Intensity Of Symptoms In Patients Research Articles

Procena uticaja vitamina D na intenzitet simptoma donjeg urinarnog trakta i kvalitet života osoba sa benignom hiperplazijom prostate

Introduction/Aaim: Older men with benign prostatic hyperplasia (BPH) are more likely to have a poor quality of life. The aim of this study was to examine the influence of serum vitamin D on the intensity of lower urinary tract symptoms and the quality of life of persons with benign prostatic hyperplasia. Methods: The study was conducted as a cross-sectional study. The study included 117 persons with benign prostatic hyperplasia (BPH) treated at the Clinical Center of Montenegro in Podgorica from May 10 th , 2022 to August 15 th , 2022. Data were collected with the help of the general questionnaire from electronic medical records, as well as with the International Prostate Symptom Score (IPSS) questionnaire. Spearman's correlation coefficient was used for the statistical analysis of data. Results: The average age of participants was 62.97±11,57. The average value of the intensity of symptoms in patients with BPH according to the IPSS questionnaire was 8.54. Of the 117 participants with BPH, 57 (48.7%) had moderate symptoms, 56 (47.9%) mild, and 4 (3.4%) severe. A significant negative correlation (r=-0.316; p=0.010) was obtained between vitamin D levels and average values of symptoms according to the IPSS questionnaire. Also, a significant negative correlation was obtained between serum vitamin D values and all individually assessed values of BPH symptoms according to the IPSS questionnaire (sensation of incomplete emptying of the bladder during urination -p=0.040; repeated urination within two hours from the previous urination -p<0.001; intermittent urination -p=0.005; inability to postpone urination -p=0.036; a thin and weak urinary stream -p=0.001; straining to begin urinating with the sensation of the need to urinate -p=0.046 and nocturia -p=0.011). Based on the serum level of vitamin D, the participants had optimal levels of vitamin D in 52.1% of cases, insufficient levels in 29.1% of cases and deficit in 18,8%. An inverse relationship between the average values of serum vitamin D and quality of life according to ISPP questionnaire was observed, but this relationship was not significant (r =-0.365; p=0.160). Conclusion: The results of the study show that higher levels of vitamin D lead to the significant reduction in urological symptoms in patients with BPH, which points to the need to prevent vitamin D deficiency. Further research in this field is necessary aimed at making more detailed recommendations.

Effects of acupuncture and medical training therapy on depression, anxiety, and quality of life in patients with frequent tension-type headache: A randomized controlled study

To compare the effects of acupuncture and medical training therapy in combination or individually with usual care on quality of life, depression, and anxiety in patients with tension-type headache. In this single-center, prospective, randomized, controlled, unblinded trial, 96 adults (38.7(+/-13.3) years of age; 75 females/20 males/one dropout) with frequent episodic or chronic tension-type headache were randomized to one of four treatment groups (n = 24). The treatment groups received six weeks of either acupuncture or medical training therapy as monotherapies or in combination (12 interventions each), or usual care. We assessed depressiveness (PHQ-9), anxiety (GAD-7), and health-related quality of life (SF-12) as secondary outcome parameters at baseline, six weeks, three months, and six months after initiation of treatment. Linear mixed models were calculated. Both, acupuncture (baseline to six-weeks change scores: mean: -2(standard deviation: 2.5 points), three months: -2.4(2.4), six-months -2.7(3.6)) and the combination of acupuncture and medical training therapy (-2.7(4.9), -2.2(4.0), -2.2(4.2)) (each within-group p < .05) significantly reduced depressiveness-scores (PHQ-9) to a greater extent than medical training therapy (-0.3(2.0), -0.5(1.6), -0.9(2.6)) or usual care alone (-0.8(2.9), 0.1(2.8), 0.2(3.6)). We found similar results with anxiety scores and the physical sum scores of the SF-12. No severe adverse events occurred. Acupuncture and the combination of acupuncture and medical training therapy elicit positive effects on depression, anxiety, quality of life, and symptom intensity in patients with episodic and chronic tension-type headache. Acupuncture appears to play a central role in mediating the therapeutic effects, underscoring the clinical relevance of this treatment. An additive benefit of the combination of both therapies does not appear to be relevant.Trial registration: Registered on 11 February 2019. German Clinical Trials Register, DRKS00016723.

The Effect of Intravenous Ketamine on Suicidal Ideation in Depressed Patients: A Randomized Clinical Trial

Background: Major depressive disorder (MDD) generally occurs together with depression in patients with no history of manic, mixed, or hypomanic episodes. The suicidal ideation in MDD patients is very common and can potentially be considered an emergency circumstance in many cases. Among the developed drugs and medicines, ketamine (KET) is a potential option to treat patients with MDD. This study aims at investigating the effect of KET on the treatment of suicidal ideation and the reduction of the intensity of symptoms in patients suffering from MDD. Materials and Methods: This randomized double-blind clinical trial was performed on 30 patients who suffered from MDD and had suicidal ideation at Ibn Sina Hospital, Bandar Abbas, Iran, during 2016-2017. The patients were divided into two groups: the KET group which received 0.5 mg/kg of intravenous (IV) KET diluted in 500 mL of normal saline over 30 minutes and the control group which received 500 mL of normal saline without KET over 30 minutes. Results: According to the statistical analysis, 24 hours after the intervention, suicidal ideation score reached 2.53 and 20.6 in the KET and control groups, respectively. In fact, KET caused a significant reduction in the score of the suicidal ideation (SSI) (SSI&lt;4) in comparison with the control group (P&lt;0.001). Conclusion: It was observed that KET can play a key role in the treatment of depression disorders, especially severe and life-threatening forms that require immediate intervention, such as the use of electroconvulsive therapy.

Hidrox® and Chronic Cystitis: Biochemical Evaluation of Inflammation, Oxidative Stress, and Pain.

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic bladder condition characterized by frequent urination, inflammation, oxidative stress, and pain. The aim of the study was to evaluate the anti-inflammatory and antioxidant effects of an oral administration of Hidrox® (10 mg/kg) in the bladder and spinal cord in a rodent model of IC/BPS. The chronic animal model of cystitis was induced by repeated intraperitoneal injections of cyclophosphamide (CYP) for five consecutive days. Treatment with Hidrox® began on the third day of the CYP injection and continued until the 10th day. CYP administration caused macroscopic and histological bladder changes, inflammatory infiltrates, increased mast cell numbers, oxidative stress, decreased expression of the tight endothelial junction (e.g., zonula occludens-1 (ZO-1) and occludin), and bladder pain. Treatment with Hidrox® was able to improve CYP-induced inflammation and oxidative stress via the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) pathway. It was also able to reduce bladder pain which was aggravated by the activation of neuroinflammation in the central nervous system. In particular, Hidrox® reduced the brain-derived neurotrophic factor (BDNF), as well as the activation of astrocytes and microglia, consequently reducing mechanical allodynia. These results indicate that nutritional consumption of Hidrox® can be considered as a new therapeutic approach for human cystitis, increasing the conceivable potential of a significant improvement in the quality of life associated with a lowering of symptom intensity in patients with IC/BPS.

Efficiency mark postoperative pain management and normalization of adaptation status in patients with reproductive system oncopathology

Purpose of the study. Studying possible management of postoperative pain and normalization of adaptation status in patients with reproductive system onychopathology using xenon- oxygen therapy.Patients and methods. The study included 97 patients receiving surgical treatment for reproductive cancer at National Medical Research Centre for Oncology in 2016–2020. All patients were divided into the main and control groups depending on the performed corrective therapy with xenon- oxygen mixture. Inclusion criteria were: established diagnosis — endometrial cancer, cervical cancer or ovarian cancer at the surgical stage of antitumor treatment, absence of decompensated concomitant pathology. In addition to general clinical tests, the intensity of symptoms in patients was assessed using a standardized Edmonton questionnaire, adaptation status and data of a numerical rating scale of pain were recorded, the severity of endogenous intoxication was measured using calculated lymphocytic, leukocyte, nuclear and leukocyte shift index. Stages of the study included functional assessment of the patient's condition before surgical treatment and on the 1st and 5th days of the postoperative period.Results. An analysis showed statistically significant differences between the groups: in the group of patients receiving xenon- oxygen therapy, 12.9% of patients complained of pain, while in the control group — 34.2%, on mild exertion 17.1% and 39.9%, respectively (p&lt;0.05). The therapy with xenon- oxygen mixture demonstrated its high significance in the adaptive status regulation and regression of negative clinical manifestations in patients after oncogynecological surgeries.Conclusion. The effectiveness of the chosen therapy with xenon- oxygen mixture demonstrates the possibility of anesthesia and normalization of the adaptive status of oncogynecological patients who underwent surgical treatment for reproductive cancers.

Диетотерапия пациентов с синдромом раздраженного кишечника: ограничение FODMAP

Restriction of the intake of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) decreases the intensity of symptoms in patients with irritable bowel syndrome (IBS). Due to the osmoticity of FODMAP molecules the volume of intestinal contents increases, and their fermentation by microbiota results in gas production, which causes distention of the bowel wall and manifests itself as abdominal pain and bloating, diarrhoea in patients with IBS. Based on analysis of publications dealing with the effectiveness and safety of a low-FODMAP content diet, the main principles, methodology and possible difficulties of diet therapy in patients with IBS are discussed. Key words: carbohydrate malabsorption, low-FODMAP diet, diet therapy, irritable bowel syndrome

A Longitudinal Pilot Study for Examining Symptom Reduction in Patients With Cancer in a Palliative Care Program: A Primarily Rural Northeast Texas Population

Many patients with cancer live in rural areas and research is lacking on the efficacy of palliative care programs in rural community settings. This pilot study was conducted in a primarily rural setting where healthcare professionals delivered palliative care to 52 mostly lower income patients with a variety of cancers. They were assessed for physical, financial, psychosocial and overall symptom intensity at baseline and at three consequent assessments. This pilot study demonstrated the potential efficacy of an outpatient palliative care program in a mostly rural setting in the reduction of physical, psychosocial, and overall symptom intensity in patients with cancer.

Frequency and intensity of symptoms in patients with chronic rhinosinusitis

Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients? quality of life. The objectiv? of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the most frequent symptom. It occured in 82 patients (91.1%), followed by nasal discharge in 81 patients (90%) and there was no difference in frequency of these two symptoms. Nasal discharge has been recorded as the most intensive symptom (x? = 5.4) and it is significantly more intensive in comparison to nasal congestion which was the second on the intesity list (x? = 4.1, p = 0.002). All other symptoms were significantly less frequently and less intensive. The average intensity value of the disease as a whole is the same as the average intensity value of the nasal discharge (x? = 5.4) while the average intensity values of all other symptoms are statistically significantly lower than the average intensity value of the disease as a whole; in all comparisons p &lt; 0.001. Conclusion. Nasal congestion and nasal discharge are the most common symptoms in the patients with chronic rhinosinusitis. Nasal discharge is the most intensive symptom in patients with chronic rhinosinusitis while its intensity determines the sensation of the intesity of the disorder as a whole.

Sundown syndrome in patients with Alzheimer's disease dementia.

ABSTRACTThe sundown syndrome is a complex neurobehavioral disorder in patients with dementia associated with high financial cost and significant caregiver burden. It is a multifactorial phenomenon with unclear pathophysiology, characterized by the presence of neuropsychiatric symptoms in the evening period.Objective:To analyze the main neuropsychiatric symptoms, their correlation with one another, with comorbidities, and with time of day of greatest symptom intensity in patients with Alzheimer’s disease dementia.Methods:This is a cross-sectional, observational and explanatory study in which caregivers/relatives of elderly patients with dementia were interviewed using a structured tool called the Neuropsychiatric Inventory (NPI).Results:The sample studied was composed of 38 patients, 60.5% female and 39.5% male, with mean age of 81±6 (67-94) years. A high frequency of neuropsychiatric symptoms in the evening period was observed, predominantly irritability (55.3%), nocturnal behavior (47.4%), and aggressiveness (42.1%). Only 36.8% of the family caregivers used non-pharmacological strategies.Conclusion:The frequency of neuropsychiatric symptoms was exacerbated in the evening among patients with Alzheimer’s disease, especially for those behavioral symptoms that had a positive correlation with one another.

Comparison of Daily versus Weekly Recording of Gastroesophageal Reflux Disease Symptoms in Patients with a Partial Response to Proton Pump Inhibitor Therapy

BackgroundThe Reflux Symptom Questionnaire electronic Diary (RESQ-eD) and the Reflux Symptom Questionnaire 7-day recall (RESQ-7) are versions of a patient-reported outcome instrument that was developed and validated for measuring the frequency and intensity of symptoms in patients with gastroesophageal reflux disease (GERD) who have a partial response to proton pump inhibitor (PPI) therapy. ObjectiveThe aim of these analyses was to assess the ability of the RESQ-7 to reproduce findings based on RESQ-eD reports of the same symptoms. MethodsThese analyses are based on data from patients with GERD with a partial response to PPI (ClinicalTrials.gov identifier: NCT00703534). Participants completed the RESQ-eD twice daily for 7 days and the RESQ-7 on day 7. ResultsData from 446 patients were available for these analyses. Symptom-level analyses showed that, for intensity, mean domain scores were higher for the RESQ-7 (range 1.49–2.72) than for the RESQ-eD (range 1.45–2.57); for frequency, scores were lower for the RESQ-7 (range 2.58–4.82) than for the RESQ-eD (range 4.22–6.24). Correspondence analyses of RESQ-7 and RESQ-eD mean domain scores indicated excellent agreement for intensity (correlation-concordance coefficient 0.77–0.83) and fair agreement for frequency (correlation-concordance coefficient 0.40–0.58). Mean RESQ-eD subscale intensity scores for GERD symptoms were higher for symptoms experienced during the daytime than for those occurring at nighttime. Symptom recall was not associated with peak or recency effects. ConclusionsPatients with GERD slightly overestimated the intensity of their reflux symptoms and markedly underestimated the frequency on weekly recall compared with twice-daily reporting.

Effect of Parenteral Hydration Therapy Based on the Japanese National Clinical Guideline on Quality of Life, Discomfort, and Symptom Intensity in Patients With Advanced Cancer

ContextAlthough an evidence-based clinical guideline for parenteral hydration therapy was established in Japan, the efficacy of the guideline has not been assessed. ObjectivesOur purpose was to explore the effect of parenteral hydration therapy based on this clinical guideline on quality of life (QoL), discomfort, symptoms, and fluid retention signs in patients with advanced cancer. MethodsThis multicenter, prospective, observational study included 161 patients with advanced abdominal cancer who received guideline-based hydration therapy. We evaluated the longitudinal changes of the global QoL (Item 30 of European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-C30); the Discomfort Scale; the intensity of seven physical symptoms; and the severity of fluid retention signs. We also evaluated patient satisfaction and the feeling of benefit from hydration one week after the study commenced, and bronchial secretions, hyperactive delirium, communication capacity, and agitation 48 hours before a patient’s death. ResultsThe global QoL, the Discomfort Scale, and the intensities of all physical symptoms, except for vomiting and drowsiness, were stable throughout the study period. More than 80% of patients maintained all fluid retention signs. Patient global satisfaction was 76.4 (0–100) and feeling of benefit was 5.43 (range 0–7). ConclusionGuideline-based parenteral hydration therapy contributed to maintaining global QoL and provided satisfaction and a feeling of benefit without increasing discomfort and worsening symptoms and fluid retention signs in patients with advanced cancer.

Therapeutic efficacy assessment of weak variable magnetic fields with low value of induction in patients with drug-resistant depression

BackgroundThe aim of this prospective study was to verify whether magnetostimulation with weak variable magnetic fields with low value of induction could enhance the effects of pharmacological therapy in drug-resistant depression. Materials and methodsThirty patients, 26 women and 4 men, with drug-resistant depression were enrolled in the study. The subjects from Group No. I (14 patients) were given fluvoxamine and treated with weak variable magnetic field using the VIOFOR JPS device; the subjects from Group No. II (16 patients) were also given fluvoxamine but they were treated with the VIOFOR JPS device in placebo mode. Changes in depressive symptoms were estimated with the 21-point Hamilton Depression Scale (HDRS), Montgomery-Asberg Depression Scale (MADRS) and Beck Depression Inventory (BDI) questionnaire. ResultsAfter 15days of treatment highly significant differences were revealed between the patients treated with magnetic field and the patients treated with placebo: the final HDRS score was 53% of the initial value for the group receiving combined treatment, and 86% in the placebo group (p<0.001); for MADRS score the values were 51% and 88% (p<0.001), respectively, and for BDI 60% and 87% (p<0.001). Thus, the average effect of placebo applied with fluvoxamine was a ca. 15% reduction of symptoms, while the concurrent application of magnetic field and SSRI treatment resulted in a 40–50% improvement. ConclusionOur study indicates that adding a two-week low-induction variable magnetic field stimulation to a classical pharmacologic therapy reduces the intensity of symptoms in patients with drug-resistant depressive disorders.

A Comparison of Symptom Intensity in Patients with Irritable Bowel Syndrome in Primary and Secondary Care

A Comparison of Symptom Intensity in Patients with Irritable Bowel Syndrome in Primary and Secondary Care

Factors associated with intensity of symptoms in patients seeking medical advice for flu

The aim of our study was to explore factors associated with the intensity of signs and symptoms of flu-like illness, on adult patients seeking medical advice for flu. We analysed 554 index patients (56% influenza positive) included in a prospective household contact study during winter 1999–2000. The intensity of illness was calculated from 19 symptoms recorded by the GP during the visit ( Z-score-GP) and from 13 symptoms reported by the patients at the first day of follow-up ( Z-score-Pat). The two Z scores were highly correlated (intraclass correlation of 0.43). Multivariate regression identified the following predictors of Z-score-GP: influenza-positive diagnosis (+0.26, p=0.002) and gender female (+0.19, p=0.03). The predictors of Z-score-Pat were: influenza-positive diagnosis (+0.39, p=0.001), current smoker (+0.20, p=0.04), gender female (+0.20, p=0.02) and influenza vaccination (−0.39, p=0.003). In influenza-positive patients, influenza vaccine was highly linked with a decrease in intensity of symptoms ( Z-score-GP: −0.38, p=0.04; Z-score-Pat: −0.49, p=0.009). This last result was not found in influenza-negative patients. The study identifies tobacco use and influenza-positive diagnosis as predictors of increased intensity of influenza-like illness. Interestingly, influenza vaccine decreased the intensity of symptoms in influenza-positive, but not in influenza-negative patients.

Memory for symptoms in COPD patients: how accurate are their reports?

The purpose of this study was to examine the accuracy of self-reports of symptom intensity in patients with chronic obstructive pulmonary disease (COPD) and factors that might influence recall of that intensity. Thirty COPD (forced expiratory volume in one second (FEV1) 36 +/- 17% predicted) subjects recorded their dyspnoea and fatigue intensity scores on a 0-10 scale for 14 consecutive days. On the fourteenth day, subjects recalled their average, greatest and least symptom intensity for the previous 14 days. General cognitive function, spirometry, and oxygenation were also measured. No significant differences were found between actual and recalled scores for dyspnoea or fatigue. General cognitive function, measured by the Mini Mental State Exam, correlated with the greatest and least dyspnoea and average fatigue difference scores (recall-actual) and contributed to the variance in the average and least dyspnoea recalled scores. The greatest contributor to the variance in the recall scores of both symptoms was the symptom intensity level on the day of recall. These results highlight the importance of current levels of symptom intensity and cognitive function when appraising symptoms in chronic obstructive pulmonary disease patients.

The passive axial compression (PAC) test: a new adjunctive provocative maneuver for the clinical diagnosis of hallucal sesamoiditis.

The authors describe a previously unreported adjunctive passive provocative maneuver that has been found to clinically reproduce the intensity of symptoms in patients diagnosed with disorders of the sesamoids. This test is useful for the initial diagnosis as well as monitoring response to treatment.

Prescribing Cannabinoids for Multiple Sclerosis

Anecdotal evidence and preclinical and clinical data indicate that cannabis and individual cannabinoids can suppress muscle spasticity/spasm and pain associated with multiple sclerosis (MS). Anecdotal data come from the responses to a questionnaire by 112 patients with MS who self-medicated with cannabis. The preclinical data come from animal experiments showing that cannabinoid receptor agonists are antinociceptive and can depress motor function, reduce the severity of primary generalised dystonia, and decrease inflammation and the intensity of behavioural signs of experimental autoimmune encephalomyelitis. The clinical data derive from 7 clinical trials, albeit involving small numbers of patients, which indicate that cannabis itself, the cannabinoid Δ9-tetrahydrocannabinol (Δ9-THC) and the synthetic analogue of Δ9-THC nabilone can reduce the intensity of several symptoms in patients with MS or spinal cord injury, including spasticity, pain, tremor and nocturia.

Diurnal variations in intensity of symptoms in patients of different diagnostic groups.

Consecutive patients, regardless of diagnostic group, upon admission to the Department of Psychiatry, University of Umea, were asked to fill in a special form about diurnal variation in their symptomatology and sleep disturbances. Three trained psychiatrists separately reviewed the records and completed a second form comprising information about diagnosis and certain background factors. Among the background factors only age and ongoing antidepressive medication were found to be of importance. In the study no strong consistency in the symptom complex of early awakening, experience of symptomatology as worst in the morning, and a feeling of relief in the afternoon was found. However, the experience of symptomatology as a whole, anxiety and inhibition as being worst in the morning is significantly more common in patients with unipolar and bipolar affective disorders but is also common in all diagnostic subgroups and seems in no way to be specific for depressive disorders. Furthermore, the phenomenon of diurnal variation of symptomatology was not found to be of diagnostic help and should be employed very cautiously as a basis in pathogenic consideration.