Symptoms In Patients Research Articles

Update Motility Disorders: Gastro-Oesophageal Reflux Disease – Diagnostic and Conservative Approach

Background: Gastro-oesophageal reflux disease (GORD) is extremely common, with at least 1 in 10 people in the general population reporting heartburn and acid regurgitation on a weekly basis. GORD can also be associated with a variety of atypical symptoms, including chest pain, chronic cough, and laryngopharyngeal symptoms. The causes of GORD are multifactorial, and the severity of symptoms is influenced by peripheral and central factors, including psychosocial stress and anxiety. Therefore, for a variety of reasons, no single investigation provides a definitive diagnosis, and standard treatment with acid suppressants is not always effective. Summary: This review introduces the Lyon Consensus, now in its second iteration, a classification system that provides a “conclusive” positive or negative diagnosis of GORD by integrating the results of endoscopy, ambulatory reflux monitoring, and high-resolution manometry. Different algorithms are applied to patients with high and low pre-test probability of a causal relationship between reflux episodes and patient symptoms. The results of these studies identify patients with “actionable” results that require escalation, revision, or discontinuation of GORD treatment. Guidance is provided on the range of conservative treatments available for GORD, including dietary and lifestyle advice, antacids and alginates, and drugs that suppress acid secretion. Key Messages: GORD is a common disorder; however, the causes of reflux and symptoms can be complex. As a result, the diagnosis can be missed, and management is sometimes challenging, especially for patients with atypical symptoms. The Lyon classification establishes a conclusive diagnosis of GORD, based on results of endoscopic and physiological investigation. Typical symptoms usually respond to empiric use of alginate-antacid preparations and acid suppression; however, the management of treatment refractory symptoms is tailored to the individual.

Investigating the Impact of the Number of Medication Use on Depression Among Hypertensive Patients: Results from the National Health and Nutrition Examination Survey Database.

Background and Objective: Hypertension is a prevalent chronic condition often treated with multiple medications, leading to polypharmacy, which can heighten the risk of adverse drug reactions and contribute to psychological issues like depression. This study aimed to investigate the relationship between polypharmacy and depressive symptoms in hypertensive patients using data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Materials and Methods: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2017 and March 2020. Results: Among 2543 hypertensive participants, 12.3% met the criteria for depression. The findings revealed that patients using 11 or more medications were ten times more likely to experience depressive symptoms compared to those taking 1 to 2 medications (OR = 10.06, p < 0.001). Additionally, younger age (18 to 45 years), female gender, and lower educational attainment were significantly associated with higher rates of depressive symptoms. Specifically, females were 1.47 times more likely to experience depression compared to males (p = 0.032). Conclusions: This research highlights the substantial impact of medication burden on mental health among hypertensive patients, emphasizing the need for tailored clinical interventions for this vulnerable population.

Effect of small dose esketamine on perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients undergoing major elective noncardiac surgery for malignant tumors: A randomized clinical trial.

Perioperative neurocognitive disorder and postoperative depressive symptoms are significant complications after surgery. Studies have indicated that esketamine possesses neuroprotective and antidepressant qualities. This trial included 209 patients aged 60 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. In group E, patients were given an intravenous dose of 0.5 mg/kg of esketamine 10 minutes after induction of general anaesthesia. In addition, esketamine (2 mg/kg) in combination with sufentanil was used for PCIA during 48 hours postoperatively. On the other hand, saline was used as a substitute for esketamine in group C. Cognitive function was evaluated using neuropsychological tests and telephone interview for cognitive status-modified, and symptoms of depression were assessed using Hamilton Depression Rating Scale 17. Compared to Group C, patients in Group E exhibited lower rates of depressive symptoms at 3, 7, and 90 days post-surgery (53.9% vs 67.7%, 26.3% vs 47.9%, and 13.3% vs 28.4%). Group E also showed decreased time for Trail Making Test on days 7 and 90. However, there were no significant differences in the incidence of delirium 1 to 5 days post-surgery or cognitive impairment 90 days post-surgery between the 2 groups (12.1% vs 10.9% and 8.4% vs 9.7%). Intraoperative low-dose esketamine and postoperative low-dose esketamine combined with sufentanil for patient-controlled intravenous analgesia has been shown to improve postoperative analgesia, alleviate postoperative depressive symptoms, and aid in the recovery of social executive ability. However, this approach did not reduce the incidence of postoperative delirium or postoperative cognitive dysfunction.

Meta-analysis of the curative effect of sacral nerve magnetic stimulation on neurogenic bladder after spinal cord injury.

The curative effect of sacral nerve magnetic stimulation on the neurogenic bladder (NB) after spinal cord injury (SCI) is unclear. This study made a meta-analysis of the curative effect of sacral nerve magnetic stimulation on the NB after SCI and put forward a theoretical basis for the clinical treatment of this disease. The databases of PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP, and CBM were searched by computer, and the randomized controlled trials of sacral nerve magnetic stimulation in the treatment of NB after SCI were collected. The retrieval time was from the establishment of the database to September 25, 2023. Meta-analysis was performed with Stata 15.0 software. This study finally included 10 articles, including 537 patients. Meta-analysis shows that the sacral nerve magnetic stimulation treatment group can effectively improve urodynamics: the maximum bladder capacity increases (mean difference [MD], 40.76 [95% confidence interval (CI), 33.24-48.28]; P ˂ .05), the bladder capacity increases at the beginning of urination (MD, 12.82 [95% CI, 11.02-14.62]; P ˂ .05), and the residual urine volume decreases (MD, -38.08 [95% CI, -51.36 to -24.79]; P˂.05). In the aspect of urination diary, the sacral nerve magnetic stimulation treatment group also has advantages compared with the conventional treatment group: the increase in single urine volume (MD, 22.49 [95% CI, 18.68-26.30]; P˂.05), the maximum urine volume (MD, 32.84 [95% CI, 22.37-43.30]; P˂.05), and the decrease in urination times (MD, -2.23 [95% CI, -3.13 to -1.33]; P˂.05). After the treatment of sacral nerve magnetic stimulation, the quality of life of patients can be improved: quality-of-life score (MD, -0.62 [95% CI, -0.91 to -0.34]; P˂.05). Combined with functional magnetic stimulation of the sacral nerve, routine treatment is superior to routine treatment in improving the clinical symptoms of patients with NB after SCI.

How large language model-powered conversational agents influence decision making in domestic medical triage contexts

IntroductionEffective delivery of healthcare depends on timely and accurate triage decisions, directing patients to appropriate care pathways and reducing unnecessary visits. Artificial Intelligence (AI) solutions, particularly those based on Large Language Models (LLMs), may enable non-experts to make better triage decisions at home, thus easing the healthcare system's load. We investigate how LLM-powered conversational agents influence non-experts in making triage decisions, further studying different persona profiles embedded via prompting.MethodsWe designed a randomized experiment where participants first assessed patient symptom vignettes independently, then consulted one of the two agent profiles—rational or empathic—for advice, and finally revised their triage ratings. We used linear models to quantify the effect of the agent profile and confidence on the weight of advice. We examined changes in confidence and accuracy of triage decisions, along with participants' perceptions of the agents.ResultsIn a study with 49 layperson participants, we found that persona profiles can be differentiated in LLM-powered conversational agents. However, these profiles did not significantly affect the weight of advice. Notably, less confident participants were more influenced by LLM advice, leading to larger adjustments to initial decisions. AI guidance improved alignment with correct triage levels and boosted confidence in participants' decisions.DiscussionWhile LLM advice improves triage recommendations accuracy, confidence plays an important role in its adoption. Our findings raise design considerations for human-AI interfaces, highlighting two key aspects: encouraging appropriate alignment with LLMs' advice and ensuring that people are not easily swayed in situations of uncertainty.

Perceived Pain in People Living with Amyotrophic Lateral Sclerosis-A Scoping Review.

(1) Background: Pain is a common symptom in patients with Amyotrophic Lateral Sclerosis (ALS). There are no evidence-based pharmacological treatments for pain in ALS; recommendations are based on guidelines for chronic non-oncological pain and clinical experience. The aim is to map the literature on how people with ALS experience pain, and how this affects their daily activities and social relationships. (2) Methods: This scoping review included studies concerning patients with spinal/bulbar ALS aged ≥ 18 years who experience pain, focusing on perception, characteristics, treatment, and impact on quality of life. Temporal and linguistic criteria were applied when searching the MEDLINE, CINAHL, and SCOPUS databases. (3) Results: The management of pain in these patients is complex and involves the use of anti-inflammatory drugs, analgesics, and opioids. Pain is associated with other conditions such as depression and anxiety, which contribute to a deterioration in the quality of life. Moreover, pain may also negatively influence patient compliance with prescribed treatment regimens and the quality of care they perceive themselves to be receiving. (4) Conclusions: It is of the most importance to identify effective ways to assess and treat this issue, with health care professionals taking an active role in this process.

Special issue: nerve compression syndromes "Brachioradialis, or "High Wartenberg", syndrome - compression of the sensory branch of the radial nerve in the proximal forearm.

Compression of the sensory branch of the radial nerve (SBRN) in the proximal forearm is an uncommon condition, leading to both motor and sensory deficits. The aim of this study is to assess the surgical outcomes of SBRN release at the level of the brachioradialis arcade. A retrospective study of prospectively collected data was conducted on patients undergoing brachioradialis release (BRR) from March 2014 to March 2021. The measured outcomes included quick-DASH (Disability of the Arm Shoulder Hand questionnaire), work-DASH, visual analog scale (VAS) scores for pain, and patient satisfaction with surgery, at a minimumsixmonth follow-up. A total of twenty patients (mean age of 44.1 (range 25-62) were included in this study, of whichnine (45%) were males. Eleven patients (55%) underwent isolated BRR, while the other nine patients (45%) underwent concomitant BRR and lacertus release. The three most common presenting symptoms in patients with isolated BRS were radiovolar forearm pain (100%), disturbed sensation in the SBRN territory (85%), and hand/thumb fatigue (75%). Forearm pain and fatigue were found in all patients with combined BRS and lacertus syndrome. The response rate for the functional outcome scores was 65% (13/20). Quick-DASH significantly improved (preoperative 29.6 (range 13.6-57.5) to postoperative 6.9 (range 0-27.27), p < 0.0001) as did the work DASH (p < 0.0001). Follow-up VAS Pain was 1 and satisfaction with surgery 9.6. BRS is an uncommon radial nerve compression syndrome in the proximal forearm that differs from the more commonly recognized radial tunnel syndrome. It presents with radio-volar forearm pain, disturbed sensation in the SBRN distribution, and loss of hand/thumb endurance. Minimally invasive BRR immediately restores wrist extension strength, significantly improves DASH scores, and yields positive outcomes at a minimum six-month follow-up.

Clinical development and proof of principle testing of new regenerative vascular endothelial growth factor-D therapy for refractory angina: rationale and design of the phase 2 ReGenHeart trial

BackgroundDespite tremendous therapeutic advancements, a significant proportion of coronary artery disease patients suffer from refractory angina pectoris, that is, quality-of-life-compromising angina that is non-manageable with established pharmacological and interventional treatment...

Prevalence and exploratory factor analysis of long COVID-19 symptoms among experienced infected population in Bangkok, Thailand

BackgroundPatients with long COVID may experience various concomitant symptoms caused by inflammation, which affect their lives and well-being. In this study, we aimed to (1) investigate the prevalence of long COVID; (2) explore the levels of symptom severity and functional disability owing to long COVID, overall health, and their relationship; and (3) conduct exploratory factor analysis of long COVID-19 symptoms among experienced infected population in the capital of Thailand.MethodsA cross-sectional research design was used and a sample of 337 community members with previously COVID-19 infection in Bangkok, Thailand was recruited for this study. Purposive sampling was used. Data collection was performed using an online and a paper-based questionnaire. Descriptive statistics (number, percentage), odds ratio, exploratory factor analysis, and Spearman’s rank correlation coefficient were used for the data analysis.ResultsThe prevalence of long COVID was 32.9%. The main reported symptoms included anxiety (28.5%), fatigue (26.1%), and dyspnea (13.4%). There was a significant relationship between symptom severity and functional disability (rs=0.385, p value < 0.01). Overall health was negatively correlated with symptom severity (rs = − 0.291, p < .01) and functional disability (rs = − 0.108, p < .05). Using principal component analysis with Promax rotation, three clusters were identified, explaining 71.44% of the total variance. The Clusters comprised (1) common symptoms of long COVID and communication, (2) fatigue, functioning, and nutritional concerns, and (3) psychosocial impacts.ConclusionsThe present results might help multidisciplinary care teams understand the concurrent symptoms of patients with long COVID and develop rehabilitation care programs to ease all symptoms simultaneously and improve patients’ quality of life.

A Remote Behaviorally Designed Intervention to Promote Physical Activity in Patients With Knee Osteoarthritis: Results of a Pilot Randomized Clinical Trial.

We evaluated a behaviorally designed intervention utilizing gamification and social support to improve physical activity and reduce symptoms in patients with osteoarthritis of the knee (KOA). Veterans with KOA, aged 40-80 years, were enrolled in this randomized controlled trial. Participants received a Fitbit and completed a 2- to 4-week baseline period. A Web-based platform administered biweekly surveys after randomization and tracked physical activity. Participants selected a daily step goal that was 33%, 40%, or 50% above their baseline. The intervention arm received game playing aspects and a social support partner to advance weekly step performance while the control arm only received weekly updates. The primary outcome was the change in steps per day averaged over 2-week intervals. We used mixed effects regression, adjusting for baseline step count. Secondary outcomes assessed the change in KOOS (Knee Injury and Osteoarthritis Outcome Score) over 32 weeks. Thirty-one participants were included in the final analysis. Most participants were male (90.3%), Black (70.96%), had a mean (SD) age of 60 (13) years, and body mass index of 33.7 (5.9) kg/m2. Participants that received the intervention walked a total of 1119 (95% confidence interval: -562, 2799) more steps per day (p = 0.19). The effect was greatest in the first 6 months (1491 [-272, 3254], p = 0.10). Compared with controls, those that received the intervention had improvement over time in total KOOS (mean 2-week change +0.62 [0.031, 1.20] vs -0.38 [-1.04, 0.28], p = 0.02) and several subscales. This intervention demonstrated promise for promoting greater physical activity and improving symptoms in patients with KOA.

Investigation and Comparison of Preoperative Symptoms in Patients With Appendicitis and Cholecystitis Before Appendectomy and Cholecystectomy Surgeries

Investigation and Comparison of Preoperative Symptoms in Patients With Appendicitis and Cholecystitis Before Appendectomy and Cholecystectomy Surgeries

The current status of somatostatin analogs in the treatment of neuroendocrine tumors and future perspectives.

Somatostatin analogs (SSAs) were developed as antisecretory agents to palliate hormonal symptoms in patients with functioning neuroendocrine tumors (NETs). Their antiproliferative activity has been established in the phase 3 PROMID and CLARINET trials. SSAs currently represent the standard first-line therapy for the majority of well-differentiated G1/G2 gastroenteropancreatic NETs as well as for pulmonary NETs. An update on the clinical applications of established SSAs for the treatment of NETs is provided. Perspectives on emerging nonpeptide SSAs such as paltusotine and innovative formulations of octreotide (CAM2029) are included. SSAs represent the cornerstone of treatment for both functioning and nonfunctioning NETs. While standard-dose SSAs have a defined place in the therapeutic algorithm of well-differentiated NETs, uncertainties remain on how to best integrate above-label doses of SSAs in the treatment sequence, particularly when tumor control is the goal. Octreotide and lanreotide appear to be clinically interchangeable, and no signs of superiority of one agent over the other has been observed so far. Whether SSAs may be exploited in the maintenance setting following more aggressive treatments, whether continuing SSAs beyond-progression after first-line therapy could be an effective treatment strategy, and whether new-generation SSAs such as pasireotide could overcome resistance to established SSAs are key areas of investigation.

Extent and pattern of symptom relief following surgical castration in patients with advanced prostate cancer treated at a tertiary referral hospital in Tanzania: a prospective cohort study

BackgroundAdvanced prostate cancer leads to many symptoms, notably bone pain and lower urinary tract symptoms (LUTs); however, the degree and duration of pain relief, changes in LUTs severity and underlying factors associated with the extent of symptom relief remain inadequately understood. Surgical castration has proven effective in relieving both bone pain and urinary symptoms for metastatic prostate cancer patients.ObjectiveTo determine the extent and pattern of symptom relief in advanced prostate cancer patients following surgical castration at Muhimbili National Hospital (MNH).MethodsWe conducted a prospective cohort study for a period of 6 months involving men with advanced Prostate cancer (PCa) undergoing surgical castration at MNH and followed them for 30 days. The international prostate symptoms score tool was used to assess changes in LUTs, and the pain rating scale was used for assessing changes in bone pain symptoms before and after surgery. Logistic regression model was used to determine factors associated with complete bone pain relief.ResultsA total of 210 participants with a mean age of 72.3 years were recruited. The LUTS score showed a decrease of 7.1 points after surgical castration (95% CI: 6.4 to 7.7, p < 0.001). The bone pain score showed an absolute decrease of 39.8% (95% CI: 34.7 to 44.9, p < 0.001) after surgical castration, with more than half of the patients (111, 52.9%) reporting bone pain relief within the first two weeks. Among the factors associated with greater pain relief were being in a marital union (aOR 2.73, 95% CI: 1.26 to 5.89, p < 0.011). Normal BMI was also linked to pain relief in bivariate analysis (OR 1.92, 95% CI: 1.03 to 3.61, p < 0.035). Additionally, patients with severe bone pain before surgical castration were more likely to achieve complete pain relief compared to those with mild or moderate pain (odds ratio 8.32, 95% CI: 3.63 to 19.1, p < 0.001).ConclusionSurgical castration improves both bone pain and lower urinary tract symptoms in patients with advanced prostate cancer. Notably, patients experiencing severe bone pain reported resolution of bone pain symptoms within the first and second weeks, respectively, indicating the prompt effectiveness of the surgery on these symptoms.

Prevalence of Depressive Symptoms in People With Osteoporosis Referred to the Bone Densitometry Center of a Hospital in Kashan

Background and Objectives: Osteoporosis is a chronic disease characterized by decreased bone density and increased risk of bone fractures. Osteoporosis can affect the quality of life and lead to depression by causing bone fractures and associated complications such as reduced physical activity, weight gain, and reduced self-care. This study aims to investigate the prevalence of depression in people with osteoporosis referred to the bone densitometry center of a hospital in Kashan, Iran. Methods: In this cross-sectional study, 150 people with osteoporosis were selected from among those referred to the bone densitometry center of Shahid Beheshti Hospital in Kashan in 2021, who were selected by a systematic sampling method. To collect information, a demographic form and Beck’s depression inventory were used. Data were analyzed in SPSS software using chi-square test and independent t-test. Results: In this study, 86% of people with osteoporosis had depressive symptoms, of whom 42% had severe depression. The prevalence of depressive symptoms in osteoporosis patients with a T score was 37.9%, on average. There was a statistically significant difference in the severity of depression among patients in terms of the family history of depression and the use of psychiatric drugs (P&lt;0.001). Conclusion: The majority of people with osteoporosis in the study center in Kashan have some degree of depression symptoms, which shows the importance of early investigation and treatment of depression in these patients.

Abnormal spirometric patterns and respiratory symptoms in HIV patients with no recent pulmonary infection in a periurban hospital in Ghana.

Human immunodeficiency virus (HIV) infection is associated with chronic airway obstruction, even in patients who have achieved viral suppression from combination antiretroviral treatment (cART). Spirometry is a supplementary test that aids in diagnosing pulmonary dysfunction in people living with HIV. To compare the prevalence of spirometric abnormalities among cART-treated HIV patients and cART-naïve HIV patients with non-HIV controls with no recent history of pulmonary infection in a peri-urban hospital in Ghana. In a case-control design, spirometry was performed in 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls. Clinical, sociodemographic data and respiratory symptoms were collected using a structured questionnaire. Spirometric abnormalities were categorised as obstructive (OSP) or restrictive (RSP) spirometric patterns based on the Cameroonian reference equation. The prevalence of OSP was higher in the cART-treated and cART-naïve HIV patients compared to non-HIV controls (13.9% vs 10.7% vs 5.1% respectively, p = 0.026), whereas that of RSP was similar among the study groups. Respiratory symptoms were common among cART-treated and cART-naïve HIV patients compared to non-HIV controls (48.1% vs 40% vs 19.2% respectively, p < 0.001). The major factors associated with OSP were female gender [OR (95% CI) = 2.46 (1.09-5.13), p = 0.031], former cigarette smoking [1.92 (1.04-3.89), p < 0.001], exposure to medium-to-high levels of biomass [3.07 (1.16-8.73), p = 0.019], presence of a respiratory symptom [1.89 (1.11-5.08), p = 0.029] and unemployment [3.26 (1.19-8.95), p = 0.042]. The major determinants of RSP were age, female gender [1.74 (1.05-4.29), p = 0.041], former cigarette smoking [2.31 (1.27-6.77), p < 0.001] and medium-to-high biomass exposure [1.58 (1.06-5.37), p = 0.043]. In HIV patients without any recent pulmonary infection in a peri-urban area of Ghana, there was a higher prevalence of OSP among cART-treated and cART naïve HIV patients compared to the non-HIV control. However, the prevalence of RSP was similar among HIV patients and non-HIV controls.

Who Gets Better After Surgery for Degenerative Cervical Myelopathy? A Responder Analysis from the Multicenter Canadian Spine Outcomes and Research Network

Degenerative cervical myelopathy (DCM) is the most common cause of acquired non-traumatic spinal cord injury worldwide. Surgery is a common treatment for DCM; however, outcomes often vary across patients. To inform preoperative education and counseling, we performed a responder analysis to identify factors associated with treatment response. An observational cohort study was conducted utilizing prospectively collected data from the Canadian Spine Outcomes Research Network (CSORN) registry collected between 2015-2022. We included all surgically treated DCM patients with complete 12-month follow-up and patient-reported outcomes (PROs) available at 1-year. Treatment response was measured using the minimal clinically important difference (MCID) in PROs including the Neck Disability Index (NDI) and EuroQol-5D (EQ-5D) at 12 months post-surgery. A Least Absolute Shrinkage and Selection Operator (LASSO) machine learning model was used to identify significant associations between 14 pre-operative patient factors and likelihood of treatment response measured by achievement of the MCID in NDI, and EQ-5D. Variable importance was measured using standardized coefficients. To test robustness of findings we trained a separate XGBOOST model, with variable importance measured using SHAP values. Among the 554 DCM patients included, 229 (41.3%) and 330 (59.6%) patients responded to treatment by meeting or surpassing MCID thresholds for NDI and EQ-5D at 1-year, respectively. LASSO regression for likelihood of treatment response measured through NDI found the variable importance rank order to be baseline NDI (OR 1.06 per 1 point increase; 95% CI 1.04 - 1.07), then symptom duration (OR 0.65; 95% CI 0.44-0.97). For EQ-5D, the variable importance rank order was baseline EQ-5D (OR 0.16 per 0.1-point increase; 95% CI 0.03 - 0.78), living independently (OR 2.17; 95% CI 1.22 - 3.85), symptom duration (OR 0.62; 95% CI 0.40 - 0.97), then number of levels affected (OR 0.80 per additional level; 95% CI 0.67 - 0.96). A separate XGBoost model of treatment response measured through NDI, corroborated findings that patients with higher baseline NDI, and shorter symptom duration were more likely to respond to treatment, and additionally found older patients, and those with kyphosis on baseline upright x-ray were less likely to respond. Similarly, an XGBoost model for treatment response measured through EQ-5D corroborated findings that patients with higher baseline EQ-5D, shorter symptom duration, living independently, with fewer affected levels were more likely to respond to treatment, and additionally found older patients were less likely to respond. Our findings suggest patients with shorter symptom duration, higher baseline patient NDI, lower EQ-5D, younger age, living independently, without kyphosis on pre-operative x-ray, and fewer affected levels are more likely to respond to treatment. Timing of surgery with respect to patient symptoms is underscored as a crucial and modifiable patient factor associated with improved surgical outcomes in DCM.

Psychiatric Symptoms in Patients with Immune-Related Mucocutaneous Lichen Planus

Background: Lichen planus (LP) is one of the most common chronic mucocutaneous diseases with an underlying immunological component. Although the pathogenesis of this condition is not exactly known, numerous studies have been conducted due to the significance of this disease and its high prevalence. Several risk factors and various contexts have been identified for this condition; however, the primary cause is still not fully understood. Some genetic and environmental factors may be involved in the development of the disease. The present study was conducted to examine psychiatric symptoms in patients with cutaneous-oral LP (COLP) referred to the dermatology clinic of Sina Hospital of Tabriz city, northwest of Iran. Methods: This descriptive study was conducted on 31 patients with LP and 31 healthy individuals referred to the dermatology clinic of Sina Hospital in Tabriz. The information required was collected using the SCL-90-R standard questionnaire, and the data were analyzed using descriptive and inferential statistics with the help of SPSS v.23 and multivariate analysis of variance (MANOVA). Results: The results showed that people with COLP do not suffer from serious psychiatric conditions but may have merely mild to moderate psychiatric symptoms. However, the MANOVA test indicated that the symptoms had a significantly higher incidence in patients with oral LP compared to matched control subjects (F (12,47)=13.86, P&lt;0.05). Conclusion: As shown by the SCL-90-R standard checklist, patients with oral LP expressed significantly more psychiatric symptoms than normal individuals, reflecting the need for these patients for more regular assessments.

Association between dietary fatty acids and depressive symptoms in Chinese haemodialysis patients: a cross-sectional study.

Depression is highly prevalent in haemodialysis patients, and diet might play an important role. Therefore, we conducted this cross-sectional study to determine the association between dietary fatty acids (FA) consumption and the prevalence of depression in maintenance haemodialysis (MHD) patients. Dietary intake was assessed using a validated FFQ between December 2021 and January 2022. The daily intake of dietary FA was categorised into three groups, and the lowest tertile was used as the reference category. Depression was assessed using the Patient Health Questionnaire-9. Logistic regression and restricted cubic spline (RCS) models were applied to assess the relationship between dietary FA intake and the prevalence of depression. As a result, after adjustment for potential confounders, a higher intake of total FA [odds ratio (OR)T3 vs. T1 = 1·59, 95 % confidence interval (CI) = 1·04, 2·46] and saturated fatty acids (SFA)(ORT3 vs. T1 = 1·83, 95 % CI = 1·19, 2·84) was associated with a higher prevalence of depressive symptoms. Significant positive linear trends were also observed (P < 0·05) except for SFA intake. Similarly, the prevalence of depression in MHD patients increasedby 20% (OR = 1.20, 95% CI = 1.01-1.43)foreach standard deviation increment in SFA intake. RCS analysis indicated an inverse U-shaped correlation between SFA and depression (P nonlinear > 0·05). Additionally, the sensitivity analysis produced similar results. Furthermore, no statistically significant association was observed in the subgroup analysis with significant interaction. In conclusion, higher total dietary FA and SFA were positively associated with depressive symptoms among MHD patients. These findings inform future research exploring potential mechanism underlying the association between dietary FA and depressive symptoms in MHD patients.

Persistent dysfunctions of brain metabolic connectivity in long-covid with cognitive symptoms.

Our study examines brain metabolic connectivity in SARS-CoV-2 survivors during the acute-subacute and chronic phases, aiming to elucidate the mechanisms underlying the persistence of neurological symptoms in long-COVID patients. We perfomed a cross-sectional study including 44 patients (pts) with neurological symptoms who underwent FDG-PET scans, and classified to timing infection as follows: acute (7 pts), subacute (17 pts), long-term (20 pts) phases. Interregional correlation analysis (IRCA) and ROI-based IRCA were applied on FDG-PET data to extract metabolic connectivity in resting state networks (ADMN, PDMN, EXN, ATTN, LIN, ASN) of neuro-COVID pts in acute/subacute and long-term groups compared with healthy controls (HCs). Univariate approach was used to investigate metabolic alterations from the acute to sub-acute and long-term phase. The acute/subacute phase was characterized by hyperconnectivity in EXN and ATTN networks; the same networks showed hypoconnectivity in the chronic phase. EXN and ATTN hypoconnectivity was consistent with clinical findings in long-COVID patients, e.g. altered performances in neuropsychological tests of executive and attention domains. The ASN and LIN presented hyperconnectivity in acute/subacute phase and normalized in long-term phase. The ADMN and PDMN presented a preseverved connectivity. Univariate analysis showed hypometabolism in fronto-insular cortex in acute phase, which reduced in sub-acute phase and disappeared in long-term phase. A compensatory EXN and ATTN hyperconnectivity was found in the acute/subacute phase and hypoconnectivity in long-term. Hypoconnectivity and absence of hypometabolism suggest that connectivity derangement in frontal networks could be related to protraction of neurological symptoms in long-term COVID patients.

Initial Study on the Impact of Probiotics on Postoperative Gastrointestinal Symptoms and Gut Microbiota after Sleeve Gastrectomy: A Placebo-Controlled Study.

Sleeve gastrectomy (SG) has become the predominant bariatric surgery, leading to significant weight loss and reductions in obesity-related complications. However, postoperative gastrointestinal symptoms such as constipation and bloating are common. This study aims to evaluate the impact of probiotic supplementation on postoperative gastrointestinal symptoms in patients undergoing SG. The secondary aim is to analyze laboratory and stool test results. This prospective, placebo-controlled study included patients undergoing SG at a single center. Participants were adults without specific gastrointestinal diseases. They were randomly assigned to either the Probiotics or Controls group. Gastrointestinal symptoms and laboratory and stool tests were assessed before surgery and one month after. Thirty-one patients participated, with 15 in the Probiotics group and 16 in the Controls group. Probiotic supplementation significantly increased the number of stools per week (p = 0.027) and reduced constipation incidence (p = 0.002). Patients in the Probiotics group reported easier defecation and greater bowel movement completeness (p = 0.015, p = 0.004). No significant differences in weight loss or laboratory tests were observed between the groups. Stool microbiota analysis showed a return to normal levels of Enterococcus faecalis, Enterococcus faecium, and Clostridium perfringens in the Probiotics group and an increase in the Controls group. Probiotic supplementation after SG significantly reduces constipation without adverse effects. These findings suggest that incorporating probiotics into postoperative care protocols can enhance patient comfort and recovery.