scholarly journals Long-Term Effects of a Multimodal Physiotherapy Program on the Severity of Somatosensory Tinnitus and Identification of Clinical Indicators Predicting Favorable Outcomes of the Program

2019 ◽  
Vol 30 (08) ◽  
pp. 720-730 ◽  
Author(s):  
Claudia Côté ◽  
Isabelle Baril ◽  
Catherine-Ève Morency ◽  
Samuel Montminy ◽  
Mélanie Couture ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Long Term Effects ◽  
Clinical Indicators ◽  
Recent Onset ◽  
Visual Analog Scales ◽  
Physiotherapy Program ◽  
Quasi Experimental ◽  
History Of ◽  
Baseline Characteristics ◽  
Multimodal Physiotherapy

AbstractTinnitus, the perception of sound in the absence of external auditory stimuli, is commonly associated with problems of the auditory system. Head and neck disorders can also be involved in tinnitus emergence. In such cases, the term somatosensory tinnitus is used. Physiotherapy treatments have been identified as a promising avenue in the treatment of somatosensory tinnitus.The aim of the study was to explore the effect of a physiotherapy program on the intensity and severity of somatosensory tinnitus and to identify the clinical characteristics of the patients who respond well to this treatment.Quasi-experimental pre–post single-group design.Thirty-one adults with presumed somatosensory tinnitus.All participants received on average ten physiotherapy treatments over six weeks. Treatments included cervical and thoracic mobilizations, as well as muscular strengthening, stretching, postural instruction, and cervical stabilization.Outcomes were measured at baseline, at the end of the physiotherapy program, and three months later. The primary outcomes were the Tinnitus Handicap Inventory and visual analog scales for loudness and annoyance caused by tinnitus.After the last evaluation, participants were divided into two groups: improved and unimproved participants. Participants were considered improved if they (1) showed significant improvement in at least two of the three primary outcome measures and (2) indicated subjective improvement. Thereafter, the baseline characteristics that correctly identify participants susceptible to improve significantly following treatment were determined (Cohen’s effect size d > 0.8).A significant improvement in tinnitus intensity was observed at the end of the program. Of the 31 participants, 14 experienced persistent improvement in the intensity of their tinnitus and were classified as improved. Baseline characteristics strongly associated with tinnitus improvement were no increase in tinnitus when exposed to noise (d = −1.57), no family history of tinnitus (d = −1.16), somatosensory modulation in response to the contraction used to resist pressure applied to the forehead (d = 1.20), and recent onset of tinnitus (d = 1.03).This exploratory study showed that a multimodal physiotherapy program is effective in decreasing the severity of tinnitus, principally in individuals presenting with somatosensory tinnitus in combination with specific clinical characteristics.

Childhood adversities and adult depression: basic patterns of association in a US national survey

1993 ◽  
Vol 23 (3) ◽  
pp. 679-690 ◽  
Author(s):  
Ronald C. Kessler ◽  
William J. Magee
Keyword(s):  
Childhood Adversity ◽  
Household Survey ◽  
The United States ◽  
Future Research ◽  
Long Term Effects ◽  
Childhood Adversities ◽  
Adult Age ◽  
Recent Onset ◽  
History Of

SynopsisThe long-term relationships between various forms of childhood adversity and adult episodes of major depression are explored in a representative household survey of the United States adult (age 25 +) population. Seven of the eight childhood adversities considered are significantly associated with recent (12-month) episodes of depression. These effects are largely indirect consequences of some childhood adversities leading to a life history of depression and prior depression leading to new episodes. Only three of the eight childhood adversities directly affect recent onset or recurrence. The paper closes with a discussion of implications for future research on the long-term effects of childhood adversities.

scholarly journals Prospective Association Between Depressive Symptoms and Stroke Risk Among Middle-aged and Older Chinese

2021 ◽  
Author(s):  
Yimin Cui ◽  
Chunsu Zhu ◽  
Zhiwei Lian ◽  
Xueyan Han ◽  
Qian Xiang ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Stroke Risk ◽  
Depression Scale ◽  
Effective Management ◽  
Regression Analyses ◽  
Recent Onset ◽  
History Of ◽  
Baseline Characteristics ◽  
Prospective Association ◽  
Older Chinese

Abstract Background: This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. Methods: We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥ 45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥ 10). We assessed whether baseline depressive symptoms and changes them, assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms) were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for baseline characteristics were performed. Results: For baseline depressive symptom analysis (n = 10,100), 545 (5.4%) had reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (OR 1.53, 95% CI 1.28–1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8,491, 430 (5.1%) stroke events), participants with stable high (OR 2.01, 95% CI 1.58–2.56) and recent-onset (OR 1.39, 95% CI 1.04–1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR 1.12, 95% CI 0.80–1.57)) were not associated with stroke risk.Conclusion: In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.

COVID-19 Pandemic: Experiences in China and Implications for its Prevention and Treatment Worldwide

2020 ◽  
Vol 20 (6) ◽  
pp. 410-416 ◽  
Author(s):  
Ning-Ning Liu ◽  
Jing-Cong Tan ◽  
Jingquan Li ◽  
Shenghui Li ◽  
Yong Cai ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
International Community ◽  
Disease Spread ◽  
Global Dynamics ◽  
The World ◽  
Prevention And Treatment ◽  
History Of

The outbreak of COVID-19 due to SARS-CoV-2 originally emerged in Wuhan in December 2019. As of March 22, 2020, the disease spread to 186 countries, with at least 305,275 confirmed cases. Although there has been a decline in the spread of the disease in China, the prevalence of COVID-19 around the world remains serious despite containment efforts undertaken by national authorities and the international community. In this article, we systematically review the brief history of COVID-19 and its epidemic and clinical characteristics, highlighting the strategies used to control and prevent the disease in China, which may help other countries respond to the outbreak. This pandemic emphasizes the need to be constantly alert to shifts in both the global dynamics and the contexts of individual countries, making sure that all are aware of which approaches are successful for the prevention, containment and treatment of new diseases, and being flexible enough to adapt the responses accordingly.

scholarly journals Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Clinical Characteristics ◽  
National Registry ◽  
Injection Drug ◽  
University Hospital ◽  
Prosthetic Heart Valves ◽  
Increased Risk ◽  
History Of

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

scholarly journals Clinical characteristics and sociodemographic features of psychotic major depression

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Meng-qi Wang ◽  
Ran-ran Wang ◽  
Yu Hao ◽  
Wei-feng Xiong ◽  
Ling Han ◽  
...  
Keyword(s):  
Family History ◽  
Major Depression ◽  
Clinical Characteristics ◽  
Missing Values ◽  
Psychotic Disorders ◽  
Mental Health Center ◽  
Psychiatric Diseases ◽  
First Onset ◽  
History Of ◽  
Psychotic Major Depression

Abstract Background Psychotic major depression (PMD) is a subtype of depression with a poor prognosis. Previous studies have failed to find many differences between patients with PMD and those with non-psychotic major depression (NMD) or schizophrenia (SZ). We compared sociodemographic factors (including season of conception) and clinical characteristics between patients with PMD, NMD, and schizophrenia. Our aim was to provide data to help inform clinical diagnoses and future etiology research. Methods This study used data of all patients admitted to Shandong Mental Health Center from June 1, 2016 to December 31, 2017. We analyzed cases who had experienced an episode of PMD (International Classification of Diseases, Tenth Revision codes F32.3, F33.3), NMD (F32.0–2/9, F33.0–2/9), and SZ (F20–20.9). Data on sex, main discharge diagnosis, date of birth, ethnicity, family history of psychiatric diseases, marital status, age at first onset, education, allergy history, and presence of trigger events were collected. Odds ratios (OR) were calculated using logistic regression analyses. Missing values were filled using the k-nearest neighbor method. Results PMD patients were more likely to have a family history of psychiatric diseases in their first-, second-, and third-degree relatives ([OR] 1.701, 95% confidence interval [CI] 1.019–2.804) and to have obtained a higher level of education (OR 1.451, 95% CI 1.168–1.808) compared with depression patients without psychotic features. Compared to PMD patients, schizophrenia patients had lower education (OR 0.604, 95% CI 0.492–0.741), were more often divorced (OR 3.087, 95% CI 1.168–10.096), had a younger age of onset (OR 0.934, 95% CI 0.914–0.954), less likely to have a history of allergies (OR 0.604, 95% CI 0.492–0.741), and less likely to have experienced a trigger event 1 year before first onset (OR 0.420, 95% CI 0.267–0.661). Season of conception, ethnicity, and sex did not differ significantly between PMD and NMD or schizophrenia and PMD. Conclusions PMD patients have more similarities with NMD patients than SZ patients in terms of demographic and clinical characteristics. The differences found between PMD and SZ, and PMD and NMD correlated with specificity of the diseases. Furthermore, allergy history should be considered in future epidemiological studies of psychotic disorders.

Infective endocarditis in patients who use IV drugs: a single centre cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Alraddadi ◽  
A Alsagheir ◽  
S Gao ◽  
K An ◽  
H Hronyecz ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Long Term Outcomes ◽  
Replacement Surgery ◽  
Short Term Mortality ◽  
History Of ◽  
Short And Long Term ◽  
Baseline Characteristics

Abstract Background Managing endocarditis in intravenous drug use (IVDU) patients is challenging: unless patients successfully quit IVDU, the risk of re-infection is high. Clinicians often raise concerns with ethical and resource allocation principles when considering valve replacement surgery in this patient population. To help inform practice, we sought to determine the long-term outcomes of IVDU patients with endocarditis who underwent valve surgery in our center. Method After research ethics board approval, infective endocarditis cases managed surgically at our General Hospital between 2009 and 2018 were identified through the Cardiac Care Network. We reviewed patients' charts and included those with a history of IVDU in this study. We abstracted data on baseline characteristics, peri-operative course, short- and long-term outcomes. We report results using descriptive statistics. Results We identified 124 IVDU patients with surgically managed endocarditis. Mean age was 37 years (SD 11), 61% were females and 8% had redo surgery. During admission, 45% (n=56) of the patients had an embolic event: 63% pulmonary, 30% cerebral, 18% peripheral and 11% mesenteric. Causative organisms included Methicillin-Sensitive Staphylococcus Aureus (51%, n=63), Methicillin-Resistant Staphylococcus Aureus (15%, n=19), Streptococcus Viridans (2%, n=2), and others (31%, n=38). Emergency cardiac surgery was performed for 42% of patients (n=52). Most patients (84%) had single valve intervention: 53% tricuspid, 18% aortic and 13% mitral. Double valve interventions occurred in 15% (n=18). Overall, bioprosthetic replacement was most commonly chosen (79%, n=98). In-hospital mortality was 7% (n=8). Median length of stay in hospital was 13 days (IQR 8,21) and ICU 2 days (IQR 1,6). Mortality at longest available follow-up was 24% (n=30), with a median follow-up of 129 days (IQR 15,416). Valve reintervention rate was 11% (n=13) and readmission rate was 14% (n=17) at a median of 275 days (IQR 54,502). Conclusion Despite their critical condition, IVDU patients with endocarditis have good intra-hospital outcomes. Challenges occur after hospital discharge with loss of follow-up and high short-term mortality. IVDU relapse likely accounts for some of these issues. In-hospital and community comprehensive addiction management may improve these patients' outcomes beyond the surgical procedure. Annual rate 2009–2018 Funding Acknowledgement Type of funding source: None

LONG-TERM EFFECTS OF OTITIS MEDIA A TEN-YEAR COHORT STUDY OF ALASKAN ESKIMO CHILDREN

PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 577-585 ◽  
Author(s):  
Gary J. Kaplan ◽  
J. Kenneth Fleshman ◽  
Thomas R. Bender ◽  
Carol Baum ◽  
Paul S. Clark
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Verbal Ability ◽  
Significant Loss ◽  
Long Term Effects ◽  
Normal Range ◽  
History Of ◽  
Conductive Component ◽  
Verbal Development

Histories of ear disease, otoscopic examinations, and audiologic, intelligence, and achievement tests were obtained from a cohort of 489 Alaskan Eskimo children who have been followed through the first ten years of life. Seventy-six per cent had experienced one or more episodes of otitis media since birth. Of these, 78% had their first attack during their first two years of life. Perforations and scars were present in 41%. A hearing loss of 26 decibels or greater was present in 16%, and an additional 25% were in the normal range but had a measurable air-bone gap. Children with a history of otitis media prior to 2 years of age and a hearing loss of 26 decibels or greater had a statistically significant loss of verbal ability and were behind in total reading, total math, and language. In addition, children who had an early onset of otitis media but now had normal hearing with a conductive component were also adversely affected in verbal areas. The number of otitis media episodes was related to tympanic membrane abnormalities, hearing loss, and low verbal and achievement scores. These findings indicate that otitis media has been a significant cause of morbidity in Alaskan Eskimo children, and its onset during the critical years of language development as well as the number of episodes play an important role in impairing verbal development.

Cardiac cephalalgia: severe, non-exertional headache presenting as unstable angina

2018 ◽  
Vol 19 (2) ◽  
pp. 173-175
Author(s):  
Jonathan Lazari ◽  
Andrew Money-Kyrle ◽  
Benjamin R Wakerley
Keyword(s):  
Clinical Characteristics ◽  
Troponin I ◽  
Coronary Intervention ◽  
Severe Stenosis ◽  
Exertional Headache ◽  
Percutaneous Coronary ◽  
History Of ◽  
St Elevation ◽  
Cardiac Cephalalgia

Cardiac cephalalgia is a migraine-like headache that occurs during episodes of myocardial ischaemia. Clinical characteristics of the headache vary widely but are often severe in intensity, worsen with reduced myocardial perfusion and resolve with reperfusion. It can present along with typical symptoms of angina pectoris, although not always. We present a 64-year-old man with a 6-month history of severe, non-exertional headaches occurring with increasing frequency. A resting ECG showed ST elevation in the inferior leads. His serum troponin I was not elevated. Coronary angiography showed severe stenosis of his right coronary artery, which was successfully stented by percutaneous coronary intervention. He remains headache free at 2-year follow-up.

A Treatment for the Acute Migraine Attack

1987 ◽  
Vol 15 (2) ◽  
pp. 71-75 ◽  
Author(s):  
E. I. Adam
Keyword(s):  
Acute Attack ◽  
Response To Treatment ◽  
Codeine Phosphate ◽  
Double Blind ◽  
Recent Onset ◽  
Randomized Crossover Trial ◽  
History Of ◽  
Specific Factors ◽  
Acute Attacks ◽  
Acute Migraine Attack

A compound analgesic/anti-emetic formulation was significantly effective in reducing the severity of acute attacks of migraine, in a double-blind, randomized, crossover trial of 34 patients referred to a migraine clinic. The preparation contained paracetamol (acetaminophen) 500 mg, codeine phosphate 8 mg, buclizine hydrochloride 6.25 mg and dioctyl sodium sulphosuccinate 10 mg. The dosage was two tablets taken as early as possible in the acute attack. No specific factors could be identified which influenced response to treatment Patients with a long history of migraine (more than 10 years) responded as well as those with a recent onset of the condition.

Coupled obturator neurotomies and lidocaine intrathecal infusion to treat bilateral adductor spasticity and drug-refractory pain

2010 ◽  
Vol 113 (3) ◽  
pp. 528-531 ◽  
Author(s):  
José D. Carrillo-Ruiz ◽  
Pablo Andrade ◽  
Nora Godínez-Cubillos ◽  
María L. Montes-Castillo ◽  
Fiacro Jiménez ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Scale Score ◽  
Infusion Pump ◽  
Spastic Diplegia ◽  
Somatic Pain ◽  
Refractory Pain ◽  
Visual Analog Scales ◽  
Postoperative Control ◽  
History Of ◽  
Multiple Treatments

Spastic diplegia is present in three-fourths of children with cerebral palsy, interfering with gait and frequently accompanied by severe pain. The authors report the case of a 28-year-old woman with history of perinatal hypoxia, who presented with cerebral palsy and severe spastic diplegia (Ashworth Scale Score 4, Tardieu Scale Score 5) and was confined to a wheelchair. She complained of pain in the left hip and knee with mixed neuropathic and somatic components. She consistently rated pain intensity as 10 of 10 on a visual analog scale, and her symptoms were resistant to multiple treatments. The patient underwent selective bilateral adductor myotomies and the implantation of an infusion pump for intrathecal lidocaine application. Postoperative control of pain and spasticity was dramatic (scores of 0 on the Ashworth, Tardieu, and visual analog scales) and persisted throughout a follow-up period of 36 months. This is the first report in the literature of combined selective neurotomies for the treatment of spasticity and chronic lidocaine subarachnoid infusion to treat associated pain. This therapy could represent an alternative to treat spasticity associated with neuropathic and somatic pain.

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