Luojia Score: A New Quantitative Option for Evaluating Precise Colonic Transit and Symptom Severity of Constipation

2020 ◽  
Author(s):  
Kongliang Sun ◽  
Qun Qian ◽  
Jinxiang Hu ◽  
Weicheng Liu ◽  
Yuntian Hong ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Colonic Transit

scholarly journals A novel quantitative method via the degree of transverse colon ptosis for chronic constipation assessment

2020 ◽  
Author(s):  
Kongliang Sun ◽  
Qun Qian ◽  
Jinxiang Hu ◽  
Weicheng Liu ◽  
Yuntian Hong ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Splenic Flexure ◽  
Transverse Colon ◽  
Retrospective Cohort ◽  
Obstructed Defecation ◽  
Colonic Transit ◽  
Slow Transit Constipation ◽  
X Ray ◽  
Slow Transit ◽  
Transit Constipation

ABSTRACTBACKGROUNDAssessment of colonic transit tend to be more subjective and qualitative. This study aimed to evaluate the capability of our new quantitative scale to predict the subtypes of constipation and assess symptom severity of patients with slow transit constipation.METHODSA retrospective cohort population was assembled, consisting of adult patients with chronic constipation who underwent both colonic transit test and defecography between 2012 and 2019. Radiological parameters were measured on AXRs. The Luojia score was introduced to convey the vertical distance from the splenic flexure to the lowest point of the transverse colon, representing the degree of transverse colon ptosis. Patients with slow transit constipation only were especially required to complete the Wexner Constipation Scale (WCS) and Hospital Anxiety and Depression Scale (HADS) for clinical severity assessment.FINDINGSOf 368 patients, 191 patients (51·9%) showed slow colonic transit, and patients with slow colonic transit were more likely to have severe ptosis of the transverse colon on AXRs. Patients with slow colonic transit had a significantly higher Luojia score than those with normal colonic transit (p˂0·001). A cut-off of 195 mm was used to distinguish slow colonic transit. A significant difference in Luojia score was also found between patients with obstructed defecation syndrome and normal patients, and a cut-off of 140 mm was identified. In patients with slow transit constipation, there was a strong correlation between Luojia score and WCS (r=0·618) and a moderate correlation between Luojia score and HADS-Anxiety (r=0·507). These results indicated that the Luojia score is a reliable predictor of symptom severity and psychological condition in patients with slow transit constipation.INTERPRETATIONThe Luojia score might be a new quantitative, precise method in the assessment of constipation.FUNDINGThe National Natural Science Foundation of China and the Clinical Research Special Fund of Wu Jieping Medical Foundation.Research in contextEvidence before this studyWe searched PubMed for papers published between Feb 1, 2000, and Jan 1, 2019, with the keywords “transverse colonic ptosis” OR “abdominal x-ray” AND “constipation” OR “colonic transit”. No restrictions on study type or language were implemented. Our search retrieved studies on the use of stool burden score on AXR in the assessment of constipation but no studies to use transverse colonic ptosis to evaluate colonic transit.Added value of this studyWe established a Luojia score which was defined as the vertical distance from the splenic flexure to the lowest point of transverse colon on the abdominal x-ray (AXR) that representing the degree of transverse colon ptosis. A retrospective cohort study of 368 patients proved that Luojia score has high sensitivity and specificity in distinguishing slow colonic transit and normal colonic transit as well as obstructed defecation syndrome and normal group. We were satisfied to found that in patients with slow transit constipation, there was a strong correlation between Luojia score and WCS (r=0·618) and a mediate correlation between Luojia score and HADS-A (r=0·507).Implications of all the available evidencePrecise assessment and evaluation of colonic transit play an important role in clinical diagnosis and treatment of constipation patients. Our result proved that Luojia Score is a simple and effective assessment system of certain clinic value in in identifying patients with constipation and is a potential predictor of symptom severity.

Hormone Replacement Therapy and Voice

2019 ◽  
Vol 4 (4) ◽  
pp. 607-614
Author(s):  
Jean Abitbol
Keyword(s):  
Replacement Therapy ◽  
Symptom Severity ◽  
Low Dose ◽  
Hormone Replacement ◽  
Clinical Signs ◽  
Female Voice ◽  
Fat Cells ◽  
High Pitch ◽  
Endocrine Effects ◽  
The Voice

The purpose of this article is to update the management of the treatment of the female voice at perimenopause and menopause. Voice and hormones—these are 2 words that clash, meet, and harmonize. If we are to solve this inquiry, we shall inevitably have to understand the hormones, their impact, and the scars of time. The endocrine effects on laryngeal structures are numerous: The actions of estrogens and progesterone produce modification of glandular secretions. Low dose of androgens are secreted principally by the adrenal cortex, but they are also secreted by the ovaries. Their effect may increase the low pitch and decease the high pitch of the voice at menopause due to important diminution of estrogens and the privation of progesterone. The menopausal voice syndrome presents clinical signs, which we will describe. I consider menopausal patients to fit into 2 broad types: the “Modigliani” types, rather thin and slender with little adipose tissue, and the “Rubens” types, with a rounded figure with more fat cells. Androgen derivatives are transformed to estrogens in fat cells. Hormonal replacement therapy should be carefully considered in the context of premenopausal symptom severity as alternative medicine. Hippocrates: “Your diet is your first medicine.”

The association between daily PTSD symptom severity and alcohol-related outcomes in recent traumatic injury victims.

2017 ◽  
Vol 31 (3) ◽  
pp. 326-335 ◽  
Author(s):  
Bryce Hruska ◽  
Maria L. Pacella ◽  
Richard L. George ◽  
Douglas L. Delahanty
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Traumatic Injury ◽  
Ptsd Symptom Severity

Risk for psychotherapy drop-out in survival analysis: The influence of general change mechanisms and symptom severity.

2020 ◽  
Vol 67 (6) ◽  
pp. 712-722
Author(s):  
Sebastian Gmeinwieser ◽  
Kai Sebastian Schneider ◽  
Maximilian Bardo ◽  
Timo Brockmeyer ◽  
York Hagmayer
Keyword(s):  
Survival Analysis ◽  
Symptom Severity ◽  
Drop Out ◽  
General Change ◽  
Change Mechanisms

Anxiety Sensitivity and PTSD Symptom Severity Following the NIU Shootings on February 14, 2008

2008 ◽  
Author(s):  
Katherine Stephenson ◽  
David Valentiner ◽  
Holly Orcutt ◽  
Mandy Rabenhorst ◽  
Leslie Matuszewich
Keyword(s):  
Anxiety Sensitivity ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Ptsd Symptom Severity

The Novelty P300 as an Index of Symptom Severity in Trauma Survivors

2008 ◽  
Author(s):  
Matthew Kimble ◽  
Molly Bowman ◽  
Yanik Bababekov ◽  
Libby Marks
Keyword(s):  
Symptom Severity ◽  
Trauma Survivors

Effects of PTSD Symptom Severity on Attentional Tuning

2013 ◽  
Author(s):  
Ryan N. Reed ◽  
Jeffrey S. Simons ◽  
Raluca M. Gaher
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Ptsd Symptom Severity ◽  
Attentional Tuning
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