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Ghorani V, Rajabi O, Mirsadraee M, Amini M, Ghaffari S, Boskabady MH. Zataria multiflora affects pulmonary function tests, respiratory symptoms, bronchodilator drugs use and hematological parameters in chronic obstructive pulmonary disease patients: A randomized doubled-blind clinical trial. J Ethnopharmacol 2024; 326:117928. [PMID: 38373666 DOI: 10.1016/j.jep.2024.117928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/28/2024] [Accepted: 02/16/2024] [Indexed: 02/21/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Zataria multiflora is employed as an antitussive, anti-spasmodic, analgesic and etc. Agent in traditional medicine. The modern medical studies are also confirmed effects of this plant for treatment of respiratory problems via anti-inflammatory, anti-oxidant and immunomodulatory properties. AIM OF STUDY We evaluated efficacy of Z. multiflora on tests of pulmonary function, respiratory symptoms, inhaled bronchodilator drugs use, and hematological factors in COPD patients. METHODS Patients (n = 45) were randomly grouped in the following three groups: placebo group (P), groups received Z. multiflora extract 3 and 6 mg/kg/day (Z3 and Z6). FEV1 and MEF25-75, respiratory symptoms, inhaled bronchodilator drugs use and hematological factors were evaluated before and 1-2 months after treatment. RESULTS Z. multiflora led to significant enhancement of FEV1 (p < 0.05 to p < 0.01). Respiratory symptoms were also considerably ameliorated following treatment with extracts for 1 and 2 months compared to baseline values (p < 0.05 to p < 0.001). In groups received extract, inhaled bronchodilator drugs use was remarkably declined at the end of study (both, p < 0.05). Reduction of total WBC was observed 1-2 months after treatment in treated groups with extract compared to baseline values (p < 0.05 to p < 0.001). Neutrophils were remarkably declined in Z3 and Z6 groups after 2-monthes compared to 1-month treatment (p < 0.05 to p < 0.01). CONCLUSION The evidence show therapeutic effect of this herb on COPD patients which could be result from properties that help to decrease inflammation.
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Affiliation(s)
- Vahideh Ghorani
- Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Rajabi
- Department of Pharmaceutical Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Mirsadraee
- Department of Internal Medicine, Faculty of Medicine, Islamic Azad University-Mashhad Medical Sciences Branch, Mashhad, Iran
| | - Mahnaz Amini
- Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shadi Ghaffari
- Department of Biology, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Mohammad Hossein Boskabady
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Physiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Alley JC, Moriarity DP, Figueroa MB, Slavich GM. Characterizing the hierarchical depression phenotype in sexually diverse individuals. J Psychiatr Res 2024; 173:157-162. [PMID: 38531146 DOI: 10.1016/j.jpsychires.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Sexual diverse individuals are at high risk for internalizing psychopathologies, such as depression. Understanding how symptom profiles of heterogeneous psychiatric disorders such as depression differ for sexually diverse vs. heterosexual individuals is thus critical to advance precision psychiatry and maximize our ability to effectively treat members of this population. Research has failed to consider the possibility of hierarchical phenotypes, wherein sexual orientation status may be uniquely and simultaneously associated with both depression broadly and with individual symptoms. METHOD To address these issues, we conducted a moderated nonlinear factor analysis in Wave IV of the Add Health study, using sexual diversity status as a predictor of (a) latent depression, (b) factor loadings, and (c) individual symptoms, with and without controlling for race. RESULTS Sexual diversity status was positively and simultaneously associated with latent depression, concentration difficulties, and happiness. DISCUSSION These findings suggest that sexually diverse populations not only face greater depression, broadly defined, but are disproportionately more likely to experience concentration difficulties and be happier compared to heterosexual counterparts. Methodologically, these models indicate that the CES-D is scalar noninvariant as a function of sexual diversity status (i.e., identical scores on the CES-D may represent different manifestations of depression for sexually diverse and heterosexual participants). Studies examining disparities in depression across heterosexual and sexually diverse samples should thus consider depression broadly as well as specific symptoms. Further, it is critical to examine whether these relations function via different mechanisms.
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Affiliation(s)
- Jenna C Alley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - Matthew B Figueroa
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
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Oehler H, Eichler K, Derwich W, Schnitzbauer AA, Schreckenbach T. [Epidemiology and diagnostics of mesenteric ischemia]. Chirurgie (Heidelb) 2024; 95:347-352. [PMID: 38158411 DOI: 10.1007/s00104-023-02021-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Mesenteric ischemia is a life-threatening condition with a complex etiology and diagnostics. OBJECTIVE Etiology, incidence, symptoms, and diagnostics of acute and chronic mesenteric ischemia. MATERIAL AND METHODS Literature search via PubMed with a focus on studies on the epidemiology and diagnostics of mesenteric ischemia and analysis of existing international guidelines. RESULTS The incidence of acute mesenteric ischemia is given as 0.63-12.9 per 100,000 people per year. There are no sufficiently reliable figures for chronic mesenteric ischemia, but an incidence of up to 3 per 100,000 inhabitants per year is generally assumed. The three-phase computed tomography has the highest diagnostic specificity and sensitivity. CONCLUSION In the presence of risk factors acute and chronic mesenteric ischemia should be considered as differential diagnoses in the presence of abdominal pain using three-phase computed tomography.
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Affiliation(s)
- Helga Oehler
- Universitätsklinikum, Klinik für Allgemein‑, Viszeral‑, Transplantations-, und Thoraxchirurgie, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| | - Katrin Eichler
- Universitätsklinikum, Institut für Diagnostische und Interventionelle Radiologie, Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
| | - Wojciech Derwich
- Universitätsklinikum, Gefäß- und Endovaskularchirurgie, Klinik für Herz- und Gefäßchirurgie, Goethe-Universität Frankfurt, Frankfurt am Main, Deutschland
| | - Andreas A Schnitzbauer
- Universitätsklinikum, Klinik für Allgemein‑, Viszeral‑, Transplantations-, und Thoraxchirurgie, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland
| | - Teresa Schreckenbach
- Universitätsklinikum, Klinik für Allgemein‑, Viszeral‑, Transplantations-, und Thoraxchirurgie, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.
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Debenham L, Khan N, Nouhan B, Muzaffar J. A systematic review of otologic injuries sustained in civilian terrorist explosions. Eur Arch Otorhinolaryngol 2024; 281:2223-2233. [PMID: 38189970 DOI: 10.1007/s00405-023-08393-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE Determine the prevalence of otological symptoms and tympanic membrane perforation, healing rates of tympanic membrane perforation with surgical and conservative management, and hearing function in civilian victims of terrorist explosions. METHODS A systematic review was conducted with searches on Medline, Embase, EMCare and CINAHL for publications between the 1st January 1945 and 26th May 2023. Studies with quantitative data addressing our aims were included. This review is registered with PROSPERO: CRD42020166768. Among 2611 studies screened, 18 studies comprising prospective and retrospective cohort studies were included. RESULTS The percentage of eardrums perforated in patients admitted to hospital, under ENT follow up and attending the emergency department is 69.0% (CI 55.5-80.5%), 38.7% (CI 19.0-63.0%, I2 0.715%) and 21.0% (CI 11.9-34.3%, I2 0.718%) respectively. Perforated eardrums heal spontaneously in 62.9% (CI 50.4-73.8%, I2 0.687%) of cases and in 88.8% (CI 75.9-96.3%, I2 0.500%) of cases after surgery. Common symptoms present within one month of bombings are tinnitus 84.7% (CI 70.0-92.9%, I2 0.506%), hearing loss 83.0% (CI 64.5-92.9%, I2 0.505%) and ear fullness 59.7% (CI 13.4-93.4%, I2 0.719). Symptomatic status between one and six months commonly include no symptoms 57.5% (CI 46.0-68.3%), hearing loss 35.4% (CI 21.8-51.8%, I2 0.673%) and tinnitus 15.6% (CI 4.9-40.0%, I2 0.500%). Within one month of bombings, the most common hearing abnormality is sensorineural hearing loss affecting 26.9% (CI 16.9-40.1%, I2 0.689%) of ears 43.5% (CI 33.4-54.2%, I2 0.500) of people. CONCLUSION Tympanic membrane perforation, subjective hearing loss, tinnitus, ear fullness and sensorineural hearing loss are common sequelae of civilian terrorist explosions.
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Affiliation(s)
- Luke Debenham
- University of Warwick, University of Warwick Medical School, Coventry, UK.
- University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK.
| | - Naairah Khan
- University of Warwick, University of Warwick Medical School, Coventry, UK
- University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK
| | | | - Jameel Muzaffar
- Department of Ear Nose and Throat Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Clevers E, Launders D, Helme D, Nybacka S, Störsrud S, Corsetti M, Van Oudenhove L, Simrén M, Tack J. Coffee, Alcohol, and Artificial Sweeteners Have Temporal Associations with Gastrointestinal Symptoms. Dig Dis Sci 2024:10.1007/s10620-024-08457-y. [PMID: 38662159 DOI: 10.1007/s10620-024-08457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Various dietary strategies for managing irritable bowel syndrome (IBS) target mechanisms such as brain-gut interactions, osmotic actions, microbial gas production, and local immune activity. These pathophysiological mechanisms are diverse, making it unclear which foods trigger IBS symptoms for a substantial proportion of patients. AIM To identify associations between foods and gastrointestinal symptoms. METHODS From the mySymptoms smartphone app, we collected anonymized diaries of food intake and symptoms (abdominal pain, diarrhea, bloating, and gas). We selected diaries that were at least 3 weeks long. The diaries were analyzed for food-symptom associations using a proprietary algorithm. As the participants were anonymous, we conducted an app-wide user survey to identify IBS diagnoses according to Rome IV criteria. RESULTS A total of 9,710 food symptom diaries that met the quality criteria were collected. Of the survey respondents, 70% had IBS according to Rome IV criteria. Generally, strong associations existed for caffeinated coffee (diarrhea, 1-2 h postprandial), alcoholic beverages (multiple symptoms, 4-72 h postprandial), and artificial sweeteners (multiple symptoms, 24-72 h postprandial). Histamine-rich food intake was associated with abdominal pain and diarrhea. Some associations are in line with existing literature, whilst the absence of an enriched FODMAP-symptom association contrasts with current knowledge. CONCLUSIONS Coffee, alcohol, and artificial sweeteners were associated with GI symptoms in this large IBS-predominant sample. Symptom onset is often within 2 h postprandial, but some foods were associated with a delayed response, possibly an important consideration in implementing dietary recommendations. Clinical trials must test the causality of the demonstrated food-symptom associations.
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Affiliation(s)
- Egbert Clevers
- SkyGazer Labs Ltd, Cambridge, UK.
- The Data Strategist, Duiven, the Netherlands.
| | | | | | - Sanna Nybacka
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stine Störsrud
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maura Corsetti
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lukas Van Oudenhove
- Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
| | - Magnus Simrén
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Functional GI and Motility Disorders, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Jan Tack
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), KU Leuven, Leuven, Belgium
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Lin HL, Zheng QQ, Huang RL, Hu R, Liu XD, Wang JY. Exploration of treatment in childhood Langerhans cell histiocytosis based on inflammatory and malignant symptoms: a pilot study. Orphanet J Rare Dis 2024; 19:174. [PMID: 38654381 DOI: 10.1186/s13023-024-03151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 03/24/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Multisystem childhood Langerhans cell histiocytosis (LCH) patients, especially those with risk organ (RO) involved, had not been satisfactorily treated under the international traditional schemes as high incidences of reactivation with late sequelae were largely reported. Over years, we have observed that LCH patients with varied clinical symptoms responded differently to different drugs, suggesting the current grouping strategies based only on the number of organs involved might be inadequate. LCH has been defined as an inflammatory myeloid tumor, thus this study has innovatively divided LCH pediatric patients into inflammatory or malignant symptoms group, and given different intensity treatment regimens to different groups. AIM This clinical study aimed to explore a more appropriate patient grouping system according to the LCH symptom presentations and examine the clinical outcomes of treatment strategies in different groups. METHODS According to the clinical manifestations, 37 cases of children were divided into Group A (only inflammatory symptoms) and Group B (malignant symptoms with or without inflammatory symptoms). Patients in Group A and B were initially treated with vindesine (VDS) and methylprednisolone (PSL), and VDS, PSL, pirarubicin (THP) and cyclophosphamide (CTX), respectively. Treatment responses were evaluated six weeks after the induction therapy in all patients, and the criteria were disease status and clinical scores of symptoms. RESULTS Pre- and post-treatment scores were 1.22 ± 0.547 and 0.00 ± 0.00 in Group A, and 14.79 ± 1.686 and 1.00 ± 1.563 in Group B, respectively. All patients had subsequentlly received maintenance therapy without progressive disease. The 4-year overall survival (OS) rate was 100% in both groups and the 4-year event-free survival (EFS) was 94.4% in Group A and 89.5% in Group B, respectively. There were no obvious adverse events (AE) in Group A, whereas the main AE in Group B were alopecia and non-lethal hematological toxicity. CONCLUSION Stratification according to patients' clinical symptoms, with low-intensity treatment for inflammatory symptoms (mild manifestations) and intensive treatment with multiple drugs for malignant symptoms (severe manifestations), is a positive exploration that simplifies stratification method, achieves good long-term remission of the disease, and obtains a higher survival rate and quality of life, which seemed to be more appropriate for LCH patients.
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Affiliation(s)
- Hui-Ling Lin
- Department of Hematology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Tianhe District, Guangzhou, 510600, China
| | - Qing-Qing Zheng
- Department of Hematology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Tianhe District, Guangzhou, 510600, China
| | - Ru-Lin Huang
- Department of Hematology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Tianhe District, Guangzhou, 510600, China
| | - Rong Hu
- Department of Pharmacy, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510600, China
| | - Xiao-Dan Liu
- Department of Hematology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Tianhe District, Guangzhou, 510600, China
| | - Jia-Yi Wang
- Department of Hematology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Road, Tianhe District, Guangzhou, 510600, China.
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KAZADI KABANDA I, KIANGEBENI NGONZO C, EMEKA BOWAMOU CK, DIVENGI NZAMBI JP, KIATOKO PONTE N, TUYINAMA MADODA O, NKODILA NATUHOYILA A, M’BUYAMBA-KABANGU JR, LONGO-MBENZA B, BANZULU BOMBA D, KIANU PHANZU B. Stroke signs knowledge and factors associated with a delayed hospital arrival of patients with acute stroke in Kinshasa. Heliyon 2024; 10:e28311. [PMID: 38571603 PMCID: PMC10988012 DOI: 10.1016/j.heliyon.2024.e28311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024] Open
Abstract
Background Rapid recognition and early medical intervention are essential to reduce stroke-related mortality and long-term disability. This study aimed to evaluate awareness of stroke symptoms/signs and determine factors delaying the hospital arrival of patients with acute stroke in Kinshasa. Methods Patients with stroke and/or accompanying family members were interviewed using a standard questionnaire, and their medical records were reviewed. Factors independently associated with a late arrival (≥4.5 h) to the hospital were identified using the logistic regression test in forward multivariate analysis. Results Overall, 202 patients with an average age of 57.9 ± 13.1 years were included. Only 27 (13.4%) patients immediately associated the initial symptoms with a stroke episode. Delayed hospital arrival was observed in 180 (89.1%) patients. Unmarried status (adjusted odds ratio [aOR], 2.29; 95% confidence interval [CI], 1.17-4.88; p = 0.007), low education level (aOR, 2.29; 95% CI, (1.12-5.10; p = 0,014), absence of impaired consciousness (aOR, 3.12; 95% CI, 1.52-4.43; p = 0.005), absence of a history of hypertention (aOR, 1.85; 95% CI, 1.18-3.78; p = 0.041), absence of a history of diabetes (aOR, 1.93; 95% CI, 1.15-4.58; p = 0.013), heavy alcohol consumption (aOR, 1.83; 95% CI, 1.12-2.83; p = 0.045), absence of a severe to very severe stroke (aOR, 4.93; 95% CI, 0.82-1.01; p = 0.002), and presence of ischemic stroke (aOR, 2.93; 95% CI, 1.54-4.59; p = 0.001) were identified as independent determinants of delayed hospital arrival. Conclusions This study depicted a low stroke awareness rate and a much longer prehospital delay than evidence-based guidelines recommend and identified eight factors that public health actions could target to promote the earliest management of stroke.
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Affiliation(s)
- Igor KAZADI KABANDA
- Faculty of Medicine, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | | | | | - Jean-Paul DIVENGI NZAMBI
- Department of Internal Medicine, Reference General Hospital, Kinshasa, the Democratic Republic of the Congo
| | - Nono KIATOKO PONTE
- Unit of Neurology, Centre Hospitalier Initiative Plus de Kinkole, Kinshasa, the Democratic Republic of the Congo
| | - Olivier TUYINAMA MADODA
- Emergency Unit, University Hospital of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Aliocha NKODILA NATUHOYILA
- Department of Biostatistics, Public Health School of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | | | - Benjamin LONGO-MBENZA
- Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Degani BANZULU BOMBA
- Department of Neuropsychiatry, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
| | - Bernard KIANU PHANZU
- Cardiology Unit, University of Kinshasa, Kinshasa, the Democratic Republic of the Congo
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Fischer S, Nilsen C. ADHD in older adults - a scoping review. Aging Ment Health 2024:1-8. [PMID: 38622905 DOI: 10.1080/13607863.2024.2339994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES This scoping review presents an overview of the available research on symptoms, comorbidities, and associated challenges among older adults with ADHD. METHOD The literature study followed Arksey and O'Malley's five-stage framework. The search was conducted in ProQuest Central, Scopus, PsycInfo, CINAHL, and PubMed. Articles were included if they were peer-reviewed, ethically approved primary studies, written in the English language, concerning ADHD, and including people 60 years of age and older. RESULTS The review included 17 articles. Symptoms of ADHD persist throughout life. Older adults with ADHD experience similar core symptoms as younger individuals, but their manifestation and intensity may differ. The most common comorbidity found was mental illness, for example depression and anxiety. ADHD in older adults is linked to several challenges, such as difficulty with relationships and social isolation. CONCLUSION Older adults with ADHD face various symptoms, comorbidities, and challenges that affect their quality of life. Age-related changes can amplify ADHD symptoms and increase the perceived burden of illness. More research is needed to understand the complex relationship between these factors and enable tailored interventions to improve their quality of life and well-being.
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Affiliation(s)
- Silke Fischer
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
| | - Charlotta Nilsen
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Sweden
- Stress Research Institute, Department of Psychology, Stockholm University, Sweden
- Aging Research Center, Karolinska Institutet/Stockholm University, Sweden
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de Bruijn S, van Hoek AJ, Mutubuki EN, Knoop H, Slootweg J, Tulen AD, Franz E, van den Wijngaard CC, van der Maaden T. Lower prevalence of post-Covid-19 Condition following Omicron SARS-CoV-2 infection. Heliyon 2024; 10:e28941. [PMID: 38617937 PMCID: PMC11015416 DOI: 10.1016/j.heliyon.2024.e28941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024] Open
Abstract
Objectives Different SARS-CoV-2 variants can differentially affect the prevalence of Post Covid-19 Condition (PCC). This prospective study assesses prevalence and severity of symptoms three months after an Omicron infection, compared to Delta, test-negative and population controls. This study also assesses symptomology after reinfection and breakthrough infections. Methods After a positive SARS-CoV-2 test, cases were classified as Omicron or Delta based on ≥ 85% surveillance prevalence. Three months after enrolment, participants indicated point prevalence for 41 symptoms and severity, using validated questionnaires for four symptoms. PCC prevalence was estimated as the difference in prevalence of at least one significantly elevated symptom, identified by permutation test, in cases compared to population controls. Results At three months follow-up, five symptoms and severe dyspnea were significantly elevated in Omicron cases (n = 4138) compared to test-negative (n = 1672) and population controls (n = 2762). PCC prevalence was 10·4% for Omicron cases and 17·7% for Delta cases (n = 6855). In Omicron cases, severe fatigue and dyspnea were more prevalent in reinfected than primary infected, while severity of symptoms did not significantly differ between cases with a booster or primary vaccination course. Conclusions Prevalence of PCC is 41% lower after Omicron than Delta at three months. Reinfection seems associated with more severe long-term symptoms compared to first infection.
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Affiliation(s)
- Siméon de Bruijn
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Albert Jan van Hoek
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Elizabeth N. Mutubuki
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology and Amsterdam Public Health from the Amsterdam UMC, Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Jaap Slootweg
- Centre for Sustainability, Environment and Health, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands
| | - Anna D. Tulen
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eelco Franz
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Cees C. van den Wijngaard
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Tessa van der Maaden
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Hussey C, Hanbridge M, Dowling M, Gupta A. Cancer survivorship: understanding the patients' journey and perspectives on post-treatment needs. BMC Sports Sci Med Rehabil 2024; 16:82. [PMID: 38605386 PMCID: PMC11010277 DOI: 10.1186/s13102-024-00864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Cancer treatments have many adverse effects on patient's health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful rehabilitation program should also include psycho-social education aimed to reduce anxiety and improve motivation. METHODS The current study aimed to collect information on the post-treatment needs of cancer patients including barriers and expectations facing them, their caregivers and their families through consultation in focus group interviews. Cancer survivors living in the Republic of Ireland were recruited from the University Hospital Galway, community-based cancer centres, cancer support groups and social media platforms to participate in the study and attend a focus group interview. The focus group discussions were designed to obtain information on the collective views of cancer survivors on relevant topics selected. The topics were developed in consultation with a patient and public involvement (PPI) group supporting the study. The topics list was circulated to all participants prior to the focus group. The interviews were audio recorded and transcribed verbatim. Focus group transcripts were analysed subjected to a thematic framework analysis using NVivo. RESULTS Thirty-six participants took part in 9 focus groups. Our analysis uncovered two main themes. The first theme 'cast adrift with no direction' was grouped into three sub-themes: everything revolves around treatment; panic and fear; and what exercise should I be doing? The second theme 'everybody is different' was clustered into two sub-themes: side effects get in the way; and personalised exercise program. CONCLUSION The study highlighted the lack of information and support needed by patients living with and beyond cancer. The study also highlighted the need for a personalised exercise programme designed to target the individual patient symptoms that would be ideal for the mitigation of long term symptoms and in improving QOL.
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Affiliation(s)
- Conor Hussey
- School of Medicine, University of Galway, Galway, Ireland
| | - Moira Hanbridge
- IPPOSI - Patient Education Programme in Health Innovation, Dublin, Ireland
| | - Maura Dowling
- School of Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - Ananya Gupta
- School of Medicine, University of Galway, Galway, Ireland.
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11
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Nakisige C, de Fouw M, Nakalembe M, Orem J, Atukonyera D, Musheshe M, Koot J, de Zeeuw J, Beltman J, Stekelenburg J. Baseline knowledge on risk factors, symptoms and intended behavior of women and men towards screening and treatment of cervical cancer in rural Uganda: a cross-sectional study. BMC Cancer 2024; 24:450. [PMID: 38605317 PMCID: PMC11008004 DOI: 10.1186/s12885-024-12223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Knowledge of risk factors and symptoms of cervical cancer has been found to promote uptake of screening of cervical cancer. Most interventions targeted women without much involvement of men (husbands/decision makers) who are often decision makers in many low- and middle-income countries. This study aimed at assessing baseline knowledge and intended behavior of both women and men to enable design specific targeted messages to increase uptake of cervical cancer screening and promote early detection of women with symptoms. METHODS This cross-sectional study was conducted in two districts in Western Uganda using the modified African Women Awareness of CANcer (AWACAN) questionnaire. Women aged 30-49 years and their husbands/decision makers were interviewed. Knowledge on risk factors and symptoms, intended behavior and barriers towards participation in cervical cancer screening and treatment were assessed. Descriptive and logistic regression analyses were done to establish the association between knowledge levels and other factors comparing women to men. RESULTS A total of 724 women and 692 men were enrolled. Of these, 71.0% women and 67.2% men had ever heard of cervical cancer and 8.8% women had ever been screened. Knowledge of risk factors and symptoms of cervical cancer was high and similar for both women and men. Lack of decision making by women was associated with low knowledge of risk factors (X2 = 14.542; p = 0.01), low education (X2 = 36.05, p < 0.01) and older age (X2 = 17.33, p < 0.01). Men had better help seeking behavior than women (X2 = 64.96, p < 0.01, OR = 0.39, 95% CI: 0.31-0.50) and were more confident and skilled in recognising a sign or symptom of cervical cancer (X2 = 27.28, p < 0.01, OR = 0.52, CI (0.40-0.67). CONCLUSION The baseline knowledge for cervical cancer was high in majority of participants and similar in both women and men. Their intended behavior towards screening was also positive but screening uptake was very low. This study suggests developing messages on multiple interventions to promote screening behavior in addition to education, consisting of male involvement, women empowerment and making services available, accessible and women friendly.
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Affiliation(s)
- Carolyn Nakisige
- Department of Gynaecologic-Oncology, Uganda Cancer Institute, Kampala, Uganda.
| | - Marlieke de Fouw
- Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Jackson Orem
- Department of Gynaecologic-Oncology, Uganda Cancer Institute, Kampala, Uganda
| | - Dan Atukonyera
- Uganda Rural Development Training Program, Kagadi, Uganda
| | | | - Jaap Koot
- Department of Health Sciences, Global Health Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Janine de Zeeuw
- Department of Health Sciences, Global Health Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jogchum Beltman
- Department of Gynaecology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jelle Stekelenburg
- Department of Health Sciences, Global Health Unit, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Obstetrics and Gynecology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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12
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Cotton SA, Subramanian A, Hughes TD, Huang Y, Sierra CJ, Pearce AK, Malhotra A, Rahmani AM, Downs CA, Pinto MD. The effect of SARS-COV-2 variant on non-respiratory features and mortality among vaccinated and non-fully vaccinated patients. Vaccine 2024; 42:2655-2660. [PMID: 38490824 DOI: 10.1016/j.vaccine.2024.02.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To determine the effect of SARS-CoV-2 variants on non-respiratory features of COVID-19 in vaccinated and not fully vaccinated patients using a University of California database. METHODS A longitudinal retrospective review of medical records (n = 63,454) from 1/1/2020-4/26/2022 using the UCCORDS database was performed to compare non-respiratory features, vaccination status, and mortality between variants. Chi-square tests were used to study the relationship between categorical variables using a contingency matrix. RESULTS Fever was the most common feature across all variants. Fever was significantly higher in not fully vaccinated during the Delta and Omicron waves (p = 0.001; p = 0.001). Cardiac features were statistically higher in not fully vaccinated during Omicron; tachycardia was only a feature of not fully vaccinated during Delta and Omicron; diabetes and GI reflux were features of all variants regardless of vaccine status. Odds of death were significantly increased among those not fully vaccinated in the Delta and Omicron variants (Delta OR: 1.64, p = 0.052; Omicron OR: 1.96, p < 0.01). Vaccination was associated with a decrease in the frequency of non-respiratory features. CONCLUSIONS Risk of non-respiratory features of COVID-19 is statistically higher in those not fully vaccinated across all variants. Risk of death and correlation with vaccination status varied.
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Affiliation(s)
- Shannon A Cotton
- University of California, Irvine, School of Nursing, 854 Health Sciences Rd, Irvine, CA 92697, USA; University of California, Irvine, Department of Computer Science, Donald Bren Hall, 6210, Irvine, CA 92697, USA.
| | - Ajan Subramanian
- University of California, Irvine, Department of Computer Science, Donald Bren Hall, 6210, Irvine, CA 92697, USA.
| | - Thomas D Hughes
- University of California, Irvine, School of Nursing, 854 Health Sciences Rd, Irvine, CA 92697, USA.
| | - Yong Huang
- University of California, Irvine, Department of Computer Science, Donald Bren Hall, 6210, Irvine, CA 92697, USA.
| | - Carmen Josefa Sierra
- University of Miami Florida, School of Nursing, 5030 Brunson Dr, Coral Gables, FL 33146, USA.
| | - Alex K Pearce
- University of California, San Diego, Dept of Pulmonary and Critical Care Medicine, 9300 Campus Point Dr, La Jolla, CA 92037, USA.
| | - Atul Malhotra
- University of California, San Diego, Dept of Pulmonary and Critical Care Medicine, 9300 Campus Point Dr, La Jolla, CA 92037, USA.
| | - Amir M Rahmani
- University of California, Irvine, School of Nursing, 854 Health Sciences Rd, Irvine, CA 92697, USA; University of California, Irvine, Department of Computer Science, Donald Bren Hall, 6210, Irvine, CA 92697, USA.
| | - Charles A Downs
- University of Miami Florida, School of Nursing, 5030 Brunson Dr, Coral Gables, FL 33146, USA.
| | - Melissa D Pinto
- University of California, Irvine, School of Nursing, 854 Health Sciences Rd, Irvine, CA 92697, USA.
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Molnar C, Shires M, Wright AA, Hoskins MC, Cowell S, Nikolaeva EV, Knier R, Nouri MT, Black B, Harper S. Putting 'X' into context: the diversity of ' Candidatus Phytoplasma pruni' strains associated with the induction of X-disease. Plant Dis 2024. [PMID: 38587800 DOI: 10.1094/pdis-10-23-2243-re] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Recurrent epiphytotics of X-disease, caused by 'Candidatus Phytoplasma pruni', have inflicted significant losses on commercial cherry and peach production across North America in the last century. During this period, there have been multiple studies reporting different disease phenotypes, and more recently, identifying different strains through sequencing core genes, but the symptoms have not, to date, been linked with genotype. Therefore, in this study we collected and assessed differing disease phenotypes from multiple U.S. states and conducted multi-locus sequence analysis on these strains. We identified a total of five lineages associated with the induction of X-disease on commercial Prunus species and two lineages that were associated with wild P. virginiana. Despite a century of interstate plant movement, there were regional trends in terms of lineages present, and lineage-specific symptoms were observed on P. avium, P. cerasus, and P. virginiana, but not on P. persica. Cumulatively, these data have allowed us to define 'true' X-disease-inducing strains of concern to the stone fruit industry across North America, as well as potential sources of infection that exist in the extra-orchard environment.
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Affiliation(s)
- Cody Molnar
- Washington State University, 6760, Plant pathology, 24106 N Bunn Rd, Prosser, WA 99350, Pullman, Washington, United States, 99164-1009;
| | - Madalyn Shires
- South Dakota State University, 2019, SDSU SAG 322, Brookings, South Dakota, United States, 57007;
| | - Alice Ann Wright
- USDA-ARS-SRU, 5883 USDA Rd, Houma, Louisiana, United States, 70360;
| | - Mason C Hoskins
- Washington State University, Plant Pathology, Prosser, Washington, United States;
| | - Sarah Cowell
- Washington State University, 6760, Plant Pathology, PO Box 641025, Pullman, Washington, United States, 99164;
| | - Ekaterina V Nikolaeva
- Pennsylvania Department of Agriculture, 272622, Plant Industry, 2301 N. Cameron Street, Harrisburg, Pennsylvania, United States, 17110-9405;
| | - Rachel Knier
- Pennsylvania Department of Agriculture, 272622, 2301 North Cameron Street, Harrisburg, Pennsylvania, United States, 17110;
| | - Mohamed Taieb Nouri
- University of California Agriculture and Natural Resources, 2101 E Earhart Ave, Ste 200, Stockton, California, United States, 95206;
| | - Brent Black
- Utah State University, 4606, Logan, Utah, United States;
| | - Scott Harper
- Washington State University, Plant Pathology, 24106 N. Bunn Rd, Prosser, Washington, United States, 99350;
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Balneaves LG, Brown A, Green M, Prosk E, Rapin L, Monahan-Ellison M, McMillan E, Zaid J, Dworkind M, Watling CZ. Canadians' use of cannabis for therapeutic purposes since legalization of recreational cannabis: a cross-sectional analysis by medical authorization status. BMC Med 2024; 22:150. [PMID: 38589855 PMCID: PMC11003000 DOI: 10.1186/s12916-024-03370-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND There has been a precipitous decline in authorizations for medical cannabis since non-medical cannabis was legalized in Canada in 2018. This study examines the demographic and health- and medical cannabis-related factors associated with authorization as well as the differences in medical cannabis use, side effects, and sources of medical cannabis and information by authorization status. METHODS Individuals who were taking cannabis for therapeutic purposes completed an online survey in early 2022. Multivariable logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) of demographic and health- and medical cannabis-related variables associated with holding medical cannabis authorization. The differences in medical cannabis use, side effects, and sources of information by authorization status were determined via t-tests and chi-squared analysis. RESULTS A total of 5433 individuals who were currently taking cannabis for therapeutic purposes completed the study, of which 2941 (54.1%) currently held medical authorization. Individuals with authorization were more likely to be older (OR ≥ 70 years vs. < 30 years, 4.85 (95% CI, 3.49-6.76)), identify as a man (OR man vs. woman, 1.53 (1.34-1.74)), have a higher income (OR > $100,000/year vs. < $50,000 year, 1.55 (1.30-1.84)), and less likely to live in a small town (OR small town/rural vs. large city, 0.69 (0.59-0.81)). They were significantly more likely to report not experiencing any side effects (29.9% vs. 23.4%; p < 0.001), knowing the amount of cannabis they were taking (32.1% vs. 17.7%; p < 0.001), obtaining cannabis from regulated sources (74.1% vs. 47.5%; p < 0.001), and seeking information about medical cannabis from healthcare professionals (67.8% vs. 48.2%; p < 0.01) than individuals without authorization. CONCLUSIONS These findings offer insight into the possible issues regarding equitable access to medical cannabis and how authorization may support and influence individuals in a jurisdiction where recreational cannabis is legalized, highlighting the value of a formal medical cannabis authorization process.
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Affiliation(s)
- Lynda G Balneaves
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Ashleigh Brown
- SheCann Cannabis, Winnipeg, MB, Canada
- Medical Cannabis Canada, Toronto, ON, Canada
| | - Matthew Green
- Medical Cannabis Canada, Toronto, ON, Canada
- Department of Psychology, Brock University, St. Catharine's, ON, Canada
| | | | | | | | | | | | - Michael Dworkind
- Santé Cannabis, Montréal, QC, Canada
- Department of Medicine, McGill University, Montréal, QC, Canada
| | - Cody Z Watling
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Gagnadoux F, Bequignon E, Prigent A, Micoulaud-Franchi JA, Chambe J, Texereau J, Alami S, Roche F. The PAP-RES algorithm: Defining who, why and how to use positive airway pressure therapy for OSA. Sleep Med Rev 2024; 75:101932. [PMID: 38608395 DOI: 10.1016/j.smrv.2024.101932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
Obstructive sleep apnea (OSA) is a common condition that is increasing in prevalence worldwide. Untreated OSA has a negative impact on health-related quality of life and is an independent risk factor for cardiovascular diseases. Despite available data suggesting that cardiovascular risk might differ according to clinical phenotypes and comorbidities, current approaches to OSA treatment usually take a "one size fits all" approach. Identification of cardiovascular vulnerability biomarkers and clinical phenotypes associated with response to positive airway pressure (PAP) therapy could help to redefine the standard treatment paradigm. The new PAP-RES (PAP-RESponsive) algorithm is based on the identification of OSA phenotypes that are likely to impact therapeutic goals and modalities. The paradigm shift is to propose a simplified approach that defines therapeutic goals based on OSA phenotype: from a predominantly "symptomatic phenotype" (individuals with high symptom burden that negatively impacts on daily life and/or accident risk or clinically significant insomnia) to a "vulnerable cardiovascular phenotype" (individuals with comorbidities [serious cardiovascular or respiratory disease or obesity] that have a negative impact on cardiovascular prognosis or a biomarker of hypoxic burden and/or autonomic nervous system dysfunction). Each phenotype requires a different PAP therapy care pathway based on differing health issues and treatment objectives.
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Affiliation(s)
- Frédéric Gagnadoux
- Service de Pneumologie et Allergologie, CHU Angers, Angers, France; MITOVASC UMR Inserm 1083 - UMR CNRS 6015, Angers, France
| | - Emilie Bequignon
- Service d'ORL et chirurgie cervico-faciale, Centre Hospitalier Intercommunal de Créteil, Créteil, France; CNRS EMR 7000, Créteil, France; INSERM, IMRB, and Faculté de Santé, Université Paris Est Créteil, Créteil, France
| | - Arnaud Prigent
- Pulmonology Medical Group, Polyclinique Saint-Laurent, Rennes, France
| | - Jean-Arthur Micoulaud-Franchi
- Université de Bordeaux, CNRS, SANPSY, UMR, 6033, Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France
| | - Juliette Chambe
- Département de Médecine Générale, Faculté de Médecine, Strasbourg, France; CNRS UPR 3212, Équipe Sommeil, Horloge, Lumière & NeuroPsychiatrie, Strasbourg, France
| | - Joëlle Texereau
- Lung Function & Respiratory Physiology Units, Cochin University Hospital, AP-HP, Paris, France; Air Liquide Healthcare, Bagneux, France
| | | | - Frédéric Roche
- Physical Exercise and Clinical Physiology Department, CHU Nord, Saint-Étienne, France; INSERM U1059 Santé Ingénierie Biologie, Université Jean Monnet, Saint-Étienne, France.
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16
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Bhattacharjee S, Saha B, Saha S. Symptom-based drug prediction of lifestyle-related chronic diseases using unsupervised machine learning techniques. Comput Biol Med 2024; 174:108413. [PMID: 38608323 DOI: 10.1016/j.compbiomed.2024.108413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/13/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND OBJECTIVES Lifestyle-related diseases (LSDs) impose a substantial economic burden on patients and health care services. LSDs are chronic in nature and can directly affect the heart and lungs. Therapeutic interventions only based on symptoms can be crucial for prompt treatment initiation in LSDs, as symptoms are the first information available to clinicians. So, this work aims to apply unsupervised machine learning (ML) techniques for developing models to predict drugs from symptoms for LSDs, with a specific focus on pulmonary and heart diseases. METHODS The drug-disease and disease-symptom associations of 143 LSDs, 1271 drugs, and 305 symptoms were used to compute direct associations between drugs and symptoms. ML models with four different algorithms - K-Means, Bisecting K-Means, Mean Shift, and Balanced Iterative Reducing and Clustering using Hierarchies (BIRCH) - were developed to cluster the drugs using symptoms as features. The optimal model was saved in a server for the development of a web application. A web application was developed to perform the prediction based on the optimal model. RESULTS The Bisecting K-means model showed the best performance with a silhouette coefficient of 0.647 and generated 138 drug clusters. The drugs within the optimal clusters showed good similarity based on i) gene ontology annotations of the gene targets, ii) chemical ontology annotations, and iii) maximum common substructure of the drugs. In the web application, the model also provides a confidence score for each predicted drug while predicting from a new set of input symptoms. CONCLUSION In summary, direct associations between drugs and symptoms were computed, and those were used to develop a symptom-based drug prediction tool for LSDs with unsupervised ML models. The ML-based prediction can provide a second opinion to clinicians to aid their decision-making for early treatment of LSD patients. The web application (URL - http://bicresources.jcbose.ac.in/ssaha4/sdldpred) can provide a simple interface for all end-users to perform the ML-based prediction.
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Affiliation(s)
- Sudipto Bhattacharjee
- Department of Computer Science and Engineering, University of Calcutta, JD-2, Sector-III, Salt Lake, Kolkata, 700098, India.
| | - Banani Saha
- Department of Computer Science and Engineering, University of Calcutta, JD-2, Sector-III, Salt Lake, Kolkata, 700098, India.
| | - Sudipto Saha
- Department of Biological Sciences, Bose Institute, EN 80, Sector V, Bidhan Nagar, Kolkata, 700091, India.
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Fathallah N, Alam A, Rentien AL, La Greca G, Co J, Pommaret E, Barré A, Kegne S, Beaussier H, Spindler L, de Parades V. Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management. J Visc Surg 2024:S1878-7886(24)00030-4. [PMID: 38580520 DOI: 10.1016/j.jviscsurg.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
INTRODUCTION There are very few French studies on hemorrhoidal disease and its management. PATIENTS AND METHODS Prospective single-center study from July to December 2021 including 472 patients. RESULTS Bleeding, prolapse and pain were the main reasons for consultation. Treatment modalities were medical (44%),±instrumental (72%), and surgical (17%). After treatment, the bleeding score and prolapse score decreased significantly (P=0.002 and P≤0.0001, respectively), but improvement was more marked in the surgery group with a better rate of "very good satisfaction" (73% vs. 54%, P=0.003). Factors associated with likelihood of surgical treatment were: age>44years, hypertrophic perianal skin tags, high scores (Bristol>5, bleeding>5, prolapse>2), severe impact on quality of life, smoking and reading during bowel movements. We have developed an online application, which aims to assess the risk of requiring hemorrhoidal surgery. CONCLUSION Less than 20% of patients who present with hemorrhoidal disease require surgical treatment, but it is associated with better effectiveness despite more complex postoperative consequences that sometimes motivate patient refusal. We have highlighted factors associated with surgical management, which can guide the practitioner in their therapeutic choices.
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Affiliation(s)
- Nadia Fathallah
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
| | - Amine Alam
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Anne L Rentien
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Giorgio La Greca
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Joshua Co
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Elise Pommaret
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Amélie Barré
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Stéphane Kegne
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Hélène Beaussier
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Lucas Spindler
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - Vincent de Parades
- Institut Léopold-Bellan, Service de Proctologie médicochirurgicale, Hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
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Almeida AM, Lima L, Martins T. Understanding quality of life's challenges in sarcoma patients: A mixed-methods study. Eur J Oncol Nurs 2024; 70:102585. [PMID: 38631125 DOI: 10.1016/j.ejon.2024.102585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Sarcoma, a highly aggressive form of cancer, profoundly affects patients both physically and psychologically. This study aimed to assess sarcoma patients' health-related quality of life and explore their experiences of living with the disease and their specific care requirements. METHODS This research employed a convergent parallel mixed-methods design. Fifty-two sarcoma patients completed the European Portuguese version of the EORTC QLQ-C30 questionnaire, and seven of them participated in semi-structured interviews. Descriptive measures, Cronbach alpha for internal consistency, t-teste-Anova and stepwise regression were employed in the quantitative analysis. Qualitative data was analysed thematically. RESULTS The most affected Quality of life (QoL) dimensions were role functioning and global health, areas of functioning that were also described as impacted in patients' experiences. Symptoms like insomnia, pain, and fatigue were frequently reported. Symptoms such as fatigue, pain, and financial difficulty explain QoL variance. No significant differences in QoL were found according to the different forms of treatment. Analysis of the interviews revealed three overarching themes: (1) disruption of daily life, (2) adaptation to life with sarcoma, and (3) the demand for more personalized care, allowing to gain a deeper understanding of living with sarcoma. CONCLUSION The results underscore the significance of delivering care that enhances the quality of life for sarcoma patients, addressing both their physical and psychosocial needs, and providing personalized support throughout all stages of the disease.
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Affiliation(s)
- Ana Maria Almeida
- ICBAS/UP - Institute for the Biomedical Sciences Abel Salazar / Porto University, Porto, Portugal; Francisco Gentil Portuguese Institute for Oncology of Porto, Portugal.
| | - Lígia Lima
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
| | - Teresa Martins
- Nursing School of Porto, Porto, Portugal; CINTESIS@RISE, Portugal
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Yamada K, Yoshii T, Hirai T, Kudo A, Nosaka N, Egawa S, Matsukura Y, Inose H, Okawa A. Action protocol of medical staff for airway obstruction after anterior cervical spine surgery: A systematic review of case reports. J Orthop Sci 2024:S0949-2658(24)00056-3. [PMID: 38575427 DOI: 10.1016/j.jos.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Postoperative airway obstruction after anterior cervical spine surgery (ACSS) can be a fatal complication. Occasionally, it rapidly progresses to complete obstruction. There are no established standardized protocols on how medical staff should assess for signs and symptoms, seek help, or facilitate airway management after ACSS to prevent unfavorable events. This study aimed to primarily describe a systematic approach by assessing the signs and treatment outcomes of airway compromise in patients who underwent ACSS. Further, it recommended an action protocol after extubation for medical staff according to patients' symptoms to prevent unfavorable outcomes. METHODS An extensive literature search was performed on PubMed, Web of Science, and the Cochrane Library to identify case reports, case series, and cohort studies restricted to English and published between January 1990 and March 2023. We included cases that described the signs, symptoms, and treatment of airway obstruction after ACSS. Meanwhile, cases involving complications of other known causes, cases of trauma or occipital-cervical fixation, or those using bone morphogenetic protein were excluded. RESULTS Twenty cases from 17 studies were obtained, and their study quality was acceptable. Four patients died, and two presented with hypoxic ischemic encephalopathy. Further, five of six patients had fatal complications that initially developed within 7 h after surgery. Then, 9 (69%) of 13 patients with evidence of hematoma (69%) showed initial symptoms within 12 h after surgery. Finally, 9 of 11 patients with early-stage symptoms had favorable outcomes, and patients who developed late-stage symptoms commonly had unfavorable outcomes. CONCLUSION The early identification of signs and symptoms and immediate treatment are important, particularly within 12 h postoperatively. We suggest a novel action protocol for medical staff according to symptom urgency, which includes the measurement of neck circumference using a string for evaluating neck swelling.
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Affiliation(s)
- Kentaro Yamada
- Department of Orthopaedics and Trauma Research, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Takashi Hirai
- Department of Orthopaedics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Atsushi Kudo
- Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Nobuyuki Nosaka
- Department of Intensive Care Medicine, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoru Egawa
- Department of Orthopaedics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yu Matsukura
- Department of Orthopaedics, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroyuki Inose
- Department of Orthopaedics, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Atsushi Okawa
- Department of Orthopaedics, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
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Lee AY, Lyons AT, Makris V, Kamaraju S, Stolley MR, Neuner JM, Flynn KE. Adherence to adjuvant endocrine therapy for breast cancer: a qualitative exploration of attribution of symptoms among post-menopausal women. Support Care Cancer 2024; 32:265. [PMID: 38565669 DOI: 10.1007/s00520-024-08463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE Oral adjuvant endocrine therapy (AET) is an effective treatment for hormone receptor positive breast cancer to decrease recurrence and mortality, but adherence is poor. This study explored post-menopausal women's experiences with AET, with a particular focus on adherence to AET as well as distress and symptoms experienced prior to and during AET treatment. METHODS Participants were recruited from a hospital registry, stratified by adherence to/discontinuation of AET. Telephone interviews followed a semi-structured interview guide and were recorded and transcribed verbatim. Transcripts were systematically coded using team-based coding, with analysis of themes using a grounded theory approach. RESULTS Thirty-three participants were interviewed; ages ranged from 57 to 86 years. Participants included 10 discontinued patients and 23 patients who completed their AET course or were adherent to AET at the time of interviewing. Both adherent and discontinued patients reported symptoms throughout their AET treatment course, and both attributed symptoms to factors other than AET (e.g., older age and pre-existing comorbidities). However, discontinued patients were more likely to attribute symptoms to AET and to describe difficulty managing their symptoms, with some directly citing symptoms as the reason for discontinuing AET therapy. Conversely, adherent patients were more likely to describe the necessity of taking AET, despite symptoms. CONCLUSIONS AET adherence was associated with beliefs about AET, symptom attribution, and symptom management. Routine symptom monitoring during AET and addressing both symptoms and patients' understanding of their symptoms may promote adherence to AET.
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Affiliation(s)
- Amy Y Lee
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Anna T Lyons
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Vaia Makris
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Sailaja Kamaraju
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Melinda R Stolley
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Joan M Neuner
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA
| | - Kathryn E Flynn
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 52336, USA.
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21
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Bosch-Capblanch X, Esu E, Oringanje CM, Dongus S, Jalilian H, Eyers J, Auer C, Meremikwu M, Röösli M. The effects of radiofrequency electromagnetic fields exposure on human self-reported symptoms: A systematic review of human experimental studies. Environ Int 2024; 187:108612. [PMID: 38640611 DOI: 10.1016/j.envint.2024.108612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the population. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF. OBJECTIVES To systematically assess the effects of exposure to RF-EMF on self-reported non-specific symptoms in human subjects and to assess the accuracy of perceptions of presence or absence of RF-EMF exposure. METHODS Eligibility criteria: experimental studies carried out in the general population and in individuals with idiopathic environmental intolerance attributed to EMF (IEI-EMF), in any language. INFORMATION SOURCES Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos, Embase and EMF portal, searched till April 2022. Risk of Bias (ROB): we used the RoB tool developed by OHAT adapted to the topic of this review. SYNTHESIS OF RESULTS we synthesized studies using random effects meta-analysis and sensitivity analyses, where appropriate. RESULTS Included studies: 41 studies were included, mostly cross over trials and from Europe, with a total of 2,874 participants. SYNTHESIS OF RESULTS considering the primary outcomes, we carried out meta-analyses of 10 exposure-outcomes pairs. All evidence suggested no or small non-significant effects of exposure on symptoms with high (three comparisons), moderate (four comparisons), low (one comparison) and very low (two comparisons) certainty of evidence. The effects (standard mean difference, where positive values indicate presence of symptom being exposed) in the general population for head exposure were (95% confidence intervals) 0.08 (-0.07 to 0.22) for headache, -0.01 (-0.22 to 0.20) for sleeping disturbances and 0.13 (-0.51 to 0.76) for composite symptoms; and for whole-body exposure: 0.09 (-0.35 to 0.54), 0.00 (-0.15 to 0.15) for sleeping disturbances and -0.05 (-0.17 to 0.07) for composite symptoms. For IEI-EMF individuals SMD ranged from -0.19 to 0.11, all of them with confidence intervals crossing the value of zero. Further, the available evidence suggested that study volunteers could not perceive the EMF exposure status better than what is expected by chance and that IEI-EMF individuals could not determine EMF conditions better than the general population. DISCUSSION Limitations of evidence: experimental conditions are substantially different from real-life situations in the duration, frequency, distance and position of the exposure. Most studies were conducted in young, healthy volunteers, who might be more resilient to RF-EMF than the general population. The outcomes of interest in this systematic review were symptoms, which are self-reported. The available information did not allow to assess the potential effects of exposures beyond acute exposure and in elderly or in chronically ill people. It cannot be ruled out that a real EMF effect in IEI-EMF groups is masked by a mix with insensitive subjects. However, studies on symptoms reporting and/or field perceptions did not find any evidence that there were particularly vulnerable individuals in the IEI-EMF group, although in open provocation studies, when volunteers were informed about the presence or absence of EMF exposure, such differences were consistently observed. INTERPRETATION available evidence suggests that acute RF-EMF below regulatory limits does not cause symptoms and corresponding claims in the everyday life are related to perceived and not to real EMF exposure status.
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Affiliation(s)
- Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Ekpereonne Esu
- Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Chioma Moses Oringanje
- Department of Biology, College of Art & Sciences, Xavier University, Cincinnati, OH 45247, USA.
| | - Stefan Dongus
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Hamed Jalilian
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - John Eyers
- Independent Consultant & Senior Research Fellow, 3ie, c/o LIDC, 20 Bloomsbury Square, London WC1A 2NS, United Kingdom.
| | - Christian Auer
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
| | - Martin Meremikwu
- Faculty of Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland; University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland.
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Haider I, Pond GR, Cameron R, Aljama M, Kouroukis TC, Wong K, Fiala MA, Wildes TM, Mian H. A structured oral chemotherapy teaching tool to improve adherence in adults with multiple myeloma: A pilot randomized controlled trial. J Geriatr Oncol 2024; 15:101735. [PMID: 38460399 DOI: 10.1016/j.jgo.2024.101735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Many of the newer treatments for adults with newly-diagnosed and relapsed multiple myeloma (MM) are orally administered. Adherence is a challenge, and little is known about strategies to optimize adherence. MATERIALS AND METHODS Forty-seven patients initiating orally-administered anti-myeloma therapy were enrolled and randomized in a pilot study to receive either standard of care teaching or the Multinational Association of Supportive Care in Cancer Oral agent Teaching Tool (MOATT), a structured teaching tool. Adherence was measured electronically with a Medication Event Monitoring System (MEMS) cap. Optimal adherence was defined as an adherence rate of ≥90% over the six months study duration. Patients completed surveys regarding cancer therapy satisfaction and self-efficacy for medication management at one month and six months following the initiation of treatment in both arms. RESULTS The mean adherence of patients over six months was 86.9%; 43.9% of the cohort were classified as non-adherent using the 90% threshold of adherence. Mean adherence was similar among standard of care teaching (87.9%) versus the MOATT intervention tool (85.6%) as was cancer therapy satisfaction and self-efficacy for medication management. DISCUSSION In our pilot, the MOATT tool was not found to be feasible or acceptable. There were no preliminary differences noted between standard of care teaching versus the structured MOATT teaching tool with regards to overall adherence rates, cancer therapy satisfaction, or self-efficacy in medication management. Overall adherence rates were suboptimal in our study. Future research should work to identify aspects of educational interventions which are effective, and investigate different strategies which can be used to supplement patient education and potentially optimize medication adherence in patients with MM.
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Affiliation(s)
- Imran Haider
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gregory R Pond
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Ruthanne Cameron
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Mohammed Aljama
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Tom C Kouroukis
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Kirk Wong
- Cancer Centre Pharmacy, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Mark A Fiala
- Division of Oncology, Washington University School of Medicine, St Louis, USA
| | - Tanya M Wildes
- Department of Medicine, University of Nebraska Medical Center/ Nebraska Medicine, USA
| | - Hira Mian
- Department of Oncology, McMaster University, Hamilton, ON, Canada.
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23
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Abou L, Peters J, Freire B, Sosnoff JJ. Fear of falling and common symptoms of multiple sclerosis: Physical function, cognition, fatigue, depression, and sleep - A systematic review. Mult Scler Relat Disord 2024; 84:105506. [PMID: 38422635 DOI: 10.1016/j.msard.2024.105506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/03/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Fear of falling (FOF) is a common concern among persons with multiple sclerosis (MS) and affects the performance of their daily living activities. Falls may result in FOF, leading to worsening of symptoms of MS, physical deconditioning, and exposure to future falls. This may trigger a vicious cycle between FOF and falls. A better understanding of the relationship between FOF and symptoms of MS may be helpful to develop a conceptual model to guide fall prevention interventions. OBJECTIVE To synthesize the correlational and predictive relationships between FOF and common symptoms of MS. METHODS Databases including PubMed, Embase, Web of Science, Scopus, CINHAL, PsycINFO, and SPORTDiscuss were searched from inception to October 2023. Studies examining correlations and/or predictions between FOF and common MS symptoms that include measures of gait, postural control, fatigue, cognition, pain, sleep, depression, and anxiety were identified by two independent reviewers. Both reviewers also conducted the methodological quality assessment of the included studies. RESULTS Twenty-three studies with a total of 2819 participants were included in the review. Correlational findings indicated that increased FOF was significantly associated with greater walking deficits (lower gait speed, smaller steps), reduced mobility, and poorer balance. Increased FOF was also significantly correlated with higher cognitive impairments, more fatigue, sleep disturbances, and depression. Decreased gait parameters, reduced balance, lower physical functions, cognitive impairments, and sleep deficits were found as significant predictors of increased FOF. CONCLUSION Evidence indicates significant correlational and bidirectional predictive relationships exist between FOF and common MS symptoms. A comprehensive conceptual framework accounting for the interaction between FOF and MS symptoms is needed to develop effective falls prevention strategies.
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Affiliation(s)
- Libak Abou
- Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
| | - Joseph Peters
- Kansas City University College of Osteopathic Medicine, Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Bruno Freire
- Health and Sports Sciences Center, Santa Catarina State University, Florianópolis, SC, Brazil
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
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24
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Fairley JL, Hansen D, Day J, Proudman S, Sahhar J, Ngian GS, Walker J, Host LV, Morrisroe K, Stevens W, Ross L, Nikpour M. Proximal weakness and creatine kinase elevation in systemic sclerosis: Clinical correlates, prognosis and functional implications. Semin Arthritis Rheum 2024; 65:152363. [PMID: 38316069 DOI: 10.1016/j.semarthrit.2024.152363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/17/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024]
Abstract
OBJECTIVES To determine the frequency, clinical correlates and implications of clinical evidence of muscle disease in systemic sclerosis (SSc). METHODS Australian Scleroderma Cohort Study participants with ≥1 creatine kinase (CK) and proximal power assessment were subdivided according to presence of proximal weakness (PW: proximal muscle power<5/5) and CK elevation(≥140IU/L). Participants were assigned to one of four groups: concurrent PW&CK elevation, PW alone, CK elevation alone or neither. Between-group comparisons were made with chi-squared, ANOVA or Kruskal-Wallis tests. Survival analysis was performed using time-varying-covariate Cox regression modelling. Longitudinal data were modelled using multinomial logistic and linear regression. RESULTS Of 1786 participants, 4 % had concurrent PW&CK elevation, 15 % PW alone, 24 % CK elevation and 57 % neither. Participants with PW&CK elevation displayed a severe, inflammatory SSc phenotype, with more frequent dcSSc(p < 0.01), tendon friction rubs(p < 0.01), synovitis(p < 0.01) and digital ulceration(p = 0.03). Multimorbidity(p < 0.01) and cardiopulmonary disease, including ischaemic heart disease(p < 0.01) and pulmonary arterial hypertension(p < 0.01), were most common in those with PW, with and without CK elevation. Men with anti-Scl70 positivity most frequently had CK elevation alone, without other significant clinical differences. Multivariable modelling demonstrated 3.6-fold increased mortality in those with PW&CK elevation (95 %CI 1.9-6.6, p < 0.01) and 2.1-fold increased mortality in PW alone (95 %CI 1.4-3.0, p < 0.01) compared to those without PW or CK elevation. CK elevation alone conferred better survival (HR 0.7, 95 %CI 0.4-1.1, p = 0.09) compared to those with no PW or CK elevation. PW regardless of CK elevation was associated with impaired physical function, with reduced six-minute-walk-distance (p < 0.01), higher HAQ-DI scores (p < 0.01) and increased patient-reported dyspnoea (p = 0.04). CONCLUSION Clinical features of myopathy are highly prevalent in SSc, affecting almost half of our study cohort. Detection of PW and elevated CK alone, even without imaging or histopathological identification of SSc-myopathy, identified important clinical associations and are associated with poorer function and overall prognosis.
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Affiliation(s)
- Jessica L Fairley
- The University of Melbourne, Melbourne, Victoria, Australia; St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
| | - Dylan Hansen
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Jessica Day
- The University of Melbourne, Melbourne, Victoria, Australia; The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Susanna Proudman
- University of Adelaide, Adelaide, South Australia, Australia; Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Joanne Sahhar
- Monash Health, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia
| | - Gene-Siew Ngian
- Monash Health, Melbourne, Victoria, Australia; Monash University, Melbourne, Victoria, Australia
| | - Jenny Walker
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Lauren V Host
- Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Kathleen Morrisroe
- The University of Melbourne, Melbourne, Victoria, Australia; St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Wendy Stevens
- St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Laura Ross
- The University of Melbourne, Melbourne, Victoria, Australia; St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Mandana Nikpour
- The University of Melbourne, Melbourne, Victoria, Australia; St. Vincent's Hospital Melbourne, Melbourne, Victoria, Australia; The University of Sydney School of Public Health, Sydney, New South Wales, Australia; Royal Prince Alfred Hospital Sydney, New South Wales, Australia
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25
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Jaarsma T, Kato NP, Klompstra L, Ben Gal T, Boyne J, Hägglund E, Vellone E, Hagenow A, Evangelista LS, Mårtensson J, Strömberg A. Changes over time in patient-reported outcomes in patients with heart failure. ESC Heart Fail 2024; 11:811-818. [PMID: 38158757 DOI: 10.1002/ehf2.14648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024] Open
Abstract
AIM This paper describes the trajectory during 1 year of four patient-reported outcomes (PROs), namely, sleep, depressive symptoms, health-related quality of life (HrQoL), and well-being, in patients with heart failure (HF), their relationship and the patient characteristics associated with changes in these PROs. METHODS AND RESULTS Data analyses of PROs from 603 patients (mean age 67 years; 29% female, 60% NYHA II) enrolled in the HF-Wii study. On short term, between baseline and 3 months, 16% of the patients experienced continuing poor sleep, 11% had sustained depressive symptoms, 13% had consistent poor HrQoL, and 13% consistent poor well-being. Across the entire 1-year period only 21% of the patients had good PRO scores at all timepoints (baseline, 3, 6, and 12 months). All others had at least one low score in any of the PROs at some timepoint during the study. Over the 12 months, 17% had consistently poor sleep, 17% had sustained symptoms of depression, 15% consistently rated a poor HrQoL, and 13% poor well-being. Different patient characteristics per PRO were associated with a poor outcomes across the 12 months. Age, education, New York Heart Association, and length of disease were related to two PRO domains and submaximal exercise capacity (6 min test), co-morbidity, and poor physical activity to one. CONCLUSION In total, 79% of the patients with HF encountered problems related to sleep, depressive symptoms, HrQoL, and well-being at least once during a 1-year period. This underscores the need for continuous monitoring and follow-up of patients with HF and the need for dynamic adjustments in treatment and care regularly throughout the HF trajectory.
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Affiliation(s)
- Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Naoko P Kato
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Rabin Medical Center, Petah Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Eva Hägglund
- Department of Cardiology, Heart and Vascular Center, Karolinska University hospital, Stockholm, Sweden
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Andreas Hagenow
- Center of Internal Medicine Elsterwerda, Elsterwerda, Germany
| | | | - Jan Mårtensson
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
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26
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Ranjan S, Thakur R. Gender differential in the pattern and severity of perceived symptoms among diabetes patients in India. Diabetol Int 2024; 15:223-236. [PMID: 38524935 PMCID: PMC10959850 DOI: 10.1007/s13340-023-00673-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/06/2023] [Indexed: 03/26/2024]
Abstract
Objective To analyze the pattern of diabetes symptoms and to estimate the association between diabetes symptom severity (level of discomfort perceived by a patient due to diabetes symptoms) among different socio-demographic variables for both women and men. Methods Primary cross-sectional data of 583 diagnosed patients (51.3% and 48.7%, women and men, respectively) were collected from Punjab, India. Frequency percentage distribution and negative binomial regressions (NBR) were used for analysis. Results More men were asymptomatic compared to women. Both genders perceived increased hunger, thirst, and frequent urination in their early stages of diabetes. More women than men have experienced hormonal change as their first symptom with a higher severity level. NBR analyzed the association between discomfort perceived by both genders due to symptoms among different socio-demographic categories. Urban patients (incidence rate ratio-IRR: 0.90) were significantly (p = 0.056) less likely to perceive discomfort than their rural counterparts, whereas men (IRR: 0.93) reported more significant discomfort than women (IRR: 0.88) in the urban area. Literate patients [Up to class 10 (IRR: 0.87), (p = 0.013) and 11-above (IRR: 0.85), (p = 0.022) categories] were significantly less likely to perceive discomfort. In all education categories, women professed more significant discomfort than men. Conclusion Given the differences in symptoms between the two genders, this paper will help comprehend the disease development process and limit the possibilities of misdiagnosis. This study will assist in identifying the order of the symptoms among both genders.
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Affiliation(s)
- Shubham Ranjan
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Mandi, Himachal Pradesh 175005 India
| | - Ramna Thakur
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Mandi, Himachal Pradesh 175005 India
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27
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Cichocki AC, Zinbarg RE, Craske MG, Chat IKY, Young KS, Bookheimer SY, Nusslock R. Transdiagnostic symptom of depression and anxiety associated with reduced gray matter volume in prefrontal cortex. Psychiatry Res Neuroimaging 2024; 339:111791. [PMID: 38359709 PMCID: PMC10938645 DOI: 10.1016/j.pscychresns.2024.111791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/25/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
Dimensional models of psychopathology may provide insight into mechanisms underlying comorbid depression and anxiety and improve specificity and sensitivity of neuroanatomical findings. The present study is the first to examine neural structure alterations using the empirically derived Tri-level Model. Depression and anxiety symptoms of 269 young adults were assessed using the Tri-level Model dimensions: General Distress (transdiagnostic depression and anxiety symptoms), Anhedonia-Apprehension (relatively specific depression symptoms), and Fears (specific anxiety symptoms). Using structural MRI, gray matter volumes were extracted for emotion generation (amygdala, nucleus accumbens) and regulation (orbitofrontal, ventrolateral, and dorsolateral prefrontal cortex) regions, often implicated in depression and anxiety. Each Tri-level symptom was regressed onto each region of interest, separately, adjusting for relevant covariates. General Distress was significantly associated with smaller gray matter volumes in bilateral orbitofrontal cortex and ventrolateral prefrontal cortex, independent of Anhedonia-Apprehension and Fears symptom dimensions. These results suggests that prefrontal alterations are associated with transdiagnostic dysphoric mood common across depression and anxiety, rather than unique symptoms of these disorders. Additionally, no regions of interest were associated with Anhedonia-Apprehension or Fears, highlighting the importance of studying transdiagnostic features of depression and anxiety. This has implications for understanding mechanisms of and interventions for depression and anxiety.
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Affiliation(s)
- Anna C Cichocki
- Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston IL 60208, United States.
| | - Richard E Zinbarg
- Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston IL 60208, United States; The Family Institute at Northwestern University, Evanston, IL, United States
| | - Michelle G Craske
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States
| | - Iris K-Y Chat
- Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston IL 60208, United States
| | - Katherine S Young
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States
| | - Susan Y Bookheimer
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Road, Evanston IL 60208, United States
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Konttajärvi T, Haapea M, Huhtaniska S, Björnholm L, Miettunen J, Isohanni M, Penttilä M, Murray GK, Koponen H, Vernon AC, Jääskeläinen E, Lieslehto J. The contribution of first-episode illness characteristics and cumulative antipsychotic usage to progressive structural brain changes over a long-term follow-up in schizophrenia. Psychiatry Res Neuroimaging 2024; 339:111790. [PMID: 38354478 DOI: 10.1016/j.pscychresns.2024.111790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 11/26/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024]
Abstract
Exposure to antipsychotics as well as certain first-episode illness characteristics have been associated with greater gray matter (GM) deficits in the early phase of schizophrenia. Whether the first-episode illness characteristics affect the long-term progression of the structural brain changes remain unexplored. We therefore assessed the role of first-episode illness characteristics and life-time antipsychotic use in relation to long-term structural brain GM changes in schizophrenia. Individuals with schizophrenia (SZ, n = 29) and non-psychotic controls (n = 61) from the Northern Finland Birth Cohort 1966 underwent structural MRI at the ages of 34 (baseline) and 43 (follow-up) years. At follow-up, the average duration of illness was 19.8 years. Voxel-based morphometry was used to assess the effects of predictors on longitudinal GM changes in schizophrenia-relevant brain areas. Younger age of onset (AoO), higher cumulative antipsychotic dose and severity of symptoms were associated with greater GM deficits in the SZ group at follow-up. None of the first-episode illness characteristics were associated with longitudinal GM changes during 9-year follow-up period. We conclude that a younger AoO and high life-time antipsychotic use may contribute to progression of structural brain changes in schizophrenia. Apart from AoO, other first-episode illness characteristics may not contribute to longitudinal GM changes in midlife.
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Affiliation(s)
| | - Marianne Haapea
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University of Hospital and University of Oulu, Finland; Department of Psychiatry, Oulu University of Hospital, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Sanna Huhtaniska
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Lassi Björnholm
- Department of Psychiatry, Oulu University of Hospital, Finland; Research Unit of Clinical Neuroscience, University of Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University of Hospital and University of Oulu, Finland
| | - Matti Isohanni
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Matti Penttilä
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Hannu Koponen
- University of Helsinki, Helsinki University Hospital, Psychiatry, Helsinki, Finland
| | - Anthony C Vernon
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; MRC Centre for Neurodevelopmental Disorders, King's College London, London,United Kingdom
| | - Erika Jääskeläinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University of Hospital and University of Oulu, Finland; Department of Psychiatry, Oulu University of Hospital, Finland
| | - Johannes Lieslehto
- Research Unit of Population Health, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University of Hospital and University of Oulu, Finland; Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland; Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Scroggins JK, Brandon D, Reuter-Rice K, Min SH, Yang Q. Changes in maternal psychological symptom profiles from 2 to 6 months postpartum: an application of latent transition analysis. Arch Womens Ment Health 2024; 27:309-316. [PMID: 38044340 DOI: 10.1007/s00737-023-01407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
To identify subgroups of postpartum women with different psychological symptom profiles at 2 and 6 months postpartum and to examine how they transition between symptom profiles over time using latent transition analysis (LTA). We used secondary data from the Family Life Project (N = 1,117) and performed LTA based on observed variables (depression, anxiety, somatization, and hostility). We examined transition probabilities and changes in latent status prevalence from 2 to 6 months postpartum. Considering the known influences of social determinants of health on psychological symptoms, bivariate analyses were conducted to describe the characteristics of different transition patterns. A 3-class model with better fit indices, entropy, and interpretability was selected. Based on symptom severity, the identified profiles were Profile 1: Low, Profile 2: Moderate, and Profile 3: High. From 2 to 6 months postpartum, the prevalence of low symptom profile decreased (82 to 78.2%) while the prevalence increased for moderate (15.8 to 17.5%) and high symptom profiles (2.2 to 4.4%). For all profiles, it was most likely for postpartum women to stay in the same profile from 2 to 6 months (low to low, moderate to moderate, and high to high). Those in persistent or worsening transition patterns were significantly younger or had less social support or education. Postpartum women in moderate or high symptom profiles at 2 months were most likely to stay in the same profile at 6 months postpartum, indicating persistent symptom burden. Clinicians should consider providing early, targeted support to prevent persistent symptom burden.
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Affiliation(s)
- Jihye Kim Scroggins
- School of Nursing, Duke University, Durham, NC, USA.
- School of Nursing, Columbia University, 560 W 168th Street, New York, NY, 10032, USA.
| | - Debra Brandon
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Karin Reuter-Rice
- School of Nursing, Duke University, Durham, NC, USA
- School of Medicine, Duke University, Durham, NC, USA
| | - Se Hee Min
- School of Nursing, Columbia University, 560 W 168th Street, New York, NY, 10032, USA
| | - Qing Yang
- School of Nursing, Duke University, Durham, NC, USA
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Barrett A, Olayinka-Amao O, Ziemssen T, Bharadia T, Henke C, Kamudoni P. Understanding the Symptoms and Impacts Experienced by People with Relapsing-Remitting MS: A Qualitative Investigation Using Semi-Structured Interviews. Neurol Ther 2024; 13:449-464. [PMID: 38345742 PMCID: PMC10951163 DOI: 10.1007/s40120-024-00584-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/17/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a disabling disease with unpredictable clinical manifestations. As clinical assessments may not fully capture the impact of MS on quality of life, they can be complemented by patient-reported outcome (PRO) measures to provide a more comprehensive picture of MS disease state and impact. The objectives of this study were to explore the experiences of people with relapsing-remitting MS, including symptoms and impacts on daily life, and to provide a conceptual model of MS outcomes. METHODS A literature review of studies that evaluated the experiences of people with MS was completed and combined with semi-structured concept elicitation interviews conducted with 14 people with relapsing-remitting MS in the USA. RESULTS The average age of the 14 participants was 43.9 (range 25-64) years, most were White (78.6%) and female (78.6%), and the mean duration since diagnosis was 6.6 (2-10) years. The most bothersome symptoms identified included fatigue (n = 9), cognitive dysfunction (n = 5), mobility/difficulty with walking (n = 3), and vision problems (n = 3). The most commonly reported impacts on daily life were balance problems/instability (n = 13), work life/productivity (n = 12), difficulty walking (n = 11), daily activities/household chores (n = 11), and leisure activities (n = 10). CONCLUSION There was a high frequency of concepts associated with physical function, fatigue, and sensory-motor actions. A conceptual model was developed that captures the disease symptoms, impairments, and impacts identified in the interviews as well as known processes and symptoms identified in the literature search. This model underpins the appropriateness of PRO instruments, such as the PROMIS Fatigue (MS) 8a and PROMIS Physical Function (MS) 15a, which evaluate symptoms and impacts that matter most to people with MS.
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Affiliation(s)
- Amy Barrett
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Oyebimpe Olayinka-Amao
- Patient-Centered Outcomes Assessment, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Neurological Clinic, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Christian Henke
- Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany
| | - Paul Kamudoni
- Merck Healthcare KGaA, Frankfurter Str. 250, 64293, Darmstadt, Germany.
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Dietz E, Pritchard E, Pouwels K, Ehsaan M, Blake J, Gaughan C, Haduli E, Boothe H, Vihta KD, Peto T, Stoesser N, Matthews P, Taylor N, Diamond I, Studley R, Rourke E, Birrell P, De Angelis D, Fowler T, Watson C, Eyre D, House T, Walker AS. SARS-CoV-2, influenza A/B and respiratory syncytial virus positivity and association with influenza-like illness and self-reported symptoms, over the 2022/23 winter season in the UK: a longitudinal surveillance cohort. BMC Med 2024; 22:143. [PMID: 38532381 DOI: 10.1186/s12916-024-03351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Syndromic surveillance often relies on patients presenting to healthcare. Community cohorts, although more challenging to recruit, could provide additional population-wide insights, particularly with SARS-CoV-2 co-circulating with other respiratory viruses. METHODS We estimated the positivity and incidence of SARS-CoV-2, influenza A/B, and RSV, and trends in self-reported symptoms including influenza-like illness (ILI), over the 2022/23 winter season in a broadly representative UK community cohort (COVID-19 Infection Survey), using negative-binomial generalised additive models. We estimated associations between test positivity and each of the symptoms and influenza vaccination, using adjusted logistic and multinomial models. RESULTS Swabs taken at 32,937/1,352,979 (2.4%) assessments tested positive for SARS-CoV-2, 181/14,939 (1.2%) for RSV and 130/14,939 (0.9%) for influenza A/B, varying by age over time. Positivity and incidence peaks were earliest for RSV, then influenza A/B, then SARS-CoV-2, and were highest for RSV in the youngest and for SARS-CoV-2 in the oldest age groups. Many test positives did not report key symptoms: middle-aged participants were generally more symptomatic than older or younger participants, but still, only ~ 25% reported ILI-WHO and ~ 60% ILI-ECDC. Most symptomatic participants did not test positive for any of the three viruses. Influenza A/B-positivity was lower in participants reporting influenza vaccination in the current and previous seasons (odds ratio = 0.55 (95% CI 0.32, 0.95)) versus neither season. CONCLUSIONS Symptom profiles varied little by aetiology, making distinguishing SARS-CoV-2, influenza and RSV using symptoms challenging. Most symptoms were not explained by these viruses, indicating the importance of other pathogens in syndromic surveillance. Influenza vaccination was associated with lower rates of community influenza test positivity.
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Affiliation(s)
- Elisabeth Dietz
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK.
| | - Emma Pritchard
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
| | - Koen Pouwels
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Joshua Blake
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | | | - Eric Haduli
- Berkshire and Surrey Pathology Services, Camberley, UK
| | - Hugh Boothe
- Berkshire and Surrey Pathology Services, Camberley, UK
| | | | - Tim Peto
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Nicole Stoesser
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Philippa Matthews
- The Francis Crick Institute, 1 Midland Road, London, UK
- Division of Infection and Immunity, University College London, London, UK
| | | | | | | | | | - Paul Birrell
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- UK Health Security Agency, London, UK
| | | | - Tom Fowler
- UK Health Security Agency, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - David Eyre
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Ann Sarah Walker
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK
- The National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
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32
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Doppenberg-Smit GE, Lamers F, van Linde ME, Braamse AMJ, Sprangers MAG, Beekman ATF, Verheul HMW, Dekker J. Network analysis used to investigate the interplay among somatic and psychological symptoms in patients with cancer and cancer survivors: a scoping review. J Cancer Surviv 2024:10.1007/s11764-024-01543-0. [PMID: 38530627 DOI: 10.1007/s11764-024-01543-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/22/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Patients with cancer often experience multiple somatic and psychological symptoms. Somatic and psychological symptoms are thought to be connected and may reinforce each other. Network analysis allows examination of the interconnectedness of individual symptoms. The aim of this scoping review was to examine the current state of knowledge about the associations between somatic and psychological symptoms in patients with cancer and cancer survivors, based on network analysis. METHODS This scoping review followed the five-stage framework of Arksey and O'Malley. The literature search was conducted in May, 2023 in PubMed, APA PsycINFO, Embase Cochrane central, and CINAHL databases. RESULTS Thirty-two studies were included, with eleven using longitudinal data. Seventeen studies reported on the strength of the associations: somatic and psychological symptoms were associated, although associations among somatic as well as among psychological symptoms were stronger. Other findings were the association between somatic and psychological symptoms was stronger in patients experiencing more severe symptoms; associations between symptoms over time remained rather stable; and different symptoms were central in the networks, with fatigue being among the most central in half of the studies. IMPLICATIONS FOR CANCER SURVIVORS Although the associations among somatic symptoms and among psychological symptoms were stronger, somatic and psychological symptoms were associated, especially in patients experiencing more severe symptoms. Fatigue was among the most central symptoms, bridging the somatic and psychological domain. These findings as well as future research based on network analysis may help to untangle the complex interplay of somatic and psychological symptoms in patients with cancer.
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Affiliation(s)
- G Elise Doppenberg-Smit
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Myra E van Linde
- Department of Medical Oncology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Annemarie M J Braamse
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Mirjam A G Sprangers
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
| | - Henk M W Verheul
- Department of Medical Oncology, Erasmus MC, Dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - Joost Dekker
- Department of Psychiatry, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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33
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Stefanolo JP, Segura V, Grizzuti M, Heredia A, Comino I, Costa AF, Puebla R, Temprano MP, Niveloni SI, de Diego G, Oregui ME, Smecuol EG, de Marzi MC, Verdú EF, Sousa C, Bai JC. Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet. World J Gastroenterol 2024; 30:1545-1555. [PMID: 38617446 PMCID: PMC11008412 DOI: 10.3748/wjg.v30.i11.1545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/31/2023] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The gluten-free diet (GFD) has limitations, and there is intense research in the development of adjuvant therapies. AIM To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease (AN-PEP) on inadvertent gluten exposure and symptom prevention in adult celiac disease (CeD) patients following their usual GFD. METHODS This was an exploratory, double-blind, randomized, placebo-controlled trial that enrolled CeD patients on a long-term GFD. After a 4-wk run-in period, patients were randomized to 4 wk of two AN-PEP capsules (GliadinX; AVI Research, LLC, United States) at each of three meals per day or placebo. Outcome endpoints were: (1) Average weekly stool gluten immunogenic peptides (GIP) between the run-in and end of treatments and between AN-PEP and placebo; (2) celiac symptom index (CSI); (3) CeD-specific serology; and (4) quality of life. Stool samples were collected for GIP testing by ELISA every Tuesday and Friday during run-ins and treatments. RESULTS Forty patients were randomized for the intention-to-treat analysis, and three were excluded from the per-protocol assessment. Overall, 628/640 (98.1%) stool samples were collected. GIP was undetectable (< 0.08 μg/g) in 65.6% of samples, and no differences between treatment arms were detected. Only 0.5% of samples had GIP concentrations sufficiently high (> 0.32 μg/g) to potentially cause mucosal damage. Median GIP concentration in the AN-PEP arm was 44.7% lower than in the run-in period. One-third of patients exhibiting GIP > 0.08 μg/g during run-in had lower or undetectable GIP after AN-PEP treatment. Compared with the run- in period, the proportion of symptomatic patients (CSI > 38) in the AN-PEP arm was significantly lower (P < 0.03). AN-PEP did not result in changes in specific serologies. CONCLUSION This exploratory study conducted in a real-life setting revealed high adherence to the GFD. The AN-PEP treatment did not significantly reduce the overall GIP stool concentration. However, given the observation of a significantly lower prevalence of patients with severe symptoms in the AN-PEP arm, further clinical research is warranted.
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Affiliation(s)
- Juan Pablo Stefanolo
- Small Bowel Section, Department of Medicine, Gastroenterology Hospital of Buenos Aires “Dr. C. Bonorino Udaondo”, Buenos Aires 1264, Argentina
| | - Verónica Segura
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville 41080, Spain
| | - Martina Grizzuti
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Abel Heredia
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville 41080, Spain
| | - Isabel Comino
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville 41080, Spain
| | - Ana Florencia Costa
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Roberto Puebla
- Small Bowel Section, Department of Medicine, Gastroenterology Hospital of Buenos Aires “Dr. C. Bonorino Udaondo”, Buenos Aires 1264, Argentina
| | - María Paz Temprano
- Small Bowel Section, Department of Medicine, Gastroenterology Hospital of Buenos Aires “Dr. C. Bonorino Udaondo”, Buenos Aires 1264, Argentina
| | - Sonia Isabel Niveloni
- Small Bowel Section, Department of Medicine, Gastroenterology Hospital of Buenos Aires “Dr. C. Bonorino Udaondo”, Buenos Aires 1264, Argentina
| | - Gabriel de Diego
- Basic and Applied Research Group in Immunology and Bioactives (GIBAIB), Institute of Ecology and Sustainable Development (INEDES), National University of Lujan, Luján 6700, Buenos Aires, Argentina
| | - María E Oregui
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
| | - Edgardo Gustavo Smecuol
- Small Bowel Section, Department of Medicine, Gastroenterology Hospital of Buenos Aires “Dr. C. Bonorino Udaondo”, Buenos Aires 1264, Argentina
| | - Mauricio C de Marzi
- Basic and Applied Research Group in Immunology and Bioactives (GIBAIB), Institute of Ecology and Sustainable Development (INEDES), National University of Lujan, Luján 6700, Buenos Aires, Argentina
| | - Elena F Verdú
- Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton L8S 4L8, Ontario, Canada
| | - Carolina Sousa
- Department of Microbiology and Parasitology, Faculty of Pharmacy, University of Seville, Seville 41080, Spain
| | - Julio César Bai
- Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital, Buenos Aires 1264, Argentina
- Facultad de Medicina, Universidad del Salvador, Buenos Aires C1051ABB, Argentina
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34
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Alberti C, Dreher M, Triantafyllias K, Schwarting A. [Current patient care of systematic lupus erythematosus in Rhineland-Palatinate and Saarland]. Z Rheumatol 2024:10.1007/s00393-024-01491-1. [PMID: 38509358 DOI: 10.1007/s00393-024-01491-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease that is associated with great suffering for those affected, as well as high socioeconomic costs. Early diagnosis and adequate medical care are essential for a mild course of the disease. However, there is a lack of current figures and data on the care situation of patients in the area. METHODOLOGY A total of 1546 general practitioners, rheumatologists, neurologists, nephrologists and dermatologists in Rhineland-Palatinate and Saarland were interviewed by fax or mail using a questionnaire regarding epidemiology, symptoms, therapy and therapy success. In addition, there was the possibility of making suggestions for improvement. RESULTS Five out of six of the 635 reported SLE patients were female. The most common main symptoms were arthralgia, fatigue, myalgia, and skin changes. Of the patients, 68% received antimalarials (AMs), whereas 46% were treated with glucocorticoids (GCs) and 50% with an immunosuppressant (IS), mainly methotrexate. In terms of comorbidities, patients suffered mainly from cardiovascular disease, fibromyalgia syndrome and depression. Rheumatologists also frequently described anaemia, diabetes mellitus and osteoporosis. DISCUSSION Compared with guideline recommendations, the low rate of AMs in therapy was particularly striking in patients not treated by rheumatologists (35% on average compared with 81% for rheumatologists). Additionally, (sustained) high doses of GCs are not in line with literature recommendations. In the free text field, the main requests were for more rheumatologists in private practice and faster appointment scheduling, as well as better communication and networking. In addition, the desire for more training and education was frequently expressed..
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Affiliation(s)
- Ciaran Alberti
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
| | - Matthias Dreher
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
- Universitäres Centrum für Autoimmunität, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Konstantinos Triantafyllias
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland
- RZ Rheumakliniken Rheinland-Pfalz GmbH, Bad Kreuznach, Deutschland
| | - Andreas Schwarting
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
- RZ Rheumakliniken Rheinland-Pfalz GmbH, Bad Kreuznach, Deutschland.
- Universitäres Centrum für Autoimmunität, Universitätsmedizin, Johannes Gutenberg-Universität Mainz, Mainz, Deutschland.
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35
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Hill L. Temperament impact on eating disorder symptoms and habit formation: a novel model to inform treatment. J Eat Disord 2024; 12:40. [PMID: 38504375 PMCID: PMC10953227 DOI: 10.1186/s40337-024-00998-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Temperament has long been described as the biological dimension of personality. Due to advancing brain-imaging technology, our understanding of temperament has deepened and transformed over the last 25 years. Temperament combines genetic, neurobiological and trait research. Temperament has been included peripherally in some eating disorder (ED) treatment approaches but has been ignored by most. Temperament fills a fundamental treatment gap by clarifying who is more vulnerable to develop ED and why some individuals are susceptible to specific ED symptoms while others are not. In addition, temperament targets possible treatment solutions. MAIN TEXT There is a need for a novel model that incorporates and explores the role of temperament in ED treatment intervention. This paper is a metaphoric temperament model to inform treatment intervention. It describes how temperament traits influences new decisions which impact new behavioural responses. In turn, it neurobiologically tracks how and why the brain efficiently transforms new decisions into new habits. This model integrates both temperament and habit research to explore (a) what temperament is; (b) how new decisions develop into habits neurobiologically; (c) that the brain wires destructive symptoms into habits in the same way that it wires healthy/productive behaviours into habits; (d) traits that trigger ED symptoms are the same traits that influence productive behaviours; and in regard to treatment implications (e) when treatment structure and intervention target client temperaments, the potential for new healthy "trait-syntonic" habits could develop. CONCLUSIONS This paper introduces a metaphoric model that synthesizes and integrates temperament neurobiological and trait findings with ED symptoms, habits, and client trait-based solutions. The model synthesizes and integrates different research domains to establish a brain-based foundation to inform treatment intervention. The model targets clients' temperament traits as central collections of innate self-expressions that could be utilized as tools to redirect client trait-syntonic ED responses into trait-syntonic productive outcomes. The brain bases of temperament and habit formation serve as a biological foundation for ED treatment intervention.
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Affiliation(s)
- Laura Hill
- Department of Psychiatry, University of California, San Diego, CA, USA.
- Adjunct Associate Clinical Professor of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA.
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Schwartz CE, Borowiec K. Development and validation of the HDSIM™ assessment system: a measure of hemorrhoid disease symptom impact. Qual Life Res 2024:10.1007/s11136-024-03619-x. [PMID: 38502416 DOI: 10.1007/s11136-024-03619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Hemorrhoid disease (HD) affects 10 million people in the US at any given time, and 50% of the US population will develop symptomatic hemorrhoids during their lifetime. Approximately 60% of people with hemorrhoids experience symptoms. Despite its prevalence and impact on quality of life, the existing patient-reported outcome measures of HD have not been validated using standard psychometric methods. The present study thus aimed to develop the Hemorrhoid Disease Symptom Impact Measure™ (HDSIM™) assessment system, a patient-reported measure of HD symptoms and impact for use in HD clinical research. METHODS On the basis of results from qualitative cognitive interviews, we generated the conceptual model and item pool. A cross-sectional web-based survey (n = 1066) was done, including a randomly selected retest subsample (n = 100) 1-2 weeks later. The survey sample was selected to be evenly distributed across mild, moderate, and severe levels of disease and to be nationally representative of the general United States population in terms of race, gender, and region. Existing disease-specific measures of symptoms and generic measures of quality of life and well-being were compared to the new tool for construct validation. RESULTS The HDSIM system includes 38 items representing six conceptual-model-driven subscales, aligning with the conceptual model: Symptoms at Worst, Symptoms at Best, Bowel Health Impact, Life Impact, Mental Health Impact, and Manageability. Psychometric analyses documented that the subscales had excellent internal consistency reliability, cross-sectional construct validity (i.e., convergent and divergent validity, known groups validity), test-retest stability, and longitudinal construct validity (i.e., responsiveness). CONCLUSION The HDSIM system is fit for purpose in hemorrhoid disease clinical trials research. Since measures are validated in an iterative manner over many studies and over time, the present study results should be considered preliminary.
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Affiliation(s)
- Carolyn E Schwartz
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742 , USA.
- Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA.
| | - Katrina Borowiec
- DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, 01742 , USA
- Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA
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Tryfonos C, Chrysafi M, Papadopoulou SK, Vadikolias K, Spanoudaki M, Mentzelou M, Fotiou D, Pavlidou E, Gkouvas G, Vorvolakos T, Michailidis A, Bisbinas A, Alexatou O, Giaginis C. Association of Mediterranean diet adherence with disease progression, quality of life and physical activity, sociodemographic and anthropometric parameters, and serum biomarkers in community-dwelling older adults with multiple sclerosis: a cross-sectional study. Aging Clin Exp Res 2024; 36:73. [PMID: 38492093 PMCID: PMC10944396 DOI: 10.1007/s40520-024-02712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/23/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) constitutes a chronic inflammatory and degenerative demyelinating disease, which can progressively lead to a broad range of sensorimotor, cognitive, visual, and autonomic function symptoms, independently of patient' age. However, the clinical studies that examine the role of dietary patterns against disease progression and symptomatology remain extremely scarce, especially concerning Mediterranean diet (MD) in the subgroup age of older adults with MS. AIMS The present study aimed to investigate the potential impact of MD compliance in disease progression and symptoms severity as well as quality of life and physical activity of community-dwelling older adults with MS. METHODS This is a cross-sectional conducted on 227 older adults with no history of other severe disease. Relevant questionnaires were applied to collect sociodemographic and anthropometric factors by face-to face interviews between patients and qualified personnel. Serum biomarkers were retrieved by patients' medical records. RESULTS Higher MD compliance was independently associated with younger patients' age, lower risk of overweight/obesity and abdominal obesity, decreased disease progression and higher muscle mass, as well as greater physical activity, better quality of life, and adequate serum ferritin and albumin levels CONCLUSIONS: MD may exert beneficial effects in older adults with MS. Future strategies and policies are highly recommended to inform both the general population and the older patients with MS for the beneficial effects of MD in preventing MS and in improving or even slowing down the disease progression and symptoms severity of MS.
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Affiliation(s)
- Christina Tryfonos
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Maria Spanoudaki
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
- Clinical Dietetics and Nutritional Department, 424 General Military Hospital, Thessaloníki, Greece
| | - Maria Mentzelou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece
| | - Dimitrios Fotiou
- Department of Neurology, School of Medicine, Aristoteleio University of Thessaloniki, Thessaloníki, Greece
| | - Eleni Pavlidou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece
| | - Georgios Gkouvas
- Clinical Dietetics and Nutritional Department, 424 General Military Hospital, Thessaloníki, Greece
| | - Theofanis Vorvolakos
- Department of Geriatric Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Alexia Bisbinas
- University General Hospital of Thessaloniki AHEPA, Thessaloníki, Greece
| | - Olga Alexatou
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400, Lemnos, Myrina, Greece.
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Pastore MC, Vannuccini F, Mandoli GE, Lisi M, Iuliano MA, Santoro A, Niglio FP, Diviggiano EE, Lorenz V, Montesi G, Cavigli L, Focardi M, D'Ascenzi F, Cameli M. Myocardial work and left heart deformation parameters across primary mitral regurgitation severity. Int J Cardiol 2024; 399:131772. [PMID: 38211675 DOI: 10.1016/j.ijcard.2024.131772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/22/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
AIMS Myocardial work (MW) estimation by pressure-strain loops using speckle tracking echocardiography (STE) has shown to evaluate left ventricular (LV) contraction overcoming the load-dependency limit of LV global longitudinal strain (GLS). This has proved useful in hemodynamic variation settings e.g. heart failure and valvular heart disease. However, the variation of MW and strain parameters across different stages of primary mitral regurgitation (MR) and its impact on symptoms, which was the aim of our study, has never been investigated. METHODS AND RESULTS Consecutive patients with mild, moderate and severe MR were prospectively enrolled. Exclusion criteria were: chronic atrial fibrillation, valvular heart prosthesis, previous cardiac surgery. Clinical evaluation, blood sample tests, ECG and echocardiography with STE and MW measurement were performed. Patients were then divided into groups according to MR severity. Differences among the groups and predictors of symptoms (as NYHA class≥2) were explored as study endpoints. Overall, 180 patients were enrolled (60 mild,60 moderate,60 severe MR). LV GLS and global peak atrial longitudinal strain (PALS) reduced according to MR severity. Global constructive work (GCW) and global wasted work (GWW) significantly improved, while global work efficiency (GWE) reduced, in patients with moderate and severe MR. Among echocardiographic parameters, global PALS emerged as the best predictor of NYHA class (p < 0.001;area under curve,AUC = 0.7). CONCLUSIONS MW parameters accurately describe the pathophysiology of MR, with initial attempt of LV increased contractility to compensate volume overload parallel to the disease progress, although with low efficacy, while global PALS is the most associated with the burden of MR symptoms.
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Affiliation(s)
- Maria Concetta Pastore
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy.
| | - Francesca Vannuccini
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Giulia Elena Mandoli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Matteo Lisi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Maria Alma Iuliano
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Alfonso Santoro
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Francesco Paolo Niglio
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Enrico Emilio Diviggiano
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Veronica Lorenz
- Division of Cardio-Thoracic Surgery, Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Gianfranco Montesi
- Division of Cardio-Thoracic Surgery, Department of Medical Biotechnologies, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Luna Cavigli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Marta Focardi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Flavio D'Ascenzi
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | - Matteo Cameli
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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Foxon F, Shiffman S. Methodological considerations when assessing symptoms of nicotine dependence by cigarette and e-cigarette use behavior and brand. Drug Alcohol Depend 2024:111255. [PMID: 38503599 DOI: 10.1016/j.drugalcdep.2024.111255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/26/2024] [Indexed: 03/21/2024]
Abstract
Letter to the Editor re: Adjei et al., 2024. Symptoms of nicotine dependence by e-cigarette and cigarette use behavior and brand: A population-based, nationally representative cross-sectional study. Drug and Alcohol Dependence 255, 111059 concerning issues of context, citations, non-psychometrically validated dependence items, and disclosure transparency.
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Ookeditse O, Ookeditse KK, Motswakadikgwa TR, Masilo G, Bogatsu Y, Lekobe BC, Mosepele M, Schirmer H, Johnsen SH. Age and healthy lifestyle behavior's disparities and similarities on knowledge of myocardial infarction symptoms and risk factors among public and outpatients in a resource-limited setting, cross-sectional study in greater Gaborone, Botswana. BMC Cardiovasc Disord 2024; 24:140. [PMID: 38439021 PMCID: PMC10910839 DOI: 10.1186/s12872-024-03792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors. METHOD Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n = 525) and the public (n = 2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities). RESULTS The valid response rate was 97.9% comprising 97.8% for the public (n = 2199) and 98.1% for outpatients (n = 515). Public respondents (35.2 ± 12.3 years) were younger than outpatients (38.5 ± 12.6 years). The public comprised 56.9% females while outpatients 54.6%. In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores ± SD of 3.49 ± 2.84 vs 2.80 ± 2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33 ± 3.22 vs 3.82 ± 3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35-49 years. Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours. CONCLUSION Results call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior.
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Affiliation(s)
- Ookeditse Ookeditse
- Department of Physical Medicine and Rehabilitation, Trust Hospital in Vestfold, Kysthospitalet, Division of Neurorehabilitation Medicine, Tønsberg, Norway
- Department of Family Medicine, Larvik County Acute and Emergency Clinic, Larvik, Norway
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | | | - Gosiame Masilo
- Department of Family Medicine, Larvik County Acute and Emergency Clinic, Larvik, Norway
- Division of Family Medicine, Nanset Medical Clinic, Larvik, Norway
| | - Yaone Bogatsu
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Baleufi C Lekobe
- Department of Internal Medicine, Sidilega Private Hospital, Gaborone, Botswana
| | - Mosepele Mosepele
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Princess Marina Referral Hospital, Gaborone, Botswana
| | - Henrik Schirmer
- UIT The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stein H Johnsen
- UIT The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway.
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.
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Andersen L, Baker KM, Difilippo H, Meghani SH, Porter D, Deng J. The Patient Symptom Experience After Tisagenlecleucel and Lisocabtagene Maraleucel CAR T-Cell Therapy for Lymphoma. Semin Oncol Nurs 2024:151614. [PMID: 38443220 DOI: 10.1016/j.soncn.2024.151614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/21/2024] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Chimeric Antigen Receptor (CAR) T-cell treatment is associated with several unique toxicities, and the short-term symptom trajectory in the immediately after therapy is well-documented. However, little is known about patients' long-term symptom experience. The study aimed to elicit the symptom experience of adult patients in remission after CAR T-cell therapy for B cell lymphoma. DATA SOURCES A qualitative descriptive design with thematic analysis was utilized. Recruitment occurred at a tertiary academic medical center using the following inclusion criteria: adult recipient of CAR T-cell therapy for B-cell lymphoma between 3 and 12 months prior to enrollment, and currently in remission. Semi-structured interviews were conducted, transcripts were inductively coded, and team members met weekly to ensure rigor. The final sample included 10 patients: Seven received tisagenlecleucel and three received lisocabtagene marleucel and were a median of 169 days post-infusion and 65 years of age. CONCLUSIONS Participants continued to report symptoms, including fatigue, neuropathy, low endurance, insomnia, memory problems, and pain. Most symptoms improved over time. Some symptoms interfered with social activities, work, driving, and physical activity, though participants reported that most symptoms existed prior to CAR T-cell therapy, and overall, found CAR T-cell therapy acceptable. IMPLICATIONS FOR NURSING PRACTICE Patients in remission after CAR T-cell therapy often continue to experience symptoms. Nurses should continue to assess this growing patient population and determine if patients require additional symptom management or support. Further research is needed to understand long-term symptom trajectory and associations with prior lines of therapy and CAR T-cell therapy.
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Affiliation(s)
- Lucy Andersen
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA.
| | - Kayla M Baker
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
| | - Heather Difilippo
- Cell Therapy and Transplant Program, Abramson Cancer Center at the University of Pennsylvania, and Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA
| | - Salimah H Meghani
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
| | - David Porter
- Cell Therapy and Transplant Program, Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA
| | - Jie Deng
- Department of Biobehavioral Health Sciences, School of Nursing, The University of Pennsylvania, Philadelphia, PA
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Zader JA, Jörres RA, Mayer I, Alter P, Bals R, Watz H, Mertsch P, Rabe KF, Herth F, Trudzinski FC, Welte T, Kauczor HU, Behr J, Walter J, Vogelmeier CF, Kahnert K. Effects of triple therapy on disease burden in patients of GOLD groups C and D: results from the observational COPD cohort COSYCONET. BMC Pulm Med 2024; 24:103. [PMID: 38424530 PMCID: PMC10905841 DOI: 10.1186/s12890-024-02902-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Randomized controlled trials described beneficial effects of inhaled triple therapy (LABA/LAMA/ICS) in patients with chronic obstructive pulmonary disease (COPD) and high risk of exacerbations. We studied whether such effects were also detectable under continuous treatment in a retrospective observational setting. METHODS Data from baseline and 18-month follow-up of the COPD cohort COSYCONET were used, including patients categorized as GOLD groups C/D at both visits (n = 258). Therapy groups were defined as triple therapy at both visits (triple always, TA) versus its complement (triple not always, TNA). Comparisons were performed via multiple regression analysis, propensity score matching and inverse probability weighting to adjust for differences between groups. For this purpose, variables were divided into predictors of therapy and outcomes. RESULTS In total, 258 patients were eligible (TA: n = 162, TNA: n = 96). Without adjustments, TA patients showed significant (p < 0.05) impairments regarding lung function, quality of life and symptom burden. After adjustments, most differences in outcomes were no more significant. Total direct health care costs were reduced but still elevated, with inpatient costs much reduced, while costs of total and respiratory medication only slightly changed. CONCLUSION Without statistical adjustment, patients with triple therapy showed multiple impairments as well as elevated treatment costs. After adjusting for differences between treatment groups, differences were reduced. These findings are compatible with beneficial effects of triple therapy under continuous, long-term treatment, but also demonstrate the limitations encountered in the comparison of controlled intervention studies with observational studies in patients with severe COPD using different types of devices and compounds.
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Affiliation(s)
- Jennifer A Zader
- Berlin School of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Rudolf A Jörres
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Comprehensive Pneumology Center Munich (CPC-M), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Imke Mayer
- Institute of Public Health, Charité Universitätsmedizin Berlin, Berlin, Germany
- PreMeDICaL, Inria Montpellier, IDESP, Montpellier, France
| | - Peter Alter
- Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Marburg, Germany
| | - Robert Bals
- Department of Internal Medicine V - Pulmonology, Allergology, Respiratory Intensive Care Medicine, Saarland University Hospital, Kirrberger Straße 1, 66424, Homburg, Germany
- Helmholtz Centre for Infection Research (HZI), Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Saarland University Campus, 66123, Saarbrücken, Germany
| | - Henrik Watz
- Member of the German Center for Lung Research, Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Woehrendamm 80, 22927, Grosshansdorf, Germany
| | - Pontus Mertsch
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany
| | - Klaus F Rabe
- Member of the German Center for Lung Research, Pulmonary Research Institute at Lung Clinic Grosshansdorf, Airway Research Center North, Woehrendamm 80, 22927, Grosshansdorf, Germany
- Faculty of Medicine, Christian-Albrechts-Universität Zu Kiel, 24098, Kiel, Germany
| | - Felix Herth
- Thoraxklinik-Heidelberg gGmbH, Röntgenstraße 1, 69126, Heidelberg, Germany
- Member of the German Center for Lung Research, Translational Lung Research Centre Heidelberg (TLRC), Heidelberg, Germany
| | - Franziska C Trudzinski
- Thoraxklinik-Heidelberg gGmbH, Röntgenstraße 1, 69126, Heidelberg, Germany
- Member of the German Center for Lung Research, Translational Lung Research Centre Heidelberg (TLRC), Heidelberg, Germany
| | - Tobias Welte
- Department of Pneumology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic & Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jürgen Behr
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany
| | - Julia Walter
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany
| | - Claus F Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, German Center for Lung Research (DZL), University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany, Marburg, Germany
| | - Kathrin Kahnert
- Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.
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Cavallazzi R, Ramirez JA. Influenza and Viral Pneumonia. Infect Dis Clin North Am 2024; 38:183-212. [PMID: 38280763 DOI: 10.1016/j.idc.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
Influenza and other respiratory viruses are commonly identified in patients with community-acquired pneumonia, hospital-acquired pneumonia, and in immunocompromised patients with pneumonia. Clinically, it is difficult to differentiate viral from bacterial pneumonia. Similarly, the radiological findings of viral infection are in general nonspecific. The advent of polymerase chain reaction testing has enormously facilitated the identification of respiratory viruses, which has important implications for infection control measures and treatment. Currently, treatment options for patients with viral infection are limited but there is ongoing research on the development and clinical testing of new treatment regimens and strategies.
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Affiliation(s)
- Rodrigo Cavallazzi
- Division of Pulmonary, Critical Care, and Sleep Disorders, University of Louisville, Louisville, KY, USA.
| | - Julio A Ramirez
- Norton Infectious Diseases Institute, Norton Healthcare, Louisville, KY, USA
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Vayne-Bossert P. Hypnosis for Symptom Management in Adult Cancer Patients: What is the Evidence? Curr Treat Options Oncol 2024; 25:364-375. [PMID: 38236333 PMCID: PMC10894763 DOI: 10.1007/s11864-023-01168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
OPINION STATEMENT As a palliative care specialist and a hypnotherapist, I use therapeutic communication and conversational hypnosis daily in my patient - doctor relationship. Formal hypnotherapy sessions are integrated in my practice whenever patients are open or wish for such an approach in relation to a specific symptom, for better overall management of their disease burden and/or enhanced well-being. Although hypnosis has been used for centuries in medical practice and for thousands of years in healing practices in ancient cultures all over the world, the evidence remains scarce. Nevertheless, in the last 10 years several randomised controlled trials have been conducted, building up an evidence base. In contrast to most oncological treatments, hypnotherapy is far from being considered evidence-based "standard care". It is however, if practiced by a trained health care professional, almost free of side effects and therefore potentially has a very favourable benefit-to-harm ratio. The question arises whether hypnotherapy will ever become a standard of care intervention? This seems unlikely since its efficacy may be influenced by the patient's belief in hypnosis and compliance to therapy. Furthermore, a fundamental necessity is a personalised approach that moves hypnotherapy more into the category of individual-centred care rather than standard care.
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Affiliation(s)
- Petra Vayne-Bossert
- Geneva University Hospitals, Hôpital de Bellerive, 11 Chemin de La Savonnière, 1245, Collonge-Bellerive, Switzerland.
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Taira N, Kikawa Y, Iwamoto T, Miyoshi Y, Hara K, Yoshitomi S, Hikino H, Takahashi H, Takabatake D, Kubo S, Ikeda M, Doihara H, Shien T, Okuyama H, Tanabe Y, Hara F, Yamanouchi K, Hagiwara Y, Sawaki M. Pilot trial of an electronic patient-reported outcome monitoring system in patients with metastatic breast cancer undergoing chemotherapy. Breast Cancer 2024; 31:283-294. [PMID: 38175422 DOI: 10.1007/s12282-023-01537-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Electronic patient-reported outcomes monitoring (ePROM) is a useful communication tool for patients and healthcare providers in cancer chemotherapy. In this study, we examined the feasibility of our newly developed ePROM system, which we refer to as "Hibilog". METHODS An ePROM app was developed by extracting 18 items from the Patient-Reported Outcome-Common Terminology Criteria for Adverse Events (PRO-CTCAE). Symptom monitoring was conducted every two weeks for patients with metastatic breast cancer undergoing chemotherapy. The primary outcome was the response rate to the ePROM system. The secondary outcomes were response time, item missing rate, and distribution of responses for each symptom. RESULTS A total of 71 cases (mean age 52.6 years) were analyzed. Performance status was 0 in 76% of the cases and 1 or higher in 24%. First-line treatment was being administered in 30% of cases, second-line treatment in 17%, and third-line or higher treatment in 53%. The response rate to the ePROM system from registration to week 40 remained high at around 80%, indicating good compliance. The average response time was 5.5 min and the missing rate for each item was below 0.4%. Among 1,093 responses, the top 3 symptoms causing interference with daily life were Fatigue (63%), Numbness and tingling (48%), and General pain (46%). CONCLUSION Our developed ePROM system was able to capture symptoms accurately in patients with metastatic breast cancer undergoing chemotherapy while maintaining a high response compliance.
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Affiliation(s)
- Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan.
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
| | - Yuichiro Kikawa
- Department of Breast Surgery, Kansai Medical University Hospital, Osaka, Japan
| | - Takayuki Iwamoto
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Yuichiro Miyoshi
- Department of Breast and Endocrine Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - Kyoko Hara
- Department of Breast and Endocrine Surgery, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Seiji Yoshitomi
- Department of Breast and Endocrine Surgery, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Hajime Hikino
- Department of Breast Surgery, Japanese Red Cross Matsue Hospital, Matsue, Japan
| | - Hirotoshi Takahashi
- Department of Breast and Endocrine Surgery, National Hospital Organization Fukuyama Medical Centre, Fukuyama, Japan
| | - Daisuke Takabatake
- Department of Breast Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shinichiro Kubo
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Masahiko Ikeda
- Department of Breast and Thyroid Surgery, Fukuyama City Hospital, Fukuyama, Japan
| | - Hiroyoshi Doihara
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
- Department of Surgery, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Hiromi Okuyama
- Advanced Cancer Translational Research Institute, Showa University, Tokyo, Japan
| | - Yuko Tanabe
- Department of Clinical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Fumikata Hara
- Department of Breast Medical Oncology, Japanese Foundation for Cancer Research Cancer Institute Hospital, Tokyo, Japan
| | - Kosho Yamanouchi
- Department of Breast and Endocrine Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Han CJ, Rosko AE, Spakowicz DJ, Hammer MJ, Von Ah D. Associations of frailty with symptoms, and HRQOL in older cancer survivors after cancer treatments: a systematic review and meta-analyses. Qual Life Res 2024; 33:583-598. [PMID: 37897643 DOI: 10.1007/s11136-023-03537-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Frailty in older adult cancer survivors after cancer treatments is associated with various health outcomes. However, there is less agreement on how frailty affects symptoms and health-related quality of life (HRQOL). This systematic review and meta-analysis aimed to evaluate the current literature on frailty, symptoms, and HRQOL, as well as the associations of frailty with these factors in older adult cancer survivors with chemotherapy. METHODS A review was conducted on peer-reviewed publications from 2008 to 2023, using seven electronic databases. Meta-analyses were performed using random effects models to determine pooled effect estimates for frailty prevalence, symptom severity, and HRQOL scores. RESULTS A total of 26 studies involving older cancer survivors were included in the analysis. Most of these studies were conducted in Western countries and focused on White survivors, particularly those with breast cancer. The mean pooled prevalence of frailty was 43.5%. Among frail survivors, the most common symptoms reported after cancer treatments were pain (36.4%), neuropathy (34.1%), and fatigue (21.3%). Frailty was associated with higher pooled mean symptom severity (B = 1.23, p = 0.046) and lower functional HRQOL (B = - 0.31, p = 0.051, with marginal significance) after cancer treatments. CONCLUSION Frail older cancer survivors are at high risk of adverse symptoms and poor HRQOL after cancer treatment. Further research on screening for frailty is needed to prevent older adults from developing worse symptoms burden and maintain HRQOL. It is also essential to understand the mechanisms of the associations between frailty, symptoms and HRQOL in this population.
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Affiliation(s)
- Claire J Han
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA.
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA.
| | - Ashley E Rosko
- Division of Hematology, The Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Daniel J Spakowicz
- Division of Medical Oncology, Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Marilyn J Hammer
- Dana-Farber Cancer Institute, and Member of the Faculty, Medical Oncology Harvard Medical School, Boston, MA, USA
| | - Diane Von Ah
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
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King L, Mahmoudian A, Waugh E, Stanaitis I, Gomes M, Hung V, MacKay C, Liew J, Wang Q, Turkiewicz A, Haugen I, Appleton C, Lohmander S, Englund M, Runhaar J, Neogi T, Hawker G. "You don't put it down to arthritis": A qualitative study of the first symptoms recalled by individuals with knee osteoarthritis. Osteoarthr Cartil Open 2024; 6:100428. [PMID: 38229918 PMCID: PMC10790080 DOI: 10.1016/j.ocarto.2023.100428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 01/18/2024] Open
Abstract
Objective As part of the first phase of the OARSI Early-stage Symptomatic Knee Osteoarthritis (EsSKOA) initiative, we explored the first symptoms and experiences recalled by individuals with knee osteoarthritis (OA). Design This qualitative study, informed by qualitative description, was a secondary analysis of focus groups (n = 17 groups) and one-on-one interviews (n = 3) conducted in 91 individuals living with knee OA as part of an international study to better understand the OA pain experience. In each focus group or interview, participants were asked to describe their first symptoms of knee OA. We inductively coded these transcripts and conducted thematic analysis. Results Mean age of participants was 70 years (range 47-92) and 68 % were female. We developed four overarching themes: Insidious and Episodic Onset, Diverse Early Symptoms, Must be Something Else, and Adjustments. Participants described the gradual and intermittent way in which symptoms of knee OA developed over many years; many could not identify a specific starting point. Participants described diverse initial knee symptoms, including activity-exacerbated joint pain, stiffness and crepitus. Most participants dismissed early symptoms or rationalized their presence, employing various strategies to enable continued participation in recreational and daily activities. Few sought medical attention until physical functioning was demonstrably impacted. Conclusions The earliest symptoms of knee OA are frequently insidious in onset, episodic and present long before individuals present to health professionals. These results highlight challenges to identifying people with knee OA early and support the development of specific classification criteria for EsSKOA to capture individuals at an early stage.
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Affiliation(s)
- L.K. King
- St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
| | - A. Mahmoudian
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
- Department of Movement Sciences and Health, University of West Florida, FL, USA
| | - E.J. Waugh
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - I. Stanaitis
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - M. Gomes
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - V. Hung
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - C. MacKay
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- West Park Healthcare Centre, Toronto, Canada and Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - J.W. Liew
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Q. Wang
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, China
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A. Turkiewicz
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - I.K. Haugen
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - C.T. Appleton
- Department of Medicine and Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
- Western Bone and Joint Institute, London, Canada
| | - S. Lohmander
- Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
| | - M. Englund
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
| | - J. Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - T. Neogi
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - G.A. Hawker
- Department of Medicine, University of Toronto, Toronto, Canada
| | - OARSI Early-stage Symptomatic Knee Osteoarthritis Initiative
- St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
- Department of Movement Sciences and Health, University of West Florida, FL, USA
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Canada
- West Park Healthcare Centre, Toronto, Canada and Department of Physical Therapy, University of Toronto, Toronto, Canada
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Orthopedics, Shanghai Sixth People's Hospital, Shanghai, China
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, the Netherlands
- Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Department of Medicine and Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
- Western Bone and Joint Institute, London, Canada
- Department of Clinical Sciences Lund, Orthopedics, Lund University, Lund, Sweden
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Judson MA. Health-Related Quality of Life Assessment in Sarcoidosis. Clin Chest Med 2024; 45:159-173. [PMID: 38245364 DOI: 10.1016/j.ccm.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Health-related quality of life (HRQoL) is of major concern to patients with sarcoidosis. HRQoL impairment is the most common reason to treat the disease. Advances in patient-reported outcome (PRO) methodology offer the promise to use these instruments to follow quality of life in individual patients with sarcoidosis over time. Several HRQoL issues will be highlighted including their clinical importance, common causes in patients with sarcoidosis, the construction and use of PROs in clinical sarcoidosis trials, methods to adapt PROs to monitor HRQoL in individual patients with sarcoidosis, and the approach to improving HRQoL in this disease.
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Affiliation(s)
- Marc A Judson
- Division of Pulmonary and Critical Care Medicine, Albany Medical Center, 16 New Scotland Avenue, MC-91 Division Pulm-CCM, Albany, NY 12208, USA.
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Cieza Rivera AM, Lobato Fuertes C, Fernández-Villa T, Martín Sánchez V, Atallah I. Impact of neurofibromatosis type 1 on quality of life using the Skindex-29 questionnaire quality of life in NF1. Orphanet J Rare Dis 2024; 19:85. [PMID: 38402381 PMCID: PMC10893671 DOI: 10.1186/s13023-024-03078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/05/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is one of the most common RASopathies predisposing affected patients to melanic lesions and benign tumors. NF1 is associated with considerable esthetic and functional burden negatively affecting the patient's quality of life (QoL). This study aims to assess the clinical features of NF1 patients and evaluate their impact on QoL. We identified NF1 patients from a public health database of a region in Spain. All patients underwent clinical and ophthalmological evaluation for NF1 features. We measured QoL using the Spanish version of the Skindex-29. RESULTS Forty patients fulfilled the NF1 National Institute of Health criteria when we recruited patients. The median age was 42.00 years (IQR 26.5 -53.75). The median total Skindex-29 score was 12.3 (IQR 5.9-22.4); (emotion: 15.0, IQR 5.0-37.5; symptoms 8.9, IQR 0.0-17.9 and functioning 8.3; IQR 0.5-18.3). Women and NF1 patients with lower educational levels were associated with poorer QoL scores. We identified itching and sleep troubles to influence NF1 patients' QoL negatively. CONCLUSION NF1 considerably influences the psychological well-being of NF1 patients. We observed that female and low-educated patients scored higher on the emotional dimension of the Skindex-29 and could, therefore, be more at risk of depression. We also pointed out some "minor symptoms" that negatively impact NF1 patients' QoL such, as itching and sleep troubles which doctors could treat if sought by doctors.
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Affiliation(s)
- Ana M Cieza Rivera
- Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
| | | | - Tania Fernández-Villa
- Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
- Research Group in interactions gene- environmental and health (GIIGAS), Institute of Biomedicine, University of León, León, Spain
- Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain
| | - Vicente Martín Sánchez
- Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain
- Research Group in interactions gene- environmental and health (GIIGAS), Institute of Biomedicine, University of León, León, Spain
- Epidemiology and Public Health Networking Biomedical Research Centre (CIBERESP), Madrid, Spain
| | - Isis Atallah
- Faculty of Health Sciences, Department of Biomedical Sciences, Area of Preventive Medicine and Public Health, Universidad de León, León, Spain.
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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50
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Williams V, DeMuro Romano C, Finelli L, Qin S, Saretsky TL, Ma J, Lewis S, Phillips M, Osborne RH, Norquist JM. Psychometric evaluation of the respiratory syncytial virus infection, intensity and impact questionnaire (RSV-iiiQ) in adults. Health Qual Life Outcomes 2024; 22:19. [PMID: 38378572 PMCID: PMC10880342 DOI: 10.1186/s12955-023-02174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/25/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Despite a number of respiratory syncytial virus (RSV) vaccine candidates being tested in clinical trials, disease-specific, self-reported instruments assessing symptom severity of RSV infection from the perspective of adult patients are still needed. The RSV Infection, Intensity and Impact Questionnaire (RSV-iiiQ) was adapted from the Influenza Intensity and Impact Questionnaire (FluiiQ™). This study evaluated some measurement properties of the RSV-iiiQ. METHODS Data were collected in a web-based survey over two consecutive days. Participants completed the RSV-iiiQ, the Patient Global Impression of Severity, Sheehan Disability Scale, Patient Global Impression of Change, EQ-5D-5L, and a demographic questionnaire. Test-retest reliability, internal consistency, construct validity, and responsiveness of the RSV-iiiQ scales were assessed. RESULTS 111 adults with RSV were enrolled and self-reported a variety of symptoms across the range of disease severity via a web-based platform. The RSV-iiiQ scales demonstrated satisfactory test-retest reliability, construct validity, and discriminating ability. One-factor confirmatory factor analyses confirmed that each of the four scales was sufficiently unidimensional, and internal consistencies indicated that the computation of RSV-iiiQ scale scores was plausible. Correlation-based analyses provided support for the construct validity of the RSV-iiiQ scores, and known groups analyses supported discriminating ability. Estimates of responsiveness of the scale scores were also satisfactory. CONCLUSIONS RSV infection is highly symptomatic and causes significant disease burden, and self-report instruments assessing symptom severity and impact are important for evaluation of new treatments. This study describes the preliminary psychometric properties of the RSV-iiiQ and indicates this tool may be useful for the assessment of the severity of symptoms and impact of acute RSV infection in adults. The findings also indicated two items, Runny nose and Ear pain, may be unnecessary and should be revisited using item response theory analysis with a larger sample size.
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Affiliation(s)
- Valerie Williams
- RTI Health Solutions, Box 12194, 3040 East Cornwallis Road Post Office, Research Triangle Park, NC, 27709-2194, USA.
| | - Carla DeMuro Romano
- RTI Health Solutions, Box 12194, 3040 East Cornwallis Road Post Office, Research Triangle Park, NC, 27709-2194, USA
| | | | - Shanshan Qin
- RTI Health Solutions, Box 12194, 3040 East Cornwallis Road Post Office, Research Triangle Park, NC, 27709-2194, USA
| | | | - Jia Ma
- RTI Health Solutions, Box 12194, 3040 East Cornwallis Road Post Office, Research Triangle Park, NC, 27709-2194, USA
| | - Sandy Lewis
- RTI Health Solutions, Box 12194, 3040 East Cornwallis Road Post Office, Research Triangle Park, NC, 27709-2194, USA
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