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Selected AbstractsEffect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunctionINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2007W. E. Lawson Summary Patients with refractory angina often suffer from erectile dysfunction. Enhanced external counterpulsation (EECP) decreases symptoms of angina, and increases nitric oxide release. This study evaluated the effect of EECP on sexual function in men with severe angina. The International Index of Erectile Function (IIEF) was used to assess erectile function of severe angina patients enroled in the International EECP Patient Registry. Their symptom status, medication use, adverse clinical events and quality of life were also recorded before and after completing a course of EECP. A cohort of 120 men (mean age 65.0 ± 9.7) was enroled. The men had severe coronary disease with 69% having a prior myocardial infarction, 90% prior coronary artery bypass graft or percutaneous coronary intervention, 49% with three vessel coronary artery disease, 86% were not candidates for further revascularisation, 71% hypertensive, 83% dyslipidaemia, 42% diabetes mellitus, 75% smoking and 68% using nitrates. Functional status was low with a mean Duke Activity Status Inventory score of 16.6 ± 14.8. After 35 h of EECP anginal status improved in 89%, and functional status in 63%. A comparison of the IIEF scores pre- and post-EECP therapy demonstrated a significant improvement in erectile function from 10.0 ± 1.0 to 11.8 ± 1.0 (p = 0.003), intercourse satisfaction (4.2 ± 0.5 to 5.0 ± 0.5, p = 0.009) and overall satisfaction (4.7 ± 0.3 to 5.3 ± 0.3, p = 0.001). However, there were no significant changes in orgasmic function (4.2 ± 0.4 to 4.6 ± 0.4, p = 0.19) or sexual desire (5.3 ± 0.2 to 5.5 ± 0.2). The findings suggest that EECP therapy is associated with improvement in erectile function in men with refractory angina. [source] Irritable bowel syndrome symptoms and health related quality of life in female veteransALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010D. P. GRAHAM Summary Background, The status and determinants of health-related quality of life (HRQOL) in female veterans with and without irritable bowel syndrome (IBS) are unknown. Aim, To compare HRQOL in female veterans with and without IBS symptoms and examine the contribution of post-traumatic stress disorder, depression and anxiety to HRQOL. Methods, A cross-sectional study of 339 female veterans. Self-report questionnaires were used to evaluate IBS symptoms, post-traumatic stress disorder, depression, anxiety and HRQOL. Results, Symptoms consistent with IBS were present in 33.5% of participants. Female veterans with IBS symptoms had significant reductions in physical component score and 5 of 8 Health Related Quality of Life subscales and on 7 of 8 Irritable Bowel Syndrome Quality Of Life subscales than female veterans without IBS symptoms. Compared with the US general female population, female veterans had significantly lower Health Related Quality of Life physical component score and mental component scores (MCS) irrespective of IBS symptom status. Differences in the MCS score were most explained by depression, while those in the physical component score were most explained by anxiety. Conclusions, Irritable bowel syndrome symptoms in female veterans are associated with considerable reduction in HRQOL. However, female veterans, regardless of IBS symptom status, have lower HRQOL compared with the general US female population. Aliment Pharmacol Ther,31, 261,273 [source] Association of the status of interstitial cells of Cajal and electrogastrogram parameters, gastric emptying and symptoms in patients with gastroparesisNEUROGASTROENTEROLOGY & MOTILITY, Issue 1 2010Z. Lin Abstract, Our goal was to investigate associations between the status of interstitial cells of Cajal (ICC) and electrogastrogram (EGG) parameters, gastric emptying and symptoms in a large cohort of patients with gastroparesis. Forty-one patients with refractory gastroparesis who were referred for gastric electrical stimulation (GES) underwent full thickness gastric (antrum) biopsy during the surgery to place the GES device. The biopsy samples were stained with c-kit and scored for the presence of ICC based on criteria obtained from 10 controls. All patients underwent EGG recordings, a 4-h standardized scintigraphic gastric emptying study and symptom assessment prior to the surgery. Based on antral biopsy, 15 patients (36%) had almost no ICC (ICC, group) and 26 patients had adequate cell numbers (ICC+ group). EGG recordings in the ICC, group displayed significantly less normal slow waves than in the ICC+ group both in the fasting and fed states. Tachygastria in the ICC, group was significantly more than in the ICC+ group both in the fasting (32 ± 8%vs 11 ± 2%) and fed states (27 ± 9%vs 12 ± 2%). There was no statistical difference in gastric emptying, symptom severity of gastroparesis, aetiology, age and gender between the two groups. Severely depleted ICC occurs in up to 36% of gastroparetic patients and significantly correlates with an abnormal EGG. Severely depleted ICC does not correlate with the severity of gastroparesis as assessed by gastric emptying or symptom status but did result in a poorer symptomatic response to GES. These data suggest that the EGG may have a role for predicting ICC status during clinical evaluation of gastroparetic patients. [source] Upper extremity pain and computer use among engineering graduate students: A replication studyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2009Cammie Chaumont Menéndez PhD Abstract Background Recent literature identified upper extremity musculoskeletal symptoms at a prevalence of >40% in college populations. The study objectives were to determine weekly computer use and the prevalence of upper extremity musculoskeletal symptoms in a graduate student population, and make comparisons with previous graduate and undergraduate cohorts. Methods One hundred sixty-six graduate students completed a survey on computing and musculoskeletal health. Associations between individual factors and symptom status, functional limitations, academic impact, medication use, and health services utilization were determined. Logistic regression analyses evaluated the association between symptom status and computing. Cross-study comparisons were made. Results More symptomatic participants experienced functional limitations than asymptomatic participants (74% vs. 32%, P,<,0.001) and reported medication use for computing pain (34% vs. 10%, P,<,0.01). More participants who experienced symptoms within an hour of computing used health services compared to those who experienced symptoms after an hour of computer use (60% vs. 12%, P,<,0.01). Years of computer use (OR,=,1.59, 95% CI 1.05,2.40) and number of years in school where weekly computer use was more than 10 hr (OR,=,1.56, 95% CI 1.04,2.35) were associated with pain within an hour of computing. Cross-study comparisons found college populations more similar than different. Conclusion The overall findings reinforced previous literature documenting the prevalence of upper extremity musculoskeletal symptoms in college populations, suggesting an important population for participating in public health interventions designed to support healthy computing practices and identify risk factors important to evaluate in future cohort studies. Am. J. Ind. Med. 52:113,123, 2009. © 2008 Wiley-Liss, Inc. [source] Inhalation incidents and respiratory health: results from the European Community respiratory health surveyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Maria C. Mirabelli MPH Abstract Background Inhalation incidents are an important cause of acute respiratory symptoms, but little is known about how these incidents affect chronic respiratory health. Methods We assessed reported inhalation incidents among 3,763 European Community Respiratory Health Survey (ECRHS) participants with and without cough, phlegm, asthma, wheezing or bronchial hyperresponsiveness. We then examined whether inhalation incidents during the 9-year ECRHS follow-up period were associated with a new onset of any of these respiratory outcomes among 2,809 participants who were free of all five outcomes at the time of the baseline ECRHS survey. Results Inhalation incidents were reported by 5% of participants, with higher percentages reported among individuals with asthma-related outcomes at the time of the baseline survey. Among participants without symptoms at baseline, our analyses generated non-statistically significant elevated estimates of the risk of cough, phlegm, asthma and wheezing and a non-statistically significant inverse estimate of the risk of bronchial hyperresponsiveness among participants who reported an inhalation incident compared to those without such an event reported. Discussion Our findings provide limited evidence of an association between inhalation incidents and asthma-related symptoms. These data could be affected by differences in the reporting of inhalation incidents according to symptom status at the time of the baseline survey; they should thus be interpreted with caution. Am. J. Ind. Med. 52:17,24, 2009. © 2008 Wiley-Liss, Inc. [source] Individual and combined impacts of biomechanical and work organization factors in work-related musculoskeletal symptoms,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2003Grant D. Huang MPH Abstract Background Investigations of work-related low back (LB) and upper extremity (UE) disorders have increasingly utilized multivariable models that include biomechanical/physical and work organization factors. However, the nature of any interactive effects is not well understood. Methods Using questionnaires, high and low exposure groups for biomechanical/physical factors, cognitive demands, cognitive processing, interpersonal demands, participatory management, skill discretion, and time pressure for 289 individuals (U.S. Marines) were identified. Musculoskeletal symptom status was also determined by questionnaire. Individual and biomechanical,psychosocial combinations were examined in adjusted multivariable logistic regression analyses. Results Time pressure was associated with both LB and UE symptoms (odds ratio(s) (OR) range,=,2.13,3.09), while higher biomechanical exposures were risk factors for LB symptoms (OR,=,2.07; 95% confidence intervals (CI): 1.00,4.35) and concurrent LB and UE symptoms (OR,=,2.80; CI: 1.35,5.83). Greater risks for concurrent LB and UE symptoms were indicated for combinations involving higher biomechanical exposure and: time pressure (OR,=,2.21; CI: 1.19,4.10); cognitive demands (OR,=,2.25; CI: 1.23,4.09); cognitive processing (OR,=,2.08; CI: 1.16,3.75); interpersonal demands (OR,=,2.44; CI: 1.35,4.41); participatory management (OR,=,2.50; CI: 1.30,4.81). Results did not suggest any interaction between biomechanical and work organization factors. Conclusions While no synergism was indicated, the present findings emphasize the need to consider both biomechanical factors and specific work organization factors, particularly time pressure, in reducing musculoskeletal-related morbidity. Am. J. Ind. Med. 43:495,506, 2003. Published 2003 Wiley-Liss, Inc. [source] Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and SwedenCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 2 2010Anne Nordrehaug Åstrøm Åstrøm AN, Ekbäck G, Ordell S. Factor structure of a conceptual model of oral health tested among 65-year olds in Norway and Sweden. Community Dent Oral Epidemiol 2010. © 2010 John Wiley & Sons A/S Abstract,,, Background:, No studies have tested oral health-related quality of life models in dentate older adults across different populations. Objectives:, To test the factor structure of oral health outcomes within Gilbert's conceptual model among 65-year olds in Sweden and Norway. It was hypothesized that responses to 14 observed indicators could be explained by three correlated factors, symptom status, functional limitations and oral disadvantages, that each observed oral health indicator would associate more strongly with the factor it is supposed to measure than with competing factors and that the proposed 3-factor structure would possess satisfactory cross-national stability with 65-year olds in Norway and Sweden. Methods:, In 2007, 6078 Swedish- and 4062 Norwegian adults borne in 1942 completed mailed questionnaires including oral symptoms, functional limitations and the eight item Oral Impacts on Daily Performances inventory. Results:, Model generation analysis was restricted to the Norwegian study group and the model achieved was tested without modifications in Swedish 65-year olds. A modified 3-factor solution with cross-loadings, improved the fit to the data compared with a 2-factor- and the initially proposed 3-factor model among the Norwegian [comparative fit index (CFI) = 0.97] and Swedish (CFI = 0.98) participants. All factor loadings for the modified 3-factor model were in the expected direction and were statistically significant at CR > 1. Multiple group confirmatory factor analyses, with Norwegian and Swedish data simultaneously revealed acceptable fit for the unconstrained model (CFI = 0.97), whereas unconstrained and constrained models were statistically significant different in nested model comparison. Conclusions:, Within construct validity of Gilbert's model was supported with Norwegian and Swedish 65-year olds, indicating that the 14-item questionnaire reflected three constructs; symptom status, functional limitation and oral disadvantage. Measurement invariance was confirmed at the level of factor structure, suggesting that the 3-factor model is comparable to some extent across 65-year olds in Norway and Sweden. [source] | ||||||||||