Symptoms In Patients Research Articles

Validity and reliability of the thirst distress scale and the short version of the xerostomia inventory for use in German patients with chronic heart failure: A multicenter cross-sectional study.

Thirst and xerostomia are prevalent and distressing symptoms in patients with chronic heart failure (CHF). Evaluation of interventions to alleviate these symptoms requires valid and reliable instruments. Such instruments are currently lacking for German patients with CHF. The purpose of this study was to evaluate the structural and convergent validity, and internal consistency reliability of the German versions of the Thirst Distress Scale for Patients with Heart Failure (G-TDS-HF) and the short form of the Xerostomia Inventory (G-SXI). A cross-sectional, multicenter study was conducted involving patients with CHF. Participants completed a questionnaire containing the G-TDS-HF, G-SXI, and a visual analog scale (VAS) to indicate intensity of thirst and xerostomia. Exploratory and confirmatory factor analyses were conducted to assess structural validity. To assess internal consistency reliability, McDonald's Omega total was calculated, and Pearson´s r was used to examine convergent validity. A total of 371 patients (62.4 (± 14.9) years, 28.3 % female) participated in the study. Factor analysis of the G-TDS-HF revealed a two-factor structure. One factor represents symptom occurrence, and the second factor is symptom distress. Internal consistency reliability was deemed adequate, with McDonald's Omega total coefficients of 0.81. The correlation between the sum scores of the G-TDS-HF and thirst intensity (VAS) was r = 0.44 (p < 0.001). The G-SXI demonstrated a single-factor structure with a McDonald's Omega total of 0.71. The correlation between the G-SXI and xerostomia intensity (VAS) was r = 0.36 (p < 0.001). Results suggest that the G-TDS-HF and the G-SXI are valid and reliable instruments. Further research is warranted to assess responsiveness and test-retest reliability to strengthen the evidence.

Association of early-onset psychiatric disorders with REM sleep behavior disorder - A retrospective study.

Association of early-onset psychiatric disorders with REM sleep behavior disorder - A retrospective study.

An integrative Chinese herbal medicine and ointment therapy for bullous pemphigoid: A case report.

An integrative Chinese herbal medicine and ointment therapy for bullous pemphigoid: A case report.

A case of suspected paraneoplastic nerve syndrome associated with prostate cancer or opsoclonus-myoclonus syndrome associated with COVID-19 infection, but symptoms improved after treatment of both.

Paraneoplastic neurological syndrome is a type of neurological syndrome that occurs in patients with cancer; however, it is rarely associated with prostate cancer. We herein report a rare case of this condition. A 76-year-old man, treated conservatively for rotatory vertigo due to a subtype of Guillain-Barré syndrome after COVID-19, was referred to our neurology department. Magnetic resonance imaging showed no obvious findings; however, paraneoplastic neurological syndrome was suspected due to opsomyoclonus, and close examination of the primary tumor revealed a high prostate-specific antigen level and bone metastases, suggesting prostate cancer. Paraneoplastic nerve syndrome associated with prostate cancer was suspected. Since the possibility of OMS associated with COVID-19 infection was considered, bilateral orchiectomy and endocrine therapy, as well as pulse steroid therapy, were performed, and the patient's symptoms resolved. This rare case suggests the need for timely and aggressive treatment for prostate cancer-associated paraneoplastic nerve syndrome.

Correction of Secondary Exophthalmos Caused by Lateral Orbital Rim Recession: Add-on Implants Through a 3D Approach.

Improving exophthalmos is a crucial aspect of treatment for patients with syndromic craniosynostosis. However, in patients who have undergone previous treatments including fronto-orbital advancement and Le Fort III distraction osteogenesis and who have reached skeletal maturity, the recurrence of exophthalmos is not uncommon. The severity of the exophthalmos may vary. Whether secondary correction involving osteotomy should be performed or symptomatic treatment strategies should be adopted is a dilemma, and the patient's symptoms and background and the invasiveness of the surgery should also be considered. Additionally, the accurate measurement and treatment of exophthalmos require the expertise of surgeons. This report introduces self-developed orbital wall implants generated through 3-dimensional simulation and 3-dimensional printing. The patient was a 23-year-old woman with Crouzon syndrome and recurrent exophthalmos. After surgery, the exophthalmos and facial appearance were improved. The use of custom-made implants provides advantages over the conventional osteotomy method; it is less invasive, involves a simple surgical procedure, and offers cost and time savings.

Efficacy of Xuanbai Chengqi decoction combined with western medicine in treating AECOPD with phlegm-heat obstructing lung syndrome: a clinical study

Efficacy of Xuanbai Chengqi decoction combined with western medicine in treating AECOPD with phlegm-heat obstructing lung syndrome: a clinical study

Neglect symptoms are related to a prediction-hypersensitivity in ipsilesional space.

Neglect symptoms are related to a prediction-hypersensitivity in ipsilesional space.

Joint association of sleep onset time and sleep duration with depression in patients with chronic kidney disease: Insights from the NHANES 2015-2020.

Joint association of sleep onset time and sleep duration with depression in patients with chronic kidney disease: Insights from the NHANES 2015-2020.

Efficacy of Xuanbai Chengqi decoction combined with western medicine in treating AECOPD with phlegm-heat obstructing lung syndrome

Efficacy of Xuanbai Chengqi decoction combined with western medicine in treating AECOPD with phlegm-heat obstructing lung syndrome

Frontal gamma-alpha ratio reveals neural oscillatory mechanism of attention shifting in tinnitus.

In clinical practice, the symptoms of tinnitus patients can be temporarily alleviated by diverting their attention away from disturbing sounds. However, the precise mechanisms through which this alleviation occurs are still not well understood. Here, we aimed to directly evaluate the role of attention in tinnitus alleviation by conducting distraction tasks with multilevel loads and resting-state tests among 52 adults with tinnitus and 52 healthy controls. We demonstrated that the abnormal neural oscillations in tinnitus subjects, reflected in an altered gamma/alpha ratio index in the frontal lobe, could be regulated by attention shifting in a linear manner for which the regulatory effect increased with the load of distraction. Quantitative measures of the regulation significantly correlated with symptom severity. Altogether, our work provides proof-of-concept for the role of attention in tinnitus perception and lays a solid foundation to support evidence-based applications of attention shifting in clinical interventions for tinnitus.

Construction and Application of a Traditional Chinese Medicine Syndrome Differentiation Model for Dysmenorrhea Based on Machine Learning.

Dysmenorrhea is one of the most common ailments affecting young and middle-aged women, significantly impacting their quality of life. Traditional Chinese Medicine (TCM) offers unique advantages in treating dysmenorrhea. However, an accurate diagnosis is essential to ensure correct treatment. This research integrates the age-old wisdom of TCM with modern Machine Learning (ML) techniques to enhance the precision and efficiency of dysmenorrhea syndrome differentiation, a pivotal process in TCM diagnostics and treatment planning. A total of 853 effective cases of dysmenorrhea were retrieved from the CNKI database, including patients' syndrome types, symptoms, and features, to establish the TCM information database of dysmenorrhea. Subsequently, 42 critical features were isolated from a potential set of 86 using a selection procedure augmented by Python's Scikit-Learn Library. Various machine learning models were employed, including Logistic Regression, Random Forest Classifier, Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Artificial Neural Networks (ANN), each chosen for their potential to unearth complex patterns within the data. Based on accuracy, precision, recall, and F1-score metrics, SVM emerged as the most effective model, showcasing an impressive precision of 98.29% and an accuracy of 98.24%. This model's analytical prowess not only highlighted the critical features pivotal to the syndrome differentiation process but also stands to significantly aid clinicians in formulating personalized treatment strategies by pinpointing nuanced symptoms with high precision. The study paves the way for a synergistic approach in TCM diagnostics, merging ancient wisdom with computational acuity, potentially innovating the diagnosis and treatment mode of TCM. Despite the promising outcomes, further research is needed to validate these models in real-world settings and extend this approach to other diseases addressed by TCM.

Role of Video Assisted Thoracoscopic Surgery (VATS) in the Management of Pulmonary Sequestration; A Meta-Analysis

Background: Pulmonary sequestration is a rare birth defect. It is a nonfunctioning dysplastic lung tissue without connection to the tracheobronchial tree, and its blood supply is from one or more aberrant systemic arteries. The aim of this study is to review the current literature regarding the role of video-assisted thoracic surgery (VATS) in the management of pulmonary sequestration. Objective: This review aims to assess the safety, efficacy, and outcomes of Video-Assisted Thoracoscopic Surgery (VATS) in managing pulmonary sequestration while considering patient characteristics, symptoms, arterial sources, surgical techniques, and postoperative advantages. Methods: The Web of Science, PubMed, MEDLINE, and Google Scholar were searched for articles published in English. Article titles containing the words “Video-Assisted Thoracoscopic Surgery for Pulmonary Sequestration and/or VATS” were filtered out of the search to exclude a large portion of irrelevant studies. The extracted data were analyzed. The data extracted were presented as frequencies and percentages. Results: After excluding the unrelated articles, 27 studies were identified for analysis; most of the studies (18) were case reports, with nine being case series, and the total number of patients who underwent pulmonary sequestration by VATS was 240. Both genders were equally affected (125, 52% were male and 115, 48% were female), the most common presenting symptom was coughing,and the descending thoracic aorta was the most common artery from which the feeders originated. About 149 patients (62.08%) underwent a lobectomy. Conclusion: Pulmonary sequestration can safely be treated by VATS at single or multiple ports with a shorter hospital stay, less postoperative pain, and fewer analgesic requirements.

Integrating Generative AI into Clinical Practice Education: Enhancing Personalized Medicine Delivery Skills for Korean Medicine Students

Objectives: We aimed to explore the use of generative AI, specifically ChatGPT, in clinical practice education for Korean Medicine (KM) students. We focused on enhancing their ability to provide personalized lifestyle guidance and analog-type symptom-tracking tools for managing chronic non-communicable diseases (NCDs).Methods: The class was part of a clinical practice course for third-year KM students. The course included role-playing and PBL combined with CBL in four modules: cardiology and neurology I, cardiology and neurology II, gynecology, and acupuncture and moxibustion medicine. In each session, students used ChatGPT 4o to create tailored patient educational materials and symptom diaries based on patient case scenarios. These results were shared and discussed throughout the presentations. After completing all modules, students took a survey to assess their satisfaction with ChatGPT and its potential for future applications.Results: Students effectively used ChatGPT in all four modules to provide individualized lifestyle advice and symptom records, tailoring the outputs to suit patient needs. When ChatGPT became momentarily unavailable, Claude was utilized as a replacement. Student feedback indicated that generative AI could enhance their understanding of disease-specific lifestyle management and improve their efficiency in creating patient-centered educational materials.Conclusions: Integrating generative AI into clinical education allows KM students to gain real experience in tailored healthcare delivery. As generative artificial intelligence becomes more extensively employed, various Korean medical college education programs utilizing it should be implemented in the future.

Effect of Instructional Guidelines on Severity of Symptoms For Patients with Irritable Bowel Syndrome

Effect of Instructional Guidelines on Severity of Symptoms For Patients with Irritable Bowel Syndrome

Naturalistic trial of nudging patients and clinicians in the Norwegian sickness absence clinics: a study protocol for the NSAC Nudge Study

IntroductionCommon mental disorders and musculoskeletal disorders are the leading causes of sickness absence and disability. There has been a rise in work-focused clinical interventions and studies investigating whether general clinical...

Atopic Dermatitis in Adults: Focus on Topical Therapy.

Objective To review the topical therapies for adults, including older adults, with atopic dermatitis. A background on atopic dermatitis in adults, overview of treatment recommendations, and the pharmacists' role for care is included. Data Sources Articles indexed in PubMed, Cochrane Reviews, and Google Scholar in the past 10 years using the search terms atopic dermatitis, atopic dermatitis and treatment, and atopic dermatitis and adults were reviewed. Current guidelines and manufacturers' prescribing information were reviewed. Primary sources were used to locate additional resources. Study Selection/Data Extraction Forty-five publications were reviewed and criteria supporting the objectives identified useful resources. Data Synthesis Selected literature included practice guidelines, review articles, research articles, product prescribing information, and drug information databases. Conclusion Atopic dermatitis is a common chronic inflammatory cutaneous disease that may present at any age. Atopic dermatitis has a relapsing course with active disease followed by periods of remission. Atopic dermatitis is not curable, but available and recommended regimens can control patient symptoms. Topical therapies are the preferred treatment and are able to control atopic dermatitis in most adults. Topical moisturizers are the mainstay of therapy. Despite regular use of a moisturizer, most patients will need a topical anti-inflammatory agent to control disease flares. The Food and Drug Administration-approved topical anti-inflammatory agents include the corticosteroids, calcineurin inhibitors, a phosphodiesterase-4 enzyme inhibitor, and a Janus Kinase inhibitor. Pharmacists are in a unique position to counsel patients about the appropriate use and benefits and risks of atopic dermatitis therapies.

Patient experiences of internet-based enhanced cognitive behavior therapy for eating disorders.

Patient experiences of internet-based enhanced cognitive behavior therapy for eating disorders.

EXIT INTERVIEWS EXPLORING PATIENTS’ EXPERIENCE OF CHANGES IN THEIR ABDOMINAL PAIN DURING THE PHASE 3 CLINICAL TRIAL OF MIRIKIZUMAB FOR TREATMENT OF MODERATELY TO SEVERELY ACTIVE CROHN’S DISEASE

Abstract INTRODUCTION Abdominal pain (AP) is the most common symptom in patients with Crohn’s disease (CD) and negatively impacts quality of life. We qualitatively examined the changes in AP among participants with moderately to severely active CD who completed the phase 3, randomized, double-blind, placebo- and active-controlled mirikizumab clinical trial (NCT03926130). METHODS Web-assisted, semi-structured exit interviews were conducted with 62 trial participants from either mirikizumab, ustekinumab, or placebo arms. Interviews were aimed to be 90 minutes and within 3 weeks after final trial visit. All 62 participants were asked exploratory questions about their CD during the trial. Of 62 participants, 30 with even interview IDs were asked questions to explore AP. The AP item from the Crohn’s Disease Activity Index (CDAI; 4-point scale; 0: None, 3: Severe) was used to assess the worst AP in the past 24 hours. Interview audio recordings were transcribed verbatim and analyzed using directed content and framework analysis. RESULTS Of 62 participants, 55% (n=34) were female, and 90% (n=56) were White. The median age was 44 years (n=61; range: 22–75), and the median duration of CD was 7.9 years (n=61; range: 1.4–54.1). Of 62 participants asked which CD symptoms they experienced, 74% (n=46) reported AP at the start of trial. Participants described AP as sharp, stabbing, intense, and severe, and 14 reported abdominal cramps. At last visit, 14 participants reported that they did not experience AP, and 22 reported a reduction in AP. Among those who were asked about changes in their AP (n=30), most reported improvement (83%, n=25/30) during the trial. Of those 25 participants, 12 reported improved AP severity and 12 reported changes in AP frequency, including reduction in frequency (n=8), rare occurrence (n=3), and AP for a shorter duration (n=1). Other participants (17%, n=5/30) reported that they had not experienced any changes in AP over the trial. Among participants who experienced an improvement in AP (83%, n=25/30), positive impacts included feeling productive (n=3), improved daily functioning (n=2), ability to go out and work (n=2), and better sleep (n=1). Twenty-nine of 30 participants rated their AP on the AP item using CDAI scale at the first and last trial visits. At the first visit, most (83%, n=24/29) participants reported moderate to severe AP. At last visit, most participants (93%, n=27/29) reported none or mild AP. Most participants (86%, n=25/29) experienced improvement, with over half (59%, n=17/29) experiencing ≥2-point improvement in their AP during the trial. Of those who experienced any improvement in their AP (n=25), 84% (n=21/25) considered it meaningful. CONCLUSIONS Exit interview results showed most interviewed participants experienced a high burden of AP at the start of the trial and a meaningful improvement in AP by the end of the trial.

Potential Impact of Choline Alphoscerate on Depressive Symptoms in Association with Insulin Resistance in Elderly Patients with Type 2 Diabetes

Background/Objectives: The aim of this study was to investigate whether Gliatamin (choline alphoscerate), an acetylcholine precursor originally used to treat dementia, improves depressive symptoms in patients with type 2 diabetes. Methods: We conducted a 6-month double-blind, randomized, and placebo-controlled trial involving 49 participants with type 2 diabetes, older than 50 years, and with mild depressive symptoms; 33 and 16 participants received choline alphoscerate (800 mg/day) and a placebo, respectively. Results: At 6 months, the Hamilton Depression Rating Scale was significantly decreased in both the choline alphoscerate (15.9 ± 6.5 to 12.6 ± 5.8, p = 0.001) and placebo (15.4 ± 4.7 to 10.2 ± 3.9, p = 0.004) groups compared with baseline, without inter-group difference (p = 0.297). Meanwhile, the choline alphoscerate group showed favorable results in insulin resistance-related parameters at 6 months, including the waist circumference (WC) and the low-density lipoprotein cholesterol (LDL)/high-density lipoprotein cholesterol (HDL) ratio (p for inter-group difference vs. placebo = 0.009 and 0.092). Even after adjusting for multiple confounding factors, choline alphoscerate use was associated with an increased odds for reduction in WC (OR 18.28 [95% CI 2.27–461.35]) and a decreased odds for a high LDL/HDL ratio at 6 months (OR 0.16 [95% CI 0.03–0.76]). Conclusions: Choline alphoscerate did not show superiority over the placebo in terms of the alleviation of depressive symptoms, despite significant pre-post changes observed within the choline alphoscerate group. Nevertheless, given its positive potential for insulin resistance, the effects of choline alphoscerate on depressive mood in relation to insulin resistance in patients with type 2 diabetes require further validation.

Headache in patients with systemic lupus erythematosus: A matched case-control study.

To compare the prevalence and characteristics of headaches between patients with systemic lupus erythematosus (SLE) and people without the disease and to assess whether there was a relationship between headaches and disease activity. Headache is a common symptom in patients with SLE; however, the effect of SLE on headaches is not fully known. This was a case-control study. Individuals with and without SLE matched by age and sex were compared. All participants were assessed by a neurologist. A semi-structured questionnaire, the six-item Headache Impact Test (HIT-6) and the Hospital Anxiety and Depression Scale were used. Disease activity was measured by a rheumatologist using the Physician Global Assessment (PGA) and quantified using the modified Systemic Lupus Erythematosus Disease Activity Index 2000 scale (modified SLEDAI-2K). Data were collected between November 2021 and January 2023. A total of 228 individuals were included, 114 in each group. The SLE group presented with more moderate/severe headache attacks than the controls (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.21-4.95; p = 0.013). When comparing patients with active SLE and those without disease activity, there was no difference in the prevalence (OR 1.48, 95% CI 0.38-5.74), type (migraine: OR 1.69, 95% CI 0.71-3.99; tension-type headache: OR 0.64, 95% CI 0.25-1.68), frequency (4; 2-15 vs. 3; 1-12 days/month; p = 0.250), intensity (moderate/severe intensity: OR 0.59, 95% CI 0.19-1.82), or impact of headache (HIT-6: 61; 50-65 vs. 56; 45-63; p = 0.278). The magnitude of SLE activity (modified SLEDAI-2K) demonstrated no statistically significant association with the impact (standardized beta coefficient: 0.02, 95% CI -0.05 to 0.09; p = 0.792) or monthly frequency of headache (standardized beta coefficient: 0.09, 95% CI -0.08 to 0.26; p = 0.275). Headache is a common symptom in SLE, although the prevalence was similar to that of the controls without the disease. While patients with SLE had more intense headache attacks than the controls without SLE, there was no association between headache and SLE activity.