Complaints In Adults Research Articles

Adverse Health Complaints of Adults Exposed to Benzene After a Flaring Disaster at the BP Refinery Facility in Texas City, Texas.

The objective of this study was to assess the adverse health symptoms experienced by adult subjects who were exposed to benzene after a flaring disaster at the BP refinery in Texas City, Texas. A total of 2162 adults aged 18 years or older and exposed to benzene were included. Using the patients' medical charts, we collected and analyzed data on health complaints as well as the patients' serum levels of beta-2-microglobulin and urinary excretion of phenol. A total of 11,368 health symptom complaints were reported in 2162 adults exposed to benzene. Neurological symptoms occurred most frequently (174%), followed upper respiratory symptoms (115%), cough (31%), painful joints (30%), cardiac symptoms (28%), dermatological symptoms (28%), gastrointestinal symptoms (27%), diarrhea (25%), vision symptoms (21%), and nausea/vomiting (19%). Logistic regression analysis indicated that urinary symptoms (R2=0.65) and painful joints (R2=0.44) were positively associated with increasing age in benzene-exposed subjects. Adult subjects exposed to benzene experience a range of adverse health symptoms and an altered profile of urinary phenol, thus indicating they are at high risk of developing serious future health complications. (Disaster Med Public Health Preparedness. 2018;12:232-240).

The impact of interpersonal violence in youth sport on adult psychopathology

IntroductionA recent cohort study in the Netherlands and Belgium showed that 38% of children experienced psychological violence, 11% physical violence, and 14% sexual violence in sport (Vertommen et al., 2016). This study aims to explore the long-term consequences on anxiety, depression and somatic complaints in adults who experienced psychological, physical or sexual violence in the specific context of organized youth sport.MethodsA web survey in a representative sample of adults, prescreened on having participated in organized sport before the age of 18 (n = 4043) was conducted. In this sample, depression, anxiety and somatic problems were assessed using the brief symptom inventory. A generalized linear model was used to quantify the impact of experiencing severe interpersonal violence in sport on psychopathology.ResultsAll three types of severe interpersonal violence (psychological, physical and sexual) were significantly associated with the total score and the subscales of the brief symptom inventory. The effect remains significant after controlling for socio-demographics, as well as disability, sexual orientation, adverse childhood experiences outside sport, recent trauma and family history of psychological problems.ConclusionsExperiencing interpersonal violence against in youth sport is associated with mental health problems in adulthood. This is an important finding to consider in child protection policy in sport.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Emergency department utilization by haemophilia patients in United States.

Patients with haemophilia are prone to medical emergencies. Emergency departments (ED) often do not have a haematologist on-call for consultation. The aim of this study was to determine the utilization of ED by patients with haemophilia. Retrospective review of the 'National ED Database Sample' for years 2006-2013 was performed. Patient and hospital demographics were collected. Hospital charges were projected to national levels using discharge-weighted variables. During the 8-year study period, haemophilia patients made 162 982 ED visits. This represents 0.016% of total ED visits nationwide. Children utilized ED the most. More than half of patients resided in metropolitan cities; 20% had over $63 000 annual household income. Government insurances were the largest primary payers; 30% had private insurance. In the year 2012, 4488 ED visits with 21 000 diagnoses codes were recorded. Mean age was 29 years. Cardiovascular were the most frequently reported complaints followed by injuries, haemorrhages and sepsis. Seventy percent patients were treated and released from the ED. Two patients died in ED, whereas 35 after admission to hospital. Cause of death included Sepsis (n = 26) and brain haemorrhage (n = 4). Among children, injuries were the most frequent complaints followed by joint/soft tissue disorders; fevers and central line complications. Average charge per visit at private vs. public hospital was $2988 and $2254 respectively (P = 0.03). National estimate of total charges was $60 million. Patients with haemophilia have tendency to utilize ED. Hypertension was the single most common presenting complaint in adults. No deaths were reported in children from brain haemorrhage.

Malrotation with midgut volvulus and bowel gangrene in a 45-year-old man

Midgut volvulus due to intestinal malrotation is a rare occurrence in adult life. Malrotation is a congenital, developmental anomaly that results from an arrest of the physiological rotation of the gut through 270°. It is often thought that complications due to it, present themselves early during childhood and rarely occur among adults. However, a few cases have occurred and have been reported among adults. When it does occur in adults, it is often associated with catastrophic consequences. We present the case of a 45-year-old man with malrotation resulting in midgut volvulus. Our patient is a 45-year-old man, who presented with sudden onset of colicky abdominal pain and abdominal swelling of 24 h duration. He had been having recurrent abdominal pain since childhood. Physical examination revealed a patient in shock with markedly distended abdomen and anterior abdominal wall edema. Plain abdominal X-ray showed multiple air-fluid levels with thickened bowel outline. A diagnosis of intestinal obstruction was made. The patient was fully resuscitated and planned for emergency exploratory laparotomy under general anesthesia. Intraoperative findings revealed a 360° clockwise rotation of the small bowel around the mesenteric pedicle of the superior mesenteric artery and vein including about 350 cm of bowel gangrene. Resection and anastomosis were done. The early postoperative period was uneventful. However, he had anastomotic dehiscence on the 5th postoperative day and had to be reoperated but sadly he died 24 h later due to complications of anesthesia. Nonspecific recurrent abdominal complaints in adults of any age should raise suspicion of the possibility of a midgut malrotation or malfixation with or without intermittent volvulus. This case highlights the importance of early diagnosis and treatment.

MEMORY COMPLAINT, COGNITIVE DISORDER, CHRONIC DISEASE AND LIFE HABITS IN ADULTS AND ELDERLY OF A BRAZILIAN URBAN COMMUNITY

MEMORY COMPLAINT, COGNITIVE DISORDER, CHRONIC DISEASE AND LIFE HABITS IN ADULTS AND ELDERLY OF A BRAZILIAN URBAN COMMUNITY

Prevalence of sleep complaints in Colombia at different altitudes

Study objectivesTo determine the prevalence of sleep complaints in adults in Colombia at different altitudes. DesignCross-sectional, population-based and observational study. SettingUrban areas in three cities (Bogotá, Bucaramanga, Santa Marta) located between 15 and 2640 masl. Subjects Over 18 years old. InterventionsEpworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), Berlin questionnaire, STOP-Bang questionnaire and diagnostic criteria for restless leg syndrome (IRLSSG). Measurements and resultsThe overall prevalence of sleep complaints was 59.6% (CI 95%: 57.3; 61.8%). According to the Pittsburgh scale, 45.3% (CI 95%: 43.0; 47.5) required medical assistance. The Berlin questionnaire indicated that 19.0% (CI 95%: 17.3; 20.8%) had a high risk of sleep apnea (OSA) compared to 26.9% (CI 95%: 24.9; 29.0%) according to STOP-Bang. Among the subjects, 13.7% (CI 95%: 12.3; 15.3%) had excessive daytime sleepiness and 37.7% (CI 95%: 35.5; 39.8%) had a restless leg syndrome. When comparing cities, significant differences in the overall frequency of subjects requiring care were found between Santa Marta (higher frequency) and the other two cities. Differences in sleep problem frequency (Pittsburgh) were observed between Bogota (higher frequency) and Bucaramanga and also between Santa Marta (higher frequency) and the other two cities. The high risk of OSA (STOP-Bang) was different between Bogota (higher frequency) and Bucaramanga and also between Santa Marta (high frequency) and Bucaramanga. ConclusionsWe observed a high prevalence of sleep complaints with significant differences among the cities, indicating a need to pay a greater attention to these problems.

Patient-Reported Defecation and Micturition Problems Among Adults Treated for Sacrococcygeal Teratoma During Childhood--The Need for New Surveillance Strategies.

To evaluate defecation and micturition complaints in adults treated for sacrococcygeal teratoma (SCT) during childhood and to identify risk factors for soiling, urinary incontinence, and constipation beyond childhood. Records of patients aged ≥18 treated for SCT during infancy in the Netherlands were retrospectively reviewed. Frequency and severity of soiling, constipation, and urinary incontinence were evaluated using questionnaires designed in line with the Krickenbeck classification. Problems during childhood were compared to outcomes at adult age in part of the cohort. Associations between patient- and disease-related factors with complaints beyond childhood were analyzed with the chi-square test or Fisher's exact test, when appropriate. Of 47 included patients (mean age 26.2 years, SD ±6.5), 49% reported at least one defecation or micturition complaint. Urinary incontinence was present in 30% and had a greater negative impact than soiling (24%). Ten patients (21%) reported constipation; five found this severely bothering. Three patients reported social restrictions due to defecation or micturition complaints (6.4%). While sex and tumor histology were not identified as risk factors, a tumor diameter of >10 cm and Altman type I or type II SCT were associated with constipation during adulthood. One-third of the patients treated for SCT during childhood reported urinary and defecation problems beyond childhood. In only a minority of cases, these led to social restrictions. A greater tumor diameter was associated with a higher risk of constipation during adulthood. Prolonged surveillance strategies are advised for all patients with SCT.

Management of the clinical issue of constipation with abdominal complaints in adults. A national survey of Primary Care physicians and gastroenterologists.

Irritable bowel syndrome and functional constipation represent a relevant and common health issue. However, real-world clinical practice includes patients with constipation who may or may not have other abdominal complaints (pain, bloating, abdominal discomfort) with variable frequency. The goal of the present study was to obtain information on the workload entailed by patients with constipation and associated abdominal complaints, predominant clinical behaviors, education needs, and potential daily practice aids both in Primary Care and gastroenterology settings. The clinical behavior of doctors is generally similar at both levels, despite differences in healthcare approach: use of empiric therapies and clinically guided diagnostic tests, with some differences in colonoscopy use (not always directly accessible from Primary Care). Regarding perceptions, general support and osmotic laxatives are most valued by PC doctors, whereas osmotic laxatives, combined laxatives, and linaclotide are most valued by GE specialists. Furthermore, over half of respondents considered differentiating both diagnoses as challenging. Finally, considerable education needs are self-acknowledged at both levels, as is a demand for guidelines and protocols to help in managing this issue in clinical practice. A strength of this study is its providing a joint photograph of the medical approach and the perceptions of constipation with abdominal discomfort from a medical standpoint. Weaknesses include self-declaration (no formal validation) and a response rate potentially biased by professional motivation.

Fat Mass Is Associated with Foot Pain in Men: The Geelong Osteoporosis Study.

Foot pain is a common complaint in adults. Evidence suggests that body composition is involved in the development of foot pain. However, whether this is the case in men remains unclear because previous studies mainly examined women. The aim of this cross-sectional study was to determine the relationship between body composition and foot pain in men while accounting for important risk factors. Among 978 men (median age 60 yrs, range 24-98) from the Geelong Osteoporosis Study who participated in a followup study in 2006 to 2011, 796 provided responses to questions on health status and foot pain. Foot pain was determined using the Manchester Foot Pain and Disability Index, and body composition was measured using dual-energy x-ray absorptiometry. Of the 796 respondents, 177 (22%) had foot pain. Risk factors for foot pain were age (OR 1.03, 95% CI 1.02-1.04), self-reported depression (OR 2.05, 95% CI 1.30-3.20), decreased mobility (OR 1.54, 95% CI 1.05-2.24), and lower education (OR 1.47, 95% CI 1.03-2.09). Foot pain was associated with body mass index (OR 1.05, 95% CI 1.00-1.10), fat mass (OR 1.02, 95% CI 1.03-1.05), and fat mass index (OR 1.08, 95% CI 1.01-1.15), but not fat-free mass (OR 1.01, 95% CI 0.98-1.04) or fat-free mass index (OR 1.05, 95% CI 0.95-1.15) after appropriate adjustments were made. Fat mass is associated with foot pain in men. These findings complement those in studies that have mainly examined women, and provide further evidence for the relationship between obesity and foot pain.

Efficacy and tolerance of lactitol supplementation for adult constipation: a systematic review and meta-analysis.

BackgroundConstipation is a common complaint in adults. Lactitol is an osmotic disaccharide laxative that increases fecal volume and stimulates peristalsis. In this paper, we present the first meta-analysis on the efficacy and tolerance of lactitol for adult constipation.MethodsWe searched MEDLINE® and Embase, with no date or language restrictions, for studies of lactitol supplementation on adult constipation. A random-effects meta-analysis was performed on pre- to posttreatment changes in stool frequency and consistency with lactitol among all studies, as well as a comparison of efficacy and tolerance outcomes in randomized controlled trials (RCTs) of lactitol versus lactulose.ResultsA total of eleven studies representing 663 distinct patients were included in the final analysis, including five single-arm studies, four RCTs comparing lactitol with lactulose, one RCT comparing lactitol with placebo, and one nonrandomized controlled trial comparing lactitol with stimulant laxatives. Weekly stool frequency was significantly increased with lactitol compared with baseline (standardized mean difference [SMD]: 1.56, P<0.001). Stool consistency also improved over the supplementation period with lactitol (SMD: 1.04, P<0.001). Approximately one-third of patients experienced an adverse event; however, symptoms were generally mild and rarely (5%) resulted in study withdrawal. In RCTs of lactitol versus lactulose, lactitol was slightly more effective than lactulose in increasing weekly stool frequency (SMD: 0.19, P=0.06). No statistically significant differences between lactitol and lactulose were identified in any other efficacy or tolerance outcome. Lactitol demonstrated favorable efficacy and tolerance in individual studies when compared to stimulant laxatives and placebo.ConclusionLactitol supplementation is well tolerated and improves symptoms of adult constipation. The efficacy and tolerance of lactitol and lactulose are similar, with a trend for more frequent stools with lactitol. Limited evidence suggests lactitol is superior to stimulant laxatives and placebo for relieving constipation symptoms.

Queixas musculoesqueléticas em uma Unidade Básica de Saúde: implicações para o planejamento das ações em saúde e fisioterapia

OBJETIVO: O objetivo deste estudo foi analisar a prevalência de queixas musculoesqueléticas em adultos em uma Unidade Básica de Saúde. MÉTODO: Foram avaliados os usuários atendidos na recepção espontânea no período de março de 2010 a maio de 2011. Ao todo, foram estudados 1.023 indivíduos. A caracterização das queixas foi realizada por meio de questionário com dados sociodemográficos e motivo da procura por atendimento. RESULTADOS: Os dados mostraram que a maioria dos usuários pertence ao sexo feminino (71,2%), está na faixa etária de 31 a 60 anos (50,0%), é solteira (31,6%), aposentada (14,2%) e apresenta queixas em vários sistemas (77,1%). O sistema musculoesquelético é o mais acometido (14,4%), representando o segundo motivo de procura por atendimento (31,0%). Analisando as razões de chance de ocorrência de queixas musculoesqueléticas com relação às variáveis estudadas, verificou-se que pessoas com idade entre 40 e 59 anos apresentaram 3,49 (IC95% 2,17-5,57) vezes mais chances de associação com essas dores do que as demais. Não houve associação entre outros sistemas e variáveis. CONCLUSÃO: A alta prevalência de queixas musculoesqueléticas requer um novo olhar de gestores em saúde para o atendimento destas demandas, pensando em incluir o fisioterapeuta na atenção básica para tratamento de dores de menor complexidade.

Fat mass is a predictor of incident foot pain

Foot pain is a common complaint in adults. Increased BMI and fat mass have been linked only to foot pain prevalence. Therefore, a longitudinal study to examine the relationship between body composition and incident foot pain over 3 years was conducted. Sixty-one community dwelling participants from a previous study of musculoskeletal health, who did not have foot pain at study inception in 2008, were invited to take part in this follow-up study in 2011. Current foot pain was determined using the Manchester Foot Pain and Disability Index, and body composition was measured using dual X-ray absorptiometry at study baseline. Of the 51 respondents (84% response rate, 37 females and 14 males), there were 11 who developed foot pain. BMI ranged from underweight to morbidly obese (17-44 kg/m2), mean 27.0 ± 6.0 kg/m2. Incident foot pain was positively associated with both fat mass (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03-1.20) and fat-mass index (OR 1.28, 95% CI 1.04-1.57) in multivariate analysis. Fat mass is a predictor of incident foot pain. This study supports the notion that incident foot pain in overweight individuals is associated with fat mass rather than body mass alone.

Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ≥ 40 Years: A Cross-Sectional Survey in Herne, Germany

BackgroundPain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce.MethodsA cross-sectional survey of a random sample of citizens of Herne, Germany, aged ≥ 40 years was performed. A detailed self-complete postal questionnaire was used, followed by a short reminder questionnaire and telephone contacts for those not responding. The questionnaire contained 66 items, mainly addressing pain of any site, musculoskeletal complaints of any site and of knee and hip, pain intensities, the Western Ontario MacMaster Universities (WOMAC) index, medication, health care utilization, comorbidities, and quality of life.ResultsThe response rate was 57.8% (4,527 of 7,828 individuals). Survey participants were on average 1.3 years older, and the proportion of women among responders tended to be greater than in the population sample. There was no age difference between the population sample and 2,221 participants filling out the detailed questionnaire. The following standardized prevalences were assessed: current pain: 59.7%, pain within the past four weeks: 74.5%, current joint complaints: 49.3%, joint complaints within the past four weeks and twelve month: 62.8% and 67.4%, respectively, knee as the site predominantly affected: 30.9%, knee bilateral: 9.7%, hip: 15.2%, hip bilateral: 3.5%, knee and hip: 5.5%. Pain and musculoskeletal complaints were significantly more often reported by women. A typical relationship of pain and joint complaints to age could be found, i.e. increasing prevalences with increasing age categories, with a drop in the highest age groups. In general, pain and joint pain were associated with comorbidity and body mass index as well as quality of life.ConclusionsOur data confirm findings of other recent national as well as European surveys. The high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany.

High-Grade Adult Isthmic L5–S1 Spondylolisthesis: A Report of Intraoperative Slip Progression Treated with Surgical Reduction and Posterior Instrumented Fusion

Adult isthmic spondylolisthesis most commonly occurs at the L5–S1 level of the lumbar spine. Slip progression is relatively rare in adults with this condition and slippage is typically associated with advanced degeneration of the disk below the pars defect. When symptomatic, radiculopathy is the typical complaint in adults with isthmic spondylolisthesis. When considering options for surgical treatment of adult isthmic spondylolisthesis, the surgeon must consider several different options, such as decompression, fusion, instrumentation, reduction, and type of bone graft to be used. All of these decisions must be individualized as deemed appropriate for each particular patient. This report presents a case of intraoperative slip progression of a L5–S1 adult isthmic spondylolisthesis to a high-grade slip, which was treated with complete surgical reduction and posterior instrumented fusion. This case demonstrates the potential instability of this condition in adults and has not been previously reported. The case details and images are reviewed and the intraoperative decisions, treatment options, and patient outcome are discussed.

Long-term Follow-up of Incontinence and Urge Complaints After Intensive Urotherapy in Childhood (75 Patients Followed Up for 16.2-21.8 Years)

To reassess the incontinence and urge complaints in adults who had undergone inpatient urotherapy during childhood and compare the results with the short-term outcomes. From 1987 to 1990, 95 children (13 boys and 82 girls; age 6-17 years) underwent hospitalized urotherapy to treat functional lower urinary tract symptoms. This group was traced and a questionnaire was administered by telephone. The long-term data on incontinence and urge complaints were compared with the results at 6 months after training. Of the 95 patients, 92 were traced, and a cohort of 75 could be analyzed. At long-term follow-up (mean 17.9 years), of the 75 patients, 63 (84%) had a good, 8 (11%) a moderate, and 4 (5%) a poor outcome. At short-term follow-up, 56 of the current 75 patients had had a good outcome, and at long-term follow-up, 47 of these 56 patients still had a good score. However, during the intervening period, 3 of these 56 patients developed incontinence recurrence and scored a poor result, and 6 others scored a moderate result. Originally, after 6 months of follow-up, 7 patients had had a moderate outcome; 5 of these had improved to good, 1 still scored moderate, and 1 had deteriorated over time to poor. Twelve patients had originally had a poor outcome at short-term follow-up. Of these, 11 had spontaneously improved to good and 1 to moderate. If the original outcomes of pediatric intensive inpatient urotherapy are good, they tend to remain so over time in most patients.

Hearing Loss in Older Adults Affects Neural Systems Supporting Speech Comprehension

Hearing loss is one of the most common complaints in adults over the age of 60 and a major contributor to difficulties in speech comprehension. To examine the effects of hearing ability on the neural processes supporting spoken language processing in humans, we used functional magnetic resonance imaging to monitor brain activity while older adults with age-normal hearing listened to sentences that varied in their linguistic demands. Individual differences in hearing ability predicted the degree of language-driven neural recruitment during auditory sentence comprehension in bilateral superior temporal gyri (including primary auditory cortex), thalamus, and brainstem. In a second experiment, we examined the relationship of hearing ability to cortical structural integrity using voxel-based morphometry, demonstrating a significant linear relationship between hearing ability and gray matter volume in primary auditory cortex. Together, these results suggest that even moderate declines in peripheral auditory acuity lead to a systematic downregulation of neural activity during the processing of higher-level aspects of speech, and may also contribute to loss of gray matter volume in primary auditory cortex. More generally, these findings support a resource-allocation framework in which individual differences in sensory ability help define the degree to which brain regions are recruited in service of a particular task.

A3309, an Ileal Bile Acid Transport (IBAT /ASBT) Inhibitor, Significantly Improved Stool Frequency and Other Constipation-Related Complaints in Adults With Chronic Constipation: Data From an 8-Week, Randomized, Double-Blind, Placebo-Controlled Study

and symptoms while subjects were at their highest dose (last 7 days of treatment period) versus placebo, adjusting for corresponding baseline values. Results. All 30 patients completed the study. 15 pts (7P, 8 PLA) had moderately severe autonomic neuropathy. P was well tolerated; mild-moderate, predominantly cholinergic side effects, were more common (p = 0.07) with P (11pt) than placebo (5pt). Compared to placebo, P accelerated colonic transit (GC24, p = 0.004), increased stool frequency (p = 0.02), reduced stool consistency (p= 0.004), and improved ease of passage (p=0.04). However, no significant treatment effects relative to placebo were detected in gastric emptying or small intestinal transit. Conclusions. P accelerated colonic transit and improved bowel symptoms in constipated patients with diabetes mellitus. Longer studies evaluating the effects of P on symptoms in DM and constipation are necessary. Supported by PO1 DK68055.

Characteristics of Chiropractors and their Patients in Belgium

Objective The purpose of this study is to describe the characteristics, practice characteristics, and opinions of chiropractors and the sociodemographic characteristics and the type of complaint of patients presenting to chiropractors in Belgium. Methods In 2008, all doctors of chiropractic in Belgium (N = 101) were asked to provide personal sociodemographic and practice-specific information via postal questionnaires. The participating practitioners presented written questionnaires to a maximum of 10 consecutive patients to collect sociodemographic and clinical data on the patients. Descriptive analyses were used. Results In total, 80 doctors of chiropractic (79.2%, n = 80/101) participated, providing information on 517 patients. Belgian doctors of chiropractic are predominantly male (75%), have a mean age of 44 (SD = 14) years, and have been in practice for 18 years on average. They typically treat neck and/or low back pain with or without radiating pain (85% of all complaints). Patients have a mean age of 43 (SD = 16.4) years, 54% are female, and most patients are employed (70%). Patients present with musculoskeletal complaints of moderate intensity, averaging 5 on a 0 to 10 numeric rating scale. Chiropractors spend, on average, 36 minutes on a new patient and 15 minutes on follow-up consultations. Diversified technique (93%) is the most often used technique, followed by mechanical-assisted (Activator) spinal manipulative therapy (41%). Ergonomic advice and instruction in exercise therapy are most often used in conjunction with spinal manipulative therapy. Most chiropractors would like to have the legal authority to request diagnostic imaging (87%). Conclusions This is the first study describing doctors of chiropractic and their patients in Belgium. Chiropractors in Belgium primarily focus on the treatment of neuromusculoskeletal complaints in adults, with emphasis on the spine. Patients presenting to the chiropractor consult with musculoskeletal complaints of moderate intensity that moderately affect their activities of daily living.

The Role of Atypical Microorganisms in Chronic Oropharyngeal Phlogosis

The recurrent or chronic “non specific pharyngitis” is one of the most common complaints of adults treated in an outpatient setting and it is a disease without a certain aetiology, but with many probable causes which can be of bacterial or viral nature, but incidence of atypical microorganism infection, such as Chlamydia trachomatis (Ct), Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) is believed to be on the rise. The increase is correlated above all to sexual behavior and to diffusion of new microbiological diagnostic methods, such as PCR. From 840 patients affected by recurrent episodes of chronic pharyngeal phlogosis and examined from 2006 to 2008, we selected 67 patients, 37 women and 30 men. On the basis of molecular and cultural analysis, 85.07% of patients were positive to Ct, and 89.55% were positive to Mollicutes (Mh+Uu), showing a vast overlapping of co-infections of Uu and Mh. Our data indicated a higher rate of infection by atypical microorganism in selected patients affected by chronic pharyngitis. It is important to suspect this aetiology during recurrent chronic pharingitis because patients with these oropharingeal infections, must be considered as carriers and the correct treatment, only possible after exact diagnosis, is above all necessary to prevent fearful complications in other body areas.

Differences in Sleep Complaints in Adults With Varying Levels of Bed Days Residing in Extended Care Facilities for Chronic Disease Management

This cohort study examined differences in perceived insomnia and daytime sleepiness in 67 adults residing in extended care facilities for chronic disease management who had varying levels of bed days. One bed day was defined as spending 24 hours in bed. Planned pairwise comparisons, using Bonferroni adjustment, were made between participants who spent 0 (n = 21), 2 to 4 (n = 23), and 5 to 7 (n = 23) days in bed during 1 week of monitoring. Participants who spent 5 to 7 days in bed had significantly greater insomnia than those who spent 2 to 4 days in bed. No group differences were found in daytime sleepiness. Based on the findings, nurses may assess subjective insomnia and explore sleep hygiene strategies, such as increasing time out of bed with patients who have high levels of 5 to 7 bed days.