Changes In Symptom Scales Research Articles

Effect of radioiodine therapy under thyroid hormone withdrawal on health-related quality of life in patients with differentiated thyroid cancer.

To investigate the effect of radioactive iodine therapy under thyroid hormone withdrawal in differentiated thyroid cancer patients on health-related quality of life. Patients who were diagnosed with differentiated thyroid cancer after thyroidectomy were involved in this study. All of them were managed with thyroid hormone withdrawal. Health-related quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and its thyroid cancer module at three different time points. Changes in health-related quality of life were evaluated by Wilcoxon and Kruskal-Wallis tests. Univariable logistic regression analysis was used to determine social-demographic and clinical factors associated with worse health-related quality of life. A total of 99 differentiated thyroid cancer patients were involved in this study. Changes in health-related quality of life at different time points showed that 1month post-radioactive iodine treatment, an improvement in nausea and vomiting, insomnia and appetite loss was observed. Impairments of global health, role, cognitive and social function and problems of discomfort in the head and neck, voice concerns, dry mouth, fatigue, pain, dyspnea, thyroid fatigue, fear, tingling or numbness, joint pain and shoulder function increased after radioactive iodine treatment. Univariable logistic regression analysis demonstrated potential factors associated with worse health-related quality of life. Thyroid stimulating hormone and parathyroid hormone levels were more sensible to changes in functional domain. Patients aged ≥55-year-old, with annual income under ¥50 000, low parathyroid hormone and pT4 tumour stage experienced higher changes in symptom scales after radioactive iodine treatment. After radioactive iodine treatment, differentiated thyroid cancer patients experienced negative health-related quality of life, and most of these impairments might not recover in the short term. Thyroid stimulating hormone and parathyroid hormone levels, annual income and pT tumours stage were independent risk factors for decreased health-related quality of life.

Neural correlates of successful psychotherapy of depression in adolescents

BackgroundWhile major effort has been put in investigating neural correlates of depression and its treatment in adults, less is known about the effects of psychotherapy in adolescents. Given the concordance of the ventral striatum, amygdala, hippocampus and the subgenual anterior cingulate cortex (sgACC) as correlates of depression and their involvement in reward processing, we used functional magnetic resonance imaging (fMRI) during performance of a monetary reward task in an intervention versus waitlist-control design to investigate the clinical and neural effects of cognitive behavioral group therapy (CBT-G). Methods22 medication naïve adolescents with major depressive disorder were scanned before and after five sessions of CBT-G (PAT-I), or before and after five weeks of waiting (PAT-W). Changes in symptom scales were analyzed along with neural activation changes within the amygdala, hippocampus, sgACC and ventral striatum regions of interest (ROI). ResultsPsychometric assessments and ROI activation remained unchanged in PAT-W. In PAT-I, significant reduction in clinical symptoms accompanied significant changes in brain activation within the left amygdala, left hippocampus and bilateral sgACC. In line with previous findings in adults, pre-to-post-activation changes in the bilateral sgACC correlated with pre-to-post and pre-to-follow-up symptom improvement, and individual expressions of sgACC activation before treatment were related to pre-to-follow-up therapeutic success. LimitationsFuture studies should include larger sample sizes. ConclusionsSuccessful group psychotherapy of depression in adolescents was related to signal changes in brain regions previously demonstrated to be reliably linked with successful, particularly pharmacological treatment in adults.

Predictors of successful treatment in patients receiving intra‐articular injections of hylan G‐F 20 or saline for painful first MTPJ OA

Methods One hundred and fifty one participants with first MTPJ OA received an intra-articular injection of 1ml hylan GF 20 or saline. Potential predictors included intervention group, demographics, height weight, BMI, symptom duration and severity, the Foot Health Status Questionnaire (FHSQ), first MTPJ dorsiflexion range of motion and radiographic OA severity (osteophytes and joint space narrowing as individual features in either the dorsal and lateral view, or as a combination, where scores of 2 for any feature in any view was considered ‘definite’ OA). The primary measure was a 15-point change in symptoms scale (range -7‘a very great deal worse’ to +7 – ‘a very great deal better’) at 12-weeks, dichotomised with scores of 3 defined as treatment success. Predictor variables were initially analysed with univariate analyses. Significant variables were than entered into a backward stepwise multivariate logistic regression.

Validation of instruments to measure the symptoms and signs of oral lichen planus

The aim of this study was to validate the visual analog scale (VAS), numeric rating scale (NRS), and change in symptoms scale (CSS) in measuring symptoms of oral lichen planus, and the modified oral mucositis index (MOMI) in measuring the signs of oral lichen planus. Criterion validity, construct validity, and internal consistency reliability were evaluated using data from a randomized, double blind, placebo-controlled clinical trial of curcuminoids in oral lichen planus. Moderate to high correlations were found between VAS, NRS, and CSS. Correlations of symptom scores with clinical signs ranged from minimal to high. Correlation of NRS with clinical signs was stronger than that of VAS with clinical signs. Significant changes from baseline at each follow-up in NRS, VAS, and MOMI scores were seen. The Cronbach alpha for erythema and ulceration scores from the MOMI were 0.66. This study gives some evidence of the validity of NRS, VAS, CSS, and MOMI for use in oral lichen planus. The NRS has better construct validity than VAS, based on higher correlations with clinical signs. Erythema plus ulceration is a better measure than ulceration alone.

Validation of visual analogue scale, numeric rating scale, change in symptoms scale, and modified oral mucositis index for measurement of symptoms and signs of oral lichen planus

Evaluation of the severity and extent of the signs and symptoms of oral lichen planus (OLP) is important for baseline assessment as well as during follow-up to monitor disease progression and treatment responses.

Cluster C personality disorder and recovery from major depression: 24-month prospective follow-up.

We investigated whether Cluster C personality disorder (CPD) is associated with recovery from depression. Changes in symptom scales in 30 patients with MD and CPD were compared with changes in 60 patients with MD alone over a 24-month follow-up period. Recovery of patients with MD and comorbid CPD was inferior to recovery of those with MD alone based on the Hamilton and Beck Depression Inventory (BDI) scales, and the SCL-90 total score. Only 18% of those with MD alone but 47% of those with CPD and MD met the criteria for major depression at the end of the 24-month follow-up. Multiple logistic regression analyses revealed an independent association between the lack of recovery (BDI score > 9 at 24 months) and the presence of CPD (OR 4.9, 95% CI 1.5-16.0). Moreover, the presence of CPD associated with the presence of major depression at 24 months (OR 4.2, 95% CI 1.4-12.2). The presence of CPD hinders the alleviation of depressive symptoms in major depression.

Cluster C personality disorder impedes alleviation of symptoms in major depression

Background: We investigated whether cluster C personality disorder (CPD) is associated with recovery from depression. Methods: The study design was observational. Diagnoses of major depression (MD) and CPD were confirmed by means of the Structured Clinical Interview for DSM-III-R (SCID-I, -II). Changes in symptom scales in 52 patients with MD and CPD were compared with changes in 65 patients with MD alone over a 6-month follow-up period. Results: On the Hamilton Depression Rating Scale and Beck Depression Inventory (BDI) scales, recovery of patients with MD and comorbid CPD was inferior to recovery of patients with MD alone. Findings were similar in relation to several other symptom scales. Of those with MD alone 54% had recovered from their depression, but only 16% of those with CPD and MD (BDI score <10 on follow-up). Logistic regression analysis revealed an independent association between lack of recovery and presence of CPD (OR 7.5, 95% CI 2.6–22.2). Limitations: Study design was observational. Conclusion: The presence of CPD hinders alleviation of depressive symptoms in major depression.