Disease Severity Is Associated with Alexithymia in Patients with Atopic Dermatitis

Dermatology ◽  
2020 ◽  
Vol 236 (4) ◽  
pp. 329-335
Author(s):  
Andrea Chiricozzi ◽  
Maria Esposito ◽  
Paolo Gisondi ◽  
Mario Valenti ◽  
Niccolò Gori ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Logistic Regression ◽  
Disease Severity ◽  
Healthy Subjects ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Control Group ◽  
Predicting Factor ◽  
Tas 20

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that is associated with higher rates of psychological disorders, but limited evidence supported the association with alexithymia, a psychoaffective dysfunction. Objectives: This study was aimed to investigate the occurrence of alexithymia in AD patients, compared to healthy subjects. Methods: This cross-sectional study assessed AD severity by the Eczema Area and Severity Index (EASI) score, sleeplessness and itch by a numeric rating scale (NRS), and alexithymia by the 20-item Toronto Alexithymia Scale (TAS-20) score. The association between disease characteristics and alexithymia was evaluated through several logistic regression models. Results: 202 AD patients and 240 healthy subjects were included in this study. The alexithymic personality trait (TAS-20 ≥51) was more frequently observed among AD patients compared to the control group (62.4% [126/202] vs. 29.2% [70/240], p < 0.0001). In particular, alexithymia (TAS-20 score ≥61) was detected in a significantly higher number of AD patients than in the controls (27.7% [56/202] vs. 7.5% [18/240]; p < 0.0001), whereas borderline alexithymia was detected in 34.6% (70/202) of AD patients compared to 21.7% of healthy controls. Alexithymia was more common among severe AD patients (43.6%) compared to mild AD patients (15.6%) and correlated with itch intensity and sleep disturbances. Among clinical variables, ordered logistic regression analyses revealed disease severity as predictor of alexithymia. Indeed, univariate analysis showed EASI score, sleep NRS, and itch NRS being significantly associated with alexithymia, while a multivariate model identified increased EASI score values as predicting factor. Conclusion:This study described alexithymia in AD patients correlating its occurrence with clinical AD severity markers (EASI score, itch, and sleeplessness) and identifying the increase in EASI score as predicting factor.

scholarly journals Low serum vitamin B12 levels are associated with degenerative rotator cuff tear

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Hwa Kim ◽  
Go-Tak Kim ◽  
Siyeoung Yoon ◽  
Hyun Il Lee ◽  
Kyung Rae Ko ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Rotator Cuff ◽  
Univariate Analysis ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Control Group ◽  
Mineral Density ◽  
Calcium Phosphorus ◽  
Healthy Control ◽  
Low Serum

Abstract Background Vitamin B12 (Vit B12) deficiency results in elevated homocysteine levels and interference with collagen cross-linking, which may affect tendon integrity. The purpose of this study was to investigate whether serum Vit B12 levels were correlated with degenerative rotator cuff (RC) tear. Methods Eighty-seven consecutive patients with or without degenerative RC tear were enrolled as study participants. Possible risk factors (age, sex, medical history, bone mineral density, and serum chemistries including glucose, magnesium, calcium, phosphorus, zinc, homocysteine, Vitamin D, Vit B12, homocysteine, and folate) were assessed. Significant variables were selected based on the results of univariate analyses, and a logistic regression model (backward elimination) was constructed to predict the presence of degenerative RC tear. Results In the univariate analysis, the group of patients with degenerative RC tear had a mean concentration of 528.4 pg/mL Vit B12, which was significantly lower than the healthy control group (627.1 pg/mL). Logistic regression analysis using Vit B12 as an independent variable revealed that Vit B12 concentrations were significantly correlated with degenerative RC tear (p = 0.044). However, Vit B12 levels were not associated with tear size. Conclusion Low serum levels of Vit B12 were independently related to degenerative RC tear. Further investigations are warranted to determine if Vit B12 supplementation can decrease the risk of this condition.

Symptoms of Depression and Anxiety, and Screening for Mental Disorders in Migrainous Patients

Cephalalgia ◽  
2003 ◽  
Vol 23 (2) ◽  
pp. 79-89 ◽  
Author(s):  
F Kowacs ◽  
MP Socal ◽  
SC Ziomkowski ◽  
VF Borges-Neto ◽  
DP Toniolo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Mental Disorders ◽  
Healthy Subjects ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Gender Education

The purpose of this clinic-based study was the assessment of symptoms of depression, anxiety, and non-specific psychiatric disorders amongst patients with migraine, compared with healthy subjects and with individuals with a non-neurological chronic disease. A cross-sectional study was carried out in which 178 individuals (migraine 51; psoriasis 35; healthy 92) were submitted to three scales: MADRS (depression), STAI-T (anxiety) and SRQ (screening for mental disorders). The subjects with migraine and psoriasis were from the Out-patient Clinics of Headache and of Dermatology, and the healthy volunteers were persons who were accompanying out-patients in the same hospital. Scores were analysed by MANOVA and by association analysis and logistic regression. Scores of all instruments were higher in the migrainous group, but the univariate analysis of association (using cut-offs) showed significance only for suspicion of mental disorders (SRQ). By logistic regression, variables with strongest association to migraine were gender, education, and SRQ in decreasing order.

Stereopsis Deficits in Parkinson’s Disease and Their Clinical Implications

2020 ◽  
Author(s):  
Fang Ba ◽  
Tina T. Sang ◽  
Jaleh Fatehi ◽  
Wenjing He ◽  
Emanuel Mostofi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Severity ◽  
Rating Scale ◽  
Disease Status ◽  
Cognitive Status ◽  
Control Group ◽  
Motor Disorder ◽  
Healthy Control ◽  
Stereo Acuity

Abstract Background: Parkinson's disease (PD) is not exclusively a motor disorder. Among non-motor features, PD patients possess sensory visual dysfunctions. Stereopsis deficit can significantly impact patients' motor performance. However, it is not routinely tested, and its significance is under-investigated. Studying stereopsis using reliable 3D stimuli may help determine its implications in disease status in PD.The objective of the study is to investigate stereopsis abnormalities in PD with reliable and more physiological tools, and their correlation with indicators of PD severity. Methods: Twenty-four healthy control and 20 PD participants were first evaluated for visual acuity, visual field, contrast acuity, and stereoperception with 2D and Titmus stereotests, followed by the assessment with the 3D active shutter system. The correlation between stereopsis and disease severity, Unified Parkinson’s disease rating scale motor scores (UPDRS-III), levodopa equivalent daily dose (LEDD), course of disease and cognitive status were evaluated using univariate regression models. Results: Screening visual tests did not reveal any differences between PD and control group. With the 3D active shutter system, PD patients demonstrated significantly worse stereopsis (i.e p=0.002, 26 seconds of arc). There was a trend that UPDRS-III and LEDD negatively correlate with the stereo acuity, suggesting poorer stereoperception is related to disease severity. Preserved cognitive function correlated with more intact stereo acuity. Conclusion: With more reliable and physiological tools, PD patients exhibit poorer stereopsis. These deficits reflected PD motor and cognitive status. How stereopsis relates to gait, fall risks and navigation warrants more investigations in the future.

Escitalopram in Treatment of Sleep Disturbances in Major Depressive Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Zivkovic ◽  
G. Djokic ◽  
D. Pavicevic ◽  
V. Ilic
Keyword(s):  
Major Depressive Disorder ◽  
Adverse Effects ◽  
Depressive Disorder ◽  
Sleep Disturbances ◽  
Rating Scale ◽  
Statistical Significance ◽  
Control Group ◽  
Major Depressive ◽  
High Statistical Significance ◽  
Experimental Group

Major depressive disorder (MDD) is common and severe affective disorder with sleep disturbances and non-bizarre delusions which are organized in permanent and unshakeable delusional system. Neurobiological basis of MDD is still completely unknown, but significant role has serotoninergic and noradrenergic neuronal systems. Escitalopram is highly potent and highly selective serotonin re-uptake inhibitor.Purpose of this study was to estimate efficacy of the escitalopram in treatment of sleep disturbances in MDD.Methods:This prospective clinical study included 95 patients diagnosed by ICD-10 criteria for MDD, who are randomly divided into control (30 patients) and experimental group (65 patients). Patients were observed for 6 months in hospital and outpatients conditions, according to specially designed protocol, which included Hamilton Depression Rating Scale (HAMD) and Leeds Sleeping Evaluation Questionnaire (LSEQ). Control group was treated with maprotiline (75-150 mg/24h) and experimental group with escitalopram (10-20 mg/24h).Results:Escitalopram therapy influenced on HAMD score with high statistical significance vs. maprotiline, p=0.000. Escitalopram therapy improves LSEQ score after 6 months in comparison to maprotiline therapy with high statistical significance p=0.000. Percentage of adverse effects is significantly lower in escitalopram (10.76%) than in maprotiline (26.67%) group.Conclusion:Escitalopram has significantly better efficacy and lower adverse effects rate in treatment of depressive symptoms and sleep disturbances in MDD patients comparing to maprotiline.

Predictors of chronic neuropathic pain after scoliosis surgery in children

2017 ◽  
Vol 17 (1) ◽  
pp. 339-344 ◽  
Author(s):  
Florence Julien-Marsollier ◽  
Raphaelle David ◽  
Julie Hilly ◽  
Christopher Brasher ◽  
Daphné Michelet ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Logistic Regression ◽  
Neuropathic Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Univariate Analysis ◽  
Opioid Consumption ◽  
Multivariate Logistic Regression Model ◽  
Scoliosis Surgery ◽  
Preoperative Pain

AbstractBackgroundNumerous publications describe chronic pain following surgery in both adults and children. However, data in the paediatric population are still sparse and both prevalence of chronic pain after surgery and risk factors of this complication still undetermined.MethodsWe prospectively evaluated the prevalence of chronic pain and its neuropathic pain component at 1 year following correction of idiopathic scoliosis in children less than 18 years of age. Pain was defined as the presence of pain (numerical rating scale – NRS ≥4), the presence of signs of neurologic damage within the area of surgery and the presence of the neuropathic symptoms as a DN4 (Douleur Neuropathique 4) questionnaire ≥4. Factors investigated as potentially associated with the presence of a persistent neuropathic pain were: age, weight, the presence of continuous preoperative pain over the 3 months before surgery, surgical characteristics, pain scores during the first five postoperative days, and DN4 at day 3. Statistical analysis employed univariate analysis and a multivariate logistic regression model.ResultsThirty six patients were included in the study. Nineteen (52.8%) had pain at one year after surgery. Among them 17 (48.2%) had neuropathic pain. Logistic regression found continuous pain over the 3 months preceding surgery and day 1 morphine consumption ≥0.5 mg kg-1 as independent predictors of persistent chronic pain with a neuropathic component. The overall model accuracy was 80.6 and the area under the curve of the model was 0.89 (95% confidence interval 0.78–0.99).ConclusionsThe present study found a high proportion of paediatric patients developing chronic persistent pain after surgical correction of scoliosis diformity. It allows identifying two factors associated with the occurrence of persistent chronic pain with a neuropathic component: the presence of persistent preoperative pain during the 3 months preceeding surgery and postoperative opioid consumption at day 1 –;0.5 mg kg-1ImplicationPatients scheduled for spine surgery and presenting with preoperative pain should be considered at risk of chronic pain after surgery and managed accordingly by the chronic and/or acute pain team. Postoperative opioid consumption should be lowered as possible by using multimodal analgesia and regional analgesia such as postoperative epidural analgesia.

scholarly journals Association between Quantitative Classification of Renal Surface Nodularity and Early Renal Injury in Patients with Arterial Hypertension

2021 ◽  
Author(s):  
Jun Zhou ◽  
Jiule Ding ◽  
Jie Chen ◽  
Liang Pan ◽  
Tingting Zha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Arterial Hypertension ◽  
Renal Injury ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Ct Imaging ◽  
Control Group ◽  
Multiple Logistic Regression ◽  
Quantitative Classification

Abstract Objective To explore the association between quantitative classification of renal surface nodularity (qRSN) based on computed tomography (CT) imaging and early renal injury (ERI) in patients with aerial hypertension.Methods A total of 143 patients with a history of hypertension were retrospectively enrolled; clinical information (age, sex, hypertension grade, hypertension course, poorly controlled hypertension), laboratory tests and qRSN were collected or assessed. The subjects were divided into an ERI (n=60) or a control (CP, n=83) group according to ERI diagnosis based on the following criteria: cystatin C > 1.02 mg/L, creatinine ≤ 127 μmol/L, and urea nitrogen ≤ 8.3 mmol/L. Univariate analysis and multiple logistic regression were used to examine the association between ERI and qRSN. A receiver operating characteristic curve (ROC) was produced to compare multiple logistic regression models with or without qRSN for differing the ERI group from the control group.Results In univariate analysis, hypertension grade, poorly controlled hypertension, hypertension course, triglycerides (TG) and qRSN were related to ERI in patients with arterial hypertension (all P<0.1), with strong interrater agreement of qRSN. Multiple logistic regression analysis showed an area under the ROC curve of 0.705 in the model without qRSN and 0.789 in the model with qRSN, which was significantly different (Z=2.317, P=0.021).Conclusion CT imaging-based qRSN was associated with ERI in patients with arterial hypertension and may be an imaging biomarker of early renal injury.

Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section II: Tools for Assessing the Severity of Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 10S-16S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Robert Bissonnette ◽  
Parbeer Grewal ◽  
Perla Lansang ◽  
Kim A. Papp ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Quality ◽  
Severity Index ◽  
Adult Patients ◽  
Physician Global Assessment ◽  
Atopic Dermatitis Severity ◽  
Patient Reported

Clinicians rely on clinical measures to define the severity of atopic dermatitis and assess outcomes of therapy. These measures can be objective (ie, physician assessments of disease severity) or subjective (ie, patient-reported symptoms and quality of life outcomes). In this review, the most commonly used tools for assessing atopic dermatitis severity in adult patients are presented and compared. These include Eczema Area and Severity Index (EASI); SCORing Atopic Dermatitis (SCORAD); Physician Global Assessment (PGA); body surface area (BSA); Atopic Dermatitis Severity Index (ADSI); Six Area, Six Sign Atopic Dermatitis (SASSAD); Patient Oriented Eczema Measure (POEM); Dermatology Life Quality Index (DLQI); and pruritus Numerical Rating Scale (NRS). Available severity strata for the tools are summarized, although the use of severity strata in clinical practice is not recommended. Since both objective and subjective assessments of disease severity are important to assess, consideration of clinical characteristics such as disease recurrence or persistence, as well as location of the affected areas, should be considered in the overall judgement of disease severity and consideration of therapy choice.

scholarly journals Human Pharmacokinetics of l-3,4-Dihydroxyphenylalanine Studied with Microdialysis

1999 ◽  
Vol 45 (10) ◽  
pp. 1813-1820 ◽  
Author(s):  
Nil Dizdar ◽  
Anita Kullman ◽  
Björn Norlander ◽  
Jan-Edvin Olsson ◽  
Bertil Kågedal
Keyword(s):  
Protein Binding ◽  
Parkinson Disease ◽  
Healthy Subjects ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Disease Stage ◽  
Control Group ◽  
Pharmacokinetic Studies ◽  
Human Pharmacokinetics ◽  
Serum Samples

Abstract Background: Intravenous and subcutaneous microdialysis was performed to compare the free concentrations and pharmacokinetics of l-3,4-dihyroxyphenylalanine (l-dopa) in blood and tissue in healthy subjects and in patients with Parkinson disease. Methods: Nine healthy volunteers and 10 patients with Parkinson disease, stage 1.5–2 according to the Hoehn-Yahr rating scale, took part of the study. In the patient group subcutaneous microdialysis and ordinary blood sampling were performed, whereas in the control group intravenous microdialysis was also performed. Microdialysis samples were collected in fractions of 15 min. The first two fractions were collected for analysis of basal concentrations. A blood sample was also taken. The patients were then given one tablet of Madopar® (100 mg of l-dopa and 25 mg of benserazide), and the microdialysis was continued for another 210 min. Blood samples were obtained at 30-min intervals. Results: The serum samples gave a significantly higher mean area under the curve (AUC; 491 ± 139 μmol · min/L) than that for intravenous dialysates (235 ± 55.3 μmol · min/L), suggesting a protein binding of 50%. The l-dopa concentrations from the subcutaneous dialysates matched those from the intravenous dialysates, indicating rapid distribution of l-dopa to the tissues. Conclusions: Parkinsonian patients in early stages of the disease have a pharmacokinetic pattern of free l-dopa similar to that of healthy subjects. Comparison of AUCs from microdialysis with ordinary serum analysis revealed data indicating significant protein binding. Microdialysis is a suitable and easily applied tool in pharmacokinetic studies.

scholarly journals Atopic dermatitis in children and adolescents with obesity and overweight: clinical, anthropometric data, psycho-emotional status and predictors of effective treatment

2021 ◽  
pp. 4-14
Author(s):  
O.B. Nemchaninova ◽  
◽  
M.Yu. Dolgikh ◽  
T.B. Reshetnikova ◽  
◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Children And Adolescents ◽  
Treatment Efficacy ◽  
Univariate Analysis ◽  
Main Group ◽  
Overweight And Obesity ◽  
Control Group ◽  
Emotional Status ◽  
Anthropometric Data ◽  
And Gender

The results of a comprehensive analysis of clinical, anthropometric data and an assessment of the psycho-emotional status of 62 children and adolescents (mean age 11.8 ± 3.0 years) with atopic dermatitis and overweight or varying degrees of obesity (the main group) are presented. The control group included 60 patients (mean age 10.1 ± 3.6 years) with atopic dermatitis and body weight corresponding to age and gender standards. In the main group, 45.2% were children and adolescents with overweight, and with first-, second- and third-degree obesity were 25.8, 11.3 and 17.7% respectively. The severe course of dermatosis in the main group was recorded 1.4 times more often than in the control group. With the aid of univariate analysis of the treatment efficacy predictors, it was revealed that weight loss and improvement in psycho-emotional state can significantly increase the treatment efficacy of atopic dermatitis in children and adolescents with overweight and obesity, which indicates the advisability of interaction between a dermatologist, endocrinologist and psychotherapist in the treatment of this category of patients.

scholarly journals A Review of the Effects of Psychological Interventions on the Quality of Life for Children with Atopic Dermatitis

2010 ◽  
Vol 1 (1) ◽  
pp. 23
Author(s):  
Maria A Czerniakow
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Disease Severity ◽  
Intervention Group ◽  
Control Group ◽  
Education Intervention ◽  
Night Time ◽  
Pubmed Database ◽  
Video Education

Atopic Dermatitis (AD) is a psychologically debilitating disease due to its embarrassing skin lesions and pruritic nature which disturb the quality of life (QOL) of the patients. Even though children are primarily affected, caregivers can also be affected due to being the first line of care for others who are inflicted. This review focuses on randomized control trials which investigated the use of non-chemical forms of treatment to improve QOL and disease severity in children. A search of the PubMed database identified six studies that met the inclusion criteria. The studies were ranked from most rigorous trial to least. Various forms of education as an intervention were used. Conversely, the viewing of a humorous film was tested to examine if it had an impact on QOL. Education intervention versus no education at all showed that the intervention group had a larger decrease in disease severity than the control group. The form of education as a single consult with an AD educated nurse showed no difference between the control and the intervention group. Comparison of nurse-led clinics with the dermatologist-led clinics indicated that the nurse-led clinics were more successful. Viewing humorous films before bedtime was demonstrated as a successful means of reducing night-time awakenings. Also specific AD education versus routine education and consultations showed improvement in both groups. Finally, AD video education versus direct parental teaching concluded that the video-education was more effective. Although the studies show that any form of education intervention is better than none, the methodological assessment of the studies showed that four of the studies were not rigorous enough or were not described at all. Further studies must be conducted in a more methodologically sound manner for the results to be considered replicable and valid. 

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