Anxiety disorders in patients with cardiac diseases

Anxiety disorders are a common problem in cardiac patients. They can be the basic condition with heart symptoms, or they can be associated with a disease of the cardiovascular system. Hence, their symptomatology and differential diagnosis is of interest not only to psychiatrists, but also family doctors, internists and cardiologists. Proper diagnosis and treatment affects not only the quality of life, but also cardiological prognosis. One of the safe and effective treatment options is pregabalin.

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Primary and Secondary Cone Cell Death Mechanisms in Inherited Retinal Diseases and Potential Treatment Options

International Journal of Molecular Sciences ◽

10.3390/ijms23020726 ◽

2022 ◽

Vol 23 (2) ◽

pp. 726

Author(s):

Alicia A. Brunet ◽

Alan R. Harvey ◽

Livia S. Carvalho

Keyword(s):

Quality Of Life ◽

Cell Death ◽

Effective Treatment ◽

Treatment Options ◽

Retinal Diseases ◽

Potential Treatment ◽

Cone Cell ◽

Similarities And Differences ◽

Cell Death Mechanisms

Inherited retinal diseases (IRDs) are a leading cause of blindness. To date, 260 disease-causing genes have been identified, but there is currently a lack of available and effective treatment options. Cone photoreceptors are responsible for daylight vision but are highly susceptible to disease progression, the loss of cone-mediated vision having the highest impact on the quality of life of IRD patients. Cone degeneration can occur either directly via mutations in cone-specific genes (primary cone death), or indirectly via the primary degeneration of rods followed by subsequent degeneration of cones (secondary cone death). How cones degenerate as a result of pathological mutations remains unclear, hindering the development of effective therapies for IRDs. This review aims to highlight similarities and differences between primary and secondary cone cell death in inherited retinal diseases in order to better define cone death mechanisms and further identify potential treatment options.

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Comparison of an epicondylitis bandage with a wrist orthosis in patients with lateral epicondylitis

Prosthetics and Orthotics International ◽

10.1177/0309364618774193 ◽

2018 ◽

Vol 42 (6) ◽

pp. 599-605 ◽

Cited By ~ 3

Author(s):

Halil Ekrem Akkurt ◽

Hilal Kocabaş ◽

Halim Yılmaz ◽

Cemile Eser ◽

Zafer Şen ◽

...

Keyword(s):

Quality Of Life ◽

Muscle Strength ◽

Visual Analogue Scale ◽

Functional Status ◽

Effective Treatment ◽

Analogue Scale ◽

Short Form ◽

Treatment Options ◽

Lateral Epicondylitis

Background: Lateral epicondylitis is one of the most common causes of elbow pain. It is generally observed in people between the ages of 40 and 50 years, and the dominant extremity is more frequently affected. Various noninvasive methods are frequently used; however, studies investigating the effectiveness of the orthoses are limited and with controversial outcomes. Objective: To investigate the effectiveness of a hand-wrist resting orthosis and an epicondylitis bandage in lateral epicondylitis. Study design: Randomized controlled trial. Methods: In total, 82 patients diagnosed with unilateral lateral epicondylitis were enrolled into the study. Hand-wrist resting orthosis was applied to 45 patients and epicondylitis bandage was applied to 41 patients. Patients were evaluated before treatment and at 6 weeks after treatment with a Visual Analogue Scale; Disabilities of the Arm, Shoulder, and Hand questionnaire; the Short Form 36; and a determination of hand grasping force. Results: Both groups were similar in terms of age, body mass index, gender, frequency of lateral epicondylitis on the dominant side, dominant extremity, and duration of complaints ( p > 0.05). A statistically significant recovery was detected in both groups between the pre-therapy values and the values at the sixth week in terms of Visual Analogue Scale scores; Disabilities of the Arm, Shoulder, and Hand questionnarie scores; hand grasping forces; and the Short Form 36 mental and physical component scores ( p < 0.05). However, there were no significant differences detected between the two therapy methods before the therapy and at the sixth week of treatment in all parameter values ( p > 0.05). Conclusion: Our results suggest that both epicondylitis bandage and hand-wrist resting orthosis are effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life. Furthermore, neither treatment option was superior to the other. Large, randomized studies are necessary for more clear statements. Clinical relevance Epicondylitis bandage and hand-wrist resting orthosis are equally effective treatment options for lateral epicondylitis–induced pain, functional status, muscle strength, and quality of life.

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What is effective care for varicose veins?

Phlebology The Journal of Venous Disease ◽

10.1177/0268355516632999 ◽

2016 ◽

Vol 31 (1_suppl) ◽

pp. 80-87 ◽

Cited By ~ 4

Author(s):

Mark H Meissner

Keyword(s):

Quality Of Life ◽

Effective Treatment ◽

Varicose Veins ◽

Treatment Options ◽

Cost Effective ◽

Symptom Improvement ◽

Ultrasound Guided ◽

Foam Sclerotherapy ◽

Cyanoacrylate Glue

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.

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Anxiety Disorders in Older People

The Senior Care Pharmacist ◽

10.4140/tcp.n.2020.198 ◽

2020 ◽

Vol 35 (5) ◽

pp. 198-206

Author(s):

Krystal Scinto ◽

Jeannette Y. Wick

Keyword(s):

Quality Of Life ◽

Anxiety Disorders ◽

Older People ◽

Common Mental Disorder ◽

Treatment Options ◽

Health Related Quality ◽

Medical Settings ◽

Related Quality ◽

Health Related

Anxiety disorders may be the most common mental disorder among older people. Experts estimate the prevalence of anxiety to be between 1.2% and 15% in community samples and 1% and 28% in medical settings. These patients manifest the symptoms of anxiety, and they are also at risk for increased disability, decreased health-related quality of life, and possibly mild cognitive impairment. For this reason, it is important for pharmacists to understand the challenges in assessing anxiety and the treatment options that are safe and effective for older people. Additionally, pharmacists must be able to communicate well with these patients despite their tendency to perseverate and fixate.

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Neurogenic Thoracic Outlet Syndrome

10.1093/med/9780190271787.003.0008 ◽

2018 ◽

Author(s):

Agnes Stogicza ◽

Virtaj Singh ◽

Andrea Trescot

Keyword(s):

Quality Of Life ◽

Thoracic Outlet Syndrome ◽

Treatment Options ◽

Healthcare Services ◽

Nerve Roots ◽

Delay In Diagnosis ◽

Neurogenic Thoracic Outlet Syndrome ◽

Detailed Medical History ◽

Proper Diagnosis

Neurogenic thoracic outlet syndrome (nTOS) is caused by compression of the brachial plexus as it travels from the exiting nerve roots to the axilla. Its presentation, with varying degrees and distributions of arm and hand pain, paresthesias, and numbness, is often either not recognized or is confused with other conditions. Delay in diagnosis causes ongoing suffering for patients, with a concomitant increased use of healthcare services. Imaging and electrodiagnostic studies are often unremarkable, and therefore the diagnosis is based on a detailed medical history, a thorough physical exam, and diagnostic injections. Treatment options are available and can lead to significantly improved quality of life for the patient. Increased awareness of nTOS will likely contribute to its proper diagnosis and treatment.

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A review of acquired blepharoptosis: prevalence, diagnosis, and current treatment options

Eye ◽

10.1038/s41433-021-01547-5 ◽

2021 ◽

Author(s):

Jason Bacharach ◽

Wendy W. Lee ◽

Andrew R. Harrison ◽

Thomas F. Freddo

Keyword(s):

Quality Of Life ◽

Differential Diagnosis ◽

Visual Function ◽

Treatment Options ◽

Current Treatment ◽

Diagnosis And Treatment ◽

Upper Eyelid ◽

Congenital Ptosis ◽

Predominant Form

AbstractBlepharoptosis (ptosis) is among the most common disorders of the upper eyelid encountered in both optometric and ophthalmic practice. The unilateral or bilateral drooping of the upper eyelid that characterises ptosis can affect appearance and impair visual function, both of which can negatively impact quality of life. While there are several known forms of congenital ptosis, acquired ptosis (appearing later in life, due to a variety of causes) is the predominant form of the condition. This review summarises the prevalence, causes, identification, differential diagnosis, and treatment of acquired ptosis. Particular attention is paid to the differential diagnosis of acquired ptosis and emerging treatment options, including surgical and pharmacologic approaches.

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Non-Hepatic Hyperammonemia: A Potential Therapeutic Target for Sepsis-Associated Encephalopathy

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527321666211221161534 ◽

2021 ◽

Vol 21 ◽

Author(s):

Lina Zhao ◽

Yun Li ◽

Yunying Wang ◽

Zengzheng Ge ◽

Huadong Zhu ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factor ◽

Hepatic Encephalopathy ◽

Effective Treatment ◽

Independent Risk Factor ◽

Treatment Options ◽

Clinical Manifestations ◽

Common Complication ◽

Potential Therapeutic Target

: Sepsis-associated encephalopathy (SAE) is a common complication in the acute phase of sepsis, and patients who develop SAE have a higher mortality rate, longer hospital stay, and worse quality of life than other sepsis patients. Although the incidence of SAE is as high as 70% in sepsis patients, no effective treatment is available for this condition. To develop an effective treatment for SAE, it is vital to explore its pathogenesis. It is known that hyperammonemia is a possible factor in the pathogenesis of hepatic encephalopathy as ammonia is a potent neurotoxin. Furthermore, our previous studies indicates that non-hepatic hyperammonemia seems to occur more often in sepsis patients; it was also found that >50% of sepsis patients with non-hepatic hyperammonemia exhibited encephalopathy and delirium. Substatistical analyses indicate that non-hepatic hyperammonemia is an independent risk factor for SAE. This study updates the definition, clinical manifestations, and diagnosis of SAE; it also investigates the possible treatment options available for non-hepatic hyperammonemia in patients with sepsis, and the mechanisms by which non-hepatic hyperammonemia causes encephalopathy.

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Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

VASA ◽

10.1024/0301-1526/a000526 ◽

2016 ◽

Vol 45 (3) ◽

pp. 201-212 ◽

Cited By ~ 13

Author(s):

Birgit Linnemann ◽

Matthias Erbe

Keyword(s):

Quality Of Life ◽

Angiotensin Receptor Blockers ◽

Raynaud’S Phenomenon ◽

Treatment Options ◽

Raynaud's Phenomenon ◽

Tissue Loss ◽

Receptor Antagonists ◽

Skin Ulcers ◽

Digital Ischaemia

Abstract. The primary goal of therapy is to reduce the frequency and intensity of Raynaud’s attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud’s phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient’s quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the efficacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fluoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafil) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a secondary, possibly reversible process that is causing or aggravating the clinical symptoms.

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MP-AzeFlu in Moderate-to-Severe Allergic Rhinitis: A Literature Review

International Archives of Allergy and Immunology ◽

10.1159/000516417 ◽

2021 ◽

pp. 1-10

Author(s):

Ludger Klimek ◽

William E. Berger ◽

Jean Bousquet ◽

Paul K. Keith ◽

Peter Smith ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Fluticasone Propionate ◽

Treatment Options ◽

Symptomatic Disease ◽

Intranasal Corticosteroids ◽

Need For Treatment ◽

Ocular Symptoms ◽

Symptom Complex

Allergic rhinitis (AR) is prevalent, and many patients present with moderate-to-severe symptomatic disease. The majority of patients are not satisfied with their AR treatment, despite the use of concurrent medications. These gaps underscore the need for treatment with more effective options for moderate-to-severe AR. The authors’ objective was to review systematically the efficacy and safety of MP-AzeFlu for the treatment of AR. The primary outcomes studied were nasal, ocular, and total symptoms. Other outcomes included time to onset and of AR control, quality of life, and safety. Searches of PubMed and Cochrane databases were conducted on May 14, 2020, with no date restrictions, to identify publications reporting data on MP-AzeFlu. Clinical studies of any phase were included. Studies were excluded if they were not in English, were review articles, did not discuss the safety and efficacy of MP-AzeFlu for AR symptoms. Treatment of AR with MP-AzeFlu results in effective, sustained relief of nasal and ocular symptoms, and faster onset and time to control compared with intranasal azelastine or fluticasone propionate. Long-term use of MP-AzeFlu was safe, with benefits in children, adults, and adults aged ≥65 years. Other treatment options, including fluticasone propionate and azelastine alone or the combination of intranasal corticosteroids and oral antihistamine, do not provide the same level of efficacy as MP-AzeFlu in terms of rapid and sustained relief of the entire AR symptom complex. Furthermore, MP-AzeFlu significantly improves patient quality of life. MP-AzeFlu is a currently available combination that may satisfy all these patient needs and expectations.

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Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

European Addiction Research ◽

10.1159/000514192 ◽

2021 ◽

pp. 1-10

Author(s):

Stephanie Paula Elisabeth Guillery ◽

Rainer Hellweg ◽

Golo Kronenberg ◽

Ulrich Bohr ◽

Hagen Kunte ◽

...

Keyword(s):

Quality Of Life ◽

Replacement Therapy ◽

Psychological Functioning ◽

Treatment Options ◽

Chronically Ill ◽

Cross Sectional ◽

Life Improvement ◽

Methadone Patients ◽

Opioid Replacement Therapy

Background: Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. Objectives: Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (n = 126), diamorphine (n = 85), or buprenorphine (n = 37) were recruited in 6 German therapy centers. Methods: Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the Profile of the Quality of Life in the Chronically Ill (PLC) questionnaire. Results: Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (p < 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (p < 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (p < 0.001, η2 = 0.141). Diamorphine patients reported a higher psychological functioning (p < 0.001, η2 = 0.078) and overall life improvement (p < 0.001, η2 = 0.060) compared to methadone, but not compared to buprenorphine patients (both p > 0.25). Conclusion: Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

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