scholarly journals Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

2021 ◽  
Author(s):  
Justin Sinclair ◽  
Laura Collett ◽  
Jason Abbott ◽  
David W. Pate ◽  
Jerome Sarris ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Gastrointestinal Symptoms ◽  
Electronic Record ◽  
Rapid Onset ◽  
Dosage Forms ◽  
Symptom Clusters ◽  
Mobile Phone Application ◽  
Canadian Data ◽  
Associated Symptoms ◽  
Symptom Ratings

Abstract Background The use of cannabis for symptoms of endometriosis was investigated utilising retrospective archival data from Strainprint Technologies Ltd., a Canadian data technology company with a mobile phone application that tracks a range of data including dose, mode of administration, chemovar and their effect on various self-reported outcomes, including pelvic pain. Methods A retrospective, electronic record-based cohort study of Strainprint™ users with self-reported endometriosis was conducted. Self-rated cannabis efficacy, defined as a function of initial and final symptom ratings, was investigated across the included symptom clusters of cramps, pelvic pain, gastrointestinal pain, nausea, depression, and low libido. Cannabis dosage form, dose and cannabinoid ratio information was also recorded. Results A total number of 252 participants identifying as suffering endometriosis recorded 16193 sessions using cannabis between April 2017 and February 2020. The most common method of ingestion was inhalation (n = 10914, 67.4%) with pain as the most common reported symptom being treated by cannabis (n = 9281, 57.3%). Gastrointestinal symptoms, though a less common reason for cannabis usage (15.2%), had the greatest self-reported improvement after use. Inhaled forms had higher efficacy for pain, while oral forms were superior for mood and gastrointestinal symptoms. Dosage varied across ingestion methods, with a median dose of 9 inhalations (IQR 5 to 11) for inhaled dosage forms and 1 mg/mL (IQR 0.5 to 2) for other ingested dosage forms. The ratio of THC to CBD had a statistically significant, yet clinically small, differential effect on efficacy, depending on method of ingestion. Conclusions Cannabis appears to be effective for pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. The greater propensity for use of an inhaled dosage delivery may be due to the rapid onset of pain-relieving effects versus the slower onset of oral products. Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories. Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.

scholarly journals Gastric Cancer Presenting as Isolated Ascites: A Diagnostic Challenge

2019 ◽  
Author(s):  
Ines Duarte ◽  
Cristina Outerelo
Keyword(s):  
Gastric Cancer ◽  
Abdominal Pain ◽  
Gastric Carcinoma ◽  
Male Patient ◽  
Gastrointestinal Symptoms ◽  
Malignant Ascites ◽  
Rapid Onset ◽  
Clinical State ◽  
Diagnostic Challenge ◽  
Gastric Endoscopy

Malignant ascites is a rare first manifestation of gastric carcinoma and is usually associated with symptoms which include early satiety, abdominal pain and deteriorating clinical state. The authors describe the case of a male patient presenting with malignant ascites of rapid onset which was the sole presentation of gastric cancer, highlighting the importance of upper gastric endoscopy even in the absence of gastrointestinal symptoms.

Symptom clustering among patients visiting a supportive oncology clinic.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 188-188 ◽  
Author(s):  
Kathryn C. Wrammert ◽  
Gwendolynn Harrell ◽  
Michael O'Neill ◽  
Anjali Grandhige ◽  
Danielle Moulia ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
Hierarchical Cluster ◽  
Symptom Assessment ◽  
Symptom Clusters ◽  
Cancer Symptoms ◽  
Patients With Cancer ◽  
Memorial Symptom Assessment Scale ◽  
Supportive Oncology ◽  
Symptom Assessment Scale ◽  
Absolute Correlation

188 Background: Multiple symptoms are common and often severe in patients with cancer. Identification of symptoms which cluster may serve to elucidate the pathophysiology of the disease and aid in symptom management. Our aim was to define symptom clusters occurring among cancer outpatients receiving chemotherapy. Methods: New and returning patients referred to a supportive oncology clinic (SOC) from our health system’s oncologists from November 2011 through May 2014 completed the Condensed Memorial Symptom Assessment Scale plus a sexual dysfunction structured assessment. Data were collected prospectively from 323 consecutive initial visits. Patients rated from 0-4 how bothersome 15 cancer symptoms were; symptoms were then graded as present (1+) or absent (0). Hierarchical cluster analysis with average linkage was used to identify symptom clusters. The absolute value of the correlation between symptoms was used as the measure of similarity between pairs of symptoms. A correlation of ≥0.6 was used to define the final clusters. A symptom cluster was defined as two or more symptoms that predictably occur together. Results: Three clusters were identified: 1. Psychological (worrying, feeling sad, feeling nervous); 2. Treatment-related (lack of energy, feeling drowsy, difficulty concentrating, dry mouth, constipation); 3. Gastrointestinal (weight loss, lack of appetite, nausea). Pain, difficulty sleeping, shortness of breath, and loss of interest did not cluster with any symptom. Gastrointestinal symptoms are important within the clusters. The prevalence of worrying, feeling sad, and feeling nervous did not cluster with lack of energy or difficulty in sleeping, nor pain with worrying or feeling sad. Conclusions: Three symptom clusters were identified as showing high absolute correlation: a psychological cluster, treatment-related cluster, and gastrointestinal cluster. Identifying symptom clusters may promote our understanding of the pathophysiology of cancer, help prioritize effective pharmacotherapies, and identify drugs likely to help more than one symptom.

scholarly journals Prevalence and Associated Symptoms of Helicobacter pylori Infection among Schoolchildren in Kassala State, East of Sudan

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Mohammed Abbas ◽  
Faiza A. Sharif ◽  
Shamselfalah M. Osman ◽  
Abdallah M. Osman ◽  
Sulieman M. El Sanousi ◽  
...  
Keyword(s):  
Primary Schools ◽  
Gastrointestinal Symptoms ◽  
Cross Sectional Study ◽  
Igg Antibodies ◽  
Normal Range ◽  
Cross Sectional ◽  
Abdominal Symptoms ◽  
Associated Symptoms ◽  
H Pylori

This study aimed to determine the prevalence of H. pylori infections among schoolchildren and investigate the associations between H. pylori seropositivity and existence of gastrointestinal symptoms. Methods. A prospective cross-sectional study was conducted during a period from January to December 2012 at Kassala state, east of Sudan. Schoolchildren from different primary schools were enrolled in the study. Sociodemographic characteristics and gastrointestinal symptoms were recorded from each child. A rapid immunochromatographic test was performed for the detection of H. pylori IgG antibodies. Data on patient demographic characteristics, clinical diagnosis, and findings of H. pylori infection were analyzed by simple descriptive statistics. Results. Among 431 schoolchildren, H. pylori seropositivity was found to be 21.8%. The majority of children (79; 84%) had BMI below the normal range. The most frequent symptoms associated with H. pylori infections were nausea (25.5%), followed by gastric pain (24.5%) and heart pain (20.2%). There were statistically significant differences in H. pylori seropositivity between boys and girls (p=0.003). Conclusions. The prevalence of H. pylori infection among schoolchildren in Kassala city has been documented. Although the majority of the disease was associated with several gastrointestinal symptoms, the role of infection in the etiology of abdominal symptoms needs further investigations.

scholarly journals Clinical features of anaphylaxis in children

2022 ◽  
Vol 43 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Mahir Serbes ◽  
Ayse Senay Sasihuseyinoglu ◽  
Dilek Ozcan ◽  
Derya Ufuk Altıntas
Keyword(s):  
Clinical Features ◽  
Considerable Increase ◽  
Age Groups ◽  
Gastrointestinal Symptoms ◽  
Rapid Onset ◽  
Older Children ◽  
Drug Induced ◽  
Male Predominance ◽  
Severe Anaphylaxis ◽  
The Mean

Background: Despite the considerable increase in anaphylaxis frequency, there are limited studies on clinical features of anaphylaxis in children in developing countries. Objective: We aimed to analyze the demographic and clinical features of anaphylaxis in children in Turkey by comparing different age groups and triggers. Methods: Medical records of 147 children, ages 0‐18 years, diagnosed with anaphylaxis between 2010 and 2019 were retrospectively analyzed. Results: The mean ± standard deviation age at first anaphylaxis episode was 5.9 ± 5.2 years, with a male predominance (63.9%); 25.2% were infants and 52.4% were < 6 years of age at their first anaphylaxis episode; 78.2% were atopic, with the highest frequency in children with food-induced anaphylaxis (FIA). The home (51.7%) was the most frequent setting. The overall leading cause of anaphylaxis was food (44.2%), which was more frequent at < 6 years of age, followed by drugs (28.6%) and bee venom (22.4%), both were more frequent among older children (>6 years). The patients with venom allergy had the highest rate of rapid onset of symptoms (p < 0.001). Gastrointestinal symptoms were observed significantly more in infants (48.6%) and in children with FIA (38.5%); cardiovascular symptoms were more frequently observed in children > 6 years of age (48.6%) and in children with drug-induced anaphylaxis (64.3%). Although recurrent anaphylaxis was reported for 23.1% of the patients, it was highest in the patients with FIA (35.9%). Overall, only 47.6% of the patients received epinephrine in the emergency department (ED) and 27.3% were referred to an allergy specialist, with the patients with FIA having the lowest rate for both, 32.3% and 10.8%, respectively. Children with drug-induced anaphylaxis had the highest rate of severe anaphylaxis (57.1%). Conclusion: There is a need to improve anaphylaxis recognition and management in all children regardless of age and trigger. Inadequate treatment was most evident in infants and patients with FIA.

scholarly journals Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Disease or Symptom? Current Perspectives on Diagnosis, Treatment, and Prognosis

2020 ◽  
Vol 14 (1) ◽  
pp. 155798832090320 ◽  
Author(s):  
Jianzhong Zhang ◽  
ChaoZhao Liang ◽  
Xuejun Shang ◽  
Hongjun Li
Keyword(s):  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Medical Intervention ◽  
Pelvic Pain Syndrome ◽  
Care Providers ◽  
Therapeutic Regime ◽  
Associated Symptoms

Definitive diagnosis and selection of effective treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are frustrations encountered frequently by urology care providers in their practice. Knowledge of etiology and pathophysiology is not sufficient and therapeutic guidelines have not yielded acceptable outcomes and prognoses for both patients and care providers. The authors present updated perspectives on CP/CPPS, including definition, diagnosis, treatment, and prognosis, based on literature review and clinical experience. A key point is to shift the diagnostic and therapeutic focus from a single entity of disease toward associated symptoms of CP/CPPS. An individualized multimodal treatment approach to cope with the course of the disorder is proposed. Communications and personal/family/community supports are emphasized as an important component in the therapeutic regime and rehabilitation of patients with CP/CPPS. The purpose is to improve comprehension on CP/CPPS and to help care providers and patients to achieve the goal of medical intervention—relieving associated symptoms of CP/CPPS and improving the quality of life.

scholarly journals Sublingual Tablets : An Overview

2019 ◽  
pp. 181-187
Author(s):  
Rohit S. Nikam ◽  
Rahul P. Jadhav ◽  
Dr. Prakash D. Jadhav ◽  
Vishal D. Yadav
Keyword(s):  
Drug Delivery ◽  
Rapid Onset ◽  
Oral Route ◽  
Dosage Forms ◽  
Peroral Administration ◽  
Systemic Delivery ◽  
Onset Of Action ◽  
Promising Alternative ◽  
Evaluation Parameters ◽  
Pass Metabolism

<p>Drug delivery via the oral mucous membrane is considered to be a promising alternative to the oral route. Sublingual route is a rapid onset of action and better patient compliance than orally ingested tablets. Sublingual literally meaning is 'under the tongue', administrating substance via mouth in such a way that the substance is rapidly absorbed via blood vessels under tongue. Peroral administration of drug has disadvantages such as Hepatic first pass metabolism and enzymatic degradation within the GI tract that limits oral administration of certain classes of drug like peptides and proteins. So, other absorptive mucosa is considered as potential sites for drug administration. Trans-mucosal routes of drug delivery (i.e. the mucosal linings of the nasal, rectal, vaginal, ocular, and oral cavity) offer several advantages over peroral administration for systemic delivery. This review highlights the sublingual dosage forms for the treatment of migraine, advantages, Disadvantages, various evaluation parameters and commercially available sublingual dosage forms.</p>

scholarly journals Core symptoms of major depressive disorder: relevance to diagnosis and treatment

2008 ◽  
Vol 10 (3) ◽  
pp. 271-277 ◽  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sleep Disturbance ◽  
Major Depressive Episode ◽  
Rating Scale ◽  
Symptom Clusters ◽  
Major Depressive ◽  
Associated Symptoms ◽  
Core Symptoms ◽  
Core Features

The construct of major depressive disorder makes no etiological assumptions about populations with diverse symptom clusters. "Depressed mood" and "loss of interest or pleasure in nearly all activities" are core features of major depressive episode, though a strong case can be made to pay increasing attention to symptoms of fatigue, sleep disturbance, anxiety, and neurocognitive and sexual dysfunction in the diagnosis and evaluation of treatment outcome. Mood, guilt, work, and interest, as well as psychic anxiety, are consistently identified across validated subscales of the Hamilton Depression Rating Scale as prevalent and sensitive to change with existing treatments. A major limitation of these antidepressant therapies is their narrow spectrum of action. While the core "mood and interest" symptoms have been the main focus of attention, the associated symptoms listed above are often unaffected or exacerbated by current treatments. Careful clinical evaluation should address all of these dimensions, recognizing that improvement may occur sooner in some symptoms (eg, mood) compared with others (eg, sleep disturbance).

Case Study: Utilizing a Low FODMAP Diet to Combat Exercise-Induced Gastrointestinal Symptoms

2016 ◽  
Vol 26 (5) ◽  
pp. 481-487 ◽  
Author(s):  
Dana Lis ◽  
Kiran D.K. Ahuja ◽  
Trent Stellingwerff ◽  
Cecilia M. Kitic ◽  
James Fell
Keyword(s):  
Dietary Intervention ◽  
Gastrointestinal Symptoms ◽  
Gi Symptoms ◽  
Habitual Diet ◽  
Symptom Ratings ◽  
Dietary Period ◽  
Exercise Induced ◽  
Fodmap Diet ◽  
Dietary Strategies

Athletes employ various dietary strategies in attempts to attenuate exercise-induced gastrointestinal (GI) symptoms to ensure optimal performance. This case-study outlines one of these GI-targeted approaches via the implementation of a short-term low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) diet, with the aim to attenuate persistent running specific GI symptoms in a recreationally competitive multisport athlete (male, 86 kg, 57.9 ml·kg·min-1 V02max, 10–15 hr/week training, with no diagnosed GI disorder). Using a single-blinded approach a habitual diet was compared with a 6-day low FODMAP intervention diet (81 ± 5g vs 7.2 ± 5.7g FODMAP s/day) for their effect on GI symptoms and perceptual wellbeing. Training was similar during the habitual and dietary intervention periods. Postexercise (During) GI symptom ratings were recorded immediately following training. Daily GI symptoms and the Daily Analysis of Life Demands for Athletes (DALDA) were recorded at the end of each day. Daily and During GI symptom scores (scale 0–9) ranged from 0–4 during the habitual dietary period while during the low FODMAP dietary period all scores were 0 (no symptoms at all). DALDA scores for worse than normal ranged from 3–10 vs 0–8 in the habitual and low FODMAP dietary periods, respectively, indicating improvement. This intervention was effective for this GI symptom prone athlete; however, randomized-controlled trials are required to assess the suitability of low FODMAP diets for reducing GI distress in other symptomatic athletes.

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