Severity Of Symptoms In Patients Research Articles

Altered morphometric similarity networks in insomnia disorder.

Previous studies on structural covariance network (SCN) suggested that patients with insomnia disorder (ID) show abnormal structural connectivity, primarily affecting the somatomotor network (SMN) and default mode network (DMN). However, evaluating a single structural index in SCN can only reveal direct covariance relationship between two brain regions, failing to uncover synergistic changes in multiple structural features. To cover this research gap, the present study utilized novel morphometric similarity networks (MSN) to examine the morphometric similarity between cortical areas in terms of multiple sMRI parameters measured at each area. With seven T1-weighted imaging morphometric features from the Desikan-Killiany atlas, individual MSN was constructed for patients with ID (N = 87) and healthy control groups (HCs, N = 84). Two-sample t-test revealed differences in MSN between patients with ID and HCs. Correlation analyses examined associations between MSNs and sleep quality, insomnia symptom severity, and depressive symptoms severity in patients with ID. The right paracentral lobule (PCL) exhibited decreased morphometric similarity in patients with ID compared to HCs, mainly manifested by its de-differentiation (meaning loss of distinctiveness) with the SMN, DMN, and ventral attention network (VAN), as well as its decoupling with the visual network (VN). Greater PCL-based de-differentiation correlated with less severe insomnia and fewer depressive symptoms in the patients group. Additionally, patients with less depressive symptoms showed greater PCL de-differentiation from the SMN. As an important pilot step in revealing the underlying morphometric similarity alterations in insomnia disorder, the present study identified the right PCL as a hub region that is de-differentiated with other high-order networks. Our study also revealed that MSN has an important potential to capture clinical significance related to insomnia disorder.

Exploring pathogenic pathways in carpal tunnel syndrome: sterile inflammation and oxidative stress.

The main objective of the current study was to find the association between oxidative stress, inflammatory markers, and electrophysiological profile with symptom severity in patients of carpal tunnel syndrome (CTS). Thirty-two carpal tunnel syndrome patients and 32 controls were included in the study. Boston CTS questionnaire along with plasma oxidative stress markers including superoxide dismutase, malondialdehyde, and nitric oxide and inflammatory markers including IL-6 and TNF-α were compared with the electrophysiological parameters derived from nerve conduction studies. Statistical significance of the levels between groups was calculated using unpaired-t test after checking for normality with D'Agostino & Pearson omnibus normality test. We found that the median nerve conduction velocity was prolonged, amplitude was decreased, while the levels of oxidative stress markers like malondialdehyde (MDA), superoxidase dismutase (SOD), and nitric oxide (NO) were increased in CTS patients compared to controls. Inflammatory markers like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were also increased in CTS patients. We found that plasma SOD and TNF-α correlated well with the median motor amplitude. There was no other significant correlation between oxidative stress markers and inflammatory markers with nerve conduction studies or disease severity. Patients with mild disease also showed lesser levels of SOD, NO, IL-6, and TNF-α markers than patients with severe disease. CTS is probably a disease of sterile inflammation and disbalance of oxidative stress, with higher inflammatory and oxidative stress markers pointing to a more severe disease.

Zinc and Inflammatory Bowel Disease: From Clinical Study to Animal Experiment.

Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract (GI) with a high incidence rate globally, and IBD patients are often accompanied by zinc deficiency. This review aims to summarize the potential therapeutic value of zinc supplementation in IBD clinical patients and animal models. Zinc supplementation can relieve the severity of IBD especially in patients with zinc deficiency. The clinical severity of IBD were mainly evaluated through some scoring methods involving clinical performance, endoscopic observation, blood biochemistry, and pathologic biopsy. Through conducting animal experiments, it has been found that zinc plays an important role in alleviating clinical symptoms and improving pathological lesions. In both clinical observation and animal experiment of IBD, the therapeutic mechanisms of zinc interventions have been found to be related to immunomodulation, intestinal epithelial repair, and gut microbiota's balance. Furthermore, the antioxidant activity of zinc was clarified in animal experiment. Appropriate zinc supplementation is beneficial for IBD therapy, and the present evidence highlights that alleviating zinc-deficient status can effectively improve the severity of clinical symptoms in IBD patients and animal models.

Association Between Baseline Serum Lipids and Severity of Dry Eye Symptoms in Acne Patients Treated with Isotretinoin.

Isotretinoin is a commonly prescribed medication for moderate-to-severe acne. Elevated triglycerides and total cholesterol, as well as eye dryness, are frequent side effects of isotretinoin. Objective:This study aims to examine the association between serum baseline levels of triglycerides and total cholesterol with regards to the severity of dry eye symptoms in acne patients treated with isotretinoin. The study was a retrospective review of acne patients treated with isotretinoin for at least four months at the dermatology clinics of Qassim University Medical City, Saudi Arabia. Thirty patients were included in the study as they met the inclusion criteria. Baseline levels of triglycerides and total cholesterol were reviewed for these patients. The Ocular Surface Disease Index (OSDI) questionnaire was sent and filled out by the study participants to assess the severity of eye dryness. 30 patients were included in the study, with 16 (53.3%) females and 14 (46.7%) males. The average age of participants was 22.1 years. The duration of treatment was between 120 and 140 days in 13 (43.3%) participants and 140 and 180 days in 17 (56.7%) participants. The mean ± 1 standard deviation (SD) was reported for each of the three variables, with an Ocular Surface Disease Index (OSDI) score of 27.6 ± 19.2, a baseline total cholesterol of 4.4 ± 0.9 mmol/L, and a baseline triglyceride level of 0.83 ± 0.4 mmol/L. Using a multiple linear regression model, baseline triglycerides and total cholesterol were used as predictors of the OSDI score. There was a significant dependent interaction between baseline total cholesterol and triglycerides and their effect on the OSDI score, with a higher OSDI score at higher levels of both triglycerides and cholesterol and a lower OSDI score at lower levels of both triglycerides and cholesterol. The study result showed that, in acne patients treated with isotretinoin for at least four months, a higher baseline level of both triglycerides and total cholesterol is associated with worse dry eye symptoms compared to those with lower baseline levels. The study concluded that baseline levels of triglycerides and total cholesterol arebothsignificant predictors of the severity of dry eye symptoms in acne patients treated with isotretinoin. Despite study limitations due to the small sample size, we hope that, based on our findings, this will open the door to future studies with a larger sample sizeto further confirmour findingsgeneralizethe result, andapply it to clinical practice so that clinicians may identify those at higher risk of severe eye dryness before starting isotretinoin and subsequently be able to recommend specific measures to minimize symptoms of eye dryness.

Common neural deficits across reward functions in major depression: a meta-analysis of fMRI studies.

Major depressive disorder (MDD) is characterized by deficient reward functions in the brain. However, existing findings on functional alterations during reward anticipation, reward processing, and learning among MDD patients are inconsistent, and it was unclear whether a common reward system implicated in multiple reward functions is altered in MDD. Here we meta-analyzed 18 past studies that compared brain reward functions between adult MDD patients (N = 477, mean age = 26.50 years, female = 59.40%) and healthy controls (N = 506, mean age = 28.11 years, females = 55.58%), and particularly examined group differences across multiple reward functions. Jack-knife sensitivity and subgroup meta-analyses were conducted to test robustness of findings across patient comorbidity, task paradigm, and reward nature. Meta-regression analyses assessed the moderating effect of patient symptom severity and anhedonia scores. We found during reward anticipation, MDD patients showed lower activities in the lateral prefrontal-thalamus circuitry. During reward processing, patients displayed reduced activities in the right striatum and prefrontal cortex, but increased activities in the left temporal cortex. During reward learning, patients showed reduced activity in the lateral prefrontal-thalamic-striatal circuitry and the right parahippocampal-occipital circuitry but higher activities in bilateral cerebellum and the left visual cortex. MDD patients showed decreased activity in the right thalamus during both reward anticipation and learning, and in the right caudate during both reward processing and learning. Larger functional changes in MDD were observed among patients with more severe symptoms and higher anhedonia levels. The thalamic-striatal circuitry functional alterations could be the key neural mechanism underlying MDD patients overarching reward function deficiencies.

Attributional styles are associated with care burden in geriatric depression: older adults and their caregivers in Taiwan

BackgroundGiven the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers’ attributional styles, that is, how individuals interpret the causes of life events, on their care burden.AimThis study examined the relationship between caregivers’ attributional styles and their care burden for older patients with depression.MethodsThis cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers’ depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver’s subjectively assessed care burden.ResultsThe sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers’ gender (β = − 0.14, p = .044), educational level (β = 0.19, p = .008), caregivers’ own depression assessed by the Center for Epidemiological Studies Depression Scale (β = 0.41, p < .001), and attributional styles, particularly manipulation (β = 0.29, p < .001) and illness/stress attributional style (β = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles.ConclusionsCertain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.

Salivary inflammatory biomarkers as a predictor of post-traumatic stress disorder and depressive symptom severity in trauma patients: A prospective study

BackgroundAlthough post-traumatic stress disorder (PTSD) and depression screening are recommended for traumatic injury patients, routine screening is still uncommon. Salivary inflammatory biomarkers have biological plausibility and potential feasibility and acceptability for screening. This study tested prospective associations between several salivary inflammatory biomarkers (proinflammatory cytokines interleukin-1β, interleukin-6, tumor necrosis factor-α; and C-reactive protein), collected during hospitalization and PTSD and depressive symptoms at 5-month follow-up. MethodsAdult traumatic injury patients (N = 696) at a major urban Level 1 trauma center provided salivary samples and completed PTSD and depressive symptom measures during days 0–13 of inpatient hospitalization. At 5-month follow-up, 368 patients (77 % male, 23 % female) completed the Clinician-Administered PTSD Scale for DSM-IV and the Self-rated Inventory of Depressive Symptomatology. Analyses focused on a latent inflammatory cytokine factor and C-reactive protein at baseline predicting 5-month PTSD and depression symptom outcomes and included baseline symptom levels as covariates. ResultsA latent factor representing proinflammatory cytokines was not related to 5-month PTSD or depressive symptom severity. Higher salivary CRP was related to greater PTSD symptom severity (β = .10, p = .03) at 5-month follow-up and more severity in the following depressive symptoms: changes in weight and appetite, bodily complaints, and constipation/diarrhea (β’s from .14 to .16, p’s from .004 −.03). ConclusionIn a primarily Latine and Black trauma patient sample, salivary CRP measured after traumatic injury was related to greater PTSD symptom severity and severity in several depressive symptom clusters. Our preliminary findings suggest that salivary or systemic CRP may be useful to include in models predicting post-trauma psychopathology.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients

ObjectiveThis study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. MethodsFrom June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. ResultsAll participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (β=0.087, 95%CI 0.030–0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (β=0.131, 95%CI 0.008–0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (β=0.027, 95%CI 0.001–0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. ConclusionThere is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. Impact on nursing practiceIt is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

Assessment of symptom severity in psychotic disorder patients based on heart rate variability and accelerometer mobility data

Background:Advancement in mental health care requires easily accessible, efficient diagnostic and treatment assessment tools. Viable biomarkers could enable objectification and automation of the diagnostic and treatment process, currently dependent on a psychiatric interview. Available wearable technology and computational methods make it possible to incorporate heart rate variability (HRV), an indicator of autonomic nervous system (ANS) activity, into potential diagnostic and treatment assessment frameworks as a biomarker of disease severity in mental disorders, including schizophrenia and bipolar disorder (BD). Method:We used a commercially available electrocardiography (ECG) chest strap with a built-in accelerometer, i.e. Polar H10, to record R-R intervals and physical activity of 30 hospitalized schizophrenia or BD patients and 30 control participants through ca. 1.5-2 h time periods. We validated a novel approach to data acquisition based on a flexible, patient-friendly and cost-effective setting. We analyzed the relationship between HRV and the Positive and Negative Syndrome Scale (PANSS) test scores, as well as the HRV and mobility coefficient. We also proposed a method of rest period selection based on R-R intervals and mobility data. The source code for reproducing all experiments is available on GitHub, while the dataset is published on Zenodo. Results:Mean HRV values were lower in the patient compared to the control group and negatively correlated with the results of the PANSS general subcategory. For the control group, we also discovered the inversely proportional dependency between the mobility coefficient, based on accelerometer data, and HRV. This relationship was less pronounced for the treatment group. Conclusions:HRV value itself, as well as the relationship between HRV and mobility, may be promising biomarkers in disease diagnostics. These findings can be used to develop a flexible monitoring system for symptom severity assessment.

Relationship Between Fluid Control and Symptom Severity in Hemodialysis Patients

Objective: This study was conducted to determine fluid control and symptom severity in hemodialysis patients, to reveal related factors, and to determine the relationship between fluid control and symptom severity. Methods: The descriptive and correlational study was conducted with 150 patients receiving treatment in a private hemodialysis center in Istanbul between 01-30 April 2022. Data were obtained using a patient identification form, the Fluid Control Scale in Hemodialysis Patients and the Dialysis Symptom Index. Results: The mean Fluid Control Scale in Hemodialysis Patients score of the patients was 50.75±8.13. The mean Dialysis Symptom Index score of the patients was 19.09±17.08. In addition, it was found that there was a weak negative correlation between the mean scores of the Fluid Control Scale in Hemodialysis Patients and the Dialysis Symptom Index (r=-0.349; p

The severity of lower urinary tract symptoms during the postoperative period as a factor in choosing an approach to surgical treatment for large prostate hyperplasia: holmium enucleation of the prostate (HoLEP) vs laparoscopic simple prostatectomy

Introduction. Analysis of complications after transurethral surgery for benign prostate hyperplasia (BPH) demonstrates that 20 – 30% of patients require prolonged postoperative treatment for severe lower urinary tract symptoms (LUTS) despite improvements in technology and surgical techniques. These complications play a significant role in reducing the quality of life of patients in the postoperative period. Severe storage symptoms and urgent urinary incontinence represent significant challenges in the postoperative phase when performing laser enucleation surgery. There are also limits to standard approaches to perform laparoscopic prostatectomy, which requires the development of improved techniques.Objective. To conduct a comparative assessment of the postoperative dynamics of LUTS in groups undergoing holmium laser enucleation of the prostate (HoLEP), a standard Millin laparoscopic simple prostatectomy (LSP), and a modified LSP.Materials &amp; Methods. This multicenter study included 439 patients who were randomly assigned to 3 groups depending on the surgical treatment technique used for bladder outlet obstruction associated with large-volume BPH: the HoLEP group (n = 151), the standard Millin LSP (n = 142) and the modified LSP, combined with temporary clamping of the internal iliac arteries and vesicourethral anastomosis (n = 146). The main criterion assessed during six-months follow-up was the severity of LUTS on the IPSS scale (obstructive and irritative components). Complications that developed during the postoperative observation period were recorded.Results. A lower severity of LUTS was revealed in the group of the modified LSP compared to the standard LSP and HoLEP (p = 0.041 and p = 0.001, respectively). The average irritative component of IPSS was significantly lower in the modified LSP group compared to the standard LSP and HoLEP (p = 0.032 and p = 0.001, respectively). The observed trend continued to the third month after surgery. Comparison of changes in symptom severity six months after surgery demonstrated a significant advantage for the modified LSP both compared to HoLEP (p = 0.017) and a standard LSP (p = 0.032). All three groups showed comparable significant improvements in quality of life.Conclusion. The severity of postoperative storage symptoms is a limitation of HoLEP use, whereas the standard LSP is associated with lower severity of LUTS. The authors' modification of the LSP has the potential to reduce the severity of storage symptoms in patients for up to three months after surgery, and is associated with a low rate of urge incontinence.

Association between homotopic connectivity and clinical symptoms in first-episode schizophrenia

BackgroundAbnormal functional connectivity (FC) in the brain has been observed in schizophrenia patients. However, studies on FC between homotopic brain regions are limited, and the results of these studies are inconsistent. The aim of this study was to compare homotopic connectivity between first-episode schizophrenia (FES) patients and healthy subjects and assess its correlation with clinical symptoms. MethodsThirty-one FES patients and thirty-three healthy controls (HC) were included in the study. The voxel-mirrored homotopic connectivity (VMHC) method of resting-state functional magnetic resonance imaging (rs-fMRI) was used to analyse the changes in homotopic connectivity between the two groups. The 5-factor PANSS model was used to quantitatively evaluate the severity of symptoms in FES patients. Partial correlation analysis was used to assess the correlation between homotopic connectivity changes and clinical symptoms. ResultsCompared to those in the HC group, VMHC values were decreased in the paracentral lobule (PL), thalamus, and superior temporal gyrus (STG) in the FES group (P < 0.05, FDR correction). No significant differences in white matter volume (WMV) within the subregion of the corpus callosum or in brain regions associated with reduced VMHC were observed between the two groups. Partial correlation analyses revealed that VMHC in the bilateral STG of FES patients was positively correlated with negative symptoms (rleft = 0.46, p < 0.05; rright = 0.47, p < 0.05), and VMHC in the right thalamus was negatively correlated with disorganized/concrete symptoms (rright = 0.45, p < 0.05). ConclusionOur study revealed that homotopic connectivity is altered in the resting-state brain of FES patients and correlates with the severity of negative symptoms; this change may be independent of structural changes in white matter. These findings may contribute to the development of the abnormal connectivity hypothesis in schizophrenia patients.

A novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomized, placebo-controlled clinical trial

IntroductionDry eye disease (DED) is multifactorial and characterized by a loss of tear film homeostasis that causes a cycle of tear film instability, tear hyperosmolarity, and inflammation. While artificial tears are the traditional mainstay of treatment, addressing the underlying pathophysiology could relieve symptoms and prevent progression. Increasing evidence indicates a role for oral nutritional supplementation in multiple ophthalmic diseases, including DED. Lutein, zeaxanthin, curcumin, and vitamin D3 have demonstrated protective and anti-inflammatory properties in ocular models. This prospective, randomized, double-blind, parallel, placebo-controlled study evaluated the efficacy and safety of a proprietary blend of lutein, zeaxanthin isomers, curcumin, and vitamin D3 (LCD) as a daily supplement in adult participants with DED.MethodsParticipants were randomized to receive one LCD supplement capsule (lutein 20 mg, zeaxanthin isomers 4 mg, curcumin 200 mg curcuminoids, and vitamin D3 600 IU) or placebo per day for 8 weeks (LCD, n=77; placebo, n=78). Primary outcomes were changes in tear volume (Schirmer’s test) and ocular symptoms (Ocular Surface Disease Index [OSDI]).ResultsThe study met its primary endpoints: the LCD group demonstrated significantly better Schirmer’s test scores and improvement in overall OSDI score, versus placebo, at Day 56 (p&amp;lt;0.001 for both). Scores for total OSDI, and symptoms and vision domains, significantly improved by Day 14 for LCD versus placebo, (p&amp;lt;0.05 for all) and were maintained to Day 56 (p&amp;lt;0.001). In addition, the LCD group demonstrated significantly improved tear film break-up time (TBUT) and tear film osmolarity, versus placebo, by Day 56 (p&amp;lt;0.001), along with significant improvements in corneal and conjunctival staining (p&amp;lt;0.001 for both), and inflammation (matrix metalloproteinase-9; p&amp;lt;0.001 for each eye). Total Standard Patient Evaluation of Eye Dryness (SPEED) score, and scores for the frequency and severity domains, were significantly improved by Day 14 for LCD versus placebo (p&amp;lt;0.05 for all) and maintained to Day 56 (p&amp;lt;0.001). There was no difference between groups for artificial tear usage. The supplement was well-tolerated.DiscussionOnce-daily LCD supplementation significantly improved tear production, stability and quality, reduced ocular surface damage and inflammation, and improved participants’ symptoms. LCD supplementation could offer a useful adjunct to artificial tears for patients with DED (NCT05481450).

The impact of outpatient supportive oncology on cancer care cost and utilization.

Supportive oncology (SO) care reduces symptom severity, admissions, and costs in patients with advanced cancer. This study examines the impact of SO care on utilization and costs. Retrospective analysis of utilization and costs comparing patients enrolled in SO versus three comparison cohorts who did not receive SO. Using claims, the authors estimated differences in health care utilization and cost between the treatment group and comparison cohorts. The treatment group consisting of patients treated for cancer at an National Cancer Institute-designated cancer center who received SO between January 2018 and December 2019 were compared to an asynchronous cohort that received cancer care before January 2018 (n=60), a contemporaneous cohort with palliative care receiving SO care from other providers in the Southeastern Pennsylvania region during the program period (n=86), and a contemporaneous cohort without palliative care consisting of patients at other cancer centers who were eligible for but did not receive SO care (n=393). At 30, 60, and 90 days post-enrollment into SO, the treatment group had between 27% and 70% fewer inpatient admissions and between 16% and 54% fewer emergency department visits (p<.05) compared to non-SO cohorts. At 90 days following enrollment in SO care, total medical costs were between 4.4% and 24.5% lower for the treatment group across all comparisons (p<.05). SO is associated with reduced admissions, emergency department visits, and total costs in advanced cancer patients. Developing innovative reimbursement models could be a cost-effective approach to improve care of patients with advanced cancer.

Neuropsychiatric Manifestations and Cognitive Decline in Patients With Long-Standing Lyme Disease: A Scoping Review.

Lyme disease (LD), or Lyme borreliosis, is a vector-borne disease that is caused by the transmission of the bacterium Borrelia burgdorferi through a tick bite. The symptoms of LD can persist in individuals chronically, even after the treatment and resolution of the initial infection. These symptoms include various neuropsychiatric manifestations and cognitive decline. The purpose of this review was to report the neuropsychiatric manifestations, cognitive decline, and effects of a delayed diagnosis on symptom severity in patients with long-standing LD (LSLD). A scoping review was conducted utilizing the electronic databases Embase, Ovid Medical Literature Analysis and Retrieval System Online (MEDLINE), and Web of Science. A total of 744 articles were retrieved and considered for inclusion. After a rigorous screening process, 10 articles that met the inclusion criteria for this review were included (i.e., reported neuropsychiatric manifestations and cognitive decline in patients with LSLD and the effects of a delayed diagnosis). Neuropsychiatric manifestations in the patients consisted of suicidal ideation, homicidal tendencies, extreme anger, depressive symptoms, aggression, and anxiety. Cognitive symptoms included dysfunctions in working memory, verbal learning/memory, non-verbal learning/memory, alertness, visuoconstructive, and frontal executive functioning. A delayed LD diagnosis increased symptom severity in most patients. The findings of this review indicate that neuropsychiatric and cognitive symptoms tend to present for a chronic period, even after disease recovery. Although researchers have established a link between a delayed LD diagnosis and increased symptom severity, LSLD is often an overlooked diagnosis in patients with neuropsychiatric symptoms and cognitive decline. More research is needed to compare the time to diagnosis and symptom severity in patients with LSLD.

Psychometric Properties and Concurrent Validity of a 10-Item Questionnaire for Patients With Vestibular Disorders.

This study aimed to investigate the psychometric properties and concurrent validity of the Haukeland Dizziness Questionnaire (HDQ-10), a 10-item questionnaire designed for simplified assessment of symptom severity and emotional effects in patients with vestibular disorders. Cross-sectional study. Secondary referral hospital. Out of 238 consecutive patients examined for suspected vestibular disease at an otolaryngology clinic, 201 completed the questionnaire. The psychometric properties of the HDQ-10 were examined by exploratory factor analysis and analysis of internal consistency. Concurrent validity was determined in comparison with the Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale-Short Form (VSS-SF), and the Hospital Anxiety and Depression Scale. The factor analysis revealed 3 subscales of the questionnaire covering "function,""unsteadiness," and "emotion."The examination of the total scale (α = .866) and its subscales indicated satisfactory psychometric properties. The HDQ-10 correlated highly with both DHI (r = .732. P < .001) and VSS-SF (r = .720. P < .001) indicating good concurrent validity. The HDQ-10 is a 10-item questionnaire designed for simplified assessment of symptom severity and emotional effects in patients with vestibular disorders. It has satisfactory psychometric properties and good concurrent validity compared to existing dizziness questionnaires.

Turkish validation of the chronic orchialgia symptom index and its association with the visual analog scale.

To conduct a translation and validation study of the Chronic Orchialgia Symptom Index (COSI), which has 12 questions in three domains pain (P), sexual symptoms (SS), and quality of life (QoL), in the Turkish language. The study included a total of 175 patients diagnosed with chronic scrotal content pain (CSCP) between January 2023 and January 2024. In addition to demographic data, the scores obtained on the COSI questionnaire and Visual Analog Scale (VAS) were recorded. Internal consistency was assessed using Cronbach alpha coefficients. Reliability was evaluated using the test-retest correlation method. The mean age of the patients was 37.2 ± 14.1 years and the median (IQR) duration of pain was 5.5 (9) months. The median total COSI score was determined as 13 (13) and the median subscores were 7 (7) for P, 1 (2) for SS, and 5 (6) for QoL. The test-retest correlation coefficient for each item was determined to be higher than r = 0.80 (p < 0.001). The Cronbach alpha values for the subscores were 0.80 for P, 0.71 for SS, and 0.80 for QoL. There was determined to be a statistically significant positive correlation between the VAS score and the COSI P, SS, QoL, and total scores (r: 0.63, p < 0.001; r = 0.32, p < 0.001; r = 0.56, p < 0.001; r = 0.59, p < 0.001, respectively). The optimal cutoff point of the COSI total score was determined to be 16.5 points (AUC:0.77, p < 0.001) for the determination of patients experiencing severe pain (⩾ 7.5) according to the VAS score. The Turkish version of the COSI questionnaire is a valid, reliable, and repeatable questionnaire that can be used to evaluate the effects of symptom severity in patients with CSCP.

The role of cognitive emotion regulation strategies in predicting the resilience, symptom severity, and quality of life of patients with irritable bowel syndrome

BackgroundPsychosocial stressors contribute to the development of irritable bowel syndrome (IBS) and exacerbate the symptoms. The capability to cope with stress is an essential element in the management of IBS. This study assessed nine cognitive emotion regulation strategies (CERS) and their role in predicting symptom severity, quality of life (QOL), and resilience in IBS subjects. MethodsThe scores regarding nine subscales of CERS were obtained by cognitive emotion regulation questionnaire (CERQ) and compared between study patients based on the severity and subtypes of IBS using one-way ANOVA. To evaluate the predictive role of CERS, logistic regression was performed. The correlation between CERS and the QOL was assessed by Pearson correlation analysis. The score of resilience was measured by Connor-Davidson Resilience Scale (CD-RISC). ResultsWe recruited 100 patients diagnosed with IBS based on ROME IV criteria. Among nine subscales of CERS, patients with more severe symptoms scored higher in catastrophizing (p < 0.001) and blaming others (p = 0.015) while lower in positive reappraisal (p = 0.028). Blaming others was the only predictor of resilience and severity of IBS in our patients (odds ratio (OR): -2.103, p=0.028, and OR:1.715, p = 0.049, respectively). We observed significant negative correlations between the quality of life and rumination (r= -0.202, p=0.044), self-blame (r= -0.241, p=0.016), catastrophizing (r= -0.342, p<0.001), and blaming others (r= -0.219, p=0.028). ConclusionMaladaptive strategies are more common in IBS patients with more severe symptoms and have negative correlations with the QOL. Blaming others has the potential to predict the resilience and severity of symptoms in IBS patients.

Value of uterus: quality of life, symptom severity, and treatment decisions in patients with fibroids

Value of uterus: quality of life, symptom severity, and treatment decisions in patients with fibroids

Abnormal functional connectivity of the reward circuit associated with early satiety in patients with postprandial distress syndrome

Postprandial distress syndrome (PDS) is the most common functional dyspepsia (FD) subtype. Early satiety is one of the cardinal symptoms of the PDS subtype in FD patients. The heterogeneity of symptoms in FD patients hampered therapy for patients based on specific symptoms, necessitating a symptom-based understanding of the pathophysiology of FD. To investigate the correlation between reward circuit and symptom severity of PDS patients, seed (Nucleus accumbens, NAc, a key node in the reward circuit) based resting-state functional connectivity (FC) was applied in the neuroimaging data analysis. The results demonstrated that the patients with PDS manifested strengthened FC between NAc and the caudate, putamen, pallidum, amygdala, hippocampus, thalamus, anterior cingulate cortex (ACC), and insula. Moreover, the FC between NAc and ACC, insula, thalamus, and hippocampus exhibited significant positive associations with symptom severity. More importantly, the strengthened FC between NAc and the ACC, insula, amygdala, and hippocampus were found associated with the early satiety symptom of patients with PDS. This study indicated that the altered FC of reward circuit regions may play a role in the pathophysiology of patients with PDS, and some of the aberrant NAc-based FC within the reward circuit were more related to the early satiety of patients with PDS. These findings improve our symptom-based understanding of the central pathophysiology of FD, lay the groundwork for an objective diagnosis of FD, and shed light on the precise prescription for treating FD based on symptoms.