Individual Symptoms Research Articles

Symptom Network Analysis and Unsupervised Clustering of Oncology Patients Identifies Drivers of Symptom Burden and Patient Subgroups With Distinct Symptom Patterns.

Interindividual variability in oncology patients' symptom experiences poses significant challenges in prioritizing symptoms for targeted intervention(s). In this study, computational approaches were used to unbiasedly characterize the heterogeneity of the symptom experience of oncology patients to elucidate symptom patterns and drivers of symptom burden. Severity ratings for 32 symptoms on the Memorial Symptom Assessment Scale from 3088 oncology patients were analyzed. Gaussian Graphical Model symptom networks were constructed for the entire cohort and patient subgroups identified through unsupervised clustering of symptom co-severity patterns. Network characteristics were analyzed and compared using permutation-based statistical tests. Differences in demographic and clinical characteristics between subgroups were assessed using multinomial logistic regression. Network analysis of the entire cohort revealed three symptom clusters: constitutional, gastrointestinal-epithelial, and psychological. Lack of energy was identified as central to the network which suggests that it plays a pivotal role in patients' overall symptom experience. Unsupervised clustering of patients based on shared symptom co-severity patterns identified six patient subgroups with distinct symptom patterns and demographic and clinical characteristics. The centrality of individual symptoms across the subgroup networks differed which suggests that different symptoms need to be prioritized for treatment within each subgroup. Age, treatment status, and performance status were the strongest determinants of subgroup membership. Computational approaches that combine unbiased stratification of patients and in-depth modeling of symptom relationships can capture the heterogeneity in patients' symptom experiences. When validated, the core symptoms for each of the subgroups and the associated clinical determinants may inform precision-based symptom management.

Effectiveness of Transcranial-Direct Current Stimulation in Individuals with Methamphetamine Use Disorder: A Systematic Review and Meta-Analysis

Context: Non-alcoholic substance abuse is a major public health concern worldwide, with methamphetamine being the second most widely used non-alcoholic substance globally, and Iran ranks fifth in methamphetamine addiction. To date, no approved pharmacological or non-pharmacological treatment by the Food and Drug Administration has been introduced for methamphetamine use disorder (MUD). Therefore, various treatment methods are currently utilized. One non-pharmacological approach that has gained attention is transcranial-direct current stimulation (tDCS), with various clinical evaluations focused on it. Objectives: The aim of this review is to assess the effectiveness of this method in improving symptoms in individuals with MUD. Methods: Databases were reviewed up to October 10, 2023, in both Persian and English languages, using PubMed, Scopus, Web of Science, Google Scholar, Science Direct, Scientific Information Database (SID), and Noormags. Keywords were MUD, tDCS, Addiction, Craving, and Cognitive Function. Studies were included based on Population, Intervention, Comparison (sham or active control), Outcomes (craving or cognition), and Study Design (randomized controlled trial). Studies were excluded if they involved brain mapping or neuroimaging. Meta-analysis was conducted based on Standardized Mean Difference (SMD) to compare tDCS to sham intervention (P ≤ 0.05, two-tailed). Random effects models were used for individual MUD data from studies that reported end-of-treatment craving data. The risk of bias was calculated using the Cochrane Risk-of-Bias Tool (RoB-2), and meta-analysis was conducted using Comprehensive Meta-Analysis Software. Results: A total of 870 studies were initially identified; twenty-three studies (mean age 30.13 ± 6.67) were identified that examined the effects of tDCS on MUD outcomes (e.g., craving, cognition). After removing heterogeneous studies, meta-analyses were performed for tDCS vs. sham control studies in the craving domain. We found that tDCS reduced craving, indicated by medium to large effect sizes (Hedges' g: -0.64; SMD -0.58, 95% CI -0.85 to -0.30; I² = 10.71%, Q value: 8.96). Results showed that complementary treatment with tDCS can be useful. The DLPFC (F3, F4) was the most commonly targeted brain region for stimulation or inhibition. However, the number of sessions and their duration varied significantly across studies. Conclusions: This systematic review and meta-analysis found that tDCS can reduce momentary and cue-induced cravings. However, the studies varied in quality and sample size and used different scales for assessing cravings and cognitive functions, leading to inconsistencies. The review highlighted the importance of targeting the DLPFC due to its role in executive functions and self-control, with right-sided stimulation showing greater effectiveness. Emotional dysregulation in MUD, such as anxiety and depression, was also noted, with tDCS showing limited support for emotion regulation. The review identified the need for larger RCTs, standardized measurement tools, and detailed participant information to improve the understanding and effectiveness of tDCS in treating MUD.

Evaluating a mobile app’s effects on depression and anxiety in medication-treated opioid use disorder

Depression and anxiety frequently co-occur with opioid use disorder (OUD) yet are often overlooked in standard OUD treatments. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a mobile application designed to address these symptoms in individuals receiving medications for OUD (MOUD). A randomized controlled trial recruited N = 63 adults with OUD who received MOUD and screened positive for moderate depression or generalized anxiety. Participants were randomized to an app-based digital intervention or treatment-as-usual for 4 weeks, and completed follow-ups at 4 and 8 weeks. Primary outcomes were self-reported severity measures for depression and generalized anxiety, and urine drug screens (UDS). Secondary outcomes included self-reported OUD severity, craving intensity, and digital biomarkers derived from passive smartphone sensors. The application was well-received (median app rating = 4/5 stars). The intervention group showed significant reductions in depressive and generalized anxiety symptoms post-intervention and at 8 weeks follow-up (d > 0.70), with large (d = 0.78) and moderate (d = 0.38) effect sizes, respectively, compared to controls. Both groups exhibited substantial decreases in self-reported severity of opioid use symptoms (d > 2.50). UDS suggested similar between-group adherence to MOUD, with a marginal decrease in opioid (MOP) use in the intervention group and increase in controls, yielding medium between group effect sizes (d = 0.44). Passive sensor data suggested significant increases in social connectedness in the intervention group, evidenced by a significant rise in incoming and outgoing calls and text connections. Initial evidence supports the feasibility and acceptability of a digital intervention for treating anxiety and depressive symptoms in persons receiving MOUD. While underpowered to confidently determine statistical significance beyond directionality, the intervention showed promise in reducing depressive and anxiety symptoms, suggesting its potential as a cost-effective and scalable adjunctive therapy alongside standard OUD treatment. Due to the preliminary nature of this pilot study, further research with sample sizes permitting greater statistical power is needed to confirm findings and explore long-term effects.

Peer-led intervention for individuals with major depression: study protocol for a randomized controlled trial (SUPEERMood)

BackgroundMajor Depressive Disorder (MDD) is one of the most disabling mental health problems worldwide. The Recovery Model emphasizes peer support to empower individuals with MDD, improve self-management, and patients' quality of life. Despite the demonstrated efficacy of peer-led interventions, further research is needed due to methodological limitations and variability in interventions across studies. Therefore, the objective of this trial is to evaluate the effectiveness of an adjuvant peer-led intervention for the reduction of depressive symptoms in individuals diagnosed with MDD attended in primary care mental health units.MethodsA controlled, parallel, randomized clinical trial will be conducted. The intervention group (n = 35) will receive 6 weeks of peer-led sessions based on a peer support program drive whilst supervised by nurses, while the control group (n = 35) will use a mobile Health (mHealth) application for emotional wellness based on CBT for 6 weeks. Measurements will be collected at baseline, at 6 weeks, at 6 and 12 months after the intervention to evaluate post-intervention effects. The primary outcome is the reduction of depressive symptoms through the Beck Depression Inventory (BDI-II) after the intervention. Secondary outcomes will involve measures such as adherence to psychiatric treatment, quality of life, adherence to mediterranean diet, alcohol consumption and physical activity.DiscussionWe hypothesize that this peer-led intervention, in contrast to the mHealth, will show improvement in BDI-II score reduction of 6 points after six weeks, 6 and 12 months. Standardized peer-led programs can benefit patients and professionals in terms of efficacy and feasibility of clinical treatment of depression, healthy habits, self-care and quality of life. In addition, they can provide recovery and relapse reduction, improved psychosocial support, minimization of intensive care use, and support for patient autonomy through self-management.Trial registrationThe trial protocol is prospectively registered with ClinicalTrials.gov under protocol registration number NCT06398561. Date of registration: May 01, 2024. Recruitment is ongoing.

Modeling the burden of long COVID in California with quality adjusted life-years (QALYS).

Individuals infected with SARS-CoV-2 may develop post-acute sequelae of COVID-19 ("long COVID") even after asymptomatic or mild acute illness. Including time varying COVID symptom severity can provide more informative burden estimates for public health response. Using a compartmental model driven by confirmed cases, this study estimated long COVID burden by age group (0-4, 5-17, 18-49, 50-64, 65+) in California as measured by the cumulative and severity-specific proportion of quality-adjusted life years (QALYs) lost. Long COVID symptoms were grouped into severe, moderate, and mild categories based on estimates from the Global Burden of Disease study, and symptoms were assumed to decrease in severity in the model before full recovery. All 10,945,079 confirmed COVID-19 cases reported to the California Department of Public Health between March 1, 2020, and December 31, 2022, were included in the analysis. Most estimated long COVID-specific QALYs [59,514 (range: 10,372-180,257)] lost in California were concentrated in adults 18-49 (31,592; 53.1%). Relative to other age groups, older adults (65+) lost proportionally more QALYs from severe long COVID (1,366/6,984; 20%). Due to changing case ascertainment over time, this analysis might underestimate the actual total burden. In global sensitivity analysis, estimates of QALYs lost were most sensitive to the proportion of individuals that developed long COVID and proportion of cases with each initial level of long COVID symptom severity (mild/moderate/severe). Models like this analysis can help translate observable metrics such as cases and hospitalizations into quantitative estimates of long COVID burden that are currently difficult to directly measure. Unlike the observed relationship between age and incident severe outcomes for COVID-19, this study points to the potential cumulative impact of mild long COVID symptoms in younger individuals.

Perceptions of Academic Performance, Impairment, and Mental Health in University Students With and Without ADHD.

This study aims to investigate the impact of positive illusory bias (PIB) on the relationship between ADHD symptoms and functioning in college students, with a focus on gender differences. The sample consisted of 195 college students, including 148 with ADHD and 47 without ADHD. Measures of ADHD symptomatology, life satisfaction, affect, gender identity, and impairment were collected, along with cumulative grade point average. ADHD symptomatology was inversely linked to subjective well-being, with PIB acting as a significant moderator. Functional impairment was predicted by ADHD symptoms and subjective well-being, while social impairment and academic functioning were predicted by PIB and well-being. Significant gender differences were found, particularly in the interaction between PIB and ADHD symptoms for non-binary individuals. This study suggests that PIB is relevant for emerging adults with ADHD enrolled in higher education. Subjective well-being and PIB act as buffers against the detrimental functional and social effects of ADHD symptoms in emerging adult college students. The study highlights the importance of considering gender-specific approaches in understanding and supporting the mental health of this population.

Current treatment strategies for vitreomacular traction and macular holes: a survey of retinal specialists in Germany

To evaluate the different treatment strategies for eyes with vitreomacular traction (VMT) and macular holes (MF) regarding the indications and initiation of treatment. The aim of this study is to facilitate clinical decision making by presenting the opinions of experienced retinal specialists in the context of the current literature and the changed approval situation for ocriplasmin. Members of the German Retina Society (RG) were questioned in an online survey. Based on aliterature review a100-question questionnaire was created and sent to all members of the RG via an electronic link to the online platform "LimeSurvey". Voluntary participation was possible from 15October 2021 to 15November 2021. Data collection and statistical analysis were anonymized. The responses of the 115 participants were congruent with the presentation of the new S1guidelines on this topic. The indications for active treatment of focal VMT without MF were postponed in favor of watchful waiting, with the individual symptoms of the patient playing amajor role in the proposed temporal management. The results on the indications for vitrectomy are consistent and convincingly confirm the opinions on the efficacy and risk assessment of this therapeutic procedure. The results presented provide an overview of the consensus and controversies in the current treatment options for VMT and MF. With the help of ahomogeneous and experienced group of retinal experts, it was possible to develop individual treatment strategies.

Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020–2021

BackgroundStudies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic.MethodsThis prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15–29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID–19 public health restrictions related factors and the severity of anxiety and depression symptoms over time.ResultsAnalyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms.ConclusionThese findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people’s mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Symptom severity reported by older adults with cancer and its impact on survival prognostication

IntroductionSymptom burden is a crucial factor for survival prognostication, but older adults may report fewer and less severe symptoms than younger patients. We investigated the impact of age on symptom severity and its prognostic implications in the prognostic model for advanced cancer (PRO-MAC). Materials and MethodsEight hundred forty subjects with incurable cancer, who were reviewed by palliative medicine at a tertiary university hospital, were categorized into four groups based on age: < 65 (young), 65–74 (young-old), 75–84 (old-old), and ≥ 85 (oldest-old) for comparison. The study compared individual symptoms reported on the Edmonton Symptom Assessment System-revised (ESAS-r) and analyzed the significance of each prognostic variable in the PRO-MAC model using multivariate Cox proportional hazards regression analysis for all age categories. We generated the log-rank test for each age group to evaluate the effectiveness of PRO-MAC across age groups. RsultsThe older adults had significantly lower unadjusted mean scores in pain, tiredness, anxiety, wellbeing, and ESAS-r summative score compared to young adults. There was a higher proportion of older adults with no symptoms. The ESAS-r summative score remained a significant prognostic factor only in the young and young-old groups. More participants in the older age groups had dementia, which may impact reporting of symptom severity. Despite these findings, the PRO-MAC model remains applicable across all age groups as a multi-domain 90-day survival prognostication tool. DiscussionSymptom burden, including pain, tiredness, anxiety, wellbeing, as well as summative ESASr scores, are lower in older adults with cancer. This could affect the prognostication of survival using symptom burden. However, a multi-dimensional prognostic model like PRO-MAC remains effective for older adults with advanced cancer. Further research is needed to explore tools that can help older adults express the severity of their symptoms and incorporate this into survival prognostication.

A New Purpose to Old Arsenal: Exploring the Safety and Efficacy of a New Regimen Comprising a Combination of Chlorhexidine Gluconate and Cetrimide for Seborrheic Dermatitis Treatment in a Randomized Placebo-Controlled Clinical Trial.

Seborrheic dermatitis is a common scalp condition affecting the quality of life of individuals across all age groups. The uninhibited proliferation of Malassezia spp. and enhanced sebaceous gland activity often leads to scalp flaking, mild erythema, and itching, thereby worsening the situation. Here, we aimed to study the efficacy of an antiseptic liquid as a pre-shampoo rinse followed by a non-anti-dandruff shampoo as a dandruff care strategy. Methods: The anti-dandruff efficacy of a chlorhexidine-cetrimide-based antiseptic liquid (ASL) as a pre-shampoo scalp rinse, followed by a regular non-anti-dandruff shampoo, was compared with a commercialZinc pyrithione (ZnPTO) based anti-dandruff shampoo following a half-head paired treatment design in a randomized, placebo-controlled, double-blind trial. The study was conducted on 50 healthy human adults of both genderswith moderate to severe dandruff. During the 12 weeks of this study, the product's safety and efficacy were evaluated based on the dermatologist's visual assessment, the subjects' self-assessment, the loose flake density score, and hair fall. ASL as a pre-shampoo scalp rinse demonstrated significant reduction (p<0.001 for n=47) in dandruff and itching after the treatment and the regression phase, performing at par with a marketed anti-dandruff shampoo. Moreover, ASL was established to be safe, non-irritant, and well-tolerated. No product-related adverse event, discomfort, or irritation symptoms were recorded, having any impact on hair sensory properties. This study demonstrates that a regimen of a chlorhexidine+cetrimide antiseptic liquid for scalp treatment followed by rinse with a regular shampoo can prove as effective as a ZnPTO-based anti-dandruff shampoo in reducing dandruff symptoms for individuals with moderate dandruff.

Dietary counseling plus omega-3 supplementation in the treatment of generalized anxiety disorder: results of a randomized wait-list controlled pilot trial (the ‘EASe-GAD Trial’)

ABSTRACT Objectives Clinical evidence suggests that nutrition interventions can significantly improve symptoms of major depressive disorder; however, the effect on clinical anxiety symptoms in individuals with anxiety disorders has not been studied. The primary objective of the present study was to assess the feasibility and acceptability of a nutrition intervention. The secondary objectives included assessing changes in anxiety symptom severity, diet quality, self-efficacy, mindful eating, quality of life, and biomarkers. Methods This study was a randomized, wait-list controlled pilot trial delivering a 12-week, biweekly dietary counseling intervention and omega-3 supplementation to 50 adult women with generalized anxiety disorder. Questionnaires and blood work were completed at baseline, after the waiting period, and after the intervention. Results 443 individuals expressed interest within eight months; 50 met the criteria for enrollment. The mean number of sessions attended was 6.4. Final questionnaires were completed by 46 participants. Eighty-four percent of participants strongly agreed with the statement ‘My experience during this study was positive’. The mean anxiety symptom severity score in the intervention group was 26.2 (95% CI 22.94–29.48) at baseline and 11.0 (95% CI 8.05–13.87) at week 12. The mean diet quality score was 7.2 (95% CI 6.32–8.10) and 10.5 (95% CI 9.55–11.49) at baseline and week 12, respectively. Among the waitlist participants, the mean baseline anxiety score was 29.3 (95% CI 24.73–33.91) and 26.8 (95% CI 22.09–31.56) at week 12. Discussion This study was feasible and acceptable. Participation in the intervention was associated with a decrease in anxiety symptoms. These findings lay the foundation for large-scale studies. Trial registration: ClinicalTrials.gov NCT05573672.

Hearing problems in humans and mouse models with rare copy number variants associated with schizophrenia: a scoping review protocol

Background Hearing loss is a risk factor for developing auditory hallucinations and other psychosis symptoms. To date, very little research has investigated hearing loss in individuals with a high genetic risk of developing schizophrenia and other types of psychosis. 13 copy number variant (CNV) loci are robustly associated with an increased risk of schizophrenia. Of these, microdeletions at 22q11.2 often lead to some hearing loss, and mouse models of this CNV display impaired auditory functioning. We hypothesise that hearing impairment is an understudied mechanism that contributes to the formation of psychosis symptoms in individuals at high genetic risk. This scoping review will explore whether the 13 schizophrenia-associated CNVs are related to hearing problems, including peripheral hearing loss and other auditory problems, in humans and related mouse models. Methods Our scoping review will follow guidelines provided by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. A systematic search will be completed using PubMed (MEDLINE), Embase, PsychINFO, and Cochrane Library databases, as well as other sources to identify relevant grey literature. Search terms will include all commonly used synonyms for hearing loss and problems with auditory perception, and both human and mouse studies that describe relevant CNVs will be included. Search lists will be screened by two authors independently, according to eligibility criteria, and data will be extracted and summarised using a narrative approach, and meta-analysis methods will be used if possible. Conclusions To our knowledge, this will be the first scoping review to explore auditory functioning across all CNVs that confer high schizophrenia risk. Looking ahead, if hearing problems are a clinical feature in these groups (including humans and related mouse models), they may serve as useful genetic models for future mechanistic studies.

Predictors of Transition from Child and Adolescent Bipolar Not Otherwise Specified to Bipolar I Disorder, a Longitudinal 3.9-Year Study.

Background: Children and adolescents with subthreshold manic symptoms not meeting full DSM criteria for bipolar I or II disorder (BP-I or BP-II) are classified as unspecified bipolar disorder (formerly bipolar not otherwise specified: BP-NOS). Factors associated with transition from BP-II or NOS to BP-I may predict the progression of the disorder. Our objective is to analyze factors associated with transition to BP-I in a Spanish sample of youth with BP-NOS or BP-II. Methods: We included all youth diagnosed with BP before 18 years of age presenting to our clinic (October 1999-December 2014). We assessed clinical factors that may predict transition to BP I with a logistic regression and a multivariable model for data analysis. Results: A total of 72 patients with BP, mean (SD) age 14.5 (10.5-16.0) years, were followed for a median period of 3.9 years. In total, 95.8% of patients retained the BP diagnosis, but they changed type. Baseline BP-I % was 37.5%, and 62.5% at endpoint. BP-NOS decreased from baseline 54.2% to 25% at endpoint. The % of BP-II was 8.3% in both time points, but they were not the same individual patients, as some transitioned from BP-II to BP-I and some BP-NOS changed to BP-II. BP-NOS was stable in 46.1% of patients, but 38.5% transitioned to BP-I over time. Psychotic symptoms during prior depressive episodes (MDD) increased the risk of transition to BP-I by 11-fold. Each individual symptom of mania increased the risk of transition to BP-I by 1.41. Conclusions: BP-NOS was stable in 46.1% of patients, but 38.5% transitioned to BP-I over time. Psychotic symptoms during prior MDD episodes increased the risk of transition from BP-NOS to BP-I.

Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies

Long COVID: A Narrative Review and Meta-Analysis of Individual Symptom Frequencies

Genetic Risk for Alcohol Use Disorder in Relation to Individual Symptom Criteria: Do Polygenic Indices Provide Unique Information for Understanding Severity and Heterogeneity?

Alcohol Use Disorder (AUD) is a heterogenous category with many unique configurations of symptoms. Previous investigations of AUD heterogeneity using molecular genetics methods studied the association between genetic liability and individual AUD symptoms at the latent level or focusing on a small number of genetic variants. Notably, these studies did not investigate potential severity differences between symptoms in their genetic analyses. Therefore, the current study aimed to examine the genetic risk for individual AUD symptom criteria by using a polygenic risk score (PRS) approach to assess the relative severity of each AUD symptom and test for associates with AUD symptoms above and beyond a unidimensional AUD construct. An AUD PRS was created using summary statistics obtained from published genome-wide association studies (GWAS), and Multiple Indicators Multiple Causes (MIMIC) models were employed to examine the effect of the PRS on overall AUD severity as well as on individual symptoms after accounting for this overall effect. The phenotypic severity of AUD symptoms was highly correlated with the genetic severity of AUD symptoms (r = 0.78). Results of MIMIC models indicated that the AUD PRS significantly predicted the AUD factor. Regression paths testing the unique, direct effects of the PRS on individual AUD symptoms, independent of the latent AUD factor, were not significant. These results imply that PRSs derived from GWAS of AUD influence symptom expression through a single genetic factor that is highly correlated with the relative severity of individual symptoms when measured at the phenotypic level. Item-level GWAS of AUD symptoms are needed to further parse heterogeneous symptom expression and allow for more nuanced tests of these conclusions.

Unveiling the Rarity: A Comprehensive Review of Carcinoid Syndrome Symptoms in Individuals Aged 38 and Younger

Unveiling the Rarity: A Comprehensive Review of Carcinoid Syndrome Symptoms in Individuals Aged 38 and Younger

The Diagnosis and Treatment of Chronic Rhinosinusitis.

Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by local chronic inflammation of the mucous membranes of the nose and paranasal sinuses. It affects approximately 5% of the population. This review is based on relevant publications retrieved by a selective search of the literature, with particular attention to current national and international guidelines. CRS is defined by, and diagnosed on the basis of, a combination of symptoms and objective findings of nasal endoscopy and imaging studies. It markedly impairs quality of life and gives rise to both direct and indirect health care costs. In 20-45% of cases, CRS is associated with comorbid bronchial asthma and a significantly elevated risk of further diseases (e.g., COPD, OR 1.73; depression, HR 1.50; obstructive sleep apnea, OR 1.91; carcinoma, OR 1.14-5.30). CRS is primarily treated medically with topical steroids (standardized mean difference of nasal symptoms, -0.63 (95% confidence interval [-0.89; -0.37]; standardized mean difference of quality of life as measured by SNOT -22, -5.46 [-8.08; -2.84]), as well as with nasal lavage and, as an option, systemic steroids (and antibiotics where appropriate). If appropriate medical treatment fails to bring about adequate and sustained improvement, endoscopic surgery on the paranasal sinuses is indicated. This improves the individual symptoms, the overall symptom score, and patients' quality of life. Severe refractory CRS with nasal polyposis can be treated with biological agents. CRS calls for individually adapted medical and/or surgical treatment.

Incidence of Dentoalveolar Trauma and its Correlation with Temporomandibular Disorders – A Systematic Review

Abstract Temporomandibular disorders (TMDs) represent a diverse set of conditions affecting the temporomandibular joint, masticatory muscles and associated structures. Previous studies suggested a notable correlation between dentoalveolar trauma (DAVT) and the incidence of TMDs. This systematic review aims to further elucidate this relationship. A comprehensive search was conducted in electronic databases to identify relevant studies published up to 2023. The included studies investigated the association between DAVT and TMDs in diverse populations. Data were extracted based on study characteristics, participant demographics and key findings. The quality of the included studies was evaluated using the established assessment tools. Five studies were included in the final review. The studies revealed a strong association between DAVT and TMDs across different populations, including adolescents, students and high-contact sports practitioners. The correlation was evident in the form of significantly higher odds ratios, increased prevalence of specific TMD subtypes and more severe symptoms in individuals with a history of DAVT. Furthermore, the studies highlighted the significant role of high-contact sports and trauma history in TMD’s prevalence and severity. The findings from this systematic review provide compelling evidence of the significant correlation between DAVT and TMD. The results underline the importance of early detection and management of DAVT, particularly in high-risk groups such as high-contact sports practitioners, to prevent the development and progression of TMDs. Future research should focus on understanding the underlying mechanisms of this association and developing effective preventive and therapeutic strategies.

Prevalence of Depressive Symptoms and Related Factors in Türkiye: Results of the 2016 and 2019 Turkish Health Survey.

We investigated the prevalence and distribution of depressive symptoms in individuals aged 15 and older, as well as the relationship between depressive symptoms and sociodemographic characteristics, chronic diseases, health status and health behaviors. The analysis of data collected from the Türkiye Health Surveys conducted by Turkish Statistical Institute (TURKSAT) in 2016 and 2019 involved using the Chi-Square independence test. Effect sizes were evaluated using Phi or Cramer's V coefficients. Patient Health Questionnaire-8 (PHQ-8) module was used to scan the depressive symptoms. The adult population's point of prevalence of depressive symptoms was 4.7%±0.24 in males and 8%±0.19 in females, with a population total of 6.3%±0.21. The yearly prevalence of depressive symptoms was 6.1%±0.45 in males, 13.2%±0.53 in females and a population total of 10%±0.49. Age, gender, income, education, social support, health status, disability, and chronic illnesses were found to be significant predictors of the incidence of depressive symptoms (p<0,05). The results indicated that the rate of people with depression getting help from psychologists, psychotherapists,and psychiatrists was low. Age, gender, income, education, marital status, self-rated health status, social support, number of chronic illnesses, and disability were the most important risk factors for depressive episodes. In addition to such self-reported research completed before the pandemic and Kahramanmaraş earthquakes in Türkiye, further studies based on structured diagnostic interviews are required.

Dose‒response effects of resistance exercise on ameliorating cravings and executive functions in individuals with methamphetamine use disorders

PurposeResistance exercise (RE) can acutely benefit symptoms in individuals with methamphetamine use disorder (MUD), though the optimal dose has not yet been established. We aimed to determine the dose response relationship between RE intensity and cue-elicited cravings and executive functions in individuals with MUD. MethodsA total of 128 male participants with MUD (34.73 ± 5.65) were randomly assigned to the low-intensity (30%–35%1-RM) RE group (LREG), moderate-intensity (55%–60%1-RM) RE group (MREG), high-intensity (75%–80%1-RM) RE group (HREG), or control group (CONG). Cravings based on the cue-reactivity paradigm were measured before, immediately after, and 40 min after acute RE, and inhibitory control, working memory, and cognitive flexibility were measured before and after acute RE. ResultsImmediately after and 40 min after RE, the Δcue-elicited cravings of the MREG from baseline was significantly more negative than that of the LREG and CONG. Trend analyses revealed a U-shaped dose‒response curve for RE intensity and Δcue-elicited cravings, indicating that moderate-intensity RE had the greatest ameliorating effect on cue-elicited cravings. Δinhibitory control and Δworking memory scores increased only in the MREG, and Δcognitive flexibility scores significantly increased in all RE groups. Trend analyses revealed a cubic curvilinear relationship between RE intensity and inhibitory control and a quadratic curvilinear relationship with working memory and cognitive flexibility. ConclusionRE proved effective in diminishing cue-elicited cravings and enhancing executive functions. A significant dose‒response relationship existed among RE intensity, cue-elicited cravings and executive function, and moderate-intensity RE had a more pronounced ameliorative effect on individuals with MUD.