Dysfunction Symptoms In Patients Research Articles

Endoscopic Sinus Surgery Significantly Reduces Eustachian Tube Dysfunction Symptoms in Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

(1) Background: Eustachian tube dysfunction (ETD) is a frequently observed clinical manifestation of chronic rhinosinusitis (CRS). This systematic review aimed to evaluate the function of the Eustachian tube following endoscopic sinus surgery (ESS) in adult CRS patients with confirmed preoperative ETD symptoms. (2) Methods: A systematic search of PubMed, Cochrane, Embase, and MEDLINE electronic databases was conducted. The review was performed following the PRISMA guidelines. Studies investigating concurrent ETD in CRS patients who underwent ESS were retrieved. The changes in ETD outcomes were measured by the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7). We employed a random-effects model to conduct the meta-analysis (3) Results: We included seven observational studies that involved a total of 436 CRS patients with concurrent ETD. The pooled results revealed a statistically significant reduction (Standardized mean difference = −1.24; 95% CI = −1.64 to −0.84) in ETDQ-7 scores among the CRS with ETD patient cohort at the 3-month postoperative follow-up. (4) Conclusions: ESS serves as an effective intervention for improving E-tube function in adult CRS patients with concurrent ETD. Future prospective randomized controlled trials that incorporate various outcome predictors should be conducted to explore potential clinical factors for greater ETD improvement and normalization after ESS.

Validation of Polish version of Gastrointestinal Dysfunction Scale for Parkinson's Disease.

The Gastrointestinal Dysfunction Scale for Parkinson's Disease (GIDS-PD) is a novel, disease-specific self-report questionnaire used to quantitatively assess features of gastrointestinal dysfunction symptoms in patients with Parkinson's Disease. The aim of this paper was to validate the Polish translation of the scale, to summarise its consistency with the English language version, and to assess its clinimetric properties. Gastrointestinal dysfunction is a common and often debilitating manifestation of Parkinson's Disease (PD). Gastrointestinal symptoms are also considered to be prodromal features of this disease. To date, there has been no scale in Polish that has precisely assessed gastrointestinal symptoms in patients with PD. The GIDS-PD was translated into Polish by two investigators (M.K. and J.N.). A back-translation was completed by two separate investigators (M.F. and A.A.) who were not involved in the original translation. Afterwards, 10 Polish PD patients underwent cognitive pre-testing. After the final translation was officially approved by the Movement Disorder Society, it was tested on 64 individuals with PD during field testing. For the purpose of testing scale reliability, 20 of the patients recruited for field testing underwent the GIDS-PD for a second time after 8-12 weeks. The GIDS-PD demonstrated overall good consistency (Cronbach's alpha of 0.74, ICC of 0.74). Regarding the individual domains, the constipation subscore demonstrated good reliability, the bowel irritability subscore demonstrated moderate reliability, and the upper GI subscore demonstrated poor reliability. Upper GI symptoms seem to be less pronounced, and also more varied, in the Polish PD population than in its English language counterpart. This paper provides a validated Polish translation of the GIDS-PD questionnaire. We highly recommend using the GIDS-PD for research purposes, as well as everyday clinical practice in the Polish PD population.

O065 Autonomic Dysregulation During Sleep in Parkinsonian Spectrum Disorders

Abstract Introduction Symptoms associated with autonomic nervous system dysfunction are common to patients with neurodegenerative disorders (NDD) resulting from the accumulation of α-synuclein in the neurons and glial cells. In this study we investigate whether a novel biomarker, the autonomic activation index, can discriminate these potentially affected NDD groups. Methods After ethics review and with informed consent, patients with Lewy body disease (DLB/PDD: n=20%), Alzheimer’s disease dementia (AD: n=27), Parkinson disease (PD: n=14), mild cognitive impairment (MCI: n=37), isolated REM sleep behavior disorder (iRBD: n=15) and a control group (CG: n=58) were studied with the Sleep Profiler. AAI was based on a 6 BPM increase in pulse rate compared to the previous/subsequent 10th second. Between-group comparisons were assessed with Mann-Whitney U and Chi-square tests. Results The AAI values for the DLB/PDD patients were decreased compared to the AD, MCI (both p<0.03), and CG (p<0.0005), while the PD was less than AD and MCI (both < 0.05) and CG (p<0.002). The proportions of cases with abnormal AAI values (<10 events/h) was greatest in DLB/PDD patients, and greater than in ADem (p<0.02), MCI (p<0.02) and CG (p<0.0001), while AAI in PD and iRBD was greater than in CG (p<0.007 and 0.05 respectively). Conclusions These findings suggest that the AAI can be used to objectively confirm subjective complaints of autonomic dysfunction symptoms in patients with synucleinopathies. Longitudinal studies are needed determine factors that influence changes in the AAI.

Racial and Ethnic Differences in the Severity of Sexual Dysfunction Symptoms in Patients with Multiple Sclerosis

Racial and Ethnic Differences in the Severity of Sexual Dysfunction Symptoms in Patients with Multiple Sclerosis

Continuous positive airway pressure therapy in obstructive sleep apnoea patients with erectile dysfunction-A meta-analysis.

Erectile dysfunction (ED) with obstructive sleep apnoea (OSA) is a relatively common issue for men. A number of clinical studies have demonstrated that continuous positive airway pressure (CPAP) therapy may effectively alleviate ED symptoms from patients with OSA. PubMed, MEDLINE, EMBASE and Cochrane Library databases were utilised and searched for the relevant studies up to September 2, 2019. The International Index of Erectile Function 5 (IIEF-5) scoring system from the patients before and after receiving their CPAP therapy were collected according to the strict inclusion and exclusion criteria. REVMEN 5.3 software was applied for the meta-analysis. A total of seven publications consisted of 206 ED patients with OSA were included in the study. ED patients with OSA received CPAP treatment were significantly improved based on the IIEF-5 scores [Weighted Mean Difference (WMD) = 1.14, 95% confidence interval (CI) = 0.89-1.38, z =9.09, p < 0.0001].Our research found that the high heterogeneity is mainly due to Zhang's data, with a higher apnoea-hypopnea index (AHI) compared to the other included studies. A moderate heterogeneity (I2 = 54%, P = 0.05) was found after removal of Zhang's data. The results suggest that continuous positive airway pressure therapy relive erectile dysfunction symptoms in patients with obstructive sleep apnoea. However, further evidence is needed due to the insufficient number of included patients and high heterogeneity.

Cognitive dysfunction profile in a sample of Egyptian patients experiencing major depressive disorder

Aim The aim was to study the profile of cognitive dysfunction in a sample of Egyptian patients experiencing major depressive disorder (MDD), during the relapse phase. Patients and methods Certain cognitive functions (types of attention, short-term memory, processing speed, verbal fluency, and executive functions) were assessed in 30 Egyptian patients diagnosed as having MDD compared with 30 controls. Results There was no statistically significant difference between MDD group and control group regarding scores of digit forward test. Patients’ mean scores of digit backward test, digit symbol test, and semantic fluency test were significantly lesser than the control group’s mean scores of the same tests. On the contrary, patients’ mean scores of trail making test (A and B) were greater significantly than control group’s mean scores of the same tests. Age, duration of education, age at illness onset, number of hospitalizations, and Hamilton score were significantly correlated with impairment of some areas of cognitive functions. Sex, employment, duration of illness, number of previous episodes, and receiving antidepressant medications were not related or correlated with cognitive dysfunction. Increase severity of illness, detected by high Hamilton score, and to a lesser extent, number of hospitalization and duration of education were significant independent predictors for poor performance of the tested cognitive fuctions. Conclusion Selective attention, divided attention, short-term memory, processing speed, verbal fluency, and executive functions are significantly affected in MDD. This can explain the patients’ clinical complaints of difficulty in concentration, easy forgetfulness, and impaired decision making. On the contrary, sustained attention is not affected in patients with MDD. Therefore, the ruminated negative thoughts and memories are manifest complaints in these patients. Severity of illness is the most important predictive factor for discovering cognitive dysfunction symptoms in patients with MDD. Age and age of illness onset are positively correlated with poor cognitive performance; however, they are dependent predictors.

The prevalence of Eustachian tube dysfunction symptoms in patients with chronic rhinosinusitis

While Eustachian tube dysfunction (ETD) is a known comorbidity of chronic rhinosinusitis (CRS), the prevalence of ETD symptoms in the CRS population is poorly understood. We sought to determine the cross-sectional prevalence of ETD in patients with CRS using the validated Eustachian Tube Dysfunction Questionnaire (ETDQ-7) and to correlate ETDQ-7 scores with 22-item Sino-Nasal Outcome Test (SNOT-22) scores, endoscopy scores, and computed tomography (CT) scores. A total of 101 patients with confirmed CRS completed the ETDQ-7 and SNOT-22 at their initial visit to our rhinology clinic. Lund-Mackay CT and Lund-Kennedy endoscopy scores were also obtained. Spearman's correlation coefficient (ρ) was calculated. Among the 101 patients, 49 patients (48.5%) had an ETDQ-7 score of ≥14.5, signifying clinically significant ETD. The mean ± standard deviation (SD) ETDQ-7 score of the entire cohort was 17.8 ± 10.1. There was a moderately strong correlation between ETDQ-7 and the SNOT-22 ear subdomain (ρ = 0.691, p < 0.001). The correlation coefficient between ETDQ-7 and total SNOT-22 scores was ρ = 0.491 (p < 0.001), indicating moderate correlation. ETDQ-7 scores were poorly correlated to objective measures of sinonasal disease, including Lund-Mackay CT score (ρ = -0.055, p = 0.594) and Lund-Kennedy endoscopy score (ρ = -0.099, p = 0.334). Symptoms of ETD are highly prevalent among patients with CRS as documented by patient-reported outcome measures. The correlation between ETDQ-7 scores and SNOT-22 ear subdomain scores is moderately strong, while the correlation between ETDQ-7 scores and SNOT-22 scores is moderate. ETD severity does not correlate with CT score or nasal endoscopy score.

Eustachian tube dysfunction symptoms in patients treated in a tertiary rhinology clinic.

Ear symptoms are common among patients presenting to a rhinology clinic. Validated inventories are available for patient quality-of-life in sinonasal disease and Eustachian tube dysfunction (ETD). This study sought to determine the extent of ETD symptoms, using validated metrics, in a large population of patients presenting to a tertiary rhinology clinic. Seven-item Eustachian Tube Dysfunction Questionnaires (ETDQ-7) and 22-item Sino-Nasal Outcome Tests (SNOT-22) were prospectively collected from 492 patients treated in a tertiary rhinology clinic. Patient diagnoses were retrospectively determined from the medical record. Correlation between reported SNOT-22 and ETDQ-7 scores were analyzed, in addition to the number of patients meeting the criterion score for ETD. A total of 213 patients reported mean ETDQ-7 scores >2.1, consistent with a diagnosis of ETD. Overall SNOT-22 scores were strongly correlated with ETDQ-7 scores (r = 0.679, p < 0.001). The SNOT-22 ear subdomain was very strongly correlated with the ETDQ-7 score (r = 0.847, p < 0.001), while there was a moderate correlation with the SNOT-22 rhinologic subdomain (r = 0.486, p < 0.001). Patients with allergic fungal sinusitis had decreased ETDQ-7 scores compared to patients with other rhinologic diagnoses (p = 0.010). Symptoms of ETD are common in patients treated in a rhinology clinic, with 43.3% of patients reporting symptom scores consistent with a formal diagnosis of ETD. Increased SNOT-22 scores are correlated with increased ETDQ-7 scores, even when only the SNOT-22 rhinologic subdomain is considered. Patients presenting for treatment of rhinologic symptoms likely have an increased prevalence of otologic symptoms and ETD.

Эффективность клинического применения тамсулозина при симптомах нижних мочевыводящих путей у пациентов с распространенным раком предстательной железы

From the moment of their first use to the present day, -adrenoblockers remain the most popular medication in urology. Indications for their clinical use for various pathological conditions are constantly expanding. To compare the efficacy of androgen deprivation therapy (ADT) alone and ADT with concomitant use of tamsulosin in treating lower urinary tract symptoms (LUTS), and to estimate the efficacy and safety of tamsulosin in relieving voiding dysfunction symptoms in patients with advanced PCa treated for 6 months. This paper presents data from a randomized, open, single-center trial that evaluated the efficacy and safety of tamsulosin co-administered with ADT for LUTS in patients with advanced prostate cancer. The study comprised 50 people aged below 75 years. In the first group of patients (n=25), ADT was used as a monotherapy, in the second group (n=25) ADT with concurrent administration of the -adrenoblocker. The duration of treatment was 6 months. Both groups showed an improvement in the severity of LUTS, decrease in the total I-PSS score and residual urine volume and increase in the urinary flow rate. At the same time, co-administration of ADT and -adrenoblocker resulted in greater and faster relief of LUTS than using ADT alone. There were no significant side effects in any of the groups. Co-administration of ADT and the -blocker is an effective and safe treatment for advanced prostate cancer in patients with LUTS.

Muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction.

The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD). Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97) participated in this study. Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC) of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF%) revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P < 0.0000). The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

Prevalence of parafunctional habits and temporomandibular dysfunction symptoms in patients attending a tertiary headache clinic

To investigate the most prevalent forms of headache in a tertiary outpatient service, and to assess the frequency of associated parafunctional habits and temporomandibular dysfunction symptoms (TMD). All new patients referred to the Headache Outpatient Service in UNIMES during 2008 were prospectively assessed by the neurologist and the dental surgeon. Eighty new patients were assessed; chronic migraine and episodic migraine without aura were the most prevalent conditions, accounting for 66.3% of all cases. There was significantly higher use of analgesics/days for the chronic migraine patients. The prevalence of parafunctional habits was 47.5% and the prevalence of TMD symptoms was 35%. The high prevalence of primary headaches, parafunctional habits and TMD symptoms and the inadequate use of analgesic drugs suggest that primary healthcare units need further training in the field of headache and orofacial pain.

Sexual dysfunctions among people living with AIDS in Brazil

INTRODUCTIONSexual dysfunction symptoms in patients with HIV have not been fully investigated in Brazil.OBJECTIVESTo investigate the association between sexual dysfunction symptoms and AIDS among participants in the Brazilian Sex Life Study.METHODSThe Brazilian Sex Life Study is a cross-sectional population study. The participants answered an anonymous self-responsive inquiry. It was applied to a population sample in 18 large Brazilian cities. Answers given by those who reported having AIDS (75) were compared with those who reported not having AIDS (control; 150). This was a case-control study nested in a cross-sectional population study.RESULTSIn females, AIDS was associated with “sexual inactivity over the last 12 months” and “does not maintain sexual arousal until the end of the sex act” (P < 0.05) after adjusting for race and thyroid disease. Compared to the control group, men with AIDS had more difficulty becoming sexually aroused (they required more help from their partner to begin the sex act, they required longer foreplay than they wished, they reported losing sexual desire before the end of the sex act, and they required longer to ejaculate than they desired) (P < 0.05). After adjusting for sexual orientation, sex hormone deficiency, depression, and alcoholism, only “does not have sexual desire,” “have longer foreplay,” and dyspareunia were associated with AIDS.DISCUSSION AND CONCLUSIONSThe results support the hypothesis that sexual dysfunctions are associated with AIDS. Men with AIDS need more time and stimulation to develop a sexual response, and a significant portion (37%) of women with AIDS reported sexual inactivity over the last 12 months.

Mandibular dysfunction symptoms in orthodontically treated patients ten years after the completion of treatment.

The study was based on 23 patients aged between 24 and 28 years who had undergone extensive orthodontic treatment 10 years earlier and were investigated for symptoms of temporomandibular dysfunction. The investigation was carried out according to a standardized schedule which has been described by Carlsson and Helkimo (1972) and Helkimo (1974). The results presented by Helkimo (1974) were used as a standard of reference. The prevalence of mandibular dysfunction symptoms is consistently lower than the reference values. No association between extensive tooth movement and the occurrence of symptoms could be discerned, but a tendency to a higher prevalence of symptoms in patients treated with fixed appliances in both jaws than in those treated with fixed appliances in the upper jaw only was noted. There seems little reason to fear an increased occurrence of mandibular dysfunction symptoms in patients subjected to orthodontic treatment. Special attention should be paid, however, to the torque on the molars, in order to avoid mediotrusive interferences.