Prevalence Of Symptoms In Patients Research Articles

Symptom prevalence in patients with advanced heart failure and its association with quality of life and activities of daily living.

Quality of life (QOL) and functional status are two key outcomes for patients with advanced heart failure (HF). We examined the association of eleven symptoms with QOL and functional status impairment in patients with advanced HF. This was a retrospective analysis of baseline data from a multi-center, cluster-randomized controlled trial (NCT01459744) which enrolled patients with an implanted cardioverter-defibrillator and advanced HF at high-risk for mortality. Study instruments included the Condensed Memorial Symptom Assessment Scale, the Kansas City Cardiomyopathy Questionnaire QOL subscale, and the number of activities of daily living (ADL) patients had difficulties with. The study included 413 subjects. In generalized linear models which were adjusted for baseline characteristics, the total number of symptoms was significantly associated with worse QOL, as was the presence of each individual symptom, except constipation. Lack of energy demonstrated the strongest negative association with QOL. Similarly, the total number of symptoms was associated with a higher number of ADL difficulties (i.e., worse functional status). The presence of pain, lack of energy and drowsiness was individually associated with more ADL difficulties. Among patients with advanced HF, a higher number of symptoms and specific individual symptoms were associated with worse QOL and functional status.

Health-Related Quality of Life and Symptom Burden Profile of Patients with Pre-Fibrotic and Overt Myelofibrosis: A Preliminary Report from the Gimema-Prophecy Observational Study

Background Patients with overt myelofibrosis (MF) suffer a significant symptom burden and impairment of health-related quality of life (HRQoL). However, very little evidence-based data is available on HRQoL and the symptom burden of patients with pre-fibrotic MF. Aim The primary objective of this study was to describe the HRQoL profile of patients with pre-fibrotic MF relative to patients with overt MF. The secondary objective was to examine disease-specific symptom prevalence in both groups. Methods. Baseline data from an ongoing prospective multicenter observational study by the GIMEMA Group were analyzed. The inclusion criteria of this study were: adult patients diagnosed with Philadelphia chromosome-negative myeloproliferative neoplasm (MPN), according to the 2016 WHO classification, within one year before the registration date. For the purpose of this analysis, only patients with pre-fibrotic and overt MF were considered. HRQoL profile was assessed with the EORTC QLQ-C30, which consists of 30 items and includes five functional scales (physical, role, emotional, social, and cognitive), three symptoms (fatigue, nausea, vomiting, and pain), a global health status/QoL scale and six single items (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Well-established evidence-based guidelines for interpreting the QLQ-C30 were used to determine clinically meaningful differences between groups (i.e., pre-fibrotic vs overt MF). Given the exploratory nature of the study, n o statistical testing was performed on mean score differences. Symptom prevalence was assessed by items of the MPN-SAF TSS. The MPN-SAF TSS is a comprehensive and brief 10-item instrument that concisely assesses the prevalence and severity of debilitating symptoms of MF. The percentage of patients who reported symptoms on the MPN-SAF TSS was based on the number of patients who answered at least 1 on a given item. Results. Overall, 104 patients with a median age of 68 years (IQR: 59-76) were enrolled across 20 community and university-based hospitals. More than half of the patients were male (n=58; 56%), and 55 (53%) revealed splenomegaly. Thirty-five patients (34%) reported at least one comorbidity. The median time since diagnosis for the overall group was 4 months (IQR: 1-7), and there were 69 and 35 patients diagnosed with overt and pre-fibrotic MF, respectively. The median age of patients with overt MF and pre-fibrotic MF was 69 (IQR: 61-76) and 63 (IQR: 57-75), respectively. At study entry, no statistically significant differences were observed between the two groups regarding age, sex, prevalence of comorbidities, WBC, and PLT counts. However, patients with overt MF had lower Hb levels (p=.003). Inspection of the HRQoL profile, according to the EORTC QLQ-C30, showed that patients with overt MF had a statistically and clinically meaningful worse global HRQoL compared to patients' pre-fibrotic MF (Δ=11.4). The following functioning scales were also mostly impaired in patients with overt MF: role functioning (Δ=14.2), cognitive functioning (Δ=4.7), and social functioning (Δ=8.1) (Figure 1). With regard to symptoms severity, patients with overt MF reported clinically meaningful higher severity for fatigue (Δ=6), pain (Δ=7.2), insomnia (Δ=6), constipation (Δ=5.4), and appetite loss (Δ=6.8). However, patients with pre-fibrotic MF reported clinically meaningful higher severity for dyspnea (Δ=5.5). The prevalence of symptoms according to the MPN-SAF TSS, overall and by disease group, is reported in Table 1. The prevalence of symptoms in the overall group of patients was high, with the top three most prevalent symptoms being fatigue (78%), concentration problems (53%), and inactivity (50%). Notably, the prevalence of symptoms was also high in patients with pre-fibrotic MF, with some one-third of them reporting: fatigue, concentrations problem, inactivity, early satiety, abdominal discomfort, night sweats, itching, and bone pain. Conclusions. To the best of our knowledge, this is one of the first evidence describing HRQoL and the symptom burden of patients with pre-fibrotic MF. Although our preliminary data suggest that the HRQoL profile of patients with pre-fibrotic MF was generally worse than those with overt MF, our findings also indicate a high symptom prevalence in patients with pre-fibrotic MF.

Symptoms and symptom clusters in patients newly diagnosed with inflammatory bowel disease: results from the IBSEN III Study

BackgroundPatients with inflammatory bowel disease report multiple symptoms, but the relationships among co-occurring symptoms are poorly understood. This study aimed to examine the prevalence of symptoms and explore symptom clusters and possible associations between symptom clusters and socio-demographic and clinical variables in patients newly diagnosed with inflammatory bowel disease.MethodsThe IBSEN III study is a prospective population-based inception cohort of patients with inflammatory bowel disease. This study used patient data from the three largest hospitals in the study catchment area. The Memorial Symptom Assessment Scale was used to assess the prevalence of symptoms. Symptom clusters were identified using principal component analysis. Possible associations between socio-demographic and clinical variables and symptom cluster membership were estimated using regression analysis.ResultsOf the 573 patients (age, ≥18 years) diagnosed with inflammatory bowel disease, 350 (61.1%) completed the questionnaire (responders). Eleven symptoms were reported by >50% of the responders. The three most prevalent symptoms were bloating (84%), drowsiness (81%), and lack of energy (81%). Three symptom clusters were identified: psychological (56% of the patients), impaired energy (28%), and physical (16%) clusters. Multinomial regression analysis revealed that vitamin D deficiency was significantly associated with the impaired energy cluster (odds ratio=2.49, 95% confidence interval [1.00-6.2],p=0.05).ConclusionsWe found high symptom prevalence in patients newly diagnosed with inflammatory bowel disease. Three distinct symptom clusters were identified, and the psychological cluster includes >50% of the patients. Vitamin D deficiency is the only factor associated with cluster membership, namely the impaired energy cluster.

Abstract P4-11-13: Prevalence of treatment-related symptoms in patients with breast cancer undergoing (neo)adjuvant endocrine therapy with or without chemotherapy for early stage breast cancer

Abstract Prevalence of treatment-related symptoms in patients with breast cancer undergoing (neo)adjuvant endocrine therapy with or without chemotherapy for early stage breast cancer. Background: Survivorship care plans require identification of post-treatment problems.Methods: After completion of (neo) adjuvant therapy and immediately prior to a survivorship visit which included a treatment summary and care planning, patients completed an automated tablet-based series of 25 biopsychosocial questions (Survivorship-SupportScreen). Problems were identified and rated on a Likert scale of 1-5. This analysis addresses the differences in patient reported symptoms in women treated with endocrine therapy (ET) alone compared to those receiving chemotherapy and ET (CT+ET). Results: 204 women with a mean age of 57.5 years at screening time (Range 27-90) completed the Survivorship-SupportScreen within a median of 0.9 years of initial diagnosis. The 113 patients receiving CT+ET were younger than the 91 treated with ET alone (Mean 54.83 versus 60.89, with p<0.001) with no significant difference in time from first diagnosis to screening. Prevalence of problems was similar for both groups, except for neuropathy (p<0.001). By Logistic regression models neuropathy was 2.5 times more likely in patients treated with chemotherapy. Patients ≥ 50 years treated with CT+ET reported more hot flashes and lack of regular exercise: OR=2.18, p=0.024, and OR=2.04, p=0.033. Conclusions: We have demonstrated the feasibility of screening patient as they transition from active treatment to survivorship. Except for neuropathy, all patients receiving CT+ET had similar problems compared with those on ET alone. Women ≥ 50 years who received CT+ET, were more likely to report hot flashes and lack of regular exercise. Despite the fact that most of these women are likely cured of their cancer, the negative lingering sequelae of problem-related distress were reported by all patients. CT+ETET alonepFatigue81/110 (73.64%)65/88 (73.86%)0.971Worry about recurrence77/113 (68.14%)60/91 (65.93%)0.739Sleeping70/112 (62.5%)51/91 (56.04%)0.351Not being physically active67/110 (60.9%)50/89 (56.18%)0.500Neuropathy64/113 (56.64%)29/91 (31.87%)<0.001Pain62/112 (55.36%)43/90 (47.78%)0.284Hot flashes61/113 (53.98%)52/91 (57.14%)0.652Thinking clearly53/111 (47.75%)38/89 (42.7%)0.476Vaginal dryness47/113 (41.59%)31/91 (34.07%)0.271Gained weight45/113 (39.82%)34/91 (37.36%)0.720 Citation Format: Joanne Mortimer, Sharla Moore, Niki Patel, Mina Sedrak, Daphne Stewart, Yuan Yuan, James Waisman, Brittany Bradford, Matthew Loscalzo, Karen Clark, Marianne Razavi. Prevalence of treatment-related symptoms in patients with breast cancer undergoing (neo)adjuvant endocrine therapy with or without chemotherapy for early stage breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-11-13.

Prevalence of Depressive Symptoms in Patients With Psoriatic Arthritis: Have Numbers Changed During the COVID-19 Pandemic?

This longitudinal analysis compares the prevalence of depressive symptoms in patients with psoriatic arthritis in the context of the COVID-19 pandemic. Data from a national patient register in Germany were analyzed regarding the Patient Health Questionnaire 2 (PHQ-2) to identify cases suspicious for depression at two time points, i.e., before and during the COVID-19 pandemic. Only patients with complete concurrent information on the Disease Activity in Psoriatic Arthritis Score (DAPSA) were included in the analysis. The frequency of depressive symptoms in psoriatic arthritis patients during the COVID-19 pandemic did not differ from the prevalence rates measured before. In addition, prevalence rates for depressive symptoms did not differ when stratifying the patient sample for DAPSA levels of disease activity measured before the pandemic. These results were confirmed further in a sensitivity analysis, limiting the second PHQ-2 assessment to lockdown periods only. However, longitudinal data on the prevalence of depressive symptoms in patients with rheumatic diseases, in general, and psoriatic arthritis, in particular, are scarce in the context of the COVID-19 pandemic. For a sensible comparison of prevalence rates for depressive symptoms in the future, underlying SARS-CoV-2 infection rates and resulting local healthcare disruptions need to be taken into account, besides the potential use of different depression screening tools to evaluate resulting numbers sensibly and draw corresponding conclusions for patient care.

#3041 High prevalence of lifetime depressive symptoms in patients referred for clinical amyloid-PET: a retrospective study

Objectives/AimsDepression has been reported as a possible risk factor for Alzheimer’s Disease, but also as one of the clinical features of Alzheimer’s as well as other dementias. Further, depression has long been associated with cognitive impairment in the absence of neurodegeneration (Connors et al. 2018). Here we sought to ascertain the prevalence of clinical depression in patients meeting widely accepted Appropriate Use Criteria for Amyloid PET Imaging (API). We examined the prevalence of lifetime depression in patients undergoing clinical API in a real-world clinical setting and compared our findings with population data from community-dwelling older adults. We also examined whether rates of depression were higher in amyloid positive or negative groups.MethodsOne-hundred-and-eighty-five older adults (mean age 67.079.37, 49% females) underwent diagnostic workup, including API, at the Imperial Memory Clinic between January 2017 and June 2019. API was performed in line with appropriate use criteria after multidisciplinary team discussion. History of depressive symptoms and features of depression were evaluated through a review of hospital records and clinical correspondence. Patients were defined as having a history of depression if there was evidence of previous or current depressive symptoms and/or of a formal diagnosis of depression in their clinical records.ResultsBased on visual reads, 83 individuals had positive Amyloid-PET scans and 102 were negative. Overall, 102 (55%) patients(mean age=66.758.99, 56% females) had a history of lifetime depressive symptoms, compared with just 12 and 19% of elderly individuals in the general population (McDougall et al. 2007; Biddulph et al. 2014). Of the 92 patients for whom further information regarding depression onset were available, 54 (58.7%) had early symptom onset (age <60), and 38 (41.3%) had late symptom onset (age ≥s60). At the time of the clinical assessment at the Imperial Memory Clinic, 71 of those 102 (69.6%) were on active treatment for depression. Finally, depression was not associated with amyloid status (χ2(1) =1.12p=.26), with 42 (41.2%) amyloid-positive and 60 (58.8%) amyloid-negative patients reporting a history of depression.ConclusionsOver half of patients with suspected cognitive impairment and meeting appropriate use criteria for clinical API had a history of depression, regardless of amyloid status. Depression is an important but incompletely understood factor in referral for evaluation with Amyloid-PET.

Prevalence of Symptoms in Patients Discharged from COVID Care Facility of NIMS Hospital: Is RT PCR Negativity Truly Reflecting Recovery? A Single-Centre Observational Study.

PurposeTo assess the prevalence of post-COVID symptoms in patients with recovered COVID-19 (nasopharyngeal RT PCR negative) who were discharged from an acute COVID care facility at a tertiary care teaching hospital in North India.MethodsThis study was an observational study with retrospective data collection, conducted in the COVID follow-up clinic, a combined clinic of medicine and endocrinology. Patients discharged from the acute COVID care facility were recruited after 14 days of discharge if they fulfilled inclusion and exclusion criteria. The retrospective data was collected from the hospital records/EMR and analysed by the SPSSv23.ResultsFifty patients, who fulfilled the inclusion and exclusion criteria, were included in the study. The Mean age of patients was 53.4±13.8 years (range 28–77). Seventy six percent were male, and 38% had type 2 diabetes. Fever (94%), cough (78%) and breathlessness (68%), were the most common symptoms at presentation to acute care facility. Oxygen saturation at presentation had a negative correlation with D-Dimer, age, and C reactive protein. When patients were evaluated clinically, after 14 days (range 15 to 50 days) of the discharge, 82% of patients had at least one persistent symptom. Fatigue (74%) was the most common symptoms in follow-up followed by breathlessness (44%), and muscle weakness (36%). Two patients had persistent fever, even after negative RT PCR status.ConclusionPatients discharged from the acute COVID care facility had a high prevalence of post-COVID symptoms even after 14 days.

The prevalence of depression in patients attending Comprehensive Care Centre, Islamabad, Pakistan

Introduction: Depression is one of the most common neuropsychiatric complications of HIV disease, and this leads to worse HIV-related health outcomes. With 350 million people affected worldwide, rates of depression are roughly two times greater in people living with HIV than in the general population. Objective: Determine prevalence of depression in patients attending Comprehensive Care Centre Shifa international Hospital, Islamabad Methods: This data is from a bigger study ‘prevalence of alcohol use disorders and depression in patients attending Comprehensive Care Centre (CCC). The study population consisted of PLWHA attending the CCC. Two hundred and seventy-two (N=272) participants from CCC attendants were recruited. All consenting male and female aged 18-65 years were interviewed using the researcher’s designed questioner to collect their socio-demographic characteristics. Fully completed questionnaires were entered into excel sheets and analyzed using the Statistical Package for Social Sciences (SPSS) Version 20. Results: The overall prevalence of depression was 23.8%, with mild depression at 9.7%, moderate depression at 10.4% and severe depression accounting for 3.7%, respectively. Depression was associated with alcohol use (p=0.024). A significant difference between depression and age where depression levels worsens as age advances; respondents in age category of 18-21 years had less or no depression compared to those in the age category of 33 years and above. We found an association between depression and employment. Those laid-off work (1/3), and the retired (15%) had more depression compared to the employed (11%) or self-employed 6%, with a P value of 0.55 (borderline). On multivariate analysis severity of depression (OR=5.5, 95% CI of OR [2.1 –14.3], p<0.0001) was associated with male gender (OR=10, 95% CI of OR [3.6 –28.3], p<0.0001). Conclusion: The study findings indicate a high prevalence of depressive symptoms in patients attending the CCC. There is need to set-up appropriate interventions and strategies to reduce the prevalence of mental health disorders into routine HIV clinical care and support.

Prevalence and risk factors of bowel symptoms in Korean patients with ulcerative colitis in endoscopic remission: a retrospective study

BackgroundMany patients with ulcerative colitis (UC) in clinical remission frequently complain of bowel symptoms such as increased stool frequency (SF) and rectal bleeding (RB). However, studies on these patient-reported outcomes in patients with inactive UC are limited, especially in Korea. Therefore, we investigated the prevalence and risk factors of bowel symptoms in Korean patients with inactive UC.MethodsWe investigated the prevalence of bowel symptoms in patients with endoscopically quiescent UC between June 1989 and December 2016 using a well-characterized referral center-based cohort. The Mayo clinic score (MCS) was used to evaluate bowel symptoms at the most recent visit near the date of endoscopy. Clinical characteristics of the patients were compared based on the presence or absence of bowel symptoms.ResultsOverall, 741 patients with endoscopically quiescent UC were identified, of whom 222 (30%) and 48 (6.5%) had an SF and RB subscore of ≥ 1, respectively. Patients with bowel symptoms (SF + RB ≥ 1; n = 244 [32.9%]) had higher rates of left-sided colitis (E2) or extensive colitis (E3) than patients without bowel symptoms (SF + RB = 0; n = 497 [67.1%]; P = 0.002). Multivariate analysis revealed that female sex (odds ratio [OR]: 1.568; 95% confidence interval [CI]: 1.023–2.402; P = 0.039) and E2 or E3 (OR 1.411; 95% CI 1.020–1.951; P = 0.038) were the significant risk factors for increased SF.ConclusionsThis study revealed that one-third of patients with endoscopically quiescent UC reported increased SF. Female sex and disease extent may be associated with bowel symptoms.

The prevalence of lower urinary tract symptoms in patients with multiple sclerosis in Riyadh, Saudi Arabia

The prevalence of lower urinary tract symptoms in patients with multiple sclerosis in Riyadh, Saudi Arabia

Prevalence of symptoms in patients poisoned with iron in Ahvaz Razi Hospital in 2014-2017

Background: Iron is an important element for normal cell metabolism, but in excess amounts is quite cytotoxic, and even deadly. Iron poisoning is a calamity repeated many times in the world. The clinical signs of the patients include gastrointestinal symptoms, a short period of relative stability, Cardiogenic shock, liver failure, and scarring of the gastrointestinal tract. Iron tablets are specifically tempting to children because they are similar to candy. Iron overdose in adults is usually to attempt suicide. Methods: The present study is a descriptive-analytic study based on hospital information, that was conducted among the patients affected with iron poisoning admitted to Razi hospital (a referral medical setting for poisoning treatment in southwest Iran) during 2014-2017. Patient information has been extracted and inserted in the inquiry form and data were analyzed by SPSS software. Results: In this study, 52 patients (94.2% female) were studied. 5 (9.6%) of women were pregnant. The majority of them (69.2%) were between 15-25 years of age. Nausea and vomiting (50%) are two of the most common side effects. 5 patients (9.6%) received deferoxamine. All Patients who received deferoxamine, symptoms had less than 6 hours of onset. Most patients were hospitalized between 6-24 hours. 25% of patients took vitamins simultaneously with iron. The Serum level of iron in 3 patients (5.8%) was above 300 µg/dL. Based on this research, mortality was reported in one patient. Conclusion: In this study, the prevalence of iron poisoning was examined based on demographic and clinical characteristics. Considering the most prevalent iron poisoning in the young age group (96.2% suicides), more research in the psychological and social problems is critical for preventative behaviors.

Look at the cognitive deficits in patients with myotonic dystrophy type 1: an exploratory research on the effects of virtual reality.

Myotonic dystrophy type 1 is a neuromuscular disease, characterized by a progressive loss of strength, muscle stiffness, and difficulty in relaxation. Myotonic dystrophy type 1 patients can present several neuropsychological deficits, as well as anxiety and mood disorders. Aim of this study is to evaluate the feasibility and the effect of virtual reality in the cognitive and behavioral recovery of myotonic dystrophy type 1 patients. Eleven patients (8 female and 3 male) underwent a specific cognitive rehabilitation program including a conventional neuropsychological treatment followed by a virtual reality neurorehabilitation training using the Virtual Reality Rehabilitation System (Khymeia, Italy). Virtual reality improved many cognitive domains, including executive function, attention, verbal and visuo-spatial abilities, as well as mood and coping strategies. Due to the high prevalence of neuropsychological symptoms in patients with myotonic dystrophy type 1, cognitive rehabilitation should enter into the framework of these patients to potentially boost cognitive and behavioral function and improve quality of life.

Assessment of the Prevalence of Symptoms in Patients Under Institutional Isolation in COVID-19 Pandemic in India.

Objective:To understand the trend of prevalence of symptoms of coronavirus disease 2019 (COVID-19) pandemic, some studies have been conducted outside India, but for Indian patients, there is no such study available. Therefore, this study was designed to analyze the trends of symptoms in Indian patients during COVID-19 pandemic.Methods:A retrospective study was conducted on 100 patients (73 males, 24 females, and 3 transgenders) admitted under institutional isolation at a tertiary care center in India using a self-designed survey-based questionnaire. A descriptive analysis of results done based on age and sex.Results:COVID incidence recorded is high in male (73%) as compared to female (24%), yet female patients have a higher prevalence of symptoms as compared to male patients.Conclusion:Male patients are more as far as COVID incidence is concerned, while female patients show high prevalence of symptoms as compared to male patients. Patients presenting with COVID-positive report suffer a significant burden of symptoms, and timely recognition of symptoms and their management can significantly reduce morbidity and mortality due to COVID-19.

Pretreatment symptom prevalence in patients with myelodysplastic syndromes (MDS) across all disease risk categories: Analysis of 914 patients.

e18220 Background: Whilst a substantial body of knowledge is available on the genetics and biology of MDS, very little is known on quality of life of these patients. We aimed to 1) examine patient-reported symptom prevalence in newly diagnosed MDS patients by disease risk at diagnosis; 2) investigate prevalence of other key symptoms by fatigue severity. Methods: Newly diagnosed MDS patients were recruited in an international prospective observational study from Nov. 2008 to Dec. 2018. As per standard practice, all patients were classified according to the International Prognostic Scoring System (IPSS) that identifies four risk subgroups of patients, i.e. low, intermediate-1 (i.e., lower risk, LR), intermediate-2, and high-risk (i.e., higher risk, HR). At baseline (i.e., pretreatment) patients also completed the validated FACIT-Fatigue scale and the EORTC QLQ-C30 questionnaires. Based on the FACIT-Fatigue median score, two groups were also identified: a lower and a higher fatigue group. Results: Out of 929 patients enrolled, 914 patients were available for current analysis of whom 496 with LR (median age of 74 years) and 418 with HR (median age of 72 years). Prevalence (i.e., with any level of concern) of symptoms by disease risk group is reported in Table. Patients with higher fatigue had a significantly higher prevalence of many other symptoms, such as pain (p < .001), dyspnea (p < .001), insomnia (p < .001), appetite loss (p < .001), diarrhea (p < .001) and constipation (p < .001) than patients with lower fatigue. To illustrate, moderate to severe dyspnea was reported by 38% of patients with higher fatigue and only by 5% of patients who reported lower fatigue. Conclusions: Pretreatment symptom prevalence in newly diagnosed MDS is high, and broadly similar in LR and HR patients. Regardless of disease severity at diagnosis, fatigue is associated with a substantial burden of other symptoms. [Table: see text]

Symptoms of and Palliative Treatment for Unresectable Skin Cancer.

The symptom prevalence in patients with advanced cancer depends on the type of primary cancer, and the palliative treatment varies according to the nature of the primary cancer. Palliative treatment for unresectable skin cancer has not been fully discussed. Patients with unresectable skin cancer sometimes show the primary lesion in the skin and metastases to the lung, skin, liver, and bone. Pain, anorexia, and dyspnea commonly occur in such patients, and bleeding, exudate, and offensive odor are characteristically observed. For the last three symptoms, surgery and radiation are effective therapeutic options, and cryotherapy, Mohs' chemosurgery, electrochemotherapy, and some topical ointments and dressing materials are also additional options. For pain due to bone metastasis, pharmacotherapy with opioid and/or non-opioid agents is the most basic treatment, and radiation and bisphosphonate therapies are other options. For dyspnea, which is an intractable and uncomfortable symptom, morphine and oxygen play a leading role in treatment. Red blood cell transfusions may be effective for some patients with dyspnea induced by anemia. Nutritional supports and pharmacotherapy are therapeutic options for anorexia. As nutritional supports, enteral nutrition is better than parenteral nutrition. There is some evidence of progestins and corticosteroids having supportive effects for anorexia. Dermatologic oncologists should be skilled with symptom managements to maintain the quality of life in patients with unresectable skin cancer and their families.

EFFECT OF USING GINGER TEA ON CHEMOTHERAPY-INDUCED NAUSEA AND VOMITING AMONG WOMEN WITH CANCER

Background: Chemotherapy-induced nausea and vomiting (CINV) remains a significant reason of distress and dissatisfaction among patients getting cancer treatment. Aim: The aim of this study is to assess the effect of ginger tea on chemotherapy induced nausea and vomiting in women with cancer. Study Design: A quasi-experimental research design. Sampling: A purposive sample of 100 women with gynecological and breast cancer. Setting: This study was conducted at the outpatient clinics of oncology and nuclear medicine department affiliated to Ain Shams University Hospital. Tools: Three tools were used for the data collection of this study I. A Patient interview questionnaire included patients’ demographic and clinical data, II. Simplified form of Rhodes index of nausea, vomiting and retching assessment scale. III. Patients ‘satisfaction questionnaire Results: The mean age of all patients was 5.84+36.79 years, 17 (34%) of the patients in the control group had secondary educational level, while 19 (38%) in experimental group were university graduates. 35 (70%) and 36 (72%) of patients in the control group and experimental group were married. (54%, 60%) of patients in the control group and experimental group were employed. Regarding total vomiting and nausea experience score, there was no significant difference between both groups before research intervention and during the first 6, 12 & 24 hours after chemotherapy. However, there was a statistically significant association in intervention (ginger tea group) and control group on the second day, third day and fourth day post chemotherapy (p = <0.001). Conclusions and recommendations: The current study showed that ginger tea can be administered to patients with gynecologic and breast cancer as a safe herbal medicine for effective prevention of chemotherapy-induced nausea and vomiting. Prospective studies and longer periods of follow up are also helpful to assess the efficacy of ginger supplementation on the prevalence of CINV symptoms in patients receiving multiple cycles of chemotherapy.

Symptom prevalence of patients with fibrotic interstitial lung disease: a systematic literature review

BackgroundThose affected by advanced fibrotic interstitial lung diseases have limited treatment options and in the terminal stages, the focus of care is on symptom management. However, quantitatively, little is known about symptom prevalence. We aimed to determine the prevalence of symptoms in Progressive Idiopathic Fibrotic Interstitial Lung Disease (PIF-ILD).MethodsSearches on eight electronic databases including MEDLINE for clinical studies between 1966 and 2015 where the target population was adults with PIF-ILD and for whom the prevalence of symptoms had been calculated.ResultsA total of 4086 titles were screened for eligibility criteria; 23 studies were included for analysis. The highest prevalence was that for breathlessness (54–98%) and cough (59–100%) followed by heartburn (25–65%) and depression (10–49%). The heterogeneity of studies limited their comparability, but many of the symptoms present in patients with other end-stage disease were also seen in PIF-ILD.ConclusionsThis is the first quantitative review of symptoms in people with Progressive Idiopathic Fibrotic Interstitial Lung Diseases. Symptoms are common, often multiple and have a comparable prevalence to those experienced in other advanced diseases. Quantification of these data provides valuable information to inform the allocation of resources.

Perfil sintomático de los pacientes con Enfermedad Renal Crónica Estadio 4 y 5

Introducción: Los pacientes con Enfermedad Renal Crónica Avanzada (ERCA) experimentan una gran variedad de síntomas que afectan negativamente la calidad de vida del paciente. Objetivos: Determinar la prevalencia e intensidad de síntomas y analizar su asociación con el filtrado glomerular (FG) y la comorbilidad. Material y Método: Estudio transversal en el que se describe la sintomatología del paciente con ERCA en diálisis y prediálisis y se realiza un análisis de la asociación de los síntomas con el FG y la comorbilidad. Para la evaluación de síntomas se utilizó la versión española modificada de la Palliative care Outcome Scale-Symptoms Renal (POS-S Renal), un cuestionario validado para evaluar la sintomatología en esta población. La comorbilidad fue evaluada con el índice de comorbilidad de Charlson modificado (ICCm). Resultados: 180 pacientes con ERCA fueron incluidos en este estudio. Más del 44% de pacientes describieron debilidad, dolor, depresión y dificultad para dormir. Se encontraron diferencias significativas en ambos grupos para síntomas como la debilidad (p=0.027), poca movilidad (p=0.018), somnolencia (p=0.03), estreñimiento (p=0.015) y piernas inquietas (p

Prevalence of Symptoms in Patients Poisoned with Iranian Crack in Ahvaz Razi Hospital in 2008-2013

Background: Crack is a strong and smoking form of cocaine, but Iranian crack is different from common crack cocaine, having symptoms and side effects similar to those of heroin. This study was to investigate the prevalence and clinical symptoms in patients poisoned with Iranian crack poisoning hospitalized in Ahvaz Razi Hospital in the years 2008-2013. Methods: In this study, 63 subjects with Iranian crack poisoning referred to the poisonings center of Ahvaz Razi Hospital, Khuzestan Province, Iran, between 2008 and 2013. The information collected from their records based on hospital data includes reference data, demographic data, prevalence and clinical symptoms and treatment. Results: Of 63 subjects, 88.9% were male. The mean age of the subjects was 25 years. The majority of the subjects were single. Most of them used another substance along with Iranian crack. The first clinical symptoms of more than half of them were loss of consciousness. 54% of them needed antidote; 69.8% admitted to ICU. 6.3% of the subjects died. Conclusion:We concluded that the most prevalent pattern and the first signs of Iranian crack overdose are similar to heroin consumption and not crack cocaine. Therefore, more studies are required for clinical management of acute or chronic toxicity of this illicit drug and to reduce further damages.

Effect of Vitamin D Deficiency on Voice.

The purpose of this article was to investigate the relationship between low level of vitamin D, phonatory symptoms, and acoustic findings. A total of 38 subjects presenting to the endocrinology clinic were enrolled in 2 groups: 19 with vitamin D deficiency who were not on treatment, and 19 with normal vitamin D level who were on treatment. Demographic data included age, gender, and history of smoking. All patients were asked about the presence or absence of dysphonia, degree of phonatory effort, and vocal fatigue. Acoustic analysis and perceptual evaluation using the grade, roughness, breathiness, asthenia, and strain scale were performed on all subjects. The mean age of the total group was 47.29 ± 13.52 years. The difference in the mean and frequency of phonatory effort, vocal fatigue, and dysphonia, and in the mean of the acoustic variables, perceptual parameters, and the score of the Voice Handicap Index-10 was not statistically significant between patients with low vitamin D levels compared with controls. The results of this study revealed no significant difference in the prevalence of phonatory symptoms in patients with vitamin D deficiency compared with patients with no vitamin D deficiency. A larger study is needed to substantiate the difference in the prevalence of phonatory systems between the 2 groups.