Evaluation Of Symptoms Research Articles

P0896 A double-blind, randomized, placebo-controlled, single-center, pilot study evaluating the efficacy of a synbiotic formulation in modulating gut microbiota biodiversity in patients with mild-to-moderate UC in clinical and endoscopic remission

Abstract Background Intestinal dysbiosis is considered a key factor in the pathogenesis and disease progression of Ulcerative Colitis (UC). Probiotics, prebiotics, and synbiotics are promising strategies for microbiota modulation and could play a role as "add-on" therapies to available drugs. Our primary aim was to characterize the ability of a synbiotic containing Boswellia, Quercetina, Bromelina, Vit. D3, Lactobacillus rhamnosus GG, Inulin, FOS, and Tryptophan in modulating fecal microbiota composition, maintaining disease remission, and controlling the quality of life in patients with Ulcerative Colitis in clinical and endoscopic remission. Methods In our double-blind single-center proof-of-concept study, 26 UC patients in clinical and endoscopic remission were enrolled and randomly divided into 2 treatment arms. One group was treated with 5-ASA + placebo and the other with the synbiotic + 5-ASA for a period of 6 months. At baseline and after 6 months disease activity was assessed through the clinical and endoscopic Mayo Score, while quality of life was evaluated through the Psychological General Well-Being Index (PGWBI) and the Gastrointestinal Symptom Rating Scale (GSRS) scores. 16S rRNA gene sequencing was used to analyze gut microbiota composition at both time points. Results At microbial analyses, the Mann-Whitney test applied on the Shannon-Weiner, Simpson, and Chao1 indices did not reveal any statistically significant difference after 6 months compared with baseline. Also, the PERMANOVA test applied on the distance matrix calculated with the Bray Curtis and Unweighted Unifrac algorithms did not show statistically significant dissimilarities between the two time points. At disease evaluation at baseline, overall only 4 patients (15%) had a Full Mayo Score (FMS) of 1, while all the others had FMS = 0. After 6 months of follow-up, 3 patients experienced a flare with an FMS ≥ 2, and 4 patients (21%) had a worsening of the Mayo endoscopic subscore from 0 to 1. In this scenario, no significant differences were registered between the two groups of patients. At quality of life evaluation, patients treated with the synbiotic experienced a significant improvement in both the psychological/general well-being and gastrointestinal symptoms scores compared with baseline and placebo-treated group. No adverse events were registered. Conclusion Our proof-of-concept study shows that the treatment with this synbiotic formulation used in addition to 5-ASA can improve both psychological and gastrointestinal symptoms in patients with UC while maintaining their clinical and endoscopic remission. No direct effects have been observed on gut microbiota modulation. Further investigations are underway to confirm these findings.

Evidence of Rapid Infection of Four Sweetpotato Potyviruses in a Commercial Field in California.

Sweetpotato (Ipomoea batatas Lam.) is grown worldwide and is a staple food in many countries. One of the main constraints for sweetpotato production is cultivar decline, caused by the accumulation of viruses and subsequent losses of storage root yield and quality over years of vegetative propagation. Virus indexing using diagnostic molecular techniques is essential for the detection and identification of the major viruses to avoid cultivar decline, but little information is available on the fate of clean (virus-tested) plant materials after field propagation. In this study, cuttings of three sweetpotato cultivars (Beauregard, Bellevue, and Vermillion) were acquired from a clean propagative material program and planted in commercial field plots in Merced County, California, over multiple growing seasons. In 2021 and 2022, the phytosanitary status of storage roots from different generations of the materials were assessed by reverse transcription quantitative PCR (RT-qPCR) at harvest at the Foundation Plant Services, University of California, Davis. The results showed their rapid infection with four major potyviruses-sweet potato feathery mottle virus, sweet potato virus 2, sweet potato virus C, and sweet potato virus G-over the two seasons. The infection by two to four potyviruses was confirmed by RT-PCR, RT-qPCR, high-throughput sequencing, and biological indexing onto Ipomoea setosa plants for symptoms evaluation.

An exceptionally rare case of a giant parathyroid adenoma with carcinoma-like presentation.

Giant parathyroid adenoma (GPA) is an extremely rare cause of primary hyperparathyroidism (PHPT) and may sometimes mimic parathyroid carcinoma (PC). Parathyroid carcinoma is also a very rare entity. Both preoperative and postoperative diagnosis of the two conditions remains a challenge. The purpose of this article is to present the diagnostic and therapeutic approach used for a 76-year-old female patient with a GPA measuring 5.4 × 2.3cm, mimicking PC. The patient was referred to our clinic for the management of severe hypercalcemia revealed during the neurological evaluation of psychiatric and cognitive symptoms, confusion, weakness, and bone pain. PHPT was confirmed based on the patient's biochemical profile, which showed extremely high levels of serum calcium and parathyroid hormone (PTH). Wholebody computed tomography revealed a large nodule below the inferior pole of the right lobe of the thyroid gland and no further pathology in other organs. En bloc resection of the tumor with removal of the ipsilateral hemithyroid and other involved tissues was performed. Histopathological evaluation was diagnostic for a GPA. Post-surgery hungry bone syndrome (HBS) developed and was treated. However, the patient succumbed 3 weeks later due to septic shock. GPA is an exceptionally rare endocrine tumor that should be suspected along with PC in patients with significantly elevated levels of PTH and calcium, and/or palpable neck mass. In our case, diagnosis was based principally on histopathological examination together with clinical presentation, biochemical profile, and imaging studies. Resection of the tumor remains the treatment of choice.

A randomized controlled trial: Effects of compression therapy combined with exercise on chemotherapy-induced peripheral neuropathy in patients with breast cancer.

To investigate the effects of compression therapy combined with exercise for cancer patients (EXCAP) in patients with peripheral neuropathy caused by breast cancer chemotherapy. Overall, 108 patients with peripheral neuropathy after chemotherapy for breast cancer were randomly divided into the control group (routine nursing), experimental group 1 (compression therapy), and experimental group 2 (compression therapy and EXCAP). The National Institute of Cancer Drug Toxicity Rating Scale and the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool were assessed and compared between groups. The incidence of grade 0 peripheral neuropathy in both experimental groups was higher than that in controls (P < 0.001), and the incidence in group 2 was higher than that in group 1 (P < 0.001). The incidence of grade 2 disease in both experimental groups was lower than that in controls (P < 0.001). The rate of symptoms in both experimental groups after the intervention were lower than that in the control group (P < 0.001), and those in experimental group 2 were lower than those in experimental group 1 (P < 0.001). Scores regarding activities of daily living in the experimental groups were lower than those of the control group (P < 0.001), and lower in group 2 than in group 1 (P < 0.001). Compression therapy and EXCAP can effectively reduce the incidence of chemotherapy-induced peripheral neuropathy in patients undergoing breast cancer chemotherapy. They can both positively impact patients' daily lives and symptom experiences; however, they are more effective when combined.

Efficacy of Using Photobiomodulation Therapy in Allergic Rhinitis: A Placebo-Controlled Randomized Clinical Trial.

Recent studies have extensively explored new non-invasive and side-effect-free therapeutic strategies for the treatment of allergic rhinitis (AR). Photobiomodulation therapy (PBMT) utilizes photons from the red to infrared spectrum to modulate biological processes, exhibiting anti-inflammatory and regenerative properties. The objective of our study was to evaluate the efficacy of PBMT in patients with AR. This study was a randomized, placebo-controlled, double-blind clinical trial involving 62 patients with AR. Participants underwent PBMT twice weekly, totaling eight sessions over the course of 1 month. The control group consisted of 29 patients who received treatment with a non-light-emitting device, while 33 patients in the laser therapy group received a protocol of 6 J of red and infrared light administered intranasally, along with 1 J of infrared light applied externally to the nose. Objective, psychophysical, and subjective assessments of nasal obstruction and olfactory function were conducted both before and after the treatment. PBMT contributed to significant improvements in various nasal and respiratory parameters. The peak nasal inspiratory flow demonstrated significant improvement (p < 0.001), and the Nasal Obstruction Symptom Evaluation scale indicated notable enhancement in nasal obstruction (p = 0.048). Additionally, the Rhinitis Control Assessment Test reflected significant symptom improvement over the past week (p = 0.035). However, the University of Pennsylvania Smell Identification Test showed no significant change in olfactory function (p = 0.251). Our data suggest that PBMT may serve as a promising therapeutic option for individuals with AR, providing an alternative for those who are unable to tolerate conventional medications. Furthermore, it demonstrates efficacy and safety as a viable treatment alternative.

Temperature-Controlled Radiofrequency Treatment of the Nasal Valve in Patients With Nasal Obstruction: Long-Term Outcomes.

To evaluate the efficacy, safety, and durability of temperature-controlled radiofrequency (TCRF) treatment of the nasal valve in patients with severe or extreme nasal airway obstruction (NAO). A long-term, prospective, multicenter, single-blind, randomized controlled trial. Sixteen otolaryngologic clinics and academic centers. Patients received TCRF treatment on the lateral nasal valve. All patients were followed through 3 years. Outcome measures included the Nasal Obstruction Symptom Evaluation (NOSE) Scale, Epworth Sleepiness Scale (ESS), and adverse events (AEs). Treatment responders were defined as a ≥1 reduction in severity class or ≥20% reduction in NOSE score. Out of 108 patients who received TCRF treatment, 54 reached the 3-year follow-up timepoint. The baseline mean NOSE score was 76.3 (95% confidence interval [CI], 73.6 to 79.1). The 3-year NOSE score treatment effect was -49.4 ([95% CI, -56.5 to -42.4]; P < .001) a 64.7% improvement from baseline; 88.7% of patients were responders. Most patients reported significant improvements in sleep post-treatment with a mean ESS score of 4.5 (95% CI, 3.4 to 5.7) at 3 years compared to 10.3 (95% CI, 9.2 to 11.4) at baseline. Treatment with the TCRF device for nasal valve obstruction resulted in sustained improvements in nasal obstruction symptoms and sleep quality over a 3-year period without any serious AEs. These findings support the long-term benefits and sustained improvements in symptoms in patients with NAO.

Effects of Pickleball Intervention on the Self-Esteem and Symptoms of Patients with Schizophrenia.

Background: Schizophrenia is classified by the World Health Organization (WHO) as one of the top ten diseases contributing to the global medical economic burden. Some studies have pointed out that exercise is effective for physical and mental health, as well as cognition. We hypothesized that participation in pickleball intervention would lead to improved self-esteem and reduced psychiatric symptoms in schizophrenia patients. Method: We recruited participants with schizophrenia from a long-term care facility and a regional hospital, dividing them into two groups based on the institutions. The experimental group underwent a nine-week pickleball exercise intervention, with sessions three times a week, each lasting 90 min, and a Dink ball test was conducted weekly. Questionnaires on self-esteem and the short-form health survey were collected both before and after the intervention. Result: This trial included 30 patients, divided equally into the experimental group (n = 15) and the control group (n = 15). After the nine-week pickleball intervention, there were no significant differences between the experimental and control groups in the Rosenberg Self-Esteem Scale (RSES) (p = 0.153) or the Brief Symptom Rating Scale (BSRS-5) (p = 0.289). However, the Dink test scores in the experimental group showed significant improvements in physical activity capabilities and attention over time, with average hit counts increasing from 5.3 ± 1.5 to 10.7 ± 2.3 (p < 0.01). Conclusions: Although the pickleball intervention did not yield significant differences in self-esteem and symptom measures between groups, the improvements observed in physical performance and attention in the experimental group suggest that exercise remains a feasible complementary approach for managing schizophrenia symptoms. Further research with larger sample sizes is recommended.

Posterior nasal nerve neurolysis in addition to radiofrequency ablation of the inferior turbinates for patients with chronic rhinitis.

This study aimed to evaluate the outcome of radiofrequency ablation of the inferior turbinates (RFIT) combined with posterior nasal nerve neurolysis (RPN3) in comparison with RFIT alone in the treatment of patients with chronic rhinitis unresponsive to pharmacological therapy. A retrospective cohort study was conducted on adult and adolescent patients with chronic rhinitis who demonstrated a poor response to medication. Patients with a total 24-hour reflective total nasal symptom score (rTNSS) of ≧5, rhinorrhea score of ≧2, and congestion score of ≧2 were included. The treatment outcomes of patients who underwent RPN3 and RFIT alone were assessed. The primary endpoint was the change from baseline in 12-h reflective total nasal symptom score (rTNSS), nasal obstruction symptom evaluation scores (NOSE), and the response rate defined as rTNSS improved ≧by 30% during follow-ups. A total of 64 patients were included (45 males, 70.3%). Overall, 49 patients underwent RPN3, and 15 patients underwent RFIT alone. The rTNSS had improved by 78.4% and 65.8% in RPN3 and RFIT groups, respectively (both p < 0.001). The NOSE score had improved by 92.89% and 86.81% in the RPN3 and RFIT groups (both p < 0.001), respectively. Patients in the RPN3 group demonstrated statistically significantly better results after three months than patients in the RFIT alone group (p < 0.05). The response rate was 98% in the RPN3 group after 3 months. The proposed RPN3 alleviated rhinitis symptoms, which demonstrated a high response rate with a superior symptom control rate than RFIT alone in chronic rhinitis with severe rhinorrhea and nasal congestion cases.

The Association Between Posting WeChat Moments and the Risk of Depressive Symptoms Among Middle-Aged and Older Chinese Adults: Prospective National Cohort Study.

The association between social media usage and the risk of depressive symptoms has attracted increasing attention. WeChat is a popular social media software in China. The impact of using WeChat and posting WeChat moments on the risk of developing depressive symptoms among community-based middle-aged and older adults in China is unknown. The objective was to assess the association between using WeChat and posting WeChat moments and the risk of depressive symptoms among middle-aged and older adults in China. A prospective national cohort study was designed based on the data obtained from the fourth and fifth waves of the China Health and Retirement Longitudinal Study (CHARLS). The strength of association between using WeChat and posting WeChat moments and the risk of depressive symptoms was estimated by modified Poisson regressions. Depressive symptoms were determined using the 10-item Center for Epidemiologic Studies Depression Scale. Meanwhile, the heterogeneity of the associations was explored through multiple subgroup analyses. Moreover, multiple sensitivity analyses were performed to verify the robustness of the associations between the exposures and depressive symptoms. A total of 9670 eligible participants were included in the cohort study, and the incidence rate of depressive symptoms was 19.08% (1845/9670, 95% CI 19.07%-19.09%) from the fourth to fifth waves of the CHARLS. Using WeChat (adjusted relative risk [aRR] 0.691, 95% CI 0.582-0.520) and posting WeChat moments (aRR 0.673, 95% CI 0.552-0.821) reduced the risk of depressive symptoms among middle-aged and older Chinese adults. The association between the exposures and depressive symptoms was robust, proved through multiple sensitivity analyses (all P<.05). However, the associations were heterogeneous in certain subgroup catagories, such as solitude, duration of sleep at night, nap after lunch, physical activity, and having multiple chronic conditions. Using WeChat and especially posting WeChat moments can mitigate the risk of depressive symptoms among community-based middle-aged and older Chinese adults. However, there is likely a need for a longer follow-up period to explore the impact of the exposures on the risk of long-term depressive outcomes.

Functional and aesthetic outcomes of alar base reduction

BackgroundThe surgical step of alar base reduction (ABR) is often done as the last stage of rhinoplasty surgery. However, it may also be done independently if the main concern is alar flare. This work was designed to assess the functional as well as aesthetic results among cases who undergo ABR which is so important to find out a better way to increase the functional, aesthetic consequences of patients.MethodsThis prospective study included 20 consecutive cases arranged for reduction rhinoplasty. All cases were categorized into three groups: group A (n = 6): patients with thick alar base had ABR, group B (n = 5): patients with wide nostrils had nostril size reduction, and group C (n = 9): patients with thick alar base with wide nostrils had combined alar base and nostril size reduction.ResultsRegarding nasal score post 1 month, levels of trouble sleeping, unable to get enough air through my nose during exercise, and total nasal obstruction symptom evaluation (NOSE) score was significantly different among all groups. Regarding nasal score post 3 month, trouble sleeping, unable to get enough air through my nose during exercise, and total NOSE score showed a significant variance among all groups (p < 0.05). Regarding standardized cosmesis and health nasal outcomes survey (SCHNOS) score post 1 month, breathing through my nose during sleep and how well my nose suits my face were significantly different among all groups (p < 0.05).ConclusionsEffectiveness of ABR in improving nasal function and alleviating symptoms associated with congestion, blockage, and trouble breathing. The procedure resulted in significant improvements in various dimensions, including nasal breathing during sleep, mood, self-esteem related to the nose, and overall symmetry of the nose, as assessed by the SCHNOS score.

Levatorplasty’s role in rectal prolapse management for patients with wide pelvic hiatus: a cohort study

Background and aimsRectal prolapse (RP) is a debilitating condition and can cause symptoms of fecal incontinence, obstructed defecation, incomplete evacuation of the rectum, and pain. In recent years, there has been increasing evidence that prolapse development is strongly associated with pelvic hiatus (GH) size (normal 4.5 +/- 0.7). Multiple surgical studies have suggested that an enlarged pelvic hiatus may be associated with prolapse recurrence. The main aim of this study is to assess the role of combining levatorplasty -with different rectal prolapse surgeries- on recurrence rate and improvement of symptoms in patients that were treated for rectal prolapse with wide pelvic hiatus.Patients and methodsOur study is a combined retrospective and prospective cohort study which included sixty patients with rectal prolapse with wide pelvic hiatus, they were divided into two groups (each group thirty patients). One group underwent rectal prolapse repair, the other group underwent rectal prolapse repair with levatorplasty.ResultsLevatorplasty group showed improvement in Wexner score, recurrence rate in comparison to the other group. Both groups showed similar results in postoperative pain and dyspareunia.ConclusionRectal prolapse repair combined with levatorplasty in patients complaining of rectal prolapse with wide pelvic hiatus have better outcome mainly in decreasing recurrence rate.

Intelligent Symptom Analysis and Report Interpretation for Thyroid Disorder Prediction Using Machine Learning

The thyroid gland, situated at the front of the neck, is essential for producing hormones that regulate many of the body’s critical functions. This paper presents a machine learning-based system aimed at enhancing early detection and providing personalized care for thyroid disorders. Leveraging the Random Forest algorithm chosen for its robust classification abilities the system incorporates two key models: an initial assessment tool that examines self-reported symptoms to determine if further diagnostic testing is recommended, and a diagnostic model that interprets test results to identify specific thyroid disorders. Additionally, the system provides customized diet and exercise suggestions. With an accuracy of 85%, the system effectively supports early symptom analysis and accurate diagnosis. By combining symptom evaluation with tailored health guidance, this approach enables timely detection, accurate diagnostics, and effective management of thyroid conditions, offering personalized insights for patients and support for healthcare providers. Key Words: Machine Learning, Random Forest, Thyroid Disease , Data Preprocessing, Healthcare informatics

The potential role of machine learning and deep learning in differential diagnosis of Alzheimer's disease and FTD using imaging biomarkers: A review.

The prevalence of neurodegenerative diseases has significantly increased, necessitating a deeper understanding of their symptoms, diagnostic processes, and prevention strategies. Frontotemporal dementia (FTD) and Alzheimer's disease (AD) are two prominent neurodegenerative conditions that present diagnostic challenges due to overlapping symptoms. To address these challenges, experts utilize a range of imaging techniques, including magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT). These techniques facilitate a detailed examination of the manifestations of these diseases. Recent research has demonstrated the potential of artificial intelligence (AI) in automating the diagnostic process, generating significant interest in this field. This narrative review aims to compile and analyze articles related to the AI-assisted diagnosis of FTD and AD. We reviewed 31 articles published between 2012 and 2024, with 23 focusing on machine learning techniques and 8 on deep learning techniques. The studies utilized features extracted from both single imaging modalities and multi-modal approaches, and evaluated the performance of various classification models. Among the machine learning studies, Support Vector Machines (SVM) exhibited the most favorable performance in classifying FTD and AD. In deep learning studies, the ResNet convolutional neural network outperformed other networks. This review highlights the utility of different imaging modalities as diagnostic aids in distinguishing between FTD and AD. However, it emphasizes the importance of incorporating clinical examinations and patient symptom evaluations to ensure comprehensive and accurate diagnoses.

Brachial Plexus Schwannoma: A Systematic Review of Clinicopathological Features, Surgical Outcomes, and Prognosis of 341 Cases.

Although primary tumors of the brachial plexus (BP) are rare, schwannomas are the most frequently encountered type. This study evaluated the clinicopathological presentation, surgical outcomes, and prognosis of patients with BP schwannomas. A systematic review was conducted using PubMed/MEDLINE, Embase, and Cochrane on the 25th of March 2024. All English human studies that reported surgically managed BP schwannomas were included. This review included 341 patients from 82 studies, with a mean age of 41.49 years and a female majority (55.72%). The most common clinical presentation was swelling, observed in 245 patients (71.85%). Surgical intervention was performed in all cases, with gross total resection (86.80%) being the most common approach. Surgical complications included new motor deficits in 41 (12.02%), sensory deficits in 33 (9.68%), and new-onset pain in 6 cases (1.76%). Prognostic information was available for all the 280 patients. At the last follow-up, only a small number of patients showed no postoperative improvement. Of the 164 patients initially presenting with pain, 3 (1.83%) reported persistent symptoms. In addition, continued sensory deficits were noted in 13 (8.67%) of the 150 cases, and continued motor deficits in 4 (9.30%) of the 43 cases. Furthermore, 14 (19.71%) of 71 postoperative new-onset symptoms persisted at the last follow-up. One (16.67%) of the 6 patients experienced constant pain. Additionally, sensory deficits persisted in 8 (28.57%) of the 28 patients, and motor deficits persisted in 5 (13.51%) of the 37 patients. No local recurrence has been reported. This systematic review highlights the complexity of BP schwannoma. Despite the occurrence of postoperative complications, the overall prognosis remains favorable with minimal rates of persistent preoperative symptoms and permanent surgical complications. Accurate diagnosis and effective surgical management are necessary to improve the outcomes of patients with this rare, yet clinically significant condition.

Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning.

Individuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms. Symptom data were analysed using K-means clustering to categorize patients based on their symptom profiles. During the study period, a total of 758 symptom diaries were completed by 84 patients, equating to 6064 individual symptom ratings. Fatigue, sleep disturbance and difficulty concentrating were the most prevalent symptoms reported. A decline in symptom burden was observed over the 35-day period, with physical and emotional symptoms showing early rates of recovery. In a correlation matrix, there were strong positive correlations between low mood and irritability (r = 0.84), and poor memory and difficulty concentrating (r = 0.83). K-means cluster analysis identified three distinct patient clusters based on symptom severity. Cluster 0 (n = 24) had a low symptom burden profile across all the post-concussion symptoms. Cluster 1 (n = 35) had moderate symptom burden but with pronounced fatigue. Cluster 2 (n = 25) had a high symptom burden profile across all the post-concussion symptoms. Reflecting the severity of the clusters, there was a significant relationship between the symptom clusters for both the Rivermead (p = 0.05) and PHQ-9 (p = 0.003) questionnaires at 6-weeks follow-up. By leveraging digital ecological momentary assessments, a rich dataset of daily symptom ratings was captured allowing for the identification of symptom severity clusters. These findings underscore the potential of digital technology and machine learning to enhance our understanding of post-concussion symptomatology and offer a scalable solution to support patients with their recovery.

Mental health and psychological resilience amid the spread of the Omicron variant: a comparison between China and Korea.

Besides physical health risks, large public health events also exert negative impacts on people's mental health. We aimed to explore the prevalence and correlates of mental distress and its association with psychological resilience among countries amid the Omicron wave. We conducted cross-sectional surveys simultaneously in China and South Korea from March 15 to 30, 2023. Brief Resilience Scale (BRS), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Patient Health Questionnaire-9 (PHQ-9) scale were used to measured psychological resilience and mental distress. Self-reported rates of anxiety and depressive symptoms in 3,000 Chinese participants were 24.5% and 30.5%, while the above-mentioned rates were 17.2%and 34.4% in 1,000 Korean participants. Chinese participants had a marginally higher BRS score. Psychological resilience was inversely associated with the prevalence of anxiety symptoms and depressive symptoms. Similar results can be observed in Korea. Results remained robust in all models. Chinese and Korean populations reported a high prevalence of mental distress with variations in different characteristics, indicating practical implications for developing tailored mental health policies and services in the context of large public health events.

Efficacy and safety of Jianpi Qinghua granules for non-erosive reflux disease with spleen deficiency and damp-heat syndrome: a multicenter, randomized, double-blind, placebo-controlled clinical trial.

Non-erosive reflux disease (NERD), the most frequent phenotype of gastroesophageal reflux disease, presents without visible esophageal mucosal damage but significantly impacts patients' quality of life. Current treatments like proton pump inhibitors show limited efficacy for many NERD patients, necessitating alternative approaches. Jianpi Qinghua (JQ) granules, a traditional Chinese medicine, have shown promise in treating NERD by targeting symptoms of spleen deficiency and damp-heat syndrome. This study aims to evaluate the efficacy and safety of JQ granules in treating patients with NERD characterized by spleen deficiency and damp-heat syndrome. A multicenter, randomized, double-blind, placebo-controlled clinical trial was conducted with a total of 78 NERD patients randomly assigned to receive either JQ granules or placebo for 4 weeks, followed by a 4-week follow-up period. Seventy-eight NERD patients with spleen deficiency and damp-heat syndrome were recruited and randomly assigned to receive either JQ granules (n = 39) or placebo (n = 39). The trial included a 1-week lead-in, followed by a 4-week double-blind treatment, and a 4-week follow-up. Primary endpoints were the improvement rates of reflux and heartburn symptoms and VAS score changes. Secondary endpoints included atypical symptom scores, total TCM syndrome scores, GERD Health-Related Quality-of-Life (HRQL), and self-rated depression and anxiety scales. Safety assessments involved routine blood, urine, and liver and kidney function tests. After 4 weeks, the improvement rate for reflux or heartburn symptoms was 79.49% in the JQ group vs. 58.97% in the placebo group (P < 0.05). VAS scores showed significant reductions in both groups but without notable inter-group differences. Total TCM syndrome scores significantly decreased in both groups, with the JQ group showing greater improvement trends. The JQ group had higher rates of effective TCM syndrome improvement and better GERD-HRQL scores. Both groups saw significant reductions in self-rated depression and anxiety scores, with trends favoring JQ granules. Safety assessments were comparable between groups. JQ granules significantly outperform placebo in treating NERD symptoms and display long-term effectiveness. They effectively address spleen deficiency and damp-heat syndrome, improving patients' social functioning, and have a favorable safety profile. https://clinicaltrials.gov/study/NCT04324138?term=NCT04324138&rank=1, identifier: NCT04324138.

Longitudinal Evaluation of Vestibular Symptoms in Patients with Vestibular Schwannoma After Robotic-Guided Stereotactic Radiosurgery Using the Dizziness Handicap Inventory (DHI).

Background: Vestibular symptoms can severely affect patients with vestibular schwannomas (VSs). Studies assessing vestibular symptoms beyond clinical routine assessment in patients with VS treated by stereotactic radiosurgery (SRS) are scarce. Therefore, we employed the standardized questionnaire Dizziness Handicap Inventory (DHI) to systematically evaluate vestibular symptoms prior to and after SRS. Methods: For this retrospective single center study, we included patients who received Cyberknife® SRS for newly diagnosed unilateral VS between 2012 and 2022, and who had a minimum of two follow-up (FU) visits. Besides clinical assessment, the presence and severeness of vestibular symptoms before and after treatment was recorded by using the DHI. Overall DHI symptom scores (1-100) were classified into four grades (0 = "none", 1 = "mild", 2 = "moderate" and 3 = "severe"). The results were correlated with tumor-, patient-, and treatment-related characteristics. Results: We analyzed 128 patients with a median age of 60 years (range: 20-82) and a median FU of 36 months (range: 11-106 months). The median tumor volume was 0.99 cm3 (range: 0.04-7.1 cm3). A median marginal dose of 13 Gy (range: 12-14 Gy) was administered. The crude rate of local tumor control was 99.2%. The mean DHI total score at last follow-up (LFU, 25.5 ± 24.7; range 0-92) was significantly lower than before SRS (29.4 ± 25.3; range:0-92, p = 0.026), which was reflected in a higher proportion of patients with DHI grade "none" and a lower proportion of patients with DHI grade "severe" at LFU. Chi-square tests showed a significant correlation of the DHI grades (DHI 0-1 vs. DHI 2-3) with the absence or presence of vestibular symptoms both before SRS (p < 0.001, CI 95%) and at LFU (p = 0.038). Conclusions: The DHI is a feasible and valid instrument for measuring vestibular symptoms after SRS. In addition, the DHI enables the quantification of symptoms and can therefore serve as an important tool for outcome assessment after SRS of VS. In the present cohort, DHI scores improved significantly during FU.

Diagnostic Dilemmas in Carpal Tunnel Syndrome and Cervical Spine Disorders: A Comprehensive Review.

Carpal tunnel syndrome (CTS) and cervical spondylosis (CS) are both common diseases, yet differentiation between the two is sometimes necessary. However, there are few evidence-based reviews on the differentiation of these conditions. This review examined the literature on the diagnosis of CTS and CS, focusing on how to distinguish between them. The analysis is divided into four categories: clinical symptoms, physical examination, diagnostic imaging, and electrodiagnosis. A total of 281 studies are reviewed, revealing a major issue: the inclusion criteria for defining each disease varies widely across studies. Understanding this limitation, the conclusion drawn is that no single clinical symptom, test, or imaging evaluation can be deemed uniquely reliable for diagnosing CTS or CS. Therefore, it is essential to apply the most up-to-date knowledge, conduct thorough examinations, and perform necessary tests for each patient to achieve a confident and accurate diagnosis.

The effects of war-related experiences on mental health symptoms of individuals living in conflict zones: a longitudinal study

On October 7, 2023, a large-scale attack in southern Israel and the subsequent war resulted in extensive loss of life and injuries, with many individuals experiencing traumatic losses, such as family members or close friends being killed or kidnapped. This study aims to longitudinally examine its effects on mental health, specifically, clinical symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). We anticipated greater symptom severity among individuals who experienced traumatic loss, were forcibly displaced, or suffered income loss, as well as among women and members of ethnic minorities. This three-wave online survey study assessed mental health symptoms in a sample of 1052 individuals, aged 18–40, residing in conflict zones in Israel from February 2024 (day 1), through March 2024 (day 30), to May 2024 (day 90). Symptoms of anxiety, depression, and PTSD were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Primary Care PTSD Screen (PC-PTSD). Individuals experiencing traumatic losses, forced displacement, or economic hardships, as well as females, consistently demonstrated higher rates of anxiety, depression, and PTSD symptoms compared to those without such experiences or to males, across all time points (F values ranged from 17.7 to 215.3, p < .001). For ethnic minorities (Arab and other), as compared to Jewish, anxiety and depression symptoms were higher at every time point (F = 8.3–97.1, p = .004 to < .001). This study highlights the urgent need for targeted mental health interventions in conflict zones, particularly for affected individuals. Further research should expand these findings to broader populations.