scholarly journals Elevated fecal calprotectin is linked to psychosocial complexity in pediatric functional abdominal pain disorders

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Erin L. Moorman ◽  
Michael Farrell ◽  
Neha Santucci ◽  
Lee Denson ◽  
Christine Le ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Functional Disability ◽  
Rating Scale ◽  
Child Anxiety ◽  
Risk Groups ◽  
Fecal Calprotectin ◽  
Numeric Rating Scale ◽  
Functional Abdominal Pain ◽  
Increased Risk

Abstract Objective Children with functional abdominal pain disorders (FAPD) and clinical elevations in three risk areas (anxiety, functional disability, and pain) have been found to be at increased risk for persistent disability. We evaluated if the presence of these three risk factors corresponded with greater gastrointestinal inflammation (measured via fecal calprotectin; FC) compared to those with no risk factors. FC concentration differences between children with three risk factors and those with one and two risk factors were explored. Results Fifty-six children with FAPD (Mage = 12.23) completed measures of anxiety (Screen for Child Anxiety Related Disorders), disability (Functional Disability Inventory), and pain intensity (Numeric Rating Scale). Participants were stratified into risk groups (range: 0–3). Fisher’s exact tests were conducted to determine if children with three versus fewer risk factors were more likely to have elevated FC (≥ 50 µg/g) versus normal levels. Children with three risk factors (MFC = 86.04) were more likely to have elevated FC compared to children with zero (MFC = 25.78), one (MFC = 38.59), and two risk factors (MFC = 45.06; p’s < 0.05). Those with three risk factors had borderline elevated FC concentrations whereas those with fewer had normal FC concentrations. Findings suggest the importance of a biopsychosocial approach to help elucidate a FAPD phenotype.

scholarly journals Prevalence of Neuropathic Pain Varies in Patients With Knee Osteoarthritis in Different Treatment Stages

2021 ◽  
Author(s):  
Li Li ◽  
Zhaohui Zeng ◽  
Hanle Zhang ◽  
Yuanyuan Lin ◽  
Linghui Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neuropathic Pain ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Nociceptive Pain ◽  
Womac Pain ◽  
Increased Risk ◽  
Outpatient Group ◽  
Paindetect Questionnaire

Abstract Background: Pain is the main symptom of knee osteoarthritis (KOA) and can be classified as nociceptive pain and neuropathic pain (NP). However, the prevalence and risk factors of NP in patients with KOA at different treatment stages vary in countries and are still unclear in China.Methods: Patients in this retrospective study were divided into three groups according to treatment stage, including outpatient stage, preoperative total knee arthroplasty (pre-TKA) stage and postoperative TKA stage (post-TKA). A numeric rating scale (NRS) and PainDETECT questionnaire were used to evaluate nociceptive pain and NP. Patient demographics, radiological assessments using Kellgren-Lawrence (K-L) grades, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were analyzed.Results: Of the 921 patients, the prevalence of possible and likely NP was 17.5% (56/320) and 2.5% (8/320) in the pre-TKA group compared with 3.4% (8/233) and 0.4% (1/233) in the outpatient group and 1.4% (5/368) and 0.5% (2/368) in the post-TKA group, respectively. In the pre-TKA group, higher NRS (NRS>3; OR=10.65, 95% CI: 3.25-34.92, p<0.001) and WOMAC pain (WOMAC>10; OR=4.88, 95% CI: 2.38-10.01, p<0.001) scores conferred an increased risk of unclear pain. Age, gender, BMI and K-L grade showed no significant differences among the unlikely, possible and likely NP groups.Discussion: Different prevalence of NP occur in KOA patients at different treatment stages. Due to the low prevalence of NP in the outpatient and post-TKA groups, we suggest not regularly screening for NP in these patients, while it may be essential to screen for NP in patients waiting for TKA. In the latter group, higher NRS and WOMAC pain scores are important risk factors of NP.

scholarly journals The Influence of Caregiver Distress and Child Anxiety in Predicting Child Somatization in Youth with Functional Abdominal Pain Disorders

Children ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. 134 ◽  
Author(s):  
Sarah C. Love ◽  
Constance A. Mara ◽  
Anne E. Kalomiris ◽  
Natoshia R. Cunningham
Keyword(s):  
Abdominal Pain ◽  
Functional Disability ◽  
Psychological Treatment ◽  
Child Anxiety ◽  
Adverse Outcomes ◽  
Caregiver Distress ◽  
Functional Abdominal Pain ◽  
Caregiver Anxiety ◽  
The Relationship

Pediatric functional abdominal pain disorders (FAPD) are associated with adverse outcomes including increased somatization (e.g., heightened physiological sensations that include gastroenterological and non-gastroenterological symptoms) and increased functional disability. Caregiver distress and child anxiety are separately associated with the adverse outcomes of pediatric FAPD. However, the cumulative role of caregiver (i.e., stress, anxiety, and depression) and child psychological functioning (anxiety) in relation to adverse outcomes associated with FAPD, and particularly somatization, is unclear. Thus, the present investigation sought to examine the role of caregiver distress and child anxiety in relation to pain-related functioning (i.e., somatization, pain intensity, functional disability) in youth with FAPD. Data were gathered as part of a larger study examining a psychological treatment for youth with FAPD. Participants (ages 9–14) with FAPD completed measures of child anxiety, pain, and pain-related functioning. Caregivers completed a measure of caregiver distress (e.g., stress, anxiety, depressive symptoms). Pearson correlations revealed significant positive associations between child anxiety and child functional disability. Additionally, caregiver anxiety, child anxiety, and child somatization were all significantly and positively correlated with one another. Therefore, we assessed whether child anxiety may potentially mediate the relationship between caregiver anxiety and child somatization in this cross-sectional study. The indirect association between caregiver anxiety and child somatization via child anxiety was not significant. Future research including longitudinal designs to further understand the relationship between caregiver anxiety, child anxiety, and child pain-related functioning, would enhance understanding of how these potentially modifiable psychological factors may impact adverse outcomes of FAPD.

scholarly journals Prevalence of Psychological Distress and Its Risk Factors in Patients with Primary Bone and Soft Tissue Tumors

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 566
Author(s):  
Masato Ise ◽  
Eiji Nakata ◽  
Yoshimi Katayama ◽  
Masanori Hamada ◽  
Toshiyuki Kunisada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Soft Tissue ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Soft Tissue Tumors ◽  
Number Of Patients ◽  
Primary Bone ◽  
Associated Risk Factors ◽  
Numeric Rating

Psychological distress is common in patients with soft tissue and bone tumors. We first investigated its frequency and the associated risk factors in patients with pre-operative bone and soft tissue tumors. Participants included 298 patients with bone and soft tissue tumors who underwent surgery in our institution between 2015 and 2020. Psychological distress was evaluated by the Distress and Impact Thermometer (DIT) that consists of two types of questions (questions about the severity of the patient’s distress (DIT-D) and its impact (DIT-I)). We used a cut-off point of 4 on the DIT-D and 3 on the DIT-I for screening patients with psychological distress. We therefore investigated: (1) the prevalence of psychological distress as assessed with DIT or distress thermometer (DT), which can be decided by DIT-D ≥ 4, (2) what are the risk factors for the prevalence of psychological distress, and (3) what is the number of patients who consulted a psychiatrist for psychological distress in patients with pre-operative bone and soft tissue tumors. With DIT and DT, we identified 64 patients (21%) and 95 patients (32%), respectively, with psychological distress. Multivariate logistic regression revealed that older age, sex (female), malignancy (malignant or intermediate tumor), a lower Barthel Index, and higher numeric rating scale were risk factors for psychological distress. Two patients (3%) consulted a psychiatrist after surgery. In conclusion, careful attention to psychological distress is needed, especially for female patients, older patients, and those with malignant soft or bone tissue tumors who have more than moderate pain.

scholarly journals Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

2018 ◽  
Vol 90 (8) ◽  
pp. 40-47 ◽  
Author(s):  
I V Maev ◽  
Yu A Kucheravy ◽  
V V Tsukanov ◽  
E Yu Eremnia ◽  
D N Andreev ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Surgical Treatment ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Marked Change ◽  
Numeric Rating Scale ◽  
Observational Assessment

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

Impact of Melanoma Diagnosis on Sun-Awareness and Protection: Efficacy of Education Campaigns in a High-Risk Population

2004 ◽  
Vol 8 (5) ◽  
pp. 303-309 ◽  
Author(s):  
Anatoli Freiman ◽  
John Yu ◽  
Antoine Loutfi ◽  
Beatrice Wang
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Risk Groups ◽  
High Risk Population ◽  
Awareness Campaigns ◽  
Number Of Patients ◽  
Increased Risk ◽  
Patients At Risk ◽  
And Behavior ◽  
Attitudes And Behavior

Background: Malignant melanoma is a significant cause of morbidity and mortality worldwide. Sun-awareness campaigns increase public knowledge but may not translate into behavioral changes in practice, which is particularly alarming when reported for individuals in high-risk groups. In particular, patients diagnosed with melanoma are at increased risk of developing subsequent primary melanomas compared with the general population. Objectives: The study was undertaken (1) to assess whether patients with known risk factors for developing melanoma had been exposed to preventative campaign messages prior to their diagnosis, (2) to quantify whether the diagnosis of melanoma changed sun-related attitudes and behavior, and (3) to assess the adequacy of sun-related advice given to patients with melanoma, as well as their compliance with the advice. Methods: Using an anonymous questionnaire, 217 patients previously diagnosed with melanoma were interviewed on the source and frequency of received sun-related advice, as well as on their knowledge, attitudes, and behavior toward sun protection before and after the diagnosis. Results: The number of patients who reported receiving sun-related advice after being diagnosed with melanoma increased by 36% (52% pre-vs. 88% postDiagnosis), with advice being given more frequently and more often by a physician (19% pre- vs. 49% postdiagnosis). Furthermore, sun-related attitudes and behavioral practices were positively altered. Yet, patients with known risk factors were not preferentially targeted for advice before their diagnosis. Conclusions: The diagnosis of melanoma leads to increased sunwareness and protection. While dermatologists should continue their efforts to promote and reinforce sun-awareness in patients with melanoma, additional emphasis on preventative targeting of high-risk individuals would be of marked benefit in decreasing the overall incidence of melanoma. Non-dermatologists, such as family physicians, can be key players in this preventative campign, and can be educated to recognize and educate patients at risk, as well as direct them to be followed under dermatology care.

scholarly journals The Effect of Ethnicity on Preterm Birth and its Influence on the Risk Factors for Prematurity

2019 ◽  
pp. 180-192
Author(s):  
P Bachkangi ◽  
AH Taylor ◽  
JC Konje
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Preterm Birth ◽  
High Risk ◽  
Risk Groups ◽  
Individual Risk ◽  
Individual Risk Factor ◽  
Increased Risk ◽  
Gestational Age At Delivery ◽  
Very High

Preterm birth (PTB) affects 9.6% of pregnancies worldwide and is associated with a very high perinatal mortality that depends on the gestational age at delivery. As a result, PTB has a significant health and financial impact on health systems, families and societies. Its aetiology is not fully understood, but in most cases it is multifactorial, with several maternal, paternal, and epidemiological factors associated with increased risk. Other factors include parental ethnicity, maternal age and body mass index, socioeconomic status, and where the families live. This review examines the influence of ethnicity as an individual risk factor for PTB. It also explores its influence on the epidemiology of PTB and demonstrates that data on certain ethnicities are lacking, despite the fact that these ethnic clusters are within the very ‘high-risk groups’ that are adequately represented in some Western societies. This review examines the influence of ethnicity as an individual risk factor for PTB and also explores its influence on the different epidemiological aspects. A thorough revisit of the ethnic epidemiology unveiled other unnoticed risk factors that if addressed appropriately prematurity can be prevented. Moreover, certain ethnicities were not within the attention of researchers, despite the facts that they are very ‘high-risk groups’ and are also adequately represented in some Western societies.

Risk factors for cognitive impairment in amyotrophic lateral sclerosis: a systematic review and meta-analysis

2021 ◽  
pp. jnnp-2020-325701
Author(s):  
Tianmi Yang ◽  
Yanbing Hou ◽  
Chunyu Li ◽  
Bei Cao ◽  
Yangfan Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Amyotrophic Lateral Sclerosis ◽  
Cognitive Impairment ◽  
Family History ◽  
Rating Scale ◽  
Or Education ◽  
Increased Risk ◽  
Bulbar Onset ◽  
History Of ◽  
Lateral Sclerosis

ObjectiveCognitive impairment is a common, far-reaching but imperceptible manifestation in patients with amyotrophic lateral sclerosis (ALS). We aimed to identify the risk factors for cognitive impairment in ALS.MethodsWe searched PubMed and EMBASE for cross-sectional, case–control and cohort studies that reported predictors of cognitive impairment in ALS. The obtained data were meta-analysed to generate overall ORs and 95% CIs.ResultsTwenty-seven eligible articles reporting on 6799 individuals were included out of 20 501 records. Nine predictors were identified: C9orf72 (OR 3.62, 95% CI 1.76 to 7.45), dysarthria (OR 2.25, 95% CI 1.20 to 4.22), family history of ALS (OR 1.76, 95% CI 1.18 to 2.61), predominant upper motor neuron (PUMN) phenotype (OR 1.73, 95% CI 1.09 to 2.73) and bulbar onset (OR 1.54, 95% CI 1.28 to 1.87) increased risk factors for cognitive impairment in ALS. ALS Functional Rating Scale-Revised scores, sex, age or education level were not significantly associated with cognitive impairment in ALS. In addition, C9orf72 (OR=5.94) and bulbar onset (OR=2.08) were strong predictors of ALS-frontotemporal dementia. Female sex conferred more susceptibility to executive cognitive impairment than male sex (OR=1.82).ConclusionsPatients with C9orf72 repeat expansion, dysarthria, family history of ALS, PUMN phenotype and bulbar onset had a high risk for cognitive impairment in ALS. These associations may contribute to understanding the heterogeneity of ALS.PROSPERO registration numberCRD42020201085.

scholarly journals 16-Year Survival of the Canadian Collaborative Cohort of Related Dementias

2018 ◽  
Vol 45 (4) ◽  
pp. 367-374
Author(s):  
Maya L. Lichtenstein ◽  
Nader Fallah ◽  
Benita Mudge ◽  
Ging-Yuek R. Hsiung ◽  
Dean Foti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Functional Disability ◽  
Rating Scale ◽  
Cox Regression ◽  
Age Of Onset ◽  
Illness Severity ◽  
Rank Test ◽  
Medical Illness ◽  
Significant Survival ◽  
Long Term Follow Up

AbstractBackground Survival estimates are integral to care for patients diagnosed with dementia. Few Canadian studies have carried out long-term follow-up of well-described cohorts, analyzing survival related to multiple risk factors. Methods Survival analysis of an inception cohort enrolled at a British Columbia (BC) tertiary dementia referral clinic between 1997 and 1999 was undertaken. Vital status was completed for 168 patients diagnosed with dementia. An evaluation of the effects of demographics, vascular risk factors, cognitive and functional ratings, apolipoprotein 4-status, and cholinesterase use on survival was performed using a log-rank test and time-dependent Cox regression. Survival of this dementia cohort was compared with the age-matched life expectancy of persons in BC. Results In all, 158/168 (94.0%) subjects died over 16.6 years, with a median survival of 7.08 years. Risk factors associated with shorter survival in dementia groups included age of onset ≥80 (hazard ratio [HR] 1.56, 95% confidence interval [CI] 1.05-2.32); greater functional disability (Disability Assessment for Dementia<55% [HR 1.47, 95% CI 1.04-2.08]); and cumulative medical illness severity (Cumulative Illness Rating Scale≥7 [HR 1.51, 95% CI 1.08-2.12)]. Compared with the BC population, years of potential life lost for dementia subjects aged <65 was 15.36 years, and for dementia subjects aged ≥80 it was 1.82 years. Conclusions Survival in dementia subjects is shorter than population life expectancies for each age strata, with greatest impact on younger patients. For people diagnosed with dementia, age ≥80 years, cumulative medical illness severity, and functional disabilities are the most significant survival predictors and can be used to guide prognosis.

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