Characteristics Of Symptoms In Patients Research Articles

Symptom burden and clusters during chemotherapy in patients with lung cancer

ObjectiveThis study aims to investigate the distribution characteristics of symptoms in patients with lung cancer during chemotherapy, identify the symptom clusters (SCs) and explore the underlying mechanisms. The findings will provide evidence to assist clinical staff in effectively managing symptoms and SCs.MethodsParticipants were recruited from the Oncology Department of Guang’anmen Hospital, China Academy of Chinese Medical Sciences, between July 2022 and December 2022. The incidence and severity of symptoms were assessed and SCs were identified. Spearman’s correlation analysis was used to examine the correlation between lung cancer-specific SC and routine blood indices.ResultsA total of 169 patients participated in the study. The most prevalent and severe symptom was loss of appetite. Based on the occurrence rate and severity of symptoms, SC extraction was performed for mild, moderate, and severe symptoms, resulting in the identification of five SCs: psycho-emotional SC, chemotherapy-related SC, lung cancer-specific SC, urinary-related SC, and gastrointestinal SC. When only the moderate and severe symptoms were considered, two SCs were identified: chemotherapy-related SC and lung cancer-specific SC. Additionally, the lung cancer-specific SC showed a negative correlation with eosinophils.ConclusionPatients with lung cancer undergoing chemotherapy experience complex and diverse symptoms. A total of five SCs were extracted based on mild, moderate and severe symptoms and two SCs were extracted based on moderate and severe symptoms. The results of the study showed that lung cancer-specific SC was negatively correlated with eosinophils. Future research should focus on developing and refining research tools, methodologies, understanding the pathogenesis, and exploring intervention measures for SCs.

Gastrointestinal manifestations in patients with COVID-19 infection

We are currently facing a major threat to public health, with a significant impact on people's lives, destabilizing societies with a high mortality rate and weakening the economy worldwide. The disease was named coronavirus disease 2019 (COVID-19). As a new infectious disease, it is extremely important to discover its clinical characteristics, especially in the initial stage, in order to help detect and isolate patients earlier and to reduce the spread of the infection. We performed a systematic literature review based on an online search in the PubMed on Jun/13/2020, 19 records were analyzed, 13954 patients were identified. This study aims to review and investigate the characteristics of gastrointestinal symptoms in patients with COVID-19, raise awareness of health professionals and facilitate early recognition as well as appropriate treatment, avoiding the spreading of the disease. In this study, we found that many of the hospitalized patients with the COVID-19 infection had at least one gastrointestinal symptom. Patients with gastrointestinal symptoms like abdominal pain, diarrhea, nausea, vomiting or anorexia deserve special attention, and it is extremely important to understand the nuances of clinical characteristics and prognosis among patients with and without these symptoms.

Health-related quality of life in patients with myalgic encephalomyelitis/chronic fatigue syndrome: an Australian cross-sectional study

BackgroundMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious and debilitating disorder associated with significant disruptions in daily life including. This study aimed to examine the impact of sociodemographic and patient symptom characteristics on health-related quality of life (HRQoL) of Australians with ME/CFS.MethodsSelf-reported data collected from 480 individuals diagnosed with ME/CFS were obtained between August 2014 and August 2018. This cross-sectional survey analysed sociodemographic, symptom characteristics and HRQoL according to the 36-Item Health Survey (SF-36). Multivariate linear regression models were used to determine ME/CFS symptoms associated with eight domains of HRQoL.ResultsReported HRQoL was significantly impaired in ME/CFS patients across all domains compared with the general population. Scores were the lowest for physical role (4.11 ± 15.07) and energy/fatigue (13.54 ± 13.94). Associations with females, higher body mass index (BMI), employment status, cognitive difficulties, sensory disturbances and cardiovascular symptoms were observed in the physical functioning domain. Impaired pain domain scores were associated with high BMI, annual visits to their general practitioner, flu-like symptoms and fluctuations in body temperature. Reduced well-being scores were associated with smoking status, psychiatric comorbidity, cognitive difficulties, sleep disturbances and gastrointestinal difficulties.ConclusionThis study provides evidence that ME/CFS has a profound and negative impact on HRQoL in an Australian cohort.

THE MODEL OF PSYCHOPATHOGENESIS OF NONPSYCHOTIC MENTAL DISORDERS IN PERSONS UNDERGOING THE PROGRAMS OF SYNTHETIC OPIOIDS SUBSTITUTION THERAPY

In order to identify the structural and dynamic characteristics of comorbid non-psychotic psychopathological symptoms in patients on the synthetic opioid substitution therapy program, 100 patients of the narcological dispensary were examined with the help of the Simptom Check List – 90 – Revised. The study used the inclusion and exclusion criteria that are identical to the criteria for participation in the substitution therapy program. The results were distributed to 3 levels, which correspond to the degree of clinical significance of the symptoms: - minimal (discomfort for this reason occurs rarely or does not occur at all, it has a low intensity) - the range of results obtained is from 0 to 0.50; - subclinical (the presence of not frequent, moderately intense discomfort for this reason) - the range of values is from 0.51 to 1.50; - clinical (frequent or persistent high intensity discomfort for this reason) - range of values greater than 1.51. The study found that non-psychotic mental disorders among this group of patients have three stages of development. All groups of symptoms are considered in the context of the three main classes of disorders (patho-affective — anxiety and depression symptoms; pseudo-neurotic — obsessive-compulsive phenomena; psycho-vegetative symptoms and self-perception disorders; and psychoorganic — associative disorders, paranoia and hostility) and two groups of intermediate symptoms (phobic — intermediate between pathogenic and pseudoneurotic and psychotic - intermediate between psychoorganic and pseudoneurotic). Also, according to the results of the assessment of the correlation dynamics of symptom groups, a model of psycho-pathogenesis of non-psychotic mental disorders in people who are on the program of drug addiction substitution therapy was constructed

Influence of Psychological Distress on Characteristics of Symptoms in Patients with GERD: The Role of IBS Comorbidity

A link between gastroesophageal reflux disease (GERD) and psychological distress has been suggested; psychological factors may modulate the characteristics of symptoms. Besides, irritable bowel syndrome (IBS) frequently coexists with GERD so it may be hypothesized that psychological distress in GERD might be an epiphenomenon of IBS comorbidity. Evaluate the association of psychological distress with GERD, the influence of psychological factors on symptoms, whether psychological distress is explained by a subset of GER patients, and if coexistence with IBS would be a surrogate marker. We performed a prospective case-control study. Cases were patients diagnosed with GERD reporting heartburn at least 2 days per week as the main complaint. Controls were matched healthy subjects without or occasional symptoms. All individuals completed a set of validated questionnaires to evaluate GERD and IBS symptoms and psychological distress (SCL-90R). Ninety-two patients and 92 controls were included. Fifty-seven patients and six controls fulfilled Rome II criteria for IBS. Body mass index (BMI), somatization, and IBS were independently related to GERD. Patients with and without IBS were not different in any measure of psychological distress. Characteristics of symptoms did not correlate to psychological measures. Cluster analysis isolated a cluster of nondistressed from distressed subjects. A higher proportion of GERD patients than controls were classified as distressed (29.7% versus 7.7%). No variable (including IBS) distinguished nondistressed from distressed GERD patients, except for sex. Nearly one-third of GERD patients attending a gastroenterologist office are psychological distressed; they cannot be identified by features of symptoms or IBS comorbidity so a specific anamnesis under the scope of a biopsychosocial model is warranted.

Stratification and symptom characteristics of non‐erosive reflux disease based on acid and duodenogastroesophageal reflux

The subgroups and symptom characteristics of non-erosive reflux disease (NERD) based on acid and duodenogastroesophageal reflux may be different in Chinese patients to Western patients. This study aimed to explore the stratification and symptom characteristics of patients with NERD. Patients with typical heartburn and/or acid regurgitation symptoms were enrolled. Each patient filled out a questionnaire. An upper gastrointestinal endoscopy was performed for each patient followed by simultaneous ambulatory 24-h esophageal pH and Bilitec (bilirubin) monitoring. A symptom index (SI) of > or =50% was considered to be positive. Eighty-two consecutive NERD patients were evaluated. Abnormal (NERD pH+) and normal (NERD pH-) 24-h pH tests were found in 24 (29.3%) and 58 (70.7%) patients, respectively. Among 42 NERD pH- patients who reported heartburn symptoms during monitoring, SI was positive in 19 (45.2%) patients (NE-SI+) and negative in 23 (54.8%) patients (NE-SI-). Pathological duodenogastroesophageal reflux (DGER) was found in 43 (52.4%) patients. No significant differences were noted regarding the prevalence of other upper gastrointestinal symptoms, except for acid regurgitation in NERD pH+ and NERD pH- groups. Additionally, no significant differences were seen in the prevalence of other symptoms, except for chest pain, in groups with pathological and normal DGER. The proportion of NERD patients with pathological acid reflux was somewhat lower than that reported in Western countries. The role of DGER in NERD may be important. It is difficult to differentiate whether NERD patients have pathological acid or bile reflux according to symptoms.

Predictors of patient satisfaction

Correlates of patient satisfaction at varying points in time were assessed using a survey with 2-week and 3-month follow-up in a general medicine walk-in clinic, in USA. Five hundred adults presenting with a physical symptom, seen by one of 38 participating clinicians were surveyed and the following measurements were taken into account: patient symptom characteristics, symptom-related expectations, functional status (Medical Outcomes Study Short-Form Health Survey [SF-6]), mental disorders (PRIME-MD), symptom resolution, unmet expectations, satisfaction (RAND 9-item survey), visit costs and health utilization. Physician perception of difficulty (Difficult Doctor–Patient Relationship Questionnaire), and Physician Belief Scale. Immediately after the visit, 260 (52%) patients were fully satisfied with their care, increasing to 59% at 2 weeks and 63% by 3 months. Patients older than 65 and those with better functional status were more likely to be satisfied. At all time points, the presence of unmet expectations markedly decreased satisfaction: immediately post-visit (OR: 0.14, 95% CI: 0.07–0.30), 2-week (OR: 0.07, 95% CI: 0.04–0.13) and 3-month (OR: 0.05, 95% CI: 0.03–0.09). Other independent variables predicting immediate after visit satisfaction included receiving an explanation of the likely cause as well as expected duration of the presenting symptom. At 2 weeks and 3 months, experiencing symptomatic improvement increased satisfaction while additional visits (actual or anticipated) for the same symptom decreased satisfaction. A lack of unmet expectations was a powerful predictor of satisfaction at all time-points. Immediately post-visit, other predictors of satisfaction reflected aspects of patient–doctor communication (receiving an explanation of the symptom cause, likely duration, lack of unmet expectations), while 2-week and 3-month satisfaction reflected aspects of symptom outcome (symptom resolution, need for repeat visits, functional status). Patient satisfaction surveys need to carefully consider the sampling time frame as well as adjust for pertinent patient characteristics.