scholarly journals Tetra-ataxiometric Posturography in Patients with Migrainous Vertigo

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E87-E95
Author(s):  
Dr. Nedim Ongun
Keyword(s):  
Visual Information ◽  
Objective Assessment ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
High Frequencies ◽  
Migrainous Vertigo ◽  
Static Posturography ◽  
Vestibular Symptoms ◽  
Postural Abnormalities

Background: Migraine is a common disorder characterized by headache attacks frequently accompanied by vestibular symptoms like dizziness, vertigo, and balance disorders. Clinical studies support a strong link between migraine and vertigo rather than between other headache types and vertigo or nonvertiginous dizziness. There is a lack of consensus regarding the pathophysiology of migrainous vertigo. Activation of central vestibular processing during migraine attacks and vasospasm-induced ischemia of the labyrinth are reported as the probable responsible mechanisms. Because vestibular examination alone does not provide enough information for diagnosis of migrainous vertigo, posturography systems which provide objective assessment of somatosensory, vestibular, and visual information would be very helpful to show concomitant involvement of the vestibular and somato-sensorial systems. There are few posturographic studies on patients with migraine but it seems that how balance is affected in patients with migraine and/or migrainous vertigo is still not clear. We want to investigate balance function in migraineurs with and without vertigo with a tetra-ataxiometric posturography system and our study is the first study in which tetra-ataxiometric static posturography was used to evaluate postural abnormalities in a well-defined population of patients with migrainous vertigo. Objective: To investigate balance functions in migraineurs with and without vertigo with a tetra-ataxiometric posturography system. Study Design: Prospective, nonrandomized, controlled study. Setting: Pamukkale University Hospital, Neurology and Physical Therapy and Rehabilitation outpatient clinics. Methods: Sixteen patients with migrainous vertigo, 16 patients with migraine without aura and no vestibular symptoms, and 16 controls were included in the study. Computerized static posturography system was performed and statistical analyses of fall, Fourier, Stability, and Weight distribution indexes were performed. The tetra-ataxiometric posturography device measures vertical pressure fluctuations on 4 independent stable platforms, each placed beneath 2 heels and toe parts of the patient; inputs from these platforms are integrated and processed by a computer digitally. Four separate plates are used and perpendicular pressures of the anterior and posterior feet are measured. Pressure of each force plate is measured and data was analyzed by the software program. Limitations: A very small, non-randomized, and controlled study with the inability to find an answer to the mechanism of involvement of the somatosensorial system and vestibular system in migrainous headaches. Results: The distribution of patients with posturographical abnormalities in the migrainous vertigo group was significantly different than the control group. Distribution of the patients with posturographical abnormalities in the high frequencies of the head-right position was significantly different in the migrainous vertigo group than in the control group and distribution of the patients with posturographical abnormalities in high frequencies of the head-right position was significantly different in the migraine group than in the controls groups. The stability index of the migrainous vertigo group was significantly higher than in the control group when tested on in the neutral-head position with open eyes. Conclusion: In this first study of tetra-ataxiometric static posturography evaluating postural abnormalities in a well-defined population of patients with migrainous vertigo, the central part of the vestibular apparatus would be responsible of postural abnormalities in patients with migraine and migrainous vertigo. Key words: Fall index, migraine, migrainous vertigo, static posturography

scholarly journals Efficacy of an Objective Structured Clinical Examination Training Approach for Training Pharmacy Students in Diabetes Mellitus Counseling: A Randomized Controlled Trial

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 229
Author(s):  
Imaneh Farahani ◽  
Samieh Farahani ◽  
Maira A. Deters ◽  
Holger Schwender ◽  
Stephanie Laeer
Keyword(s):  
Diabetes Mellitus ◽  
Communication Skills ◽  
Controlled Trial ◽  
Objective Assessment ◽  
Intervention Group ◽  
Pharmacy Students ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Training Approach

Pharmacists’ tasks are multifaceted and include, for example, vital counseling and communication skills. Objective Structured Clinical Examinations (OSCEs) could be used to train pharmacy students in these skills. Our study sought to determine the efficacy of our OSCE training approach for training pharmacy students’ counseling and communication skills on diabetes mellitus compared to a control group. This randomized controlled study was conducted with pharmacy students using a pre-post-design. The intervention group completed diabetes OSCE training, while the control group solved diabetes patient cases using subjective, objective, assessment, and plan notes. Before and after the respective training, both groups completed OSCEs evaluating counseling and communication skills. Before each OSCE encounter, the participants completed a self-assessment questionnaire and, upon completion of the seminar, filled out a satisfaction survey. The OSCE-trained group demonstrated a significantly greater increase in counseling and communication skills and self-confidence than the control group. Both groups were generally satisfied with the seminar. These results demonstrate that our OSCE training approach allows for the effective training of pharmacy students’ diabetes counseling and communication skills and suggests the inclusion of such a skill-based approach more widely in pharmacy students’ education.

Verbal communication disorders in psychogenic dysphonia

2019 ◽  
Vol 73 (2) ◽  
pp. 1-5
Author(s):  
Bożena Kosztyła-Hojna ◽  
Diana Moskal-Jasińska ◽  
Anna Kraszewska ◽  
Anna Łobaczuk-Sitnik ◽  
Maciej Zdrojkowski ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Communication Disorders ◽  
Vocal Folds ◽  
Speech Quality ◽  
University Hospital ◽  
Mental Condition ◽  
Control Group ◽  
Self Assessment ◽  
Speech Prosody ◽  
Voice And Speech

Psychogenic dysphonia is defined as disturbances in voice and speech quality with emotional background with lack of organic changes in the larynx. Mental condition has significant impact on the process of producing voice, functioning of respiratory-phonatory-articulation mechanism and speech prosody. The aim of the study was visual, acoustic, perceptual assessment as well as self-assessment of voice and speech quality using subjective and objective methods in patients with psychogenic dysphonia. The study included 50 patients with psychogenic dysphonia diagnosed in the Department of Clinical Fonoaudiology and Logopedics, Medical University of Białystok and treated at the Foniatric Outpatient Clinic, University Hospital in Białystok in 2017 - 2018. The control group consisted of 30 subjects with euphonic voice. All patients underwent subjective and objective assessment of voice and speech quality. The GRBAS scale, breathing pathway assessment, respiratory-phonatory-articulation analysis, voice and speech intensity evaluation have been performed. Speech prosody has also been examined. Patient self-assessment of voice has been conducted using Voice Handicap Index (VHI). Objective evaluation of larynx included vibrations of vocal folds visualization using High Speed Digital Imaging (HSDI). Acoustic analysis of voice quality has been performed using DiagNova Technologies. The maximum phonation time (MPT) has been determined. Hyperfunctional dysphonia is the most common clinical form of psychogenic dysphonia. Abnormal breathing pathway influence the reduction of MPT and disturbance of respiratory-phonatory-articulation coordination in patients with psychogenic dysphonia. In psychogenic dysphonia intonation and speech rate disorders are observed. Results of voice self-assessment in the majority of examined patients indicates a mild voice disability.

Art therapy improves coping resources: A randomized, controlled study among women with breast cancer

2006 ◽  
Vol 4 (1) ◽  
pp. 57-64 ◽  
Author(s):  
INGER ÖSTER ◽  
ANN-CHRISTINE SVENSK ◽  
EVA MAGNUSSON ◽  
KARIN EGBERG THYME ◽  
MARIE SJÕDIN ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Art Therapy ◽  
Primary Breast Cancer ◽  
Intervention Program ◽  
Postoperative Radiotherapy ◽  
Coping Resources ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
Therapy Intervention

Objective: Women with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer.Method: In this article, we report some of the results from a study including 41 women, aged 37–69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99–386).Results: There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion.Significance of results: This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.

scholarly journals Anosmia in SARS-CoV-2 Patients: a Retrospective Study

2021 ◽  
Author(s):  
ChenHui Yee ◽  
Matthew Koh ◽  
Paul Anantharajah Tambyah ◽  
David Allen ◽  
Jyoti Somani ◽  
...  
Keyword(s):  
Objective Assessment ◽  
University Hospital ◽  
University Of Pennsylvania ◽  
Control Group ◽  
Inpatient Setting ◽  
Item Questionnaire ◽  
Olfactory Testing ◽  
National University ◽  
Smell Identification ◽  
Question Survey

Abstract BackgroundPost viral anosmia has been reported in human coronavirus infections. In this current pandemic, olfactory dysfunction (OD) has emerged as a common key presenting symptom of COVID-19 infection. In this study, we describe OD assessment in the inpatient setting of patients both suspected of and with confirmed COVID-19 infection via University of Pennsylvania Smell Identification Test (UPSIT) objective assessment and a simple self-reported 3-item questionnaire.MethodsThirty patients admitted to the isolation wards of the National University Hospital, Singapore for either suspected or confirmed COVID-19 infection from April to May 2020 were recruited to this study. 10 patients who tested negative for SARS-CoV-2 were recruited as control subjects. The 20 patients with COVID-19 infection were divided into two groups (10 had olfactory testing performed during the first week of illness, 10 in the second week of illness). A simple 3-question survey was administered to each participant - to rank the severity, state the onset and duration of their hyposmia. Olfactory testing was performed using an English version of the UPSIT.ResultsLoss of smell was reported in 2 participants from the control group, 6 participants from the in the first week of illness and 5 participants from the second week of illness. Two COVID-19 patients have anosmia on the UPSIT. COVID-19 patients were more likely to have severe hyposmia or anosmia by objective assessment, a difference that was statistically significant (P = 0.0485). The differences in degree of OD among COVID-19 patients in their first and second week of illness were not statistically significant (P= 0.6563).ConclusionSelf-reported anosmia was higher among COVID-19 patients compared to controls who were admitted to isolation wards for respiratory symptoms but were tested negative for SARS-CoV-2 infection. On objective assessment by the UPSIT, COVID-19 patients were found to have higher rates of severe hyposmia or anosmia, a difference that was statistically significant (P = 0.0485). A limitation of this study is the odorants used in UPSIT which may be less familiar to the primarily Asian participants in this study, owing to cultural differences.

scholarly journals Chronic Ankle Instability Impairs Submaximal Force Steadiness and Accuracy

10.4085/15-20 ◽  
2020 ◽  
Author(s):  
Hyunwook Lee ◽  
S. Jun Son ◽  
Hyunsoo Kim ◽  
Seunguk Han ◽  
Matthew Seeley ◽  
...  
Keyword(s):  
Visual Information ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Feedback Mechanism ◽  
Controlled Study ◽  
Control Group ◽  
Force Output ◽  
Force Steadiness ◽  
Lower Accuracy ◽  
Accuracy Measure

Abstract Context: Patients with chronic ankle instability (CAI) have demonstrated sensorimotor impairments. Submaximal force steadiness and accuracy measure sensory, motor, and visual function via a feedback mechanism, which helps researchers and clinicians to comprehend sensorimotor deficits associated with CAI. Objective: To determine if participants with chronic ankle instability experience deficits in hip and ankle submaximal force steadiness and accuracy compared to healthy controls. Design: A case-controlled study Setting: Research Laboratory Patients and Other Participants: Twenty-one CAI patients and 21 uninjured controls participated in this study. Intervention(s): n/a. Main Outcome Measure(s): Maximal voluntary isometric contraction (MVIC), force steadiness and accuracy (10% and 30% of their MVIC) of ankle evertors, invertors, and hip abductors. The central 10-sec (20–87% of the total time) of the 3 trials were analyzed. An independent t-test was used to assess MVIC. Two-way, 2 × 3, ANOVAs were used to assess force steadiness and accuracy. Results: Relative to controls, the CAI group demonstrated lower accuracy in invertors (p =.0006). Across all motions, the CAI group showed less steadiness (p = .0005) and lower accuracy (p = .0074) than the controls in 10% MVIC. In terms of MVIC, the CAI group showed less force output in hip abduction compared with the control group (p < .0001). Conclusions: CAI patients showed an inability to control ongoing fine force (10% and 30% of their MVIC) through a feedback mechanism during an active test. These findings suggest deficits in sensorimotor control that lead CAI patients to be more susceptible to injury positions since they have difficulty integrating the peripheral information and correcting their movement in relation to visual information.

scholarly journals The Effectiveness of Self-Instructional Video vs. Classroom Teaching Method on Focused Assessment With Sonography in Trauma Among House Officers in University Hospital

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohd Hisham Isa ◽  
Kristina Lim ◽  
Mohd Johar Jaafar ◽  
Ismail Mohd Saiboon
Keyword(s):  
Intervention Group ◽  
University Hospital ◽  
Absolute Difference ◽  
Controlled Study ◽  
Classroom Teaching ◽  
Instructional Video ◽  
Control Group ◽  
Learning Preference ◽  
Hands On ◽  
And Control

Background: The aim of this study was to compare the effectiveness of self-instructional-video (SIV) and classroom training method (CTM) in learning Focus-Assessment with Sonography-in-Trauma (FAST) among house officers (HO).Method: A randomized controlled study involving house officers working in the university hospital in Malaysia was conducted where participants were randomized into SIV group (intervention) and CTM group (control). Each group had to undergo a 4 h hands-on training. The intervention group has undergone self-training using the video material without any facilitation while the control group received lecture and hands-on training with facilitators. Participants' performance was assessed using a validated Objective Structured Clinical Examination checklist for landmark identification and interpretation of images generated. Learning preference and confidence level were also assessed.Result: A total of 33 HO were enrolled in this study. Marks obtained in image acquisition by the intervention and control were 25.3 (SD = 5.3) and 25.6 (SD = 2.3) p > 0.05, respectively. While in image interpretation, the mean score for the intervention and control group was 10.3 (SD 1.7) and 9.8 (SD = 1.7) p > 0.05, respectively. Overall performance assessment, showed the intervention group obtained 35.6 (SD = 5.9) compared to control 35.3 (SD = 3.4), p > 0.05. Based on pre-specified determinant these scores difference falls within the 10% of non-inferiority margin. The absolute difference between both groups was 0.3 (CI = −3.75 to 3.21, p = 0.871), which proves non-inferiority but not superiority. In terms of learning preference and confidence to perform FAST, most of the participants preferred the control group approach.Conclusion: The SIV method is as effective as the CTM for learning FAST among the house officers and served as an alternative to classroom teaching. However, this technique needs improvement in promoting their confidence and preference. Perhaps incorporating a feedback session after going through the SIV would improve the confidence.

scholarly journals Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Laurent Zieleskiewicz ◽  
Alexandre Lopez ◽  
Sami Hraiech ◽  
Karine Baumstarck ◽  
Bruno Pastene ◽  
...  
Keyword(s):  
Point Of Care ◽  
Circulatory Failure ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
Point Of Care Ultrasound ◽  
Clinical Trial Registration ◽  
Ultrasound Device ◽  
Management Protocol ◽  
The Impact

Abstract Background Rapid response teams are intended to improve early diagnosis and intervention in ward patients who develop acute respiratory or circulatory failure. A management protocol including the use of a handheld ultrasound device for immediate point-of-care ultrasound (POCUS) examination at the bedside may improve team performance. The main objective of the study was to assess the impact of implementing such a POCUS-guided management on the proportion of adequate immediate diagnoses in two groups. Secondary endpoints included time to treatment and patient outcomes. Methods A prospective, observational, controlled study was conducted in a single university hospital. Two teams alternated every other day for managing in-hospital ward patients developing acute respiratory and/or circulatory failures. Only one of the team used an ultrasound device (POCUS group). Results We included 165 patients (POCUS group 83, control group 82). Proportion of adequate immediate diagnoses was 94% in the POCUS group and 80% in the control group (p = 0.009). Time to first treatment/intervention was shorter in the POCUS group (15 [10–25] min vs. 34 [15–40] min, p < 0.001). In-hospital mortality rates were 17% in the POCUS group and 35% in the control group (p = 0.007), but this difference was not confirmed in the propensity score sample (29% vs. 34%, p = 0.53). Conclusion Our study suggests that protocolized use of a handheld POCUS device at the bedside in the ward may improve the proportion of adequate diagnosis, the time to initial treatment and perhaps also survival of ward patients developing acute respiratory or circulatory failure. Clinical Trial Registration NCT02967809. Registered 18 November 2016, https://clinicaltrials.gov/ct2/show/NCT02967809.

scholarly journals An Evaluation of Electroacupuncture at the Weizhong Acupoint (BL-40) as a Means of Relieving Pain Induced by Extracorporeal Shock Wave Lithotripsy

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Wei-Ta Chen ◽  
Fang-Chia Chang ◽  
Yi-Hung Chen ◽  
Jaung-Geng Lin
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Vital Signs ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
Extracorporeal Shock Wave ◽  
Relieve Pain ◽  
Hospital Patients

Background. Extracorporeal shock wave lithotripsy (ESWL) is the preferred option for urolithiasis treatment. However, intensities of pain may be induced and the sedative anesthetic or analgesics were usually needed. The aim of this study was to develop an improved acupuncture-assisted anesthesia approach in pain relief.Methods. We conducted a single-blind, randomized controlled study in China Medical University Hospital. Patients treated by ESWL due to upper urolithiasis were randomly divided into control group, sham-EA group, and 100 Hz EA group. The high frequency electroacupuncture (EA) was applied at the Weizhong acupoint (100 Hz EA group) for 20 minutes prior to the ESWL. In the sham-EA group, the same procedures were performed as those of 100 Hz EA group but no electric current was given to stimulate the acupoints. In the control group, no action was taken before operation. The information including the numbers and dosage of analgesic requirements, pain score, vital signs, and the satisfaction of procedure was collected.Results. A total of 74 subjects were recruited and we found that the interval to the first request analgesic, the number/total dosage of additional analgesic, recovery time from anesthesia, and the satisfaction were all better in both the 100 Hz EA and the sham-EA group. The 100 Hz EA also showed better relief of painful sensations by delaying the onset of pain.Conclusions. The 100 Hz EA and the sham-EA can effectively relieve pain due to ESWL as well as reducing the dosage of opium analgesic used.

Controlled Study of Distress in Parents of Children with Epilepsy

2020 ◽  
Author(s):  
Mostafa Abdelnaem ◽  
Maha Ali Hassan ◽  
Mohamed Helmy Abdel Hafeez
Keyword(s):  
Parental Education ◽  
Rating Scale ◽  
The Other ◽  
University Hospital ◽  
Controlled Study ◽  
Anxiety And Depression ◽  
Control Group ◽  
Other Hand ◽  
Significant Difference ◽  
Epileptic Children

Abstract BackgroundChildhood epilepsy can have a significant impact on family functioning with high rates of patent anxiety and depression being reported.ObjectivesTo demonstrate the frequency of depression, anxiety and distress among the parents of epileptic children.Patients and MethodsA cross sectional study design was carried out on 100 children and their parents attending the outpatient clinics in Minia University Hospital, arranged in two groups, Group (A) consisted of 50 epileptic children and their caregivers. On the other hand, Group (B) consisted of 50 age- and sex matched controls. Comprehensive Assessment was carried out. A well-prepared sheet had been used for the evaluation of subjects of the study. Twenty-one item Depression Anxiety Stress Scale (DASS-21), Hamilton Anxiety Scale (HAM - A) and Hamilton Rating Scale for Depression (HRSD) were used for interviewing the parents of the epileptic children to screen for depression, anxiety, stress in those parents. This process preceded by full explanation of all the previous tools.There was statistically significant difference between the parents of the epileptic group and the control group regarding DASS score, and HAM-A score. There was no statistically significance between the 2 groups regarding the HRSD. The parents group of generalized fits shows to have a higher score of DASS (9.5±4.7), HDRS (5.1±3.3). In contrast to the focal fits group. On the other hand, the parents of group of generalized fits shows to have lower score of HAM-A (6.7±4) in contrast to the focal fits group but not statistically significant.Compliant group shows to have higher score of HAM-A, HDRS score in contrast to non-compliant group. These correlations were not statistically significant.ConclusionsParents of the epileptic children had more anxiety, depression and stress than the control. Lower parental education was associated with more distress and anxiety.Ploy-therapy increased parent anxiety and depression. Compliance on treatment decreased parent distress but increased parent anxiety and depression.

scholarly journals Positive correlation between serum and peritoneal fluid CA-125 levels in women with pelvic endometriosis

2006 ◽  
Vol 124 (4) ◽  
pp. 223-227 ◽  
Author(s):  
Vivian Ferreira do Amaral ◽  
Rui Alberto Ferriani ◽  
Marcos Felipe Silva de Sá ◽  
Antonio Alberto Nogueira ◽  
Julio César Rosa e Silva ◽  
...  
Keyword(s):  
Peritoneal Fluid ◽  
University Hospital ◽  
Ca 125 ◽  
Controlled Study ◽  
Control Group ◽  
Pelvic Endometriosis ◽  
Serum Samples ◽  
Cross Sectional ◽  
Positive Correlation ◽  
High Concentrations

CONTEXT AND OBJECTIVE: One of the diagnostic markers of endometriosis is CA-125, and elevated levels of this are caused by high concentrations in the ectopic endometrium. The objective of this study was to correlate CA-125 levels in serum and peritoneal fluid from women with and without pelvic endometriosis. DESIGN AND SETTING: This was a prospective, cross-sectional, controlled study of consecutive pa-tients undergoing laparoscopy for infertility, pelvic pain or tubal ligation, during early follicular phase, at the university hospital of Faculdade de Medicina de Ribeirão Preto. METHODS: Fifty-two patients were divided into two groups: endometriosis group, consisting of 35 patients with biopsy-confirmed pelvic endometriosis, and control group, consisting of 17 patients without endometriosis. CA-125 levels in serum samples and peritoneal fluid were determined by chemiluminescence. RESULTS: CA-125 levels in serum and peritoneal fluid were higher in patients with advanced pelvic endometriosis (means of 39.1 ± 45.8 U/ml versus 10.5 ± 5.9 U/ml in serum, p < 0.005; 1,469.4 ± 1,350.4 U/ml versus 888.7 ± 784.3 U/ml in peritoneal fluid, p < 0.05), and showed a positive correlation between each other (correlation coefficient (r) = 0.4880). Women with more advanced degrees of endometriosis showed higher CA-125 levels in both serum and peritoneal fluid (p = 0.0001). CONCLUSION: There is a positive correlation between serum and peritoneal fluid values of CA-125 in women with and without endometriosis, and their levels are higher in peritoneal fluid. Advanced endometriosis is related to higher levels in both serum and peritoneal fluid.

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