Symptoms In Patients Research Articles

The Association Between COVID-19 Infection Severity and Micronutrient Deficiencies in Children

Background: Coronavirus disease 2019 (COVID-19) can cause pulmonary and systemic inflammation in both children and adults. Investigating the potential impact of micronutrient deficiencies on COVID-19 infection is of great importance. Objectives: This case-control study was designed to compare the serum levels of vitamins D and C and zinc between healthy children and children with mild or severe COVID-19 infection, as well as to investigate the impact of micronutrient deficiencies on the clinical symptoms of patients. Methods: This case-control study was conducted at a teaching hospital in Tehran, Iran. Control subjects were recruited from healthy children, and cases were included from children with mild and severe symptoms of COVID-19. Blood samples were obtained from participants to measure the levels of micronutrients and were analyzed using statistical software. Results: A total of 85 subjects were included (33 controls, 25 cases with mild symptoms, and 27 cases with severe symptoms). We found no differences in the means of serum vitamin D and vitamin C levels between the studied groups. However, the mean serum zinc level was significantly lower in severe patients compared to the controls (P < 0.01). Moreover, no significant difference was observed in the frequency of patients with micronutrient deficiencies based on their clinical conditions. Conclusions: Our findings revealed zinc deficiency in children with severe COVID-19 infection, while no significant differences were found in the mean serum levels of vitamins D and C between healthy children and patients. More studies are necessary to provide more robust evidence.

Carotid Web Management in Symptomatic Patients: A Case Report and Literature Review

Carotid Web Management in Symptomatic Patients: A Case Report and Literature Review

Vision-related quality of life and near-work visual symptoms in patients with attention-deficit/hyperactivity disorder

Vision-related quality of life and near-work visual symptoms in patients with attention-deficit/hyperactivity disorder

Lower urinary tract symptoms in men after surgery for benign prostatic hyperplasia

BACKGROUND: The development of medical technologies has resulted into a significant increase in the number of patients undergoing minimally invasive surgeries for benign prostatic hyperplasia. However, 29.9–41% of patients after surgical treatment are not satisfied with the surgical treatment results. AIM: To assess the rate and nature of lower urinary tract symptoms in men after surgical treatment of benign prostatic hyperplasia with various surgical techniques. MATERIALS AND METHODS: A telephone survey was carried out among 6117 men aged 59.57 ± 11.11 years (48–83 years), who underwent surgical treatment for benign prostatic hyperplasia with various surgical techniques and 5960 of these patients were surveyed using the IPSS questionnaire in the period 2012–2022. Moreover, to assess urination, patients kept their voiding diaries for 72 hours, a questionnaire to evaluate the symptoms of overactive bladder; ultrasound of the bladder, prostate and upper urinary tract, uroflowmetry, and, if indicated, a urodynamic study were performed. RESULTS: The study showed that 2413 (40.5%) patients were “absolutely satisfied” with the surgical treatment results, 829 (13.9%) patients were “partially satisfied” and noted improved urination, although its quality was assessed as unsatisfactory, and 2718 (45.6%) operated men were “absolutely dissatisfied”. Lower urinary tract symptoms persisted in 2655 (47.9%) men which underwent surgery, and in 3.3% of cases (87 patients) their severity increased in the postoperative period. CONCLUSIONS: The high rate of dissatisfaction with the surgical treatment results of patients with benign prostatic hyperplasia is caused by the persistence of irritative symptoms in the postoperative period and does not depend on the surgery performed. The origin of symptoms in most patients is not associated with benign prostatic hyperplasia, and the surgery indications are overestimated.

Validation of the Russian version of the pelvic pain and urgency/frequency patient symptom scale (C.L. Parsons, 2000) for patients with chronic recurrent uncomplicated cystitis

BACKGROUND: Questionnaires allow to objectify and quantify the disease severity, especially at the patient’s initial visit, its impact on the patients’ quality of life, as well as the dynamics of symptoms during treatment. AIM: To validate the Russian version of the Pelvic Pain and Urgency/Frequency Patient Symptom Scale (PUF scale; C.L. Parsons, 2000) for patients with chronic recurrent uncomplicated cystitis. MATERIALS AND METHODS: The Russian version of the PUF Scale was suggested to two respondent groups aged 19 to 53 years: relatively healthy volunteers, 15 women who did not complains of urinary disorders or pain/discomfort in the bladder, and 14 patients with verified diagnosis of chronic recurrent uncomplicated cystitis. RESULTS: The resulting data demonstrate the validity of the proposed Russian version of the PUF Scale. Statistically significant differences were noted in the answers to most of the questionnaire issues between two respondent groups: conditionally healthy volunteers and patients with chronic recurrent uncomplicated cystitis. A high level of internal consistency of the questionnaire was found. Cronbach’s alpha coefficient in the main group was 0.888, in the control group — 0.819. CONCLUSIONS: The study findings proved that the Russian version of the Pelvic Pain and Urgency/Frequency Patient Symptom Scale (C.L. Parsons, 2000) is a valid tool for subjective assessment of the severity of chronic recurrent uncomplicated cystitis symptoms.

Health Diagnostic Assistant using LLMs

The Health Diagnostic Assistant leverages advanced Large Language Models (LLMs) and Natural Language Processing (NLP) techniques to enhance patient diagnosis and healthcare decision-making. This innovative system employs Retrieval-Augmented Generation (RAG) to combine the strengths of pre-trained language models with a dynamic retrieval mechanism, allowing it to access and synthesize real-time medical knowledge from a wide array of databases. By analyzing patient symptoms, medical histories, and contextual data, the assistant generates accurate, context-aware recommendations and insights. The project aims to streamline the diagnostic process, reduce the burden on healthcare professionals, and improve patient outcomes by providing evidence-based suggestions tailored to individual cases. Through continuous learning and integration of user feedback, the Health Diagnostic Assistant aspires to evolve into a reliable tool for both patients and clinicians, fostering informed decision-making in the healthcare landscape.

Baseline gut microbiome alpha diversity predicts chemotherapy-induced gastrointestinal symptoms in patients with breast cancer.

Chemotherapy frequently causes debilitating gastrointestinal symptoms, which are inadequately managed by current treatments. Recent research indicates the gut microbiome plays a role in the pathogenesis of these symptoms. The current study aimed to identify pre-chemotherapy microbiome markers that predict gastrointestinal symptom severity after breast cancer chemotherapy. Fecal samples, blood, and gastrointestinal symptom scores were collected from 59 breast cancer patients before, during, and after chemotherapy. Lower pre-chemotherapy microbiome alpha diversity and abundance of specific microbes (e.g., Faecalibacterium) predicted greater chemotherapy-induced gastrointestinal symptoms. Notably, tumor and diet characteristics were associated with lower pre-chemotherapy alpha diversity. Lower baseline alpha diversity also predicted higher chemotherapy-induced microbiome disruption, which was positively associated with diarrhea symptoms. The results indicate certain cancer patients have lower microbiome diversity before chemotherapy, which is predictive of greater chemotherapy-induced gastrointestinal symptoms and a less resilient microbiome. These patients may be strong candidates for pre-chemotherapy microbiome-directed preventative interventions (e.g., diet change).

Seizure Burden and Clinical Risk Factors in Glioma-Related Epilepsy: Insights From MRI Voxel-Based Lesion-Symptom Mapping.

Epilepsy is the most common preoperative symptom in patients with supratentorial gliomas. Identifying tumor locations and clinical factors associated with preoperative epilepsy is important for understanding seizure risk. To investigate the key brain areas and risk factors associated with preoperative seizures in glioma patients. Retrospective. A total of 735 patients with primary diffuse supratentorial gliomas (372 low grade; 363 high grade) with preoperative MRI and pathology data. Axial T2-weighted fast spin-echo sequence at 3.0 T. Seizure burden was defined as the number of preoperative seizures within 6 months. Tumor and high-signal edema areas on T2 images were considered involved regions. A voxel-based lesion-symptom mapping analysis was used to identify voxels associated with seizure burden. The involvement of peak voxels (those most associated with seizure burden) and clinical factors were assessed as risk factors for preoperative seizure. Univariable and multivariable binary and ordinal logistic regression analyses and chi-square tests were performed, with results reported as odds ratios (ORs) and 95% confidence intervals. A P-value <0.05 was considered significant. A total of 448 patients experienced preoperative seizures. Significant seizure burden-related voxels were located in the right hippocampus and left insular cortex (based on 1000 permutation tests), with significant differences observed in both low- and high-grade tumors. Tumor involvement in the peak voxel region was an independent risk factor for an increased burden of preoperative seizures (OR = 6.98). Additionally, multivariable binary logistic regression results indicated that 1p/19q codeletion (OR = 1.51), intermediate tumor volume (24.299-97.066 cm3), and involvement of the peak voxel (OR = 6.06) were independent risk factors for preoperative glioma-related epilepsy. Voxel areas identified through voxel-based lesion-symptom mapping analysis, along with clinical factors, show associations with clinical seizure burden, offering insights for assessing seizure burden for glioma patients. 4 TECHNICAL EFFICACY: Stage 1.

The clinical and pathological significance of tertiary lymphoid structure in extramammary Paget's disease

BackgroundTumor-associated tertiary lymphoid structures (TLSs) are functional immune-responsive aggregates, which have been reported to be associated with better prognosis in various tumors. However, their exact characteristics and prognostic value in extramammary Paget’s disease (EMPD) remain unknown.ObjectiveTo explore the features of TLSs in EMPD and their association with clinicopathological characteristics.MethodsIn total, 171 EMPD patients from 2015 to 2023, retrospective, single center cohort were collected to assess the presence, maturation status, and location of TLSs by immunohistochemistry. Then, their clinicopathologic association and prognostic significance were further examined.ResultsTLSs were detected in 97 cases (57%) of 171 EMPD patients, including high-density TLSs in 88 cases (91%), peritumoral TLSs (pTLSs) in 89 cases (92%), TLSs around appendages (aTLSs) in 23 cases (24%), and mature TLSs in 16 cases (16%). Secondary EMPD was more likely to produce TLS (Secondary: 16/21 [76%]; Primary: 81/150 [54%]; P = 0.06), and more likely to produce Mature TLS (Secondary: 5/10 [50%]; Primary: 11/80 [14%]; P = 0.02). The subjective symptoms of EMPD patients did not seem to correlate with the presence of TLS. EMPD patients with tumor invasion were more likely to form mature TLS (Invasion: 8/32 [25%]; In situ: 8/65 [12%]; P = 0.06), recurrent EMPD patients were more likely to form TLS (Recurrent: 34/50 [68%]; Initial: 63/121 [52%]; P = 0.06) especially mature TLS (Recurrent: 8/34 [24%]; Initial: 8/63 [13%]; P = 0.04). The depth of tumor invasion in EMPD patients with mature TLS was mostly less than or equal to 4mm (mature TLS+: 7/8 [88%]; TLS-: 6/17 [35%]; P = 0.05), aTLS were less common in EMPD patients with skin appendage invasion (aTLS+: 4/23 [17%]; aTLS-: 32/74 [43%]; P = 0.03). The same EMPD patients relapse after, the existence of TLS increased [TLS+ (initial): 9/17 (53%); TLS+ (recurrence):14/17 (82%); P =.07].LimitationsRetrospective study design.ConclusionsMature TLS is a positive prognostic factor for invasive EMPD and may serve as a new biomarker and therapeutic target for EMPD.

Positive and negative syndromes in schizophrenia: analysis of determinants and severity of symptoms in Moroccan patients

Abstract Background Schizophrenia is a debilitating psychiatric condition distinguished by a variety of cognitive, emotional, and behavioral manifestations. It affects an individual’s cognition, emotions, and actions, resulting in challenges in discerning reality from illusion. The objective of the current study was to assess the determinants and severity of symptoms in Moroccan patients hospitalized in Ar-Razi Hospital, Rabat, Morocco using Positive and Negative Syndromes scales (PANSS). Methods One hundred sixty-one schizophrenic patients were admitted to Ar-Razi Hospital in Sale. The PANSS scale, in conjunction with a sociodemographic questionnaire, is utilized as the assessment tool for symptoms. A chi-square test at a 5% error level and a Pearson correlation test were applied to investigate possible associations. Results The findings demonstrate a significant bias towards males (9:1), with 90% being unmarried, and 96.3% originating from urban settings. The breakdown of patients based on symptoms reveals a prevalence of 14.3% for the positive scale, 18% for the negative scale, and 11.2% for the psychopathological scale. The correlation analysis demonstrates a strong relationship between the three scales. The factors that were found to have a notable impact are gender (p &lt; 0.000), functional ability (p &lt; 0.032), socioeconomic status (p &lt; 0.008), living environment (p &lt; 0.05), and use of tobacco and cannabis. Conclusion Confronted with this scenario, healthcare professionals are required to evaluate the key factors in the timely detection of schizophrenia and advocate for the consistent utilization of the PANSS scale in the management and monitoring of patients.

Why Symptoms Linger in Quiescent Crohn's Disease: Investigating the Impact of Sulfidogenic Microbes and Sulfur Metabolic Pathways.

Even in the absence of inflammation, persistent symptoms in patients with Crohn's disease (CD) are prevalent and worsen quality of life. We previously demonstrated enrichment in sulfidogenic microbes in quiescent Crohn's disease patients with (qCD + S) vs without persistent GI symptoms (qCD-S). Thus, we hypothesized that sulfur metabolic pathways would be enriched in stool while differentially abundant microbes would be associated with important sulfur metabolic pathways in qCD + S. We performed a multicenter observational study nested within SPARC IBD. Quiescent inflammation was defined by fecal calprotectin level < 150 mcg/g. Persistent symptoms were defined by CD-PRO2. Active CD (aCD) and non-IBD diarrhea-predominant irritable bowel syndrome (IBS-D) were included as controls. Thirty-nine patients with qCD + S, 274 qCD-S, 21 aCD, and 40 IBS-D underwent paired shotgun metagenomic sequencing and untargeted metabolomic profiling. The fecal metabolome in qCD + S was significantly different relative to qCD-S and IBS-D but not aCD. Patients with qCD + S were enriched in sulfur-containing amino acid pathways, including cysteine and methionine, as well as serine, glycine, and threonine. Glutathione and nicotinate/nicotinamide pathways were also enriched in qCD + S relative to qCD-S, suggestive of mitochondrial dysfunction, a downstream target of H2S signaling. Multi-omic integration demonstrated that enriched microbes in qCD + S were associated with important sulfur metabolic pathways. Bacterial sulfur metabolic genes, including CTH, isfD, sarD, and asrC, were dysregulated in qCD + S. Finally, sulfur metabolites with and without sulfidogenic microbes showed good accuracy in predicting the presence of qCD + S. Microbial-derived sulfur pathways and downstream mitochondrial function are perturbed in qCD + S, which implicate H2S signaling in the pathogenesis of this condition. Future studies will determine whether targeting H2S pathways results in improved quality of life in qCD + S.

Impact of empirical treatment in patients with extrapulmonary tuberculosis and their outcome

Abstract Background Tuberculosis (TB), primarily caused by mycobacterium tuberculosis (Mtb), remains a significant public health concern globally, particularly in low-resource settings. Extrapulmonary tuberculosis (EPTB), which affects organs beyond the lungs, presents diagnostic and treatment challenges, necessitating improved clinical management strategies. This work was aimed to assess the impact of empirical anti-TB treatment on the outcomes of patients with extrapulmonary tuberculosis and to analyze the demographic and risk factors associated with EPTB. Methods A retrospective cohort study was conducted over three years (2020–2023) at PSG Hospitals, Coimbatore. Ninety-two subjects, all with negative microbiological results but symptoms indicative of EPTB, were carefully selected. Results A total of 92 patients were included in the study, all of whom had negative microbiological diagnosis with symptoms suggestive of EPTB. The mean age of patients was 58.14 years, with a male predominance (59.78%). Pleural effusion was the most common EPTB site, with many patients having no co-morbidities. Occupational factors, such as cotton millwork, and lifestyle factors, including alcohol use and malnutrition, were prominent risk factors. Clinical manifestations varied, with fever being the most common symptom. Treatment completion was 65.22%, falling below National Tuberculosis Elimination Program (NTEP) guidelines, with notable loss to follow-up and mortality rates. Conclusion Empirical treatment for EPTB showed notable improvement in the patient's symptoms and overall health. However, challenges persist in treatment completion, especially among socioeconomically disadvantaged populations. Early detection, prompt treatment initiation, and comprehensive management are essential to address the multifaceted challenges posed by EPTB effectively.

3D printing of the brachial plexus and its osseous landmarks using magnetic resonance neurography for thoracic outlet syndrome evaluation.

Patient-specific three-dimensional (3D) printed anatomic models are valuable clinical tools that facilitate enhanced visualization of pertinent anatomic structures and have demonstrated benefits of reduced surgical times, increased surgeon confidence, and improved operative results and subsequent patient outcomes. Medical image-based 3D printed anatomic models are generally created from computed tomography (CT), however magnetic resonance imaging (MRI), which offers exquisite soft tissue characterization and flexible contrast avoiding the use of ionizing radiation, is an attractive alternative. Herein, the application of 3D printing incorporating both MR neurography and zero-echo time (ZTE) MRI for visualization of the brachial plexus anatomy in a subject with thoracic outlet syndrome (TOS) is described. A 28-year-old man presented with chronic right upper limb discomfort and paresthesias extending from the shoulder region to the third and fourth digits. The subject underwent evaluation with a unilateral brachial plexus MR neurography protocol at 3.0 Tesla for suspicion of TOS. The protocol included T2-weighted, 3D fast spin echo short-tau inversion recovery (STIR-FSE) and 3D radial ZTE sequences for depiction of the nerves and bones, respectively. The first rib and its synostosis impinged upon the inferior aspect of the T1 nerve root (T1NR), with accompanying mild enlargement of the T1NR. A 3D printed anatomic model was created and included: (1) bone (spine, ribs, clavicle, scapula, and humerus), (2) brachial plexus, and (3) costal cartilage. The 3D printed model clearly demonstrated a T1NR impingement from the synostosis, confirming the diagnosis of neurologic thoracic outlet syndrome (TOS) and guided the treatment approach in prescribing TOS-specific physical therapy, which led to significant improvements in the patient's condition. To our knowledge, this is the first in-vivo human 3D printed case for TOS using MRI-only data. The 3D printed model allowed for improved visualization and understanding of the spatial relationships between the nerves of the brachial plexus and surrounding osseous structures responsible for the patient's symptoms. Not applicable.

Depigmented, polymerized cat epithelium extract is safe and improves rhinitis and asthma symptoms in cat allergic patients: A real-world retrospective study.

Cat allergy is often difficult to avoid. Here, we evaluated the safety and effectiveness of a depigmented, polymerized cat epithelium extract (Dpg-pol-cat) for the treatment of allergic rhinoconjunctivitis and asthma. Real-world, retrospective study of patients ≥12 years with cat allergy and moderate to severe allergic rhinitis/rhinoconjunctivitis, with or without asthma, who started allergen immunotherapy (AIT) with Dpg-pol-cat extract during routine visits to the Allergy Department. Safety and effectiveness (improvement in FEV1) of AIT were evaluated. The use of rescue medication and patient perceptions were also assessed. A total of 62 patients were included, of which 34 (54.8%) received at least 12 months of AIT. There were 15 adverse reactions, 8 local and 7 systemic, of which 3 led to AIT discontinuation. Patients with moderate to severe rhinitis decreased from 88.2% at baseline to 29.4% at 12 months (p <0.0001), and patients with moderate asthma decreased from 76.5% to 38.2% (p = 0.0004). FEV1 improved from a mean (SD) of 3188.9 (771.4) ml to 3419.6 (878.4) ml (p = 0.0023). The use of rescue medications for rhinitis decreased from 94.1% to 23.5% (p <0.0001), all patients requiring rescue medications for conjunctivitis (20.6%) were medication free at 12 months, and 97.1% and 92.6% of patients reported improvement in rhinitis and asthma symptoms, respectively. AIT with Dpg-pol-cat extract shows a favorable safety and effectiveness profile in patients with allergic rhinitis/rhinoconjunctivitis, with or without allergic asthma, due to cat allergy, representing a valuable treatment option for these patients.

Mental health care needs of caregivers of people with Alzheimer's disease from online forum analysis.

Informal caregivers of people with Alzheimer's disease and related dementias (ADRD) are at risk of poor mental health. This study aimed to investigate the feasibility and validity of studying caregivers' mental stressors using online caregiving forum data (March 2018-February 2022) and natural language processing and machine learning (NLP/ML). NLP/ML topic modeling generated eight prominent topics, which we compared with qualitatively defined themes and the existing caregiving framework to assess validity. Among a total of 60,182 posts, 5848 were mental distress-related; for the ADRD patients (symptoms, medication, relocation, care duty share, diagnosis, conversation strategy) and the caregivers (caregiving burden and support). While we observed novel topics from NLP/ML-defined topics, mostly those were aligned with the existing framework. For feasibility assessment, qualitative title screening was done. The findings shed new light on the potential of NLP/ML text analysis of the online forum for informal caregivers to prepare tailored support for this vulnerable population.

Prodromal symptoms of a first manic episode: a qualitative study to the perspectives of patients with bipolar disorder and their caregivers'.

Diagnosing bipolar disorder (BD) is challenging, and adequate treatment is of major importance to minimalize the consequences of the illness. Early recognition is one way to address this. Although in clinical research the prodromal phase of BD is gaining interest, the perspective of patients with BD and their caregivers on prodromal symptoms is still lacking. The aim of this study is to gain insights in prodromal symptoms of patients with BD and their caregivers before the onset of a first manic episode. A qualitative research method was used to investigate prodromal symptoms one year prior to a first manic episode. In-depth interviews were conducted with patients with BD type I and their caregivers. Only patients with a first manic episode in the previous five years were included. The prodromal symptoms from patients' and caregivers' perspectives could be clustered into seven themes, with underlying subthemes: behavior (increased activity, destructive behavior, disinhibited behavior, inadequate behavior, changes in appearance), physical changes (changes in sleep, physical signals, differences in facial expression), communication (reciprocity, process, changes in use of social media), thought (process and content), cognition (changes in attention and concentration, forgetfulness), emotions (positive emotions, more intense emotions, mood swings), and personality (more pronounced manifestation of existing personality traits). Patients with bipolar I disorder and their caregivers described subsyndromal manic features one year prior to a first manic episode. In addition, they recognized mood lability, physical changes and more pronounced manifestation of existing personality traits. The results of this study confirm the presence of a prodromal phase. In clinical practice, monitoring of prodromal symptoms of BD can be useful in patients with depression, especially those with a familial risk of BD.

Logistic regression analysis of risk factors for anxiety and depression in patients with coronary heart disease and subclinical hypothyroidism.

We sought to explore the risk factors for anxiety and depression in patients with coronary heart disease and subclinical hypothyroidism through logistic regression analysis. A retrospective analysis was conducted on 168 patients with coronary heart disease and subclinical hypothyroidism admitted to the Department of Cardiology of our hospital from February 2020 to November 2022. Patients were categorized into the control group, anxiety group, and depression group based on the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores. All participants were informed about the protocol and provided signed informed consent upon inclusion. The study examined influencing factors for anxiety and depression in patients with coronary heart disease and subclinical hypothyroidism. Collect patients' gender, age, presence or absence of chronic diseases (including Diabetes, hypertension and hyperthyroidism), sleep quality, dietary habits, psychosocial stress, living environment, social support, education level, and blood TSH levels. The linear relationship between anxiety, depression, and each influencing factor was quantified using the Pearson correlation coefficient. Blood level of TSH and free T4 were detected by chemiluminescence immunoassay. Multiple logistic regression was applied to analyze the factors influencing anxiety and depression in these patients. Various factors were identified as significant influencers of anxiety and depression in patients with coronary heart disease and subclinical hypothyroidism. For anxiety, presence or absence of chronic diseases, sleep quality, dietary habits, psychosocial pressure, living environment, and blood TSH levels were found to be influential (P < 0.05). Similarly, for depression, presence or absence of chronic diseases, sleep quality, social support, quality of life, social support, education level, and blood TSH levels were identified as significant factors (P < 0.05). The study revealed positive correlations between presence or absence of chronic diseases, psychosocial stress, and TSH levels with anxiety symptoms in patients with coronary heart disease and subclinical hypothyroidism (P < 0.05). Conversely, sleep quality, dietary patterns, and living environment showed negative correlations with anxiety symptoms (P < 0.05).Gender and age had no correlation with anxiety levels (P > 0.05). Presence or absence of chronic diseases and TSH levels were positively correlated with depressive symptoms in patients with coronary heart diseaseand subclinical hypothyroidism (P < 0.05). On the other hand, sleep quality, social support, quality of life, and educational level were negatively correlated with anxiety symptoms (P < 0.05). Gender and age had no correlation with depression (P > 0.05). Notably, TSH levels in both the anxiety and depression groups were higher than those in the control group (P < 0.05), with no significant difference in free T4 levels among the groups (P > 0.05). The combination of chronic illness types, living habits (sleep quality, dietary habits), psychosocial pressure, living environment, and TSH levels emerged as risk factors for anxiety in patients with coronary heart disease and subclinical hypothyroidism (P < 0.05). Similarly, the combination of chronic illness types, sleep quality, social support, quality of life, education level, and TSH levels were identified as risk factors for depression in these patients (P < 0.05). This logistic regression analysis underscores the significant impact of factors such as types of chronic illness, sleep quality, social support, living environment, education level, and TSH levels on anxiety and depression symptoms in patients with coronary heart disease and subclinical hypothyroidism. These findings highlight the importance of considering these multiple risk factors collectively when devising treatment and management strategies to reduce the risk of mental health issues in this patient population.

BN SO62 - Laparoscopic technique for right sided paraduodenal hernia repair: A clinical study and surgical insights

Abstract Background Paraduodenal hernias can present significant diagnostic and therapeutic challenges, with up to 50% potentially leading to bowel obstruction. A minimally invasive approach to repairing these defects offers reduced morbidity and quicker recovery. This report highlights the feasibility and safety of laparoscopic repair of a right-sided paraduodenal hernia. Method A 19-year-old female presented with persistent postprandial bilious vomiting and a long history of forceful regurgitation 10-30 minutes after eating. The preoperative evaluation, surgical technique and operative outcomes are detailed. Results Preoperative evaluation included magnetic resonance imaging, computed tomography and a barium swallow, revealing an incidental finding of the duodenojejunal flexure and most jejunal loops on the right side of the abdomen. A right paraduodenal hernia was diagnosed during laparoscopy. After delineating and reducing the hernia laparoscopically, the sac was obliterated by opening up the posterior aspect over the inferior vena cava. The repair was completed by suturing the hernia orifice and plicating the duodenum. The patient's symptoms resolved postoperatively, with no intraoperative or immediate postoperative adverse outcomes reported. Scheduled outpatient follow-up showed satisfactory resolution of symptoms. Conclusion The laparoscopic repair of the right paraduodenal hernia was successfully performed, leading to the resolution of the patient's symptoms. This case underscores the importance of considering laparoscopic approaches for managing complex and rare hernias, especially when cross-sectional imaging modalities do not clearly identify the cause of symptoms. The laparoscopic technique offers significant advantages, including reduced pain and faster recovery.

Symptom Management in Patients Diagnosed with Ovarian Cancer

Symptom Management in Patients Diagnosed with Ovarian Cancer

The mechanism of transcutaneous gastric pacing treatment on gastrointestinal motility recovery and inflammation improvement in early-stage acute pancreatitis patients.

Acute pancreatitis (AP) is often accompanied by gastrointestinal motility disorders. The purpose of this study was to investigate the efficacy and possible mechanism of transcutaneous gastric pacing (TGP) in early-stage AP patients. Sixty-five AP patients were randomly divided into conventional treatment group and TGP group. The serum ghrelin and vasoactive intestinal peptide (VIP) were used to assess the possible gastrointestinal hormonal mechanism involved. The parameters of electrogastrogram (EGG) were used to evaluate the gastric motility in AP patients. The first defecation time was used to assess the recovery of intestinal motility. The heart rate variability (HRV) test was performed to assess autonomic nervous function. Compared with the conventional treatment group, the TGP treatment significantly improved symptoms in early AP patients, and shortened the first defecation time (p < 0.05) and the hospital days (p < 0.05). The level of VIP (P < 0.05) was also decreased in TGP group. The percentage of normal gastric slow waves (GSWS) (p < 0.05) was increased. The interleukin (IL)-6 level was decreased (P < 0.05). Concurrently, the vagal activity (HF) was increased (p < 0.01), the sympathetic activity (LF) was decreased (p < 0.01), and the ratio of sympathetic vagal (LF/HF) was decreased (p < 0.01). The TGP treatment significantly improves the clinical symptoms in early AP patients. It also increases the percentage of normal GSWS. The therapeutic effect of TGP may be caused by autonomic nervous function mechanisms.