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Symptom Index (symptom + index)
Kinds of Symptom Index Selected AbstractsAre there differences between women with urge predominant and stress predominant mixed urinary incontinence?,NEUROUROLOGY AND URODYNAMICS, Issue 2 2007Jack B. Lewis Abstract Objective We sought to determine if there are differences in clinical and urodynamic parameters between women with urge predominant and those with stress predominant mixed urinary incontinence (MUI). Methods Charts of 99 female patients with complaints of MUI were reviewed. Patients were divided into two groups based on the subjective predominance of either stress incontinence (MSUI) or urge incontinence (MUUI). All patients completed a subjective evaluation including an AUA Symptom Index, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7). Objective non-invasive measures included physical exam, 48-hr voiding diary, and a 24-hr pad test. Videourodynamics studies (VUDS), performed in all patients, were reviewed and the presence and characteristics of detrusor overactivity (DO) and stress incontinence were noted. Results There were no significant differences between groups with respect to symptom scores. MUUI patients had significantly higher pad usage, and lower maximum and average voided volumes than MSUI patients. They were also more likely to have lower urodynamic bladder capacities and demonstrable DO (70% vs. 26%) on VUDS with contractions occurring at lower bladder volumes and with higher amplitude. MSUI patients were more likely to have demonstrable SUI on physical examination (63% vs. 16%) and on VUDS (100% vs. 61%). Conclusions There do appear to be differences in clinical and urodynamic parameters between patients with stress predominant and urge predominant MUI. These may help to determine which component of the mixed incontinence is more problematic. Neurourol. Urodynam. 26:204,207, 2007. © 2006 Wiley-Liss, Inc. [source] Effectiveness of Acupuncture in Patients with Category IIIB Chronic Pelvic Pain Syndrome: A Report of 97 PatientsPAIN MEDICINE, Issue 4 2010Volkan Tugcu MD Abstract Objective., Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is of significant interest in urology and unfortunately, the therapy modalities recommended are not fully effective. Therefore, we undertook a pilot study to determine whether acupuncture improves the pain, voiding symptoms, and quality of life in men with category IIIB CP/CPPS. Design., Prospective, one-group trial, cohort study. Setting., Outpatient urology clinic. Patients and Interventions., Ninety-seven CP/CPPS patients received six sessions of acupuncture to the BL-33 acupoints once a week. The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was completed by each patient before and after the treatment and on 12th and 24th weeks following the treatment. Outcome Measures., Mean values of total CPSI score, pain subscore, urinary subscore, and quality of life subscore after the treatment and on follow-up after the treatment were compared with the baseline values. Results., There was a statistically significant decrease in all of the subscores evaluated at all periods compared with the baseline. Eighty-six patients out of 93 (92.47%) were NIH-CPSI responders (more than 50% decrease in total NIH-CPSI score from baseline) at the end of the treatment. Conclusions., The results of this study suggest that acupuncture appears to be a safe and potentially effective treatment in improving the symptoms and quality of life of men clinically diagnosed with CP/CPPS. [source] Estimation of the number of working hours critical for the development of mental and physical fatigue symptoms in Japanese male workers,application of benchmark dose methodAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2007Yasushi Suwazono PhD Abstract Background To clarify the influence of working hours on subjective fatigue symptoms and obtain the critical dose (number of hours) to determine the number of permissible working hours, we calculated the benchmark dose (BMD) and the 95% lower confidence limit on BMD (BMDL) of working hours for subjective mental and fatigue symptoms using multivariate logistic regression. Methods Self-administered questionnaires were distributed to all 843 male daytime workers aged ,60 years in a single chemical factory, and 715 provided complete replies. The odds ratios of daily working hours were determined using positive findings of the Self-rating Depression Scale and 8 subscales of the Cumulative Fatigue Symptom Index as dependent variables, and other potential covariates as independent variables. Using significant parameters for the working hours and those for other covariates, the BMD and BMDL (BMD/BMDL) values were calculated for corresponding dependent variables. The benchmark response (BMR) was set at 5% or 10%. Results The BMDL with a BMR of 5% was shown to be 9.6,11.6 hr per day, which corresponds to 48,58 working hours per week and 36,78 overtime hours per month. Conclusions These results suggest that special attention should be paid to the workers whose working hours exceed these BMD/BMDL values. Am. J. Ind. Med. 50: 173,182, 2007. © 2007 Wiley-Liss, Inc. [source] Laryngeal sensory deficits in patients with chronic cough and paradoxical vocal fold movement disorder,THE LARYNGOSCOPE, Issue 8 2010Thomas Murry PhD Abstract Objectives/Hypothesis: Although the diagnostic accuracy of paradoxical vocal fold movement disorder and chronic cough has improved, the underlying pathophysiology remains relatively unknown. We hypothesize that one potential etiological factor in these patients is an aberrant laryngeal sensory response and sought to determine if respiratory retraining in addition to antireflux therapy alters this aberrant response. Study Design: Retrospective, outcomes. Methods: Sixteen patients who had been on at least 3 months of twice-daily proton pump inhibitors with no subjective improvement in their primary complaint of cough, self-reported symptoms of gastroesophageal and laryngopharyngeal reflux, and concurrent paradoxical vocal fold movement (PVFM) were included in the current study. In addition to continuing twice daily pharmacological therapy, subjects underwent a course of respiratory retraining. Outcome measures including the Reflux Symptom Index (RSI), transnasal flexible laryngoscopy, and laryngopharyngeal sensory discrimination thresholds were obtained prior to and following a course of respiratory retraining. Results: Mean bilateral laryngeal sensory response improved significantly after combined respiratory retraining and aggressive proton pump inhibitor therapy (P = .01). In addition, mean RSI score decreased significantly following treatment (P = .02). Specifically, 13 of 16 patients experienced improved sensory response, corresponding with patient reports of improved PVFM symptoms following treatment. Conclusions: Aberrant laryngeal sensation was identified in patients with PVFM and chronic cough. This response, however, normalized following a limited course of respiratory retraining, corresponding with improved patient symptoms. Laryngoscope, 2010 [source] An electron microscopic study,Correlation of gastroesophageal reflux disease and laryngopharyngeal reflux,THE LARYNGOSCOPE, Issue 7 2010Sanghoon Park MD Abstract Objectives/Hypothesis: Laryngopharyngeal reflux (LPR) originates from regurgitation of gastric contents, a mechanism seemingly identical to gastroesophageal reflux disease (GERD). Some researchers postulate a connection between LPR and GERD, whereas some assert LPR is a disease apart from GERD. We examined symptoms of GERD from LPR patients, and performed gastrointestinal endoscopy and transmission electron microscopy (TEM) to evaluate GERD findings from these patients. Study Design: Prospective study at an academic tertiary care center. Methods: Control subjects had no symptoms or signs of LPR/GERD. LPR was diagnosed with a Reflux Symptom Index >13 and Reflux Finding Score >7, and were questioned for GERD-related symptoms and examined with esophagogastroduodenoscopy, then allocated into either an LPR without GERD or LPR with GERD group. Esophageal tissues were obtained from the squamocolumnar junction and managed for TEM, and the intercellular space (IS) was measured to find dilatation, a characteristic GERD finding. Results: About 30% (8/26) of LPR patients showed GERD-related symptoms, connecting LPR with the GERD group. Most of the LPR patients showed grossly normal endoscopic findings. On TEM, IS of control group (n = 15) was measured as 0.35 ± 0.27 ,m, whereas the LPR without GERD group (n = 18) and LPR with GERD group (n = 8) revealed a dilated IS of 0.61 ± 0.47 ,m and 0.95 ± 0.44 ,m, respectively. This difference was statistically significant compared to the control group (P < .05). Conclusions: The mean IS of LPR was significantly increased, suggesting common pathogenesis between LPR and GERD. Laryngoscope, 2010 [source] Incidence of seropositivity to bordetella pertussis and mycoplasma pneumoniae infection in patients with chronic laryngotracheitis,THE LARYNGOSCOPE, Issue 9 2009FACS, Mary Es Beaver MD Abstract Objectives/Hypothesis: Determine the incidence of bordetella pertussis and mycoplasma pneumonia infection in patients with chronic laryngotracheitis. Study Design: A prospective case study. Methods: Fifty-four consecutive adult patients presenting with symptoms (throat clearing, hoarseness, cough, globus) and signs (laryngeal and subglottic erythema and edema) of chronic laryngotracheitis (CLTR) for >6 weeks were included in the study. A single blood draw for anti-pertussis toxin IgG, IgA, IgM, and mycoplasma IgM was performed at presentation. Duration of symptoms, symptom score (Reflux Symptom Index [RSI]), and physical exam score were recorded. Results: Thirteen patients (24%) had elevated IgA and IgG to pertussis toxin. Nine patients (17%) had elevated IgM to pertussis toxin. Eight patients (15%) had elevated IgM to mycoplasma pneumoniae. There were no significant differences in symptom duration, RSI score, or Voice Handicap Index-10 score among patients with current infection, recent past infection, or no infection. Subglottic erythema scores were significantly higher for patients with current or recent past infection compared to the no infection group. Patients with current infection or recent past infection had significantly more tracheal erythema than supraglottic or vocal fold erythema. Conclusions: Bordetella pertussis and mycoplasma pneumoniae infection play a significant role in the etiology of CLTR. Pertussis can be a mild but chronic presentation and may not produce typical symptoms of severe cough. Symptom duration and severity cannot differentiate between CLTR of infectious or other etiology. Infection should be considered in patients with CLTR that have significant tracheal erythema. Laryngoscope, 2009 [source] Serum sex hormones and the 20-year risk of lower urinary tract symptoms in community-dwelling older menBJU INTERNATIONAL, Issue 11 2010Michael D. Trifiro Study Type , Prognosis (inception cohort) Level of Evidence 2b OBJECTIVE To evaluate serum sex steroid hormone concentrations and long-term risk of subsequent lower urinary tract symptoms (LUTS) in a cohort of community-dwelling older men. SUBJECTS AND METHODS Between 1984 and 1987, serum sex hormone concentrations were measured in participants in the Rancho Bernardo Study, a prospective, community-based study. In 2006, the American Urological Association Symptom Index (AUA-SI) was mailed to surviving male participants. Logistic regression was used to examine associations of baseline hormone concentrations with AUA-SI. RESULTS Among 158 surviving men with complete data and no history of prostate cancer, the mean (sd) age at serum sex steroid assessment was 58 (6.6) years with a mean (sd) follow-up of 20.3 (0.6) years. In age-adjusted logistic regression, there was a significant inverse association of testosterone : dihydrotestosterone (DHT) with LUTS (P = 0.05). Also, men with higher concentrations of bioavailable testosterone had a 56% decreased risk of LUTS compared with those with hypogonadal concentrations, although the association was not statistically significant (odds ratios 0.44, 95% confidence interval 0.14,1.40) or distributed evenly among quartiles. There were no significant associations of total testosterone, oestradiol (E2), testosterone : E2, DHT, or dehydroepiandrosterone with LUTS or with any measured hormones and urinary bother. CONCLUSIONS In this cohort, men with higher mid-life levels of testosterone : DHT and bioavailable testosterone had a decreased 20-year risk of LUTS. These data support other studies reporting inverse associations of serum testosterone with LUTS. Clinical trials of testosterone therapy should include LUTS and clinical benign prostatic hyperplasia as outcomes. [source] A prospective, randomized, double-blind trial to evaluate the role of a short reducing course of oral corticosteroid therapy in the treatment of chronic prostatitis/chronic pelvic pain syndromeBJU INTERNATIONAL, Issue 2 2007Sylvia M. Bates OBJECTIVES To assess the validity of our observational experience that a short course of oral prednisolone therapy might be of value in the management of symptoms of chronic pelvic pain syndrome (CPPS) in men. PATIENTS AND METHODS Twenty-one men with CPPS (inflammatory or non-inflammatory) for ,6 months, and who had failed to improve with standard antibiotic therapy, were randomized to receive either a 1-month reducing course of oral prednisolone (nine) or an equivalent placebo regimen (12 men). The outcome measures used were the McGill Pain Questionnaire, the Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire-30 (GHQ-30) and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI), which were completed at baseline and 3 months. RESULTS Outcomes were analysed for the 18 patients (six treated, 12 placebo) who completed the 3 months of follow-up. At both baseline and 3 months, respectively, there was no statistically significant difference between the groups in the NIH-CPSI total score (P = 0.48 and 0.62; Mann,Whitney U -test), or in the HADS (anxiety, P = 0.85 and 0.67; depression P = 0.96 and 0.74), and there was no significant improvement or deterioration over time. Although not statistically significant, there was a trend to improvement in the depression score for the active group (P = 0.13). However, the clinical significance is doubtful, as both baseline and follow-up depression scores were within the normal range. No patient had clinically negative changes in depression. A 3-month follow-up analysis was not possible for the McGill Pain Questionnaire or GHQ-30 as not all patients completed the questionnaire. CONCLUSIONS Whilst the study showed no clinical benefit of using corticosteroids in the management of CPPS, the few patients recruited limited the validity of firm conclusions from the data. There was a trend towards an improvement of depression levels amongst subjects. The study highlights the difficulties of recruitment and illustrates the complex psychological profiles of patients with CPPS. [source] Chronic prostatitis during pubertyBJU INTERNATIONAL, Issue 4 2006Yuan Li OBJECTIVE To investigate the features of chronic prostatitis (CP) during puberty and the effects of biofeedback on young males with this disease. PATIENTS AND METHODS In all, 40 patients were divided into two groups; group 1 included 25 pubertal patients with CP (mean age 16.5 years, sd 1.1) and group 2 was a control group including 15 patients (mean age 16.2 years, sd 1.2) with a normal lower urinary tract. National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores (three parts) were assessed individually in both groups. Expressed prostatic secretions and urine samples after prostate massage from group 1 were cultured to determine whether patients were infected with bacteria, and group 1 was categorized into various NIH types. Each patients in the two groups underwent urodynamics and group 1 were treated with biofeedback. RESULTS In group 1, there were one, three and 21 patients with type II, IIIA and IIIB prostatitis. The incidence of staccato voiding and detrusor-sphincter dyssynergia (DSD), and the maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), maximum detrusor pressure (Pdetmax) and maximum urethral closure pressure (MUCP) between the groups were significantly different (P < 0.05). The total NIH-CPSI scores and all the subdomains between the groups before biofeedback were significantly different (P < 0.001). In group 1 the difference in NIH-CPSI scores and Qmax before and after biofeedback was significant (P < 0.05). CONCLUSIONS The main type of CP during puberty is IIIB; the dominating symptom is a voiding disorder. The impact on life and psychological effects are substantial. Pubertal boys with CP have pelvic floor dysfunction and several abnormal urodynamic values, i.e. staccato voiding, DSD, decreasing Qmax, and increasing Pdetmax and MUCP. The effect of biofeedback strategies for treating pubertal CP is satisfactory. [source] Impact of prostate-specific antigen level and prostate volume as predictors of efficacy in photoselective vaporization prostatectomy: analysis and results of an ongoing prospective multicentre study at 3 yearsBJU INTERNATIONAL, Issue 6 2006ALEXIS E. TE In a multicentre study from the USA, 3-year results of the high-power KTP laser prostatectomy are presented. The authors used preoperative PSA level as a marker of prostate volume and assessed its potential predictive value on the level of clinical efficacy for treating symptomatic BPH. They found that the overall results from the technique were positive and durable, and suggested that there was a significant difference in efficacy between patients presenting with a total PSA of <6 or >6 ng/mL. Many patients who have had a radical prostatectomy are followed for a prolonged period and several observations are presented from an Italian study of urinary incontinence. The authors present their detailed results, finding a considerable trend in incontinence and anastomotic stricture, which decreased over time. OBJECTIVE To report the 3-year results and analyse whether total prostate-specific antigen (tPSA) levels and prostate volume before treatment can predict the level of clinical efficacy of photoselective vaporization prostatectomy (PVP) for treating obstructive benign prostatic disease, as high-power potassium-titanyl-phosphate (KTP) laser prostatectomy was previously shown to be safe and to efficiently vaporize prostatic adenoma secondary to benign prostatic hyperplasia (BPH), with minimal bleeding and morbidity. PATIENTS AND METHODS From October 2001 to January 2003, 139 men (mean age 67.7 years, sd 8.7) diagnosed with obstructive lower urinary tract symptoms secondary to BPH, had PVP with an average 80 W of KTP laser energy, at six investigational centres. A subanalysis evaluating each patient for tPSA and prostate volume before PVP was conducted, with a long-term assessment of the primary efficacy outcomes at 3 years after PVP. Each patient was assigned to one of two subgroups according to the tPSA level (group 1, ,,6.0 ng/mL; group 2 ,,6.1 ng/mL) and evaluated separately. Each subgroup was assessed for changes from baseline in American Urological Symptom Index (AUA SI) score, quality of life (QoL) score, peak urinary flow rate (Qmax), prostate volume, and postvoid residual urine volume (PVR) at 1, 2 and 3 years after PVP. RESULTS All tPSA subgroups had a sustained improvement in all efficacy outcomes maintained through the 3 years. There was a statistically significant difference in the level of improvement between groups 1 and 2 (P < 0.05) in AUA SI and Qmax at 1, 2 and 3 years. The mean (sd) prostate volume for group 1 was 48.3 (16.7) mL (87 men), and was 83.1 (30.6) mL (52 men) in group 2. The mean percentage improvement in the AUA SI at 1, 2 and 3 years in group 1 and 2, respectively, was 86%, 92% and 85%, and 69%, 74% and 76%; the corresponding percentage improvement in Qmax was 194%, 185% and 179%, and 124%, 145% and 139%, respectively. Overall treatment efficacy in all patients evaluated showed a mean 83%, 79%, 71% and 165% improvement in AUA SI, QoL, PVR and Qmax, respectively. Adverse events were minimal and the re-treatment rate was 4.3%. CONCLUSIONS These results suggest that there is a significant difference in efficacy in patients with a tPSA of ,,6.0 ng/mL or ,,6.1 ng/mL before PVP. However, the overall results achieved with PVP were very positive and durable to 3 years, irrespective of tPSA level and prostate volume. [source] Posterior tibial nerve stimulation in patients with intractable interstitial cystitisBJU INTERNATIONAL, Issue 1 2004Jimao Zhao OBJECTIVE To evaluate the efficacy of intermittent percutaneous posterior tibial nerve stimulation (PPTNS) in patients with refractory interstitial cystitis. PATIENTS AND METHODS One man and 13 women (mean age 58.3 years) with suprapubic or perineal pain were enrolled in a prospective open study, in which they had 10 weekly sessions of PPTNS. Their mean duration of symptoms was 8.3 years. All patients were previously diagnosed as having interstitial cystitis according to the National Institute of Diabetes and Digestive and Kidney Diseases criteria. The response to the treatment were assessed using voiding diary, visual analogue scale diary for a pain index, and the Interstitial Cystitis Problem Index (ICPI), O'Leary/Sant Interstitial Cystitis Symptom Index (ICSI) and the 36-item short-form health survey (SF-36) quality-of-life questionnaire. RESULTS Of the 14 patients, 13 completed the 10 weeks of treatment with no complications; 12 continued treatment for a short period after the study. There were no statistically significant changes in pain scores, voiding frequency and volumes, or in the ICPI, ICSI and SF-36 scores. However, there was an improvement in some patients, with one having complete resolution of the pain. CONCLUSION Intermittent PPTNS in patients with refractory interstitial cystitis has no significant clinical effect over 10 weeks of treatment. [source] The Finnish version of The National Institutes Of Health Chronic Prostatitis Symptom Index correlates well with the visual pain scale: translation and results of a modified linguistic validation studyBJU INTERNATIONAL, Issue 3 2003M.J. Leskinen Authors from Finland have assessed a version in their language of the National Institutes of Health-Chronic Prostatitis Symptom Index; they found that their translated version was valid and easily understandable in the management of the symptoms of chronic pelvic pain syndrome. They felt it should be used as a primary outcome measure in studies with these patients. There are three papers in this issue relating to the effect of drugs on LUTS; the first of these is a pooled analysis of three double-blind placebo-controlled studies into the safety and efficacy of the 10 mg dose of alfuzosin. The second evaluates the effect on quality-of-life issues of treatment with dutasteride. Finally, authors from Australia compare the effect of a Serenoa repens extract with placebo for LUTS. OBJECTIVES To provide a fluent and easily comprehensible Finnish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and to study its linguistic validity and correlation with a visual pain scale (VAS). PATIENTS AND METHODS The double-back translation method with two interim modifications was used to produce the Finnish version of the NIH-CPSI. The validity was tested by presenting the questionnaire to 155 men with clinically confirmed chronic pelvic pain syndrome (CPPS) and 12 controls with no previous urological symptoms. Convergent validity of the NIH-CPSI was tested by determining the correlation between the Finnish NIH-CPSI and VAS. Patients' and urologists' opinions about the utility of the Finnish NIH-CPSI were also reviewed. RESULTS The total Finnish NIH-CPSI scores and the pain domain and voiding symptom domain scores differed significantly (P < 0.001) between the groups, suggesting good discriminant validity of the symptom index. The NIH-CPSI scores correlated well with the VAS (Pearson's correlation 0.76). The preciseness and comprehensibility of the questionnaire were consistently evaluated to be ,good' or ,excellent' both by patients and urologists. CONCLUSIONS The Finnish version of the NIH-CPSI is valid and easily comprehensible for measuring CPPS symptoms. In addition, it provides good discriminant and convergent validity in distinguishing CPPS symptoms and should be used as primary outcome measure in CPPS studies. [source] IMPACT OF MARITAL AND PSYCHOLOGICAL DISTRESS ON THERAPEUTIC ALLIANCE IN COUPLES UNDERGOING COUPLE THERAPYJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2005Salima Mamodhoussen In this study, we describe the psychometric properties of the Couple Therapy Alliance Scale, revised (CTAS,r) and investigates the impact of marital and psychiatric distress on alliance. Seventy-nine couples in therapy completed a French version of the Dyadic Adjustment Scale and of the Psychiatric Symptoms Index at session one, and a French version of the CTAS,r at session three. Results indicate that the French version of the CTAS,r has adequate psychometric properties, although the subscales of the instrument are highly intercorrelated. Furthermore, marital adjustment predicts alliance scores, whereas psychiatric symptoms do not. Finally, male marital adjustment and female psychiatric symptoms are lower in couples where spouses have divergent perceptions of the alliance. Future research directions are discussed. [source] Validity of the osu post-traumatic stress disorder scale and the behavior assessment system for children self-report of personality with child tornado survivors,PSYCHOLOGY IN THE SCHOOLS, Issue 2 2008Linda Garner Evans Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale,Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP). Correlations were significant at 0.01 between BASC-SRP scales of Anxiety, Atypicality, and Clinical Maladjustment, and at least 0.05 between OSU PTSDS-CF scales for Social Stress, Depression, Inadequacy, and Emotional Symptoms Index (ESI). Analyses of variance (ANOVAs) yielded significant differences at 0.01 between children with and without PTSD, based on OSU PTSDS-CF cut-off scores, for BASC-SRP Anxiety, Atypicality, and Clinical Maladjustment. ANOVAs were significant at 0.05 for Social Stress, Locus of Control, Relationship with Parents, and ESI. Results yielded moderate effect sizes, and BASC-SRP means were within normal limits for all groups. Practitioners are encouraged to supplement the BASC-SRP with PTSD measures in children who have experienced trauma. © 2008 Wiley Periodicals, Inc. [source] Relationship between symptoms of temporomandibular disorders and dental status, general health and psychosomatic factors in two cohorts of 70-year-old subjectsGERODONTOLOGY, Issue 3 2007Tor Österberg Objective:, To study the prevalence of symptoms of temporomandibular disorders (TMD) in two cohorts of 70-year-old subjects examined 8 years apart and analyse the relationship between such symptoms and dental status, general health and various background factors. Materials and methods:, Two cohorts of 70-year-old subjects, born in 1922 (n = 422) and 1930 (n = 491) respectively, were examined with an interval of 8 years. A TMD symptom index (0,5) was established on answers to five questions related to TMD symptoms. Results:, There were no statistically significant differences between the two cohorts for prevalence of TMD symptoms and TMD index, neither for headache, neck ache, bruxism and chewing ability. TMJ sounds was the most prevalent symptom, 14%, whereas other TMD symptoms had low prevalence. The distribution of the TMD symptom index showed that 81% reported no symptoms, 15% one symptom, 3% two symptoms and 1% three to five symptoms. Single TMD symptoms and the TMD index exhibited significant associations (p < 0.001) with bruxism, headache, neck pain and several general health and psychosomatic factors, but with dental status only in women. Logistic regression showed that bruxism, neck pain, mouth dryness and a number of psychosomatic factors were associated with the TMD index. Conclusions:, Besides TMJ sounds (14%), other TMD symptoms were rarely reported by the 70-year-old subjects. The TMD index was significantly associated with bruxism and several general health and psychosomatic complaints but with dental status only in women. [source] Interstitial Cystitis and the Therapeutic Effect of Suplatast TosilateLUTS, Issue 2009Yukio HAYASHI Painful bladder syndrome (PBS)/interstitial cystitis (IC) can be a chronic and debilitating disease characterized by urinary urgency, frequency, and bladder pain, which are often very difficult to treat, regardless of currently-proposed treatments. Suplatast tosilate (IPD-1151T) is an immunoregulator that suppresses Th2 cytokine production, immunoglobulin E (IgE) synthesis, chemical mediator release from mast cells, and eosinophilic recruitment. In a preliminary, open-label clinical study of IPD-1151T in 14 women with IC, treatment with IPD-1151T significantly increased bladder capacity and decreased urinary urgency, urinary frequency, and lower abdominal pain, as measured by the IC symptom index, in patients with non-ulcerative IC. A concomitant reduction in immunological parameters (eosinophils, IgE, and urine T cells) was observed. Also, in basic experimental studies using hydrochloric acid-induced chronic cystitis rats, the oral administration of IPD-1151T (0.1,100 mg/kg/day) for 7 days after the induction of cystitis dose dependently increased the intercontraction intervals and micturition volume. In addition, the infiltration of mast cells and eosinophils into the bladder was suppressed by IPD-1151T. These findings suggest that IPD-1151T could be a new medicine for treating debilitating symptoms, such as bladder pain and urinary frequency in PBS/IC. [source] Paradoxical Vocal Fold Motion: A Sensory-Motor Laryngeal Disorder,THE LARYNGOSCOPE, Issue 2 2008Sabrina Cukier-Blaj SLP Abstract Objectives: The purpose of this study is to determine the laryngeal sensitivity (LS) thresholds and the ratings of laryngopharyngeal reflux symptoms in patients with paradoxical vocal fold motion (PVFM). Methods: This is a chart review following Institutional Review Board approval of 75 patients from January 2006 to June 2007. The patients were diagnosed with PVFM following case history, transnasal flexible laryngoscopy and spirometric testing. The data analyzed consisted of the reflux symptom index (RSI) and laryngopharyngeal sensitivity (LS). Laryngeal sensitivity and RSI were graded according to mild, moderate, or severe. Results: There were 12 (16%) patients with normal RSI scores, 37 patients (49.3%) with moderate RSI (RSI 11,22), and 26 patients (34.7%) with severe RSI (RSI >22). The right LS was normal in 11 patients (14.7%), moderately impaired in 16 patients (21.3%), and severely impaired in 48 (64%) patients. The left LS showed normal sensation in 11 patients (14.7%), moderately impaired LS in 13 patients (17.3%), and severe impairment in 51 patients (68%). Only one patient had both normal sensation and normal RSI, and 70.4% of patients had abnormal RSI and sensation thresholds. Conclusions: Patients diagnosed with PVFM had a high prevalence of symptoms related to LPR and markedly reduced LS. These findings suggest that PVFM may be triggered by reduced peripheral sensation or laryngeal inflammation. [source] The Finnish version of The National Institutes Of Health Chronic Prostatitis Symptom Index correlates well with the visual pain scale: translation and results of a modified linguistic validation studyBJU INTERNATIONAL, Issue 3 2003M.J. Leskinen Authors from Finland have assessed a version in their language of the National Institutes of Health-Chronic Prostatitis Symptom Index; they found that their translated version was valid and easily understandable in the management of the symptoms of chronic pelvic pain syndrome. They felt it should be used as a primary outcome measure in studies with these patients. There are three papers in this issue relating to the effect of drugs on LUTS; the first of these is a pooled analysis of three double-blind placebo-controlled studies into the safety and efficacy of the 10 mg dose of alfuzosin. The second evaluates the effect on quality-of-life issues of treatment with dutasteride. Finally, authors from Australia compare the effect of a Serenoa repens extract with placebo for LUTS. OBJECTIVES To provide a fluent and easily comprehensible Finnish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and to study its linguistic validity and correlation with a visual pain scale (VAS). PATIENTS AND METHODS The double-back translation method with two interim modifications was used to produce the Finnish version of the NIH-CPSI. The validity was tested by presenting the questionnaire to 155 men with clinically confirmed chronic pelvic pain syndrome (CPPS) and 12 controls with no previous urological symptoms. Convergent validity of the NIH-CPSI was tested by determining the correlation between the Finnish NIH-CPSI and VAS. Patients' and urologists' opinions about the utility of the Finnish NIH-CPSI were also reviewed. RESULTS The total Finnish NIH-CPSI scores and the pain domain and voiding symptom domain scores differed significantly (P < 0.001) between the groups, suggesting good discriminant validity of the symptom index. The NIH-CPSI scores correlated well with the VAS (Pearson's correlation 0.76). The preciseness and comprehensibility of the questionnaire were consistently evaluated to be ,good' or ,excellent' both by patients and urologists. CONCLUSIONS The Finnish version of the NIH-CPSI is valid and easily comprehensible for measuring CPPS symptoms. In addition, it provides good discriminant and convergent validity in distinguishing CPPS symptoms and should be used as primary outcome measure in CPPS studies. [source] Combining a symptoms index with CA 125 to improve detection of ovarian cancerCANCER, Issue 3 2008M. Robyn Andersen PhD Abstract BACKGROUND. The current study sought to examine whether an index based on the specific pattern of symptoms commonly reported by women with ovarian cancer could be used in combination with CA 125 to improve the sensitivity or specificity of experimental methods of screening for ovarian cancer. METHODS. A prospective case-control study design was used. Participants included 254 healthy women at high risk for disease because of family history, and 75 women with ovarian cancer. Logistic regression analysis was used to determine whether the symptom index predicted cancer. RESULTS. Symptom index information was found to make a significant independent contribution to the prediction of ovarian cancer after controlling for CA 125 levels (P<.05). The combination of CA 125 and the symptom index identified 89.3% of the women with cancer, 80.6% of the early,stage cancers, and 95.1% of the late-stage cancers. The symptom index identified cancer in 50% of the affected women who did not have elevated CA 125 levels. Unfortunately, 11.8% of the high-risk women without cancer also received a positive symptom index score. CONCLUSIONS. The addition of a symptom index to CA 125 created a composite index with a greater sensitivity for the detection of ovarian cancer than CA 125 alone and identified >80% of women with early-stage disease. A composite marker such as this could serve as a first screen in a multistep screening program in which false-positive findings are identified via transvaginal sonography before referral for surgery, leading to an adequate positive predictive value for the multistep program. Cancer 2008. © 2008 American Cancer Society. [source] The search for meaning,Symptoms and transvaginal sonography screening for ovarian cancer,CANCER, Issue 16 2009Predicting malignancy Abstract BACKGROUND: The mortality rate of ovarian cancer is greater than that of all other major gynecologic malignancies. Detecting ovarian cancer at an early and curable stage long has been an objective of oncologists. Recently, it was reported that certain symptom patterns are informative for the presence of ovarian malignancy. In this article, the authors report on how symptoms and ultrasound predict ovarian malignancy. METHODS: Two hundred seventy-two women who were participating in annual transvaginal sonography (TVS) screening were selected from among 31,748 women who were enrolled. Symptom results were correlated with ultrasound and surgical pathology findings. RESULTS: TVS performed better than symptoms analysis for detecting malignancies (sensitivity, 73.3% vs 20%), and symptoms analysis performed better for distinguishing benign tumors (specificity, 91.3% vs 74.4%). The use of TVS and symptoms analysis in series resulted in poorer identification of malignancy (sensitivity, 16.7%) but improved the ability to distinguish benign tumors (specificity, 97.9%). Decisions using either symptoms or TVS combined in parallel had small increases in sensitivity (+3.3%) and had coordinated, small decreases in specificity (,5.8%). CONCLUSIONS: Symptoms did identify ovarian malignancies, but not as well as TVS. The current findings indicated that: 1) tumors that are negative by both ultrasound and a symptoms index are likely to be benign (specificity, >97%), and 2) adding symptoms information that has weight equal to the weight of ultrasound only slightly improves the discrimination of malignancy (sensitivity increase, +3.3%). Thus, a major benefit in discriminating malignancy was achieved through ultrasound, whereas the absence of symptoms in conjunction with an abnormal ultrasound (characterized by a low morphology index) indicated that the mass was benign and that surgery may not be required. Finally, informative symptoms can be expected to be absent in 80% of patients with ovarian malignancies. Cancer 2009. © 2009 American Cancer Society. [source] | |||||||||||||