Symptom Scores In Patients Research Articles

A comparative study of Silodosin vs. Tamsulosin in the management of Benign Prostatic Hyperplasia: Outcomes in a tertiary care setting in Karachi.

Background: Lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) are prevalent among aging males, with acute urinary retention (AUR) being a common urological emergency. Alpha-blockers, such as tamsulosin and silodosin, are widely used in managing BPH-related LUTS and improving outcomes in Trial Without Catheter (TWOC). However, the comparative efficacy of these two medications remains a topic of clinical interest. This study aims to compare the efficacy of tamsulosin versus silodosin in achieving successful TWOC and improving the International Prostate Symptom Score (IPSS) in patients with BPH at a tertiary care hospital in Karachi. Methodology: A randomized controlled trial was conducted involving 100 male patients with BPH, aged 45-85 years, who were randomly assigned to two groups: Group A (silodosin, 50 patients) and Group B (tamsulosin, 50 patients). The primary outcomes included successful TWOC (defined as a post-void residual volume of <100 ml) and improvement in IPSS after one month. Statistical analyses were performed using the chi-square and Mann-Whitney U tests, with a significance level set at P ≤ 0.05. Results: In Group A, 70% of patients achieved a successful TWOC, compared to only 20% in Group B (P = 0.001). The mean IPSS score in Group A was significantly lower than in Group B (P = 0.001), indicating better symptom control with silodosin. Conclusion: Silodosin demonstrated superior efficacy in facilitating TWOC success and reducing LUTS compared to tamsulosin. These findings suggest that silodosin should be considered the preferred alpha-blocker for managing BPH, especially in patients with AUR, offering improved outcomes for both catheter removal and symptom relief.

The benefits of septoplasty for patients with deviated nasal septum and allergic rhinitis: a meta-analysis

BackgroundThe value of endoscopic septoplasty for patients with deviated nasal septum and allergic rhinitis has not been systematically summarized. This study aims to assess the impact of surgical intervention on quality of life through a meta-analysis.MethodsWe conducted a comprehensive search of PubMed, CNKI, EMBASE, and the Cochrane Library for studies on the treatment of patients with deviated nasal septum and allergic rhinitis up to 2024. Studies that were duplicates, lacked full text, had incomplete data, or involved animal experiments, commentaries, or systematic reviews were excluded. Meta-analysis was performed using STATA 16.0.ResultsThe total nasal symptom score (TNSS) in patients who received endoscopic surgery was considerably reduced compared to those treated with spray therapy alone, indicating a significant improvement (SMD = -21.29, 95% CI: -26.26, -116.33). Classic symptoms of allergic rhinitis, including rhinorrhea (SMD=-9.97, 95% CI: -16.97, -2.98), nasal obstruction (SMD=-27.25, 95% CI: -41.12, -13.38), nasal itching (SMD=-10.32, 95% CI: -13.16, -7.48), and sneezing (SMD=-12.66, 95% CI: -14.99, -10.34), showed significant improvement. There was no significant difference in the incidence of complications between the two treatments (OR = 1.01, 95% CI: 0.49, 2.10).ConclusionPatients with a deviated nasal septum and allergic rhinitis benefit more from septoplasty. However, the procedure should be performed cautiously by experienced clinicians, taking into account the specific condition of the nasal septum.

The relationship between neuropathic pain and lower urinary tract symptom scores in patients with primary Sjögren's syndrome.

To evaluate the effect of neuropathic pain on lower urinary tract symptoms (LUTS) scores in patients with primary Sjögren's syndrome (pSS). Seventy-two patients diagnosed with pSS were included in the study. The patients with pSS were divided into two groups according to the presence/absence of neuropathic pain. The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire was recorded assess neuropathic pain. LUTS was evaluated using the International Prostate Symptom Score (IPSS), International Incontinence Consultation Questionnaire Short Form (ICIQ-SF) and Overactive Bladder Questionnaire (OAB-V8). The mean age of the patients was 52.4 ± 11.2 years. Neuropathic pain was recorded in 21 (29.2%) patients. Among the patients, the number of patients with mild symptoms was recorded as 41 (56.9%), moderate symptoms in 25 (34.7%), and severe symptoms in 6 (8.3%) according to IPSS. IPSS and IPSS voiding subscores were statistically significantly higher in patients with neuropathic pain than non-neuropathic pain group (p = 0.035; p = 0.001, respectively). Although ICIQ-SF, OAB-V8 and IPSS storage subscores were found to be higher in patients with neuropathic pain group, there was no statistically significant difference between the groups (p = 0.299; p = 0.283; p = 0.237, respectively). Neuropathic pain concomitant with PSS patients may negatively affect bladder voiding functions.

FERMT1 contributes to the epithelial-mesenchymal transition of chronic rhinosinusitis with nasal polyps via PI3K/Akt signaling

BackgroundEpithelial-mesenchymal transition (EMT) is a key process of chronic rhinosinusitis with nasal polyps (CRSwNP). The molecular mechanism of EMT in CRSwNP remains unknown. In this study, we aimed to investigate the role of FERMT1 during the EMT process in CRSwNP. MethodsWestern blotting, qRT-PCR, and immunohistochemistry (IHC) were performed to examine the expression of related proteins and mRNAs. The migration ability of human nasal epithelial cells (HNEpCs) was evaluated with wound scratch assay. RNA sequencing was performed to investigate the downstream genes of FERMT1. The CRSwNP mouse model was established to study the effect of FERMT1 in vivo. ResultsWe found that FERMT1 was increased in nasal polyp tissues and correlated with the symptom scores of CRSwNP patients. Knockdown of FERMT1 inhibited the EMT process and cell migration induced by TGF-β1 through the PI3K/Akt pathway, and Akt inhibitor partially blocked the EMT induced by FERMT1 overexpression. In the CRSwNP mouse model, FERMT1 knockdown reduced nasal polyp formation and reversed the EMT process. ConclusionsOur data indicate that knockdown of FERMT1 inhibits migration and EMT process of HNEpCs via PI3K/Akt signaling pathway, suggesting that FERMT1 may be a novel and potential therapeutic target for CRSwNP treatment.

Transcranial Doppler ultrasound in evaluating cerebral blood flow abnormalities in major depressive disorder.

Previous research has shown that blood flow abnormalities affect major depressive disorder (MDD) from multiple perspectives. Therefore, this study aims to investigate the relationship between middle cerebral artery (MCA) blood flow velocity parameters and clinical symptom scores (Hamilton Depression Rating Scale [HAMD] and Montgomery-Åsberg Depression Rating Scale [MADRS]) in patients with MDD. We compared the MCA blood flow velocity parameters, including peak systolic velocity (MCA-PSV), end-diastolic velocity (MCA-EDV), and mean velocity (MCA-MV), between 50 MDD patients and 50 control subjects. Additionally, we analyzed the correlation between these parameters and HAMD and MADRS scores. Hemodynamic parameters such as pulsatility index and resistance index were also compared between the 2 groups. MCA-PSV, MCA-EDV, and MCA-MV were significantly lower in MDD patients compared to the control group, while pulsatility index and resistance index were significantly higher. Correlation analysis revealed that MCA-PSV, MCA-EDV, and MCA-MV were significantly negatively correlated with HAMD and MADRS scores in MDD patients, indicating that cerebral blood flow velocity decreases as depressive symptoms worsen. Furthermore, regression analysis confirmed the negative relationship between blood flow velocity parameters and clinical symptom scores. The results of this study suggest that the reduction in cerebral blood flow velocity in MDD patients may be associated with the severity of depressive symptoms. This finding provides new insights into the pathophysiological mechanisms of MDD and offers a potential theoretical basis for developing depression treatment strategies based on cerebral blood flow velocity parameters.

Two-Year Outcomes of Prostatic Artery Embolization for Symptomatic Benign Prostatic Hyperplasia: An International, Multicenter, Prospective Study

PurposeTo describe clinical outcomes among patients with benign prostatic hyperplasia (BPH) 24 months following prostatic artery embolization (PAE).Materials and MethodsThis was an international, multicenter, prospective trial of males with BPH with lower urinary tract symptoms (LUTS) or acute urinary retention (AUR) treated with PAE. The primary outcome was the 12 month change in the International Prostate Symptom Score (IPSS) for patients referred for bothersome LUTS, or urinary catheter independence for patients treated for AUR. Secondary outcome measures included changes in IPSS at 3 and 24 months, changes in quality of life (QoL), changes in the Sexual Health Inventory for Men (SHIM) questionnaire, technical success rate, and adverse events (AEs). Data were summarized using descriptive statistics.ResultsFour hundred seventy-eight consecutive patients underwent PAE (bothersome LUTS: N = 405; AUR: N = 73), mean age was 70 years. For patients treated for bothersome LUTS, mean total IPSS at baseline was 21.8 and decreased to 9.3, 10.6, and 11.2 at 3, 12, and 24 months following PAE, respectively (all p < 0.001); QoL at baseline was 4.7 and decreased to 2.0, 2.1, and 2.3 at 3, 12, and 24 months, respectively (all p < 0.001). The mean SHIM score at baseline and 12 months following PAE was 13.8 and 13.9, respectively. Of the 73 patients treated for AUR, 48 (65.8%) had their indwelling catheter removed within 3 months of PAE and remained catheter free at 24 months. Fifty-five patients (11.5%) experienced ≥ 1 AE and 10 (2.1%) experienced a serious AE.ConclusionPAE is a safe and effective treatment for symptomatic BPH and LUTS.Level of Evidence Level 3Trial registration ClinicalTrials.gov NCT03527589.Graphical

A Study on the Effectiveness of Musculoskeletal Corticosteroid Injections for Reducing Patient Symptom Scores in Primary Care Practice.

To present data on the effectiveness of corticosteroid injections (CSI) in reducing symptom scores for musculoskeletal conditions in patients treated in an NHS primary care CSI service. The data will also examine whether adding local anaesthetic to the corticosteroid preparation affects the overall patient outcomes in symptom scores. A Patient-reported outcomes (PRO) questionnaire was used to collect data. Patients were asked to complete the questionnaire post-CSI. Patients were asked to rate their symptoms on a score of 0-6 before and after their injection. Data were calculated using standard deviation and paired t-test to assess the effectiveness of CSI in reducing symptom scores. Overall, 172 patients (79.6%) reported an improvement in symptomatology post CSI. Improvements were seen across all injection sites. Of those taking medication for their symptoms, 73 patients (55.7%) reported that they were able to reduce their medication. Data did not suggest that adding local anaesthetic to the injectate resulted in better patient outcomes. Post-injection symptom scores were statistically similar across all clinicians. 83.7% of patients experienced a reduction in symptom scores post injection. Adding lidocaine to the injectate preparation did not result in any statistically significant improvement in patient outcome. Over half of the participants were able to reduce their medication post injection, which demonstrates this is a highly effective primary care service for treatment/management of some MSK conditions.

Correlation between the Visual Prostate Symptom Score and International Prostate Symptom Score in Patients with Symptomatic Benign Prostatic Hyperplasia

Background: Benign prostatic hyperplasia affects about 210 million males as of 2010 (6% of the population). BPH is the most common disease of men above 50 years of age. BPH is a major cause of morbidity in the ageing men. Lower urinary tract symptoms, are a collective term for the symptoms of disrupted voiding in males, which has long been associated with BPH. Materials and Methods: Study was descriptive cross-sectional study conducted in Department of Urology, Nobel medical college, Biratnagar, Nepal over a period from January 2022 to December 2022. The entire Patient with visiting urology clinic of the provisionally diagnosed as BEP was enrolled in the study with approval of institutional review committee. Results: We enrolled a cohort of 75 patients who had been diagnosed with BEP. The mean age was 51.31 years. The mean prostate size among these individuals was measured to be 45.63 grams, and their mean Prostate-Specific Antigen level was determined to be 3.57.We observed a moderate positive correlation (r = 0.536) with statistical significance (p &lt; 0.01) between VPSS total and IPSS total. Out of total, 35 (47%) completed VPSS alone without any assistance while filling IPSS only 9 (12%) could complete one. Median time for completing VPSS versus IPSS was 60sec and 300 sec respectively. Conclusion: In assessment of symptom severity visual prostate symptom score is equally effective as International prostate symptom score in cases of benign prostatic hyperplasia presenting with Lower urinary tract symptoms. All parameters of visual prostate symptom score is significantly correlated with International prostate symptom score.

Association between angiotensin-converting enzyme gene insertion/deletion polymorphism and cognition impairment in patients with schizophrenia.

Several lines of evidence indicate that an insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme gene (ACE) gene may be involved in the pathogenesis of schizophrenia and cognitive impairment. However, the relationship between ACE I/D polymorphism and cognitive impairment in patients with schizophrenia remains unclear. The aim of this study was to examine whether ACE gene I/D polymorphism contributed to cognitive impairment in Chinese patients with schizophrenia, and whether the association between clinical symptoms and cognitive impairment depended on different ACE genotypes. The ACE I/D polymorphism was genotyped in 928 schizophrenia patients and 325 healthy controls using a case-control design. The severity of psychopathological symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). Cognitive functioning was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). There were significant differences in genotype and allele frequencies of the ACE I/D polymorphism between patients and healthy controls (both P < 0.01). After controlling for demographic characteristics, patients who are homozygous carriers of D and I performed worse on the RBANS attention index than heterozygous carriers (P = 0.009). In addition, attention index score was negatively correlated with PANSS negative symptom score in patients of all genotypes (all P < 0.05), and positively correlated with positive symptom score only in the I/I genotype (P = 0.005). These findings suggest that ACE I/D gene variants play a role in susceptibility to schizophrenia, specific cognitive impairment and the association between clinical symptoms and cognitive impairment in schizophrenia patients.

TaqMan qPCR and IgM Detection in Samples of Patients with Tick-Borne Encephalitis Virus Infection in Northeast China.

Tick-borne encephalitis virus (TBEV) infections result in severe central nervous system diseases in humans across Asia and Europe. In China, cases of tick-borne encephalitis are primarily caused by the Far East subtype of TBEV, which exhibits a distinct disease course compared to other extensively studied subtypes. However, there is limited knowledge regarding the nucleic acid and serological diagnostic characteristics of patients infected with the TBEV in China, which is the focus of investigation in the present study. This study established a TaqMan qPCR approach to detect TBEV RNA in the serum with optimal specificity, sensitivity, and precision. Using TaqMan qPCR and ELISA assay for TBEV IgM detection, serum samples from 63 hospitalized patients bitten by ticks in Northeast China were investigated for diagnostic characteristics. Twenty-five patients were positive for viral RNA; nineteen patients were positive for IgM, and nine were positive for both viral RNA and IgM. Through comparative analysis, TBEV RNA copies were negatively correlated with the virus incubation period. IgM levels were positively correlated with the clinical symptom scores of patients. The severity of clinical symptoms and the length after the tick bite could be used to predict the IgM occurrence. Furthermore, IgM levels and viral RNA copies were not correlated in double-positive patients. Both nucleic acid and serological detection methods exhibited distinct windows for detecting TBEV infection, with some overlap, and were associated with specific correlated factors. This study provided novel insights into the diagnosis and course of TBEV-induced tick-borne encephalitis in China.

Residential radon decay products are associated with cough and phlegm in patients with COPD

Radon decay products attach to particulate matter (referred to as particle radioactivity, PR) has been shown to be potential to promote airway damage after inhalation. In this study, we investigated associations between PR with respiratory symptoms and health-related quality of life (HRQL) in patients with COPD. 141 male patients with COPD, former smokers, completed the St. George's Respiratory Questionnaire (SGRQ) after up to four 1-week seasonal assessments (N=474) of indoor (home) and ambient (central site) particulate matter ≤ 2.5 µm in diameter (PM2.5) and black carbon (BC). Indoor PR was measured as α-activity (radiation) on PM2.5 filter samples. The ratio of indoor/ambient sulfur in PM2.5 (a ventilation surrogate) was used to estimate α-PR from indoor radon decay. SGRQ responses assessed frequent cough, phlegm, shortness of breath, wheeze, and chest attacks in the past 3 months. Multivariable linear regression with generalized estimating equations accounting for repeated measures was used to explore associations, adjusting for potential confounders. Median (IQR) indoor α-PR was 1.22 (0.62) mBq/m3. We found that there were positive associations between α-PR with cough and phlegm. The strongest associations were with estimated α-PR of indoor origin for cough (31.1 % increase/IQR, 95 %CI: 8.8 %, 57.8 %), and was suggestive for phlegm (13.0 % increase/IQR, 95 %CI: −2.5 %, 31.0 %), similar adjusting for indoor BC or PM2.5. α-PR of indoor origin was positively associated with an increase in SGRQ Symptoms score [1.2 units/IQR; 95 %CI: −0.3, 2.6] that did not meet conventional levels of statistical significance. Our results suggested that exposure to indoor radon decay products measured as particle radioactivity, a common indoor exposure, is associated with cough, and suggestively associated with phlegm and worse HRQL symptoms score in patients with COPD.

Surgical and regenerative treatment options for empty nose syndrome: A systematic review.

Patients with empty nose syndrome usually suffer from paradoxical nasal congestion, nasal dryness, epistaxis and suffocation. Conservative management is general option for the empty nose syndrome. However, there are several patients who continually complain of symptoms. If symptoms persist, surgical options are considered. Therefore, we reviewed surgical and regenerative treatment options of empty nose syndrome. PubMed, Embase, Scopus, Cochrane Register of Controlled Trials, and Google Scholar were searched from the earliest date provided in the database until December 2022. In the studies, treatment outcomes were measured by patient symptom scores such as Sino-Nasal Outcome Test (SNOT-20, 22, and 25), and Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) along with various clinical examiniations. Twenty-eight studies were analyzed. Submucosal injectable materials, allografts/xenografts/cadaveric implants, autologous implants, and synthetic implants were used. Among them, polyethylene implant was most commonly used (23.3%), followed by autologous, homologous, or cadaveric costal cartilage (20%). The most common administration site was the anterior-inferior lateral nasal wall. Most of the studies showed that surgical intervention brought significant improvements in clinical findings including endoscopic exam, acoustic rhinometry, and CT, as well as patients reporting nasal symptom-, psychological-, or overall health-related quality of life questionnaires. However, several studies did not confirm improvement effects in some psychological-related questionnaires or saccharin transit time. The average follow-up duration was 12.0 (2.0-27.6) months. Postoperative adverse effects were reported in only two studies. Several surgical options and recent tissue regeneration techniques have shown its positive efficacy in treating empty nose syndrome. However more detailed investigations with a larger number and a randomized control study are needed to establish a standardized protocol in treating empty nose syndrome patients.

INTERNATIONAL PROSTATE SYMPTOM SCORE (IPSS) CORRELATION WITH SONOGRAPHIC PROSTATE SIZE

The International Prostate Symptom Score (IPSS) is a broadly used questionnaire designed to assess the severity of lower urinary tract symptoms (LUTS) in men, particularly those related to harmless prostatic hyperplasia (BPH). Objectives: The primary aim of this study is to find the International Prostate Symptom Score (IPSS) and its correlation with sonography and prostate size. Methods: This cross-sectional study was conducted at CMH Lahore February 17, 2024, to May 16, 2024. Data were collected from 250 patients. Male patients aged&gt;40 years who presented with LUTS were included in the study. Patients with a history of prostate cancer, bladder dysfunction and prostate surgery were excluded from the study. Data were collected through a systematically designed questionnaire. All the study participants completed the IPSS questionnaire to find the severity and urinary symptoms. Results: Data were collected from 250 patients according to the study's inclusion criteria. The mean age of the patients was 62.4 ± 8.6 years, and the mean BMI was 27.1 ± 3.2 kg/m2. The mean PSA was 6.8 ± 2.5 ng/mL, and the mean IPSS score was 19.5 ± 6.8. there, 140 (56%) patients were smokers, and 125 (50%) also suffering from hypertension. Patients with IPSS scores ranging from 0-7 exhibited a mean PV of 32.5 ± 5.6 mL, with a Pearson correlation coefficient (r) of 0.25 (p = 0.038). As IPSS scores increased to the 22-35 range, the mean PV rose to 54.3 ± 9.2 mL, with a more robust correlation coefficient of 0.75 (p &lt; 0.001). Conclusion: It is concluded that there is a significant positive correlation between the International Prostate Symptom Score (IPSS) and prostate volume (PV) in patients with benign prostatic hyperplasia (BPH).

Predictors of symptom scores in myeloproliferative neoplasms: A real-world retrospective cohort study.

6582 Background: Although high symptom burden indicates poor survival and informs treatment decisions, little is known about the impact of demographic, clinical, and laboratory features on total symptom score (TSS) in patients with myeloproliferative neoplasms (MPN). Methods: Patients with MPN (polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF)) were identified from the retrospective chart review. TSS, individual symptom scores (fatigue, early satiety, abdominal discomfort, inactivity, concentration problems, fever, night sweats, itching, bone pain, weight loss), demographic characteristics (race, ethnicity, age, gender), clinical features (time since diagnosis, depression status, obesity status, spleen size), laboratory results and season at the time of visit were recorded from the clinical encounter when index assessment of TSS was performed for each patient. Normality was assessed using visual inspection of data distribution, whereas multicollinearity was assessed using various inflation factors. A univariable regression followed by a multivariable regression analysis was conducted using a backward selection approach. A p-value &lt;0.05 indicated a statistically significant association of a given feature with TSS. Results: The chart review identified 252 patients (PV: 78; ET: 81; MF: 93). Mean age was 59 (SD: 17.7), 67 (SD: 13.0), and 68 (SD: 10.9) years for ET, PV, and MF respectively. Most patients were white (PV, MF: 92%; ET: 83%) and females (ET: 75%; PV: 60%; MF: 53%). The TSS of patients was highest with PV (mean: 18.5; SD: 16.9) followed by MF (mean: 18.1; SD: 15.4) and ET (mean: 14.3; SD: 15.9). Fatigue was the most reported symptom whereas the least reported symptoms were fever and weight loss. Univariable regression analyses showed depression (B: 17.7; p=0.02), female gender (B: 10.6; p=0.01), platelet count (B: 0.03; p=0.03), and hemoglobin (Hb) (B: -2.6; p=0.01) in PV patients, depression (B: 19.8, p=2x10-5) in ET patients and depression (B: 11.0, p=0.03), white blood cell (WBC) count (B: 0.2; p=0.01), neutrophil count (B: 0.3, p=0.01), and non-neutrophil WBC count (B: 0.6; p=0.02) in MF patients to have significant association with TSS. Multivariable regression analyses ( Table) showed Hb (B: -2.5; p=0.01) and platelet count (B: 0.02; p=0.03) in PV patients, depression (B: 19.7; p=2x10-5) in ET patients and depression (B: 12.3, p=0.01) and WBC count (B: 0.3; p=0.002) in MF patients to have a significant association with TSS. Conclusions: Depression in ET and MF and low Hb in PV were identified as significant drivers of symptom burden. Identifying and managing patients with these comorbidities could improve their quality of life with a potential survival benefit. [Table: see text]

In Vivo Reactive Astrocyte Imaging in Patients With Schizophrenia Using Fluorine 18–Labeled THK5351

ImportanceIn vivo imaging studies of reactive astrocytes are crucial for understanding the pathophysiology of schizophrenia because astrocytes play a critical role in glutamate imbalance and neuroinflammation.ObjectiveTo investigate in vivo reactive astrocytes in patients with schizophrenia associated with positive symptoms using monoamine oxidase B (MAO-B)–binding fluorine 18 ([18F])–labeled THK5351 positron emission tomography (PET).Design, Setting, and ParticipantsIn this case-control study, data were collected from October 1, 2021, to January 31, 2023, from the internet advertisement for the healthy control group and from the outpatient clinics of Seoul National University Hospital in Seoul, South Korea, for the schizophrenia group. Participants included patients with schizophrenia and age- and sex-matched healthy control individuals.Main Outcomes and MeasuresStandardized uptake value ratios (SUVrs) of [18F]THK5351 in the anterior cingulate cortex (ACC) and hippocampus as primary regions of interest (ROIs), with other limbic regions as secondary ROIs, and the correlation between altered SUVrs and Positive and Negative Syndrome Scale (PANSS) positive symptom scores.ResultsA total of 68 participants (mean [SD] age, 32.0 [7.0] years; 41 men [60.3%]) included 33 patients with schizophrenia (mean [SD] age, 32.3 [6.3] years; 22 men [66.7%]) and 35 healthy controls (mean [SD] age, 31.8 [7.6] years; 19 men [54.3%]) who underwent [18F]THK5351 PET scanning. Patients with schizophrenia showed significantly higher SUVrs in the bilateral ACC (left, F = 5.767 [false discovery rate (FDR)–corrected P = .04]; right, F = 5.977 [FDR-corrected P = .04]) and left hippocampus (F = 4.834 [FDR-corrected P = .04]) than healthy controls. Trend-level group differences between the groups in the SUVrs were found in the secondary ROIs (eg, right parahippocampal gyrus, F = 3.387 [P = .07]). There were positive correlations between the SUVrs in the bilateral ACC and the PANSS positive symptom scores (left, r = 0.423 [FDR-corrected P = .03]; right, r = 0.406 [FDR-corrected P = .03]) in patients with schizophrenia.Conclusions and RelevanceThis case-control study provides novel in vivo imaging evidence of reactive astrocyte involvement in the pathophysiology of schizophrenia. Reactive astrocytes in the ACC may be a future target for the treatment of symptoms of schizophrenia, especially positive symptoms.

Development and implementation of an evidence-based biofield therapy standardized documentation tool

IntroductionBiofield therapy (BT) is a complementary health practice involving the use of subtle energy to promote healing; however, monitoring the quality of care after implementing a BT program can be particularly challenging. The aim of this project was to strategically design, implement, and evaluate an evidence-based BT documentation tool to capture relevant data elements to display in a quality metric dashboard, while also being satisfactory to the practitioners who use it. MethodsUtilizing the Consolidated Framework for Implementation Research (CFIR) method, key stakeholders at a government healthcare facility were gathered to design and use a structured documentation tool. After the tool's deployment, the stakeholders were routinely assessed over a three-month period to evaluate its effectiveness and identify areas for improvement. At the end of the period a practitioner satisfaction questionnaire was deployed and a quality metric dashboard was launched. ResultsSeven of the eleven BT-trained practitioners (64 %) used the template during the evaluation period and 255 sessions were documented. Forty-five percent of the staff responded to the Likert scored satisfaction questionnaire with 100 % indicating the template improved documentation, fit into the workflow, and facilitated interdisciplinary communication. The dashboard presented nine data elements, such as session indication and patient symptom scores, which can be filtered by date and location. DiscussionThe satisfaction scores validated findings from the literature relative to structured documentation, quality review, and program evaluation. These outcomes support the expansion of BT into different clinical settings, foster future BT research endeavors, and allow for BT to be included in broader medical data analytic efforts. ConclusionA structured documentation tool designed with findings from the evidence and input from key stakeholders can be an effective and satisfactory means of capturing quality metrics for evaluating the implementation of BT.

Effects of a single subanesthetic dose of esketamine on postoperative subthreshold depressive symptoms in patients undergoing unilateral modified radical mastectomy: a randomised, controlled, double-blind trial

BackgroundBreast cancer is the most common malignant tumor in females worldwide. During disease development, breast cancer patients suffer anxious and depressed, which may lead to worse quality of life or even higher mortality. Esketamine has been regarded as an antidepressant in breast cancer patients with mild or moderate depression. Here, we wonder whether the administration of esketamine could reduce the postoperative depressive symptom score of breast cancer patients who have no preoperative depression.MethodsA total of 64 patients treated with unilateral modified radical mastectomy were randomly divided into an experimental group (esketamine group, Group E) and a control group (Group C), with 32 cases in each one. After anesthesia induction, Group C received 0.2 ml/kg of normal saline intravenously and Group E was administered 0.2 mg/kg intravenous esketamine. The primary outcome was the Patient Health Questionnaire-9 (PHQ-9) scores. The secondary outcomes included the Visual Analogue Scale (VAS) scores for pain, inflammatory markers, perioperative-related indicators, and the incidence of postoperative delirium, nausea and vomiting.ResultsThe PHQ-9 score on postoperative day (POD) 1 in Group E declined from the preoperative level, while the score in Group C was higher than before, and the former was far lower than the latter (P = 0.047). There is no statistically significant difference in PHQ-9 scores between Group E and Group C on POD 3, 7, and 30. Moreover, the postoperative leukocyte level of Group E was higher than that of Group C, and the difference was statistically significant (P = 0.030).ConclusionsA single subanesthetic dose of esketamine can result in lower postoperative score on subthreshold depressive symptoms compared to the Group C on POD 1, without increasing the occurrence of postoperative adverse reactions.Trial registrationRegistration number: Chinese Clinical Trial Registry ChiCTR2200057028. Date of registration: 26/02/2022.

Analysis of the Effectiveness of Biling Weitong Granules Combined with Trimethoprim and Vonoprazan in The Treatment of Reflux Esophagitis

Objective: To analyze the effectiveness of Biling Weitong Granules (BLWTG) combined with trimethoprim and vonoprazan in treating reflux esophagitis. Methods: Sixty patients with reflux esophagitis admitted to our hospital from March 2020 to March 2023 were selected as study subjects and randomly divided into a control group and an experimental group, with 30 cases in each group. The control group received only the combination treatment of trimethoprim and vonoprazan, while the experimental group was treated with BLWTG based on the control group. The acid reflux and heartburn symptom scores, quality-of-life scores, clinical efficacy, Chinese medicine symptom incidences, and the occurrence of adverse reactions before and after treatment in the two groups were compared. Results: After treatment, the acid reflux and heartburn symptom scores of patients in the experimental group were lower than those of the treatment control group, and the quality-of-life scores were higher than those of the treatment control group (P &lt; 0.05). The total clinical efficacy of the experimental group was 96.66%, which was significantly higher than that of the control group (73.33%, P &lt; 0.05). After treatment, the incidence of Chinese medicine symptoms, such as nausea and vomiting, abdominal distension and abdominal pain, and loss of appetite of the patients in the experimental group were significantly lower than those of the control group (P &lt; 0.05). During the treatment period, there was no significant difference in the incidence of adverse reactions between the two groups, which indicated that the safety of the two treatments was comparable (P &gt; 0.05). Conclusion: BLWTG combined with trimethoprim and vonoprazan was safe and reliable in treating reflux esophagitis, effectively relieving the symptoms and improving its clinical efficacy. This treatment is worthy of popularization.

Efficacy of 300 IR house dust mite immunotherapy as a function of disease activity: Tertile analysis in clinical trials.

The symptoms of house dust mite (HDM)-induced allergic rhinitis (AR) vary with changes in exposure related to the weather or the domestic environment. In allergen immunotherapy (AIT) studies, a certain level of AR disease activity is necessary to demonstrate treatment efficacy; the latter can be underestimated if a substantial proportion of the patient population is weakly symptomatic. To better estimate the real treatment effect of a HDM sublingual AIT (SLIT) tablet, we analysed the results of natural field studies in detail by applying a tertile approach. We used data from three randomised, controlled trials (RCT) in a total of 2585 patients with AR treated with the 300 index of reactivity (IR) HDM SLIT-tablet or placebo. The study centres were grouped into tertiles according to the level of combined symptom and medication scores in patients in the placebo group. In each tertile, the difference between SLIT and placebo was assessed through an analysis of covariance. In the three RCTs, combined scores were found to be similar in the SLIT and placebo groups in the low tertiles. The treatment effect of the 300 IR HDM tablet increased in the medium and high tertiles, with notably significant differences versus placebo in the highest tertile and greater (ranging from -21% to -39%) than in the entire study population (-13% to -20%). The positive relationship between treatment efficacy and the combined score in each tertile was independent of the RCT and the score used. Application of the tertile approach to AIT studies in a field in which many variables interact strongly might provide more accurate and meaningful measurements of efficacy and benefit for patients, better reflecting their real-life condition.

Observation of the efficacy of elongated needle therapy in treating patients with ⅢB prostatitis of stagnant dampness-heat syndrome.

To observe the clinical efficacy in patients with ⅢB prostatitis of stagnant dampness-heat syndrome treated with elongated needle therapy. A total of 90 patients with ⅢB prostatitis of stagnant dampness-heat syndrome were selected and randomly divided into a treatment group(45 cases, 2 dropped out) and a control group(45 cases, 1 dropped out) using a random number table method. The control group was treated with oral administration of Qianlie Shutong Capsule, 3 capsules per dose, 3 times a day for a total of 4 weeks. The treatment group received elongated needle therapy at Qihai(CV6), Zhongji(CV3), bilateral Zhibian(BL54) and Shuidao(ST28), with one treatment per day for 4 weeks. Before and after treatment, the traditional Chinese medicine syndrome score, National Institutes of Health Chronic Prostatitis Symptom Index(NIH-CPSI) score were compared between the two groups, and the clinical efficacy was compared after treatment. Compared with that before treatment, the control group showed significant decrease in traditional Chinese medicine syndrome score, testicular pain, urinary frequency, unending remnants of urine, scrotal wetness, yellowish urine, urinary symptoms, and quality of life scores after treatment(P<0.05)；the treatment group showed significant decrease in traditional Chinese medicine syndrome score, and perineal pain, groin pain, pelvic pain, testicular pain, scrotal wetness, yellowish urine scores, NIH-CPSI total score, pain symptoms, urinary symptoms, and quality of life scores after treatment(P<0.05). After treatment, the treatment group showed significantly lower traditional Chinese medicine syndrome score, and perineal pain, groin pain, pelvic pain, testicular pain scores, NIH-CPSI total score, pain symptoms, and quality of life scores than those of the control group(P<0.05). The effective rate in the treatment group (63.64%, 28/43) was significantly higher than that in the control group (88.37%, 38/44, P<0.05). Elongated needle therapy can significantly improve the traditional Chinese medicine syndrome score, NIH-CPSI total score, and pain symptom scores in patients with ⅢB prostatitis of stagnant dampness-heat syndrome. It can significantly improve the cure rate in these patients and is particularly effective in relieving pain.