Anticholinergic medication use is associated with globus pharyngeus

2016 ◽  
Vol 130 (12) ◽  
pp. 1125-1129 ◽  
Author(s):  
S Haft ◽  
R M Carey ◽  
D Farquhar ◽  
N Mirza

AbstractBackground:Globus pharyngeus has been linked to salivary hypofunction. We hypothesise that a considerable portion of the globus experienced by patients is due to a drying effect secondary to anticholinergic medication use; this study aimed to determine their association.Methods:A cross-sectional study was conducted of 270 patients who presented to a laryngology practice over 6 months. Participants rated globus sensation on a 5-point severity scale, with those scoring 0 considered as controls (non-globus). Participants were excluded if they had a likely cause of globus. Scores were compared with participants’ medication lists, co-morbidities, age and gender, and evaluated using multivariate analysis, with significance set at p < 0.05.Results:Any participant taking at least 2 anticholinergic medications had a 3.52 increased odds (p = 0.02) of experiencing globus. A previous diagnosis of gastroesophageal reflux disease was also significantly associated with globus (p = 0.004), with an odds ratio of 3.75.Conclusion:A substantial portion of idiopathic globus may be due to anticholinergic use or reflux. The findings implicate medication use as a risk factor for globus. An awareness of these associations is invaluable for identifying cause and treating globus.

2020 ◽  
Vol 10 ◽  
pp. 2235042X2092044
Author(s):  
Lucy E Stirland ◽  
Sarah Gregory ◽  
Tom C Russ ◽  
Craig W Ritchie ◽  
Graciela Muniz-Terrera

Background: Multimorbidity including physical and mental illness is increasing in prevalence. We aimed to investigate the associations between physical conditions and medication use with anxiety and depression in midlife. Methods: We conducted an observational cross-sectional study of volunteers in the PREVENT Dementia study. Using logistic and linear regression, we investigated the association between increasing numbers of self-reported chronic physical conditions and medications with self-reported depression and anxiety disorder, and scores on the Center for Epidemiologic Studies Depression (CES-D) scale and Spielberger State-Trait Anxiety Inventory (STAI) state subtest. Results: Of the 210 participants, 148 (71%) were women and 188 (90%) Caucasian. The mean age was 52 (standard deviation (SD) = 5.5) years. The mean number of physical conditions was 2.2 (SD = 1.9) and medications 1.7 (SD = 2.2). Each additional physical condition was associated with increased odds of self-reported depression (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.11–1.80; p = 0.004, adjusted for age and gender) and anxiety disorder (OR 1.70, 95% CI 1.30–2.37; p < 0.001). Increasing medication use was associated with self-reported depression (adjusted OR per additional medication 1.35, 95% CI 1.08–1.71; p = 0.008) but not anxiety disorder. For each additional condition, CES-D scores increased by 0.72 (95% CI 0.11–1.33; p = 0.020) and for each extra medication, by 0.88 (95% CI 0.32–1.44; p = 0.002). There was no significant association between increasing conditions and medications with STAI scores. In models accounting for antidepressant use, all associations were attenuated. Conclusions: Having more physical conditions is associated with anxiety and depression in midlife, and taking more medications is associated with depression but not anxiety.


2018 ◽  
Vol 57 (3) ◽  
pp. 140-147 ◽  
Author(s):  
Eva Gorup ◽  
Janez Rifel ◽  
Marija Petek šter

AbstractIntroductionAnticholinergic burden in older adults has been correlated with cognitive decline, delirium, dizziness and confusion, falls and hospitalisations. Nevertheless, anticholinergic-acting medications remain commonly prescribed in up to a third of older adults in primary care population. Our aim was to study the anticholinergic burden in older adults in Slovenian ambulatory setting and explore the most commonly involved medications which could be avoided by the physicians.MethodsA cross-sectional study was conducted in 30 general practices in Slovenia as part of a larger trial. Data on prescribed medications were collected for randomly chosen adults of over 65 years of age visiting general practice, who were taking at least one regularly prescribed medication. Anticholinergic burden was calculated using Duran’s scale and Drug Burden Index.ResultsAltogether, 622 patients were included, 356 (57.2%) female, average age of 77.2 (±6.2), with an average of 5.6 medications. At least one anticholinergic medication was present in 78 (12.5 %) patients. More than half (N=41, 52.6%) of anticholinergic prescriptions were psychotropic medications. Most common individual medications were diazepam (N=10, 1.6%), quetiapine (N=9, 1.4%) and ranitidine (N=8, 1.3%).ConclusionsThough the prevalence of anticholinergic medications was low compared to international research, the most commonly registered anticholinergic prescriptions were medications that should be avoided according to guidelines of elderly prescriptions. It would be probably clinically feasible to further decrease the anticholinergic burden of older adults in Slovenian primary care setting by avoiding or replacing these medications with safer alternatives.


2014 ◽  
pp. 90-93
Author(s):  
Van Tuan Nguyen ◽  
Tam Vo ◽  
Bui Bao Hoang

Elevated serum Transforming growth factor-beta1 (TGF-beta1) levels have been linked to tissue fibrosis including chronic kidney disease. Objectives: (1) Investigate serum TGF-beta1 levels in healthy adult people and (2) Examined the relation between serum TGF-beta1 level and gender, age, body mass index (BMI). Method: A cross-sectional study. TGF-beta1 were quantified by ELISA. Results: Levels of serum TGF-beta1 in healthy people were 13,45 ± 7,17 ng/mL mL (0,59 - 33,10 ng/mL). There are no difference of serum TGF-beta1 levels between men and women, between the age groups (<40 years, 40 to < 60 years and ≥ 60 years), between BMI groups < 23 and BMI group ≥ 23. Key words: TGF-beta1, healthy people


2020 ◽  
Vol 7 ◽  
pp. 2333794X2098134
Author(s):  
Henry Clark ◽  
Delesha Carpenter ◽  
Kathleen Walsh ◽  
Scott A. Davis ◽  
Nacire Garcia ◽  
...  

The purpose of this study was to describe the number and types of errors that adolescents and caregivers report making when using asthma controller medications. A total of 319 adolescents ages 11 to 17 with persistent asthma and their caregivers participated in this cross-sectional study. Adolescent and caregiver reports of asthma medication use were compared to the prescribed directions in the medical record. An error was defined as discrepancies between reported use and the prescribed directions. About 38% of adolescents reported 1 error in using asthma controller medications, 16% reported 2 errors, and 5% reported 3 or more errors. About 42% of caregivers reported 1 error in adolescents using asthma controller medications, 14% reported 2 errors, while 6% reported 3 or more errors. The type of error most frequently reported by both was not taking the medication at all. Providers should ask open-ended questions of adolescents with asthma during visits so they can detect and educate families on how to overcome errors in taking controller medication use.


Author(s):  
Maria Theresa Costa Ramos de Oliveira Patrial ◽  
Rogério Hamerschmidt ◽  
Jorge Eduardo Fouto Matias ◽  
Evaldo Dacheux de Macedo Filho ◽  
Bettina Carvalho

Abstract Introduction The study of larynx lesions is of great importance. More than 50% of people with vocal complaints have benign vocal fold alterations and some require surgery. Objective To determine which factors are related to surgical recurrence of benign laryngeal lesions and to determine which videolaryngoscopic diagnoses are related to the risk or protection of surgical relapses over time. Methods Observational, analytical, cross-sectional study with retrospective data collection of 1,383 surgeries in 1,301 patients. Results The mean age at the first surgery was 39.2 years old. The predominant gender was female (65.6%).There were 396 cases of polyps (25.34%), 349 cases of cysts (22.33%), 261 cases of Reinke edema (16.7%), 175 cases of nodules (11.2%), 153 cases of minor structural alterations (MSAs) (9.79%), 94 cases of leukoplakia (6.01%), 77 cases of granulomas (4.93%) and 58 cases of pseudocysts (3.71%). The age presented statistical significance with the risk of surgical relapses (p = 0.016). Male gender was associated with the greatest chance of relapse.Diagnosis of granuloma (p < 0.001) and of leukoplakia (p < 0.001) were associated with a higher risk of surgical recurrence. Cyst diagnosis was associated with protection (p = 0.015) in relation to the chance of further surgeries. Patients with associated lesions, bilaterals or voice professionals did not present a statistically significant association with surgical recurrence. Conclusion Age and gender are statistically related to the increase of surgical relapses. Leukoplakia and granuloma are associated with increased surgical relapses. Patients submitted to cyst microsurgery appear to be protected against surgical recurrence.


2020 ◽  
Vol 41 (S1) ◽  
pp. s380-s380
Author(s):  
Sree Kalpana Mohankumar ◽  
Vishweshwarayya Hiremath ◽  
Rajashree Koppad

Background: Countries that have good rubella surveillance, report ∼10,000–20,000 rubella cases annually. In India, not many cases of rubella are reported. The Hebballi Agasi ward of Dharwad district in Karnataka state, India, reported rubella cases on the last week of January 2015. Objective: We investigated the outbreak by time, place, person, and clinical symptoms. Methods: We performed a cross-sectional study. We defined a case as any resident of Heballi Agasi who had fever and rash, with or without lymphadenopathy, arthralgia, conjunctivitis, coryza, and cough, after December 15, 2014. We collected sociodemographic details and clinical symptoms of patients. We collected 5 serum samples and sent them to the National Measles Laboratory, Bangalore. We tested for measles and rubella antibodies. We drew an epidemic curve and a spot map. We computed mean age of cases, and we calculated attack rates by mean age and gender. We calculated proportions to describe clinical symptoms, and we interviewed stakeholders regarding rubella vaccination. We continued surveillance until March 2015. Results: The population of Heballi Agasi was 1,458. We identified 15 rubella cases (9 girls and 6 boys). The outbreak lasted between December 10, 2014, and February 21, 2015, with a peak on January 16, 2015. The overall attack rate was 1% (15 of 1,458). The mean age of the cases was 6 years (range, 1–23). The attack rate was high (7.7%) among those aged 1–6 years (11 of 143). The attack rate among those aged >6 years was 0.3% (4 of 1,315). In addition to fever and rash, 93% of cases (14 of 15) had coryza, 47% had cough (7 of 15), and 40% had conjunctivitis (6 of 15). Lymphadenopathy was present in only 1 case (1 of 15), and arthralgia was absent among all 15 cases. There was no death among the cases. All 5 sera were positive for rubella and negative for measles. Rubella vaccination was not given for any of the cases because no rubella vaccination is provided in the routine immunization program. Conclusions: There was a rubella outbreak in Heballi Agasi ward. Children aged 1–6 years were most affected. We recommend rubella vaccination in the routine immunization.Funding: NoneDisclosures: None


2019 ◽  
Vol 11 (01) ◽  
pp. e1-e8
Author(s):  
Michael Solotke ◽  
Susan Forster ◽  
Jessica Chow ◽  
Jenesis Duran ◽  
Hasna Karim ◽  
...  

Purpose The aim of this article is to examine the association between industry payments to ophthalmologists and scholarly impact. Design Retrospective cross-sectional study. Methods All ophthalmology faculty at United States accredited ophthalmology residency programs were included in this study. The main exposure was industry payments to ophthalmologists in 2016, as reported in the Centers for Medicare and Medicaid Services Open Payments Database. The primary outcome was Hirsch index (H-index), a measure of scholarly impact. Results Among 1,653 academic ophthalmologists in our study, 1,225 (74%) received industry payments in 2016. We did not observe a difference between the mean H-index of ophthalmologists receiving any industry payments versus those not receiving any payments (p = 0.68). In analysis including only ophthalmologists who received industry payments, H-index differed significantly by payment amount: 12.6 for ophthalmologists receiving less than $100, 12.2 for those receiving $100 to 1,000, 18.8 for those receiving $1,000 to 10,000, 21.3 for those receiving $10,000 to 100,000, and 29.4 for those receiving greater than $100,000 (p < 0.001). Within each academic rank and gender, industry payments greater than $1,000 were associated with a higher H-index (p < 0.05). Conclusions Although our analysis cannot prove causality, we observed a significant association between industry payments and scholarly impact among academic ophthalmologists, even after adjusting for gender, academic rank, and subspecialty. Prospective studies should further evaluate this relationship.


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