The Psychological and HRQoL related Aftermaths of Extra Corporeal Membrane Oxygenation Treatment: A Cross‐Sectional Study

ObjectivesTo assess symptoms of post-traumatic stress disorder, anxiety, depression and health related quality of life in a sample of adult patients treated with veno-arterial extracorporeal membrane oxygenation.Design and settingThis is a cross-sectional study. The population were all patients discharged (2008–2018) from a thoracic surgical intensive ward at a tertiary university hospital in Norway. A sample of 20 patients was recruited.Main outcome measuresSymptoms of post-traumatic stress disorder were assessed using Impact of Events Scale-Revised, while symptoms of depression and anxiety were assessed using Hospital Anxiety and Depression Scale. RAND 36-Item Short Form Health Survey was applied to measure health-related quality of life.ResultsSymptoms of post-traumatic stress disorder were reported by 40% of the participants. Twenty percent reported symptoms of depression and anxiety. Compared to the general population, participants reported poorer health-related quality of life on all domains, and significantly worse on the domains physical function, general health and social function.ConclusionPatients in our study reported symptoms of post-traumatic stress disorder, anxiety, depression and impaired health-related quality of life following treatment with veno-arterial extra corporeal membrane oxygenation. Addressing possible emotional and psychological distress could represent a potential major improvement in health care provided to this group. Further research is needed to incorporate prophylactic methods, such as identifying vulnerable patients and implement corresponding interventions, into clinical practice.     

Prevalence and evolution of snoring and the associated factors in two-year-old children

ObjectivesTo evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts and to assess the associated factors.Study designThe study population comprised 947 children from the CHILD-SLEEP (CS) and 1393 children from the FinnBrain (FB) birth cohorts. Questionnaires were provided to both parents when the child was 24 months of age. The questionnaire consisted of parts concerning the child's sleep and environmental factors.ResultsThe combined prevalence of habitual snoring in the two birth cohorts at the age of 24 months was 2.3% (95% CI 1.5–3.1), which is markedly lower than reported previously.Children suffering from recurrent infections (CS odds ratio (OR) 3.9, 95% CI 1.2–12.5) or asthma (FB OR 4.3, 1.4–13.5) snored habitually more often. Both the mother's (CS OR 3.2, 1.2–9.0) and father's (CS OR 3.4, 1.4–8.0) snoring every night added to the risk of the child snoring. In the multivariate models, parental snoring (CS adjusted odds ratio (OR_a) 2.8, 1.1–6.8), the mother's lower level of education (CS OR_a 2.9, 1.2–7.5, FB OR_a 2.1, 1.0–4.5), and the mother's lower monthly income (FB OR_a 2.9, 1.3–6.3) associated with the child's habitual snoring.ConclusionsThe prevalence of habitual snoring in two Finnish birth cohorts is lower than reported previously. The independent risk factors for habitual snoring at the age of two years were the parents' snoring and the mother's low income and low education.     

Predicting COVID-19-related anxiety: The role of obsessive-compulsive symptom dimensions,anxiety sensitivity,and body vigilance

The novel coronavirus disease (COVID-19), first detected in December of 2019 and declared a global pandemic in March of 2020, continues to pose a serious threat to public health and safety worldwide. Many individuals report anxiety in response to this threat, and at high levels, such anxiety can result in adverse mental health outcomes and maladaptive behavioral responses that have consequences for the health of communities more broadly. Predictors of excessive anxiety in response to COVID-19 are understudied. Accordingly, the present study examined psychological factors that predict more intense COVID-19-related anxiety. 438 community members completed measures assessing COVID-19-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of COVID-19. As expected, obsessive-compulsive symptoms related to contamination, the fear of arousal-related body sensations (i.e., anxiety sensitivity), and body vigilance each predicted more severe anxiety related to the pandemic. Obsessive-compulsive symptoms related to responsibility for causing harm also emerged as a predictor. Study limitations and implications are discussed.     

复苏室患儿苏醒期探视信念和态度量表的初步构建及信效度评价

目的 构建护士对麻醉复苏室(post-anesthesia care unit,PACU)患儿苏醒期家属探视信念和态度的量表并评价其信效度。方法 通过回顾相关文献、专家咨询等方法构建护士对PACU患儿苏醒期家属探视信念和态度的量表暂定版,采用暂定版对460名PACU护理人员进行调查并检验其信效度。结果 修订的PACU患儿苏醒期家属探视信念和态度量表包含20个条目,其中信念维度3个因子,17个条目;态度维度1个因子,3个条目。总量表的Cronbach′s α系数为0.924,重测信度为0.898,内容效度为0.892。探索性因子分析提取信念维度3个因子的累积方差贡献率62.423%,各维度之间的相关系数为0.53～0.65,各维度与量表总分之间的相关系数为0.73～0.91,验证性的因子分析证实PACU患儿苏醒期家属探视信念和量表各项适配指数均达标。结论 PACU患儿苏醒期家属探视信念和态度量表有较好的信效度,可用作PACU护士对患儿苏醒期家属开放性探视信念和态度测评工具的参考。     

Motor dysfunction in mild cognitive impairment as tested by kinematic analysis and transcranial magnetic stimulation

ObjectivePrevious studies have demonstrated voluntary movement alterations as well as motor cortex excitability and plasticity changes in patients with mild cognitive impairment (MCI). To investigate the pathophysiology of movement abnormalities in MCI, we tested possible relationships between movement abnormalities and primary motor cortex alterations in patients.MethodsFourteen amnestic MCI (aMCI) patients and 16 healthy controls were studied. Cognitive assessment was performed using clinical scales. Finger tapping was recorded by a motion analysis system. Transcranial magnetic stimulation was used to test the input/output curve of motor evoked potentials, intracortical inhibition, and short-latency afferent inhibition. Primary motor cortex plasticity was probed by theta burst stimulation. We investigated correlations between movement abnormalities, clinical scores, and cortical neurophysiological parameters.ResultsMCI patients showed less rhythmic movement but no other movement abnormalities. Cortical excitability measures were normal in patients, whereas plasticity was reduced. Movement rhythm abnormalities correlated with frontal dysfunction scores.ConclusionOur study in MCI patients demonstrated abnormal voluntary movement and plasticity changes, with no correlation between the two. Altered rhythm correlated with frontal dysfunction.SignificanceOur results contribute to the understanding of pathophysiological mechanisms of motor impairment in MCI.     

Effets de l’huile des fruits de Dacryodes edulis sur les symptômes de l’anxiété et les performances cognitives chez la souris,après administration prolongée

ObjectiveTo study the effects of prolonged administration of Dacryodes edulis (G. Don) H.J. Lam (HDE) fruit oil on the symptoms of anxiety and cognitive performance in mice.MethodsAnxiolytic activity and effects of HDE (5 and 10 ml/kg) on cognitive performance were evaluated in male mice after oral administration for 45 days. Anxiolytic effects were investigated in open field test, elevated plus Maze and hole board test. The Morris Water Maze test was used to evaluate cognitive performance in mice. Efficacy of HDE (5 and 10 ml/kg) was compared with that of fluoxetine (2 mg/kg p.o).ResultsHDE decreases the total distance traveled, significantly increases the number of adjustments and the number of entries in the central area of open field. In the elevated cross labyrinth test, HDE increases the number of entries and the time spent in the open arms. HDE significantly increases the number of head insertion into the holes. In the Morris Water Maze test, HDE reduces latency before finding the platform and increases the time spent in the target quadrant.ConclusionThe results confirm anxiolytic effects and improved cognitive performance after prolonged oral administration of HDE in rodents.     

Concealed cosmetic closure in total knee replacement surgery – A prospective audit assessing appearance and patient satisfaction

ObjectiveWith the trend towards accelerated rehabilitation, the method of skin closure has become increasingly important in orthopedic surgery. It is imperative to evaluate a technique that provides superior clinical and cosmetic results specifically for TKA, due to relatively thin skin anterior to the knee making poor wound healing an issue of concern. We conducted a prospective, single-arm audit evaluating the patient assessments of incision cosmesis for a novel technique in TKA wound closure called Concealed Cosmetic Closure (CCC).Methods570 knees were included in the study whose wound was closed with concealed cosmetic subcuticular interrupted sutures (CCCIS) between January 2014 and May 2016. A validated, ordinal questionnaire, Stony Brooks Scar Evaluation Scale (SBSES) designed to elicit a score evaluating scar satisfaction was interviewed by the investigators to patients 6 months to 3 years postoperatively.ResultsCCC is a simple and relatively rapid single-operator technique that takes about 7–10 min to close 11–17 cm knee incision. In our study, the mean score for Stony Brook Scar Evaluation Scale (SBSES) was 4.4 (SD of 0.73) (range 3–5). The scar was rated highly in terms of cosmesis, patient satisfaction and appearance of the wound.ConclusionCCC is an effective modality for skin closure in total knee arthroplasty providing superior cosmetic healing with minimal complications leading to improved long term patient satisfaction.     

Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV-1

IntroductionErectile dysfunction (ED) is associated with neurological damage due to human T-lymphotropic virus 1 (HTLV-1) infection, but hormonal and psychogenic factors also cause ED.AimTo evaluate the association of psychogenic and hormonal factors with ED in men infected with HTLV-1.MethodsIn this cross-sectional study, we compared total testosterone, follicle stimulating hormone, luteinizing hormone, prolactin, anxiety symptoms, depressive symptoms, and neurologic manifestations in HTLV-1-infected men with or without ED. The International Index of Erectile Function was used to determine the degree of ED. Participants were grouped according to Osame’s Motor Disability Scale and the Expanded Disability Status Scale: HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP), probable HAM/TSP, or HTLV-1 carrier. Chi-square and Fisher’s exact tests were used to compare the groups, and regression analyses were used to show predictors of ED.Main Outcome MeasureSexual hormonal levels, psychogenic factors, and neurologic disabilities were found to be associated with ED.ResultsED was associated with age older than 60 years (P < .001), degree of neurologic involvement (P < .001), depression (P = .009), and anxiety (P = .008). In the multivariate analyses, only age and degree of neurological injury remained as risk factors for ED.Clinical ImplicationsNeurological manifestations are a stronger predictor of ED than hormonal and psychogenic factors in HTLV-1-infected men.Strengths & LimitationsThe statistical power of the study was limited due to the low number of participants, but neurologic manifestations were clearly associated with ED. There was no strong association between hormonal and psychogenic factors and ED.ConclusionHormonal and psychogenic factors did not show a strong association with ED in individuals with HTLV-1, but neurological manifestations were strongly associated with ED in these individuals.de Oliveira CJV, Neto, JAC, Andrade RCP, et al. Hormonal and Psychogenic Risk Factors for Erectile Dysfunction in Men with HTLV–1. J Sex Med 2019; 16:1763–1768.     

舌三针为主治疗脑卒中后吞咽功能障碍的临床研究

目的观察舌三针为主治疗脑卒中后吞咽功能障碍的临床疗效及其对脑神经机制的影响。方法将130例脑卒中后吞咽功能障碍患者随机分为治疗组和对照组,每组65例。对照组采用康复训练配合低频脉冲电刺激治疗,治疗组在对照组基础上采用舌三针治疗。观察两组治疗前后吞咽功能(洼田饮水试验评分)、精神状态[汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分]及表面肌电图各项指标[平均振幅值(AEMG)、持续时间(t)]的变化情况。结果两组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后洼田饮水试验评分、HAMA评分及HAMD评分与对照组比较,差异均具有统计学意义(P<0.05)。两组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标(颏下肌群及舌骨下肌群的AEMG和t)与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后空吞咽时及吞咽5 mL水时sEMG各项指标与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗后误吸及肺部感染的发生率分别为16.1%和17.7%,对照组分别为36.2%和32.8%,两组比较差异均具有统计学意义(P<0.05)。结论舌三针配合康复训练及低频脉冲电刺激能有效改善脑卒中患者的吞咽功能。