on SES measures such as education and income, these measures may not completely capture the characteristics of social stratification in China. In the socio-historical context of China, for example, the work unit sector is a crucial SES factor. Yet, few health studies have paid attention to unique SES factors in China. Furthermore, women generally report worse mental health than men, but it is unclear whether this gender gap could be influenced by SES. In this article, using data from the China Health and Retirement Longitudinal Study, we (1) expand SES measures to explore the impact of the work unit sector and use other SES measures, including Communist Party of China (CPC) membership and hukou (household registration) status, to examine the relationship between SES and depression and (2) investigate whether SES could modify the relationship between gender and depression. We find that all the SES measures negatively predict the depression symptoms of elderly individuals. We also find that women on average report higher depressive symptom scores than men. However, the gender differences in depressive symptom scores are smaller among elderly individuals with higher SES than among those with lower SES. We demonstrate that the work unit sector and CPC membership are crucial SES factors affecting the mental health of elderly Chinese individuals. Moreover, we show that the gender gap in depression could vary by SES, suggesting that women might benefit more from obtaining higher SES.

Tonic immobility triggered by COVID-19-related trauma is associated with long-term PTSD symptoms

During the COVID-19 pandemic healthcare workers were repeatedly exposed to traumatic experiences. Facing life-threatening events and repeated exposure to traumatic duty-related situations may cause posttraumatic stress disorder (PTSD). While tonic immobility has been considered a key vulnerability factor for PTSD, little is known about this relationship in the long term. In this study, we aimed to determine whether peritraumatic tonic immobility triggered by COVID-19-related trauma predicts PTSD symptom severity six to twelve months later. We conducted an online longitudinal survey using the PTSD Checklist for the DSM-5 (PCL-5) and the Tonic Immobility Scale to assess PTSD symptoms and the tonic immobility response, respectively. Multivariate regression models revealed a significant association between tonic immobility and PTSD symptoms. Each one-unit increase in the tonic immobility score was associated with a 1.5 % increase in the average PTSD symptom score six to twelve months after the traumatic event that triggered the tonic immobility. Furthermore, participants who showed significant or extreme levels of tonic immobility were 3.5 times or 7.3 times more likely to have a probable PTSD diagnosis, respectively. Hence, peritraumatic tonic immobility seems to have a lasting deleterious effect on mental health. Psychological treatment for health care professionals is urgent, and psychoeducation about the involuntary, biological nature of tonic immobility is essential to reduce suffering.

Effect of Reflexology Massage on Chemotherapy Induced Peripheral Neuropathy in Breast Cancer Patients Receiving Taxanes: A Randomized Controlled Study

Objectives: This study was conducted as a randomized controlled trial of the efficacy of reflexology in reducing chemotherapy induced peripheral neuropathy in breast cancer women receiving taxanes. Methods: The research was carried out at the hospitals' outpatient chemotherapy unit during the period spanning from June 1st to December 30th. Data were assessed using the Chemotherapy- Induced Peripheral Neuropathy Assessment Tool (CIPNAT), Patients' Information on Disease Variables and the Patient Information Form. Analysis was performed by number, percentage, independent t-test, chi-square test and one-way analysis of variance test for repeated measures. Results: The participants were divided randomly into two groups: experimental (n=29) and control (n=29). During the 6-week intervention period, foot reflexology was administered to the experimental group, while the control group followed the clinic's standard protocol. Following the intervention, the average neuropathy symptom scores of the female participants in the experimental group did not increase significantly (p &amp;lt;0.05). Conclusions: The results of this study indicate that the administration of foot reflexology has a positive impact on symptoms of peripheral neuropathy.

Resilience of University Students During the Coronavirus Disease 2019 Pandemic and Results of a Pilot Positive Psychotherapy Intervention Study.

University students were significantly affected by the 2019 coronavirus disease pandemic, with significant impacts on their mental health, resilience skills, and life skills. The primary aim of this study was to evaluate these parameters by focusing on the experiences of 472 university students as well as examining correlations between mental states, resilience, and life skills. The secondary aim was to conduct a pilot study of a 10-week psychoeducation program that uses positive psychotherapy to improve resilience skills. The first phase of this research project was designed as a quantitative and correlative study, while the second phase was designed as a quasi-experimental model. Data collection tools used in the first phase included the Sociodemographic Information Form, Life Skills Scale (LSS), Symptom Checklist (SCL90R), and Brief Resilience Scale (BRS). The Resilience Scale for Adults (RSA) was used in the second phase. The sample group for the first phase was 472 university students from several university institutes in Cyprus, while the quasi-experimental group consisted of 33 psychology students from the University of Cyprus. The average mental symptoms score for students based on SCL90R was 1.10 ± 0.70, showing they have psychological symptoms and grievances. Significant negative correlations were found between the BRS general score and the LSS general and SCL90R scores (all P = .001). The model was found to be significant and could explain 18.5% of the effect according to the predictive status of LSS and SCL90R scores in BRS scores. In conclusion, this study provides vital insights into the mental well-being of university students during the pandemic. The findings reveal a concerning prevalence of psychological symptoms and distress among students, indicating a significant impact of the COVID-19 crisis on their mental health. This research also demonstrated the effectiveness of targeted interventions. The positive changes in resilience skills and reduced mental health symptoms observed after the 10-week study period highlight the importance of proactive approaches. This study underscores the urgent need for accessible mental health resources and tailored support mechanisms for university students, especially during times of crisis. Addressing these issues is crucial for fostering a resilient and mentally healthy student population.

The relationship between depression, anxiety and lower urinary tract symptoms in men

PurposePatients with lower urinary tract symptoms (LUTS) often experience comorbid depression and anxiety, yet the mechanisms underlying this association remain incompletely understood. This prospective study aimed to investigate the relationship between depression, anxiety, and LUTS in men. Materials and methodsA prospective study was conducted with 350 male patients who underwent urologic examinations at our institution from January 2021 to December 2021. Of these, 131 patients meeting the inclusion criteria were included. Various questionnaires, including the International Prostate Symptom Score (IPSS) and the Hospital Anxiety and Depression Scale (HADS), as well as LUTS examinations (prostate-specific antigen test, transrectal ultrasonography, and urine flowmetry), were administered. ResultsAmong the 350 patients, 131 were included in the analysis, with an average age of 58.0 ± 13.69 years. The total IPSS was 18.0 ± 8.69, with the average voiding symptom score at 8.7 ± 5.19 and the average storage symptom score at 6.0 ± 3.27. Both anxiety and depression were found to be correlated with LUTS (P < 0.05). After adjusting for age, hypertension, and diabetes, anxiety (but not depression) was significantly associated with LUTS based on regression analysis. ConclusionMen with LUTS are more likely to experience anxiety. Therefore, it is essential to assess and address anxiety when managing men with LUTS.

(207) Ejaculatory Function After Benign Prostatic Hyperplasia (BPH) in Gay and Bisexual Men

Abstract Introduction Retrograde ejaculation (RE) is a common outcome of surgical treatments for benign prostatic hyperplasia (BPH). Previous qualitative work in the context of prostate cancer has shown that gay and bisexual men (GBM) experience greater bother from loss of ejaculatory function. Ideally, BPH treatment decision-making for GBM who prioritize ejaculatory function would take into consideration their specific needs and outcomes. However, there is no quantitative or prospective data on BPH outcomes in GBM men to inform their care. Objective Our objective was to analyze the characteristics of BPH patients in a urology clinic catered to the needs of GBM in order to fill the gaps in knowledge of BPH outcomes in GBM and improve care. Methods We performed a retrospective review of all GBM patients presenting to an LGBT specialized urology clinic between 9/1/2021 and 4/30/2023. Patients who underwent a procedure for BPH with at least one recorded AUA symptom score were included. Results 24 gay and bisexual BPH patients presenting to the clinic between 9/29/2021 and 4/25/2023 were included. Ages ranged from 32 to 82, with a mean age of 64.23 (SD = 11.43, n=24). The distribution of treatments offered was TURP (n=14), Rezum (n=4) and TUIP (n=1). Of the TURP procedures, 10 were ejaculatory sparing. Four patients received two forms of treatment. Of the 16 patients asked, 14 said ejaculatory sparing mattered to them (Mean age = 67.03, SD = 6.28) and 2 said it did not (Mean age = 77.63, SD = 10.57). The average pre-treatment AUA-Symptom Score for the patients was 20.85 (SD = 6.89, n=13) and average QoL was 4.00 (SD = 1.13, n=12). The average post-treatment AUA symptom score for patients was 8.50 (SD = 5.21, n=8), and average QoL was 1.38 (SD = 1.41, n=8). Conclusions A vast majority of the clinic’s GBM patients place importance on ejaculatory function. Younger GBM placed greater importance on ejaculatory function compared to older men. AUA symptom scores on average were on the low end of severe pre-treatment, with patients feeling mostly dissatisfied with urinary function. Post treatment AUA symptom scores varied but were centered around the low end of moderate, with patients feeling mostly pleased with urinary function. These initial findings from our clinic highlight the need for further prospective research on GBM patient values and outcomes surrounding ejaculatory function. Disclosure No.

FEASIBILITY AND ACCEPTABILITY OF A DEPRESSION AND PAIN INTERVENTION WITH OLDER AFRICAN AMERICAN WOMEN

Abstract Older African American women experience social determinants of health that put them at risk for experiencing comorbid pain and depressive symptoms. The purpose of our study was to tailor a preexisting evidence-based depression intervention to include pain and test it in older African American women. We conducted a randomized waitlist control study with 21 frail or pre-frail, African American women, 50 years of age and older with pain and depressive symptoms. The average age of the participants was 64.8 (SD: 10.5), average pain intensity was 7.0 (SD: 1.9) out of 10, and average PHQ-9 depressive symptoms score was11.9 (SD: 4.0). Effect sizes at 12 weeks post intervention were -1.05 for depressive symptoms indicating a substantial decrease in depressive symptoms. We did not see a significant change in pain intensity but identified changes in pain behavior scores. The women described the intervention as beneficial and provided suggestions for future iterations.

A Novel Intervention to Simultaneously Address the Dual Pathologies of Breathing Disorders During Sleep and Undiagnosed Attention Deficit Hyperactivity Disorder in School-Aged Children Ages 5–12

Purpose: To evaluate the improvement of ADHD related symptoms in school-aged children ages 5 to 12 in treatment with a monobloc appliance (MOA) for Sleep Disordered Breathing (SDB). Methods: A retrospective review of questionnaire scores of ADHD symptoms from school-aged children being treated with a MOA for SDB. Data was obtained from parent survey questionnaires of 40 school-aged children in three dental offices in treatment with an MOA for SDB showing symptoms of ADHD yet to be confirmed with a formal diagnosis between 2019 and 2021. ADHD symptom scores were ascertained by a parent survey questionnaire completed at the initial visit before MOA treatment, and 2 to 6 months, and 7+ months during MOA treatment. Results: At the 7+ month endpoint, 17 of the 28 (61%) children ages 5 to 12 saw at least a 1-point drop in the sum of their questionnaire scores indicating an improvement in ADHD symptoms after initiating treatment with an MOA. Although there was a reduction of the overall average symptom score from the initial visit to 2 to 6 months (M = 4.06, SD ± 1.55), a statistically significant improvement in ADHD symptoms occurred at the 7+ month endpoint (M = 15.29, SD ± 4.50) during MOA treatment. Conclusions: Treatment with an MOA may be highly effective in addressing the dual pathologies of SDB and ADHD in school-age children ages 5 to 12.

US migration history and depressive symptoms among older mexican adults.

To explore the association between US migration, chronic conditions (diabetes, stroke, heart attack, cancer, and hypertension), and mental health (depressive symptoms, and depression). We assessed average changes in depressive symptom scores as well as depression over time and their link with migration experience controlling for health and sociodemographic factors among older Mexican adults (50+) using 2012, 2015, and 2018 waves of the Mexican Health and Aging Study (MHAS). Non-migrants had higher average depressive symptom scores and prevalence of depression (5+ score) in 2012 and 2015, but there was no significant difference in either measure in 2018 or on changes over time. Although there were no significant differences in average depressive symptoms and depression over time by migration history, this study highlights some differences in 2012 and 2015. Comparing groups across migration histories allowed the researchers to examine how life course differences impact mental health outcomes.

The Efficacy of Double-Dose Mometasone Furoate Nasal Spray in Postoperative Management of Nasal Polyps: A Randomized Controlled Trial

Background: Nasal polyps are benign growths of nasal mucosa associated with inflammation and topical nasal corticosteroids are the medical treatment of choice. Surgical removal is indicated for patients not responding adequately to medical treatment. There is little evidence on the efficacy of double-dose mometasone furoate nasal spray and conventional dose to prevent the recurrence of nasal polyps and decrease nasal symptom score following endoscopic sinus surgery. Objective: To compare the efficacy of double-dose mometasone furoate and conventional dose to prevent the recurrence of postoperative nasal polyps. Materials and Methods: The present study was a randomized controlled trial. Thirty patients who met the inclusion criteria were randomly divided into two groups, 15 patients in each group. Group I patients were given mometasone furoate two sprays in each nostril twice a day (400 μg) and Group II received mometasone furoate two sprays in each nostril once a day (200 μg) as a conventional dose for six months. Grading of nasal polyps and nasal symptom score were recorded before and after treatment at the first, second, fourth, twelfth and twenty-four weeks. Results: After six months of the endoscopic sinus surgery, Meltzer clinical scoring system of nasal polyps showed an average score of 0.67±0.72 in the conventional dose, which was significantly reduced to 0.07±0.26 (p&lt;0.01) in the double dose of mometasone furoate. The average nasal symptom score in the conventional dose was 0.70±0.70, which was not significantly decreased to 0.30±0.50 (p=0.25) in the double dose. There were no side effects in both groups. Conclusion: Double-dose of mometasone furoate nasal spray might be recommended for preventing the recurrence of nasal polyps and decreasing nasal symptom score following surgery. Keywords: Nasal polyps; Intranasal corticosteroid; Endoscopic sinus surgery; Mometasone furoate; Recurrent nasal polyps; Nasal spray; Nasal symptom score; Randomized controlled trial; Postoperative management

Acceptability and Feasibility of a Pain and Depressive Symptoms Management Intervention in Middle-Aged and Older African American Women.

The intersection of race, gender, and age puts older African American women at high risk of experiencing comorbid pain and depressive symptoms. The purpose of this study was to assess the feasibility and acceptability of a 12-week behavioral activation intervention to target self-selected goals related to pain and depressive symptoms in middle-aged and older African American women. This randomized waitlist control study included 34 self-identified African American women, 50 years of age or older, with moderate-to-severe chronic pain and depressive symptoms. The intervention consisted of 8 in-person or virtual 1-hour visits with a nurse. Follow-up acceptability assessments were conducted with 10 participants. The average age of the participants was 64.8 (standard deviation [SD] 10.5). They reported an average pain intensity score of 7.0 (SD 1.9) out of 10 and an average Patient Health Questionnaire-9 depressive symptoms score of 11.9 (SD 4.0) at baseline. Of the 34 participants who consented, 28 (82.4%) women started the intervention and 23 (82.1%) completed the intervention. Participants described the study as useful and beneficial. Participants recommended including a group component in future iterations. Effect sizes at 12 weeks were -0.95 for depressive symptoms indicating a substantial decrease in experienced depressive symptoms, but pain intensity was virtually unchanged (+0.09). The findings of this study demonstrate that the intervention is acceptable among middle-aged and older African American women and their personal goals were met. Including a group component and identifying effective ways to decrease attrition rates will be key in the next steps of development for this intervention. It is crucial to provide tailored, nonpharmacological approaches to pain, and depression symptom management in older adult populations who experience inequities in pain and mental health outcomes. This study emphasizes the importance of participant-driven goal-setting interventions.

Evaluation of the Outcome of Osteoarthritis among Patients Undergoing Total Knee Replacement.

To assess the outcome of osteoarthritis among patients undergoing total knee replacement (TKR). One hundred and four subjects with one hundred and fifty-two cemented total knee arthroplasties have been analyzed in the current research. Functional assessment was carried out using the preoperative and postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) score and its five subscales: pain, other symptoms, function in activity of daily living (ADL), function in sport and recreation (Sport/Rec), and knee-related quality of life (QOL). A significant improvement in the KOOS symptom score was seen with score grade changing to excellent from poor. The average postoperative KOOS symptom score occurred to be 89.9198, whereas the mean preoperative KOOS score was 30.7960 with a mean difference of 59.02385. The mean postoperative KOOS pain score was 94.6304 and the mean preoperative KOOS score was 18.4831 with a mean difference of 76.14731. A significant improvement in the KOOS pain score was seen with score grade changing to excellent from poor. Sixty patients of 104 (57.7%) had an excellent satisfaction level with a postoperative range of motion, twenty-eight patients (26.9%) had a good, eleven patients (10.6%) had a fair, and five patients (4.8%) had a poor satisfaction level with a postoperative range of motion. Surgery for a TKR is successful in reducing individuals' pain and restoring their functional ability. Preoperative expectations and KOOS subscale scores are factors in patients' satisfaction, which is determined a year following surgery.