Male Lower Urinary Tract Symptoms: Hypertension as a Risk Factor for Storage Symptoms,but Not Voiding Symptoms

Objective: Both the presence of lower urinary tract symptom (LUTS) and that of hypertension (HT) increase with age. We investigated the associations between male LUTS and HT, and also whether α1‐blockers could allow for the alteration of symptoms. Methods: The subjects comprised 10 744 men with LUTS in a multicenter Japan‐Tamsulosin International Prostate Symptom Score (IPSS) Survey to assess the long‐term effects of α1‐blockers. A total of 4828 men (mean age, 68.5 years) who received a 12‐week administration of tamsulosin (0.2 mg/day) were assessed using IPSS and quality of life (QOL) surveys before and after tamsulosin administration. Data were collected by self‐administered questionnaires including age, complete history and IPSS at the initial visit. Results: HT was a more common comorbidity (25.9%) than diabetes mellitus (9.9%) or cardiac disease (7.2%). The presence of HT increased significantly with the degree of frequency (mild, 21%; severe, 29%) and nocturia (mild, 23%; severe, 28%), but did not increase with the degree of urgency. Tamsulosin significantly improved all storage and voiding symptoms in every age group above 40 years. The effect of tamsulosin on storage symptoms was more prominent in patients with HT than in patients without it. Concerning voiding symptoms, however, tamsulosin was as effective in patients with HT as it was in patients without HT. Conclusion: HT represents a risk factor for the increased frequency and severity of storage symptoms and it also influences the efficacy of α1‐blockers.     

Musculoskeletal symptoms and associated risk factors among African hair braiders

African hair braiders are potentially subject to work-related musculoskeletal disorders (WMSDs) because they perform repetitive hand motions for many hours a day together with prolonged standing and/or prolonged sitting. A complete enumeration of African hair braiders was attempted in Oklahoma City (OKC) and Dallas/Fort Worth (DFW). Braiders were identified through the channels they typically use to offer services to clients. Potential risk factors and symptoms of WMSDs were assessed using an oral interview. Participation rates were 95% (18/19) in OKC and 83% (83/101) in DFW. More than 75% of braiders reported discomfort in the fingers, wrist/hand, upper back, and lower back. In multivariate analysis, years worked as a braider but not age was a significant risk factor (p < 0.005) for reported pain in the wrist/hand, time spent sitting during the work day was found to be a significant predictor (p < 0.05) of upper back pain and lower back pain, and time spent sitting and time spent standing during the work day were both significant predictors (p < 0.05) of shoulder pain. Braiders in OKC, where licensing requirements were stricter, were significantly more likely than braiders in DFW to work at home (67% vs. 4%, p < 0.001) and to report pain in the lower leg (p < 0.005) and ankle/foot (p < 0.05). The close-knit nature of the African hair braiding community makes it an appealing candidate for community-based participatory research aimed at further elucidating occupational health concerns and reducing risk.     

个体化健康管理对改善成年男性下尿路症状的效果评价

目的 探讨个体化健康管理对改善成年男性下尿路症状的效果.方法 对100例成年男性下尿路症状患者进行为期一年的个性化健康管理.结果 健康管理后患者的国际前列腺症状评分下降、生活质量评分提高,与管理前比较差异均具有统计学意义(P<0.01);健康管理后患者勃起功能国际问卷-5评分明显下降,与管理前比较差异具有统计学意义(P...     

Validation of the Danish version of the brief negative symptom scale

Abstract

Objective: The Brief Negative Symptom Scale (BNSS) is an instrument for evaluating negative symptoms (NS) in schizophrenia based on the 2005 consensus statement by the National Institute of Mental Health. This study examines the validity and reliability of the Danish version of BNSS.

Materials and methods: Acutely and chronically affected patients with schizophrenia or schizoaffective disorder were assessed with BNSS along with other psychopathological scales and clinical measures. Convergent and discriminant validity of BNSS was evaluated by its relationships with these assessments. Inter-rater agreement was estimated by the intraclass correlation coefficient (ICC).

Results: Forty-nine subjects were included; the mean age was 33.1 (±10.8) years and 32 (65%) were males. BNSS correlated strongly with traditional assessment tools for NS and poorly with measures of depressive and extrapyramidal symptoms, except for Parkinsonism. Moreover, BNSS correlated well with the assessment of positive symptoms. The ICC of BNSS was 0.95 (n?=?19, 95% CI: 0.88–0.98).

Conclusions: Overall, BNSS holds appropriate psychometric properties in terms of reliability and validity. However, discriminant validity was compromised by correlations with positive symptoms and Parkinsonism. The former originates presumably from NS secondary to positive symptoms since the sample included acutely psychotic patients, and the latter from overlapping rating criteria regarding facial expressivity impairment.     

积极人格与大学生心理素质的关系

目的:研究大学生希望、乐观、自我效能感与主观幸福感、心身症状的关系。方法:采用成人性情希望量表(ADHS)、一般自我效能感量表(GSES)、生活取向测验修订版(LOT-R)、牛津幸福量表修订版(ROHS)和症状自评量表(SCL-90)对2578名在校大学生进行调查和测量。结果:(1)大学生主观幸福感和SCL-90总均分及每一个因子都负相关,特别是和抑郁因子负相关最高。(2)路径思维、动力思维、希望、自我效能和乐观与主观幸福感呈正相关;与SCL-90总均分及每一个因子都呈负相关。(3)以路径思维、动力思维、希望、自我效能和乐观为自变量,以主观幸福感和症状自评量表总均分为因变量,分别进行逐步回归分析,结果希望、乐观、自我效能都进入方程,三个因素分别对主观幸福感和心身症状的解释率为42.1%和7.1%。结论:无论单独考虑(相关分析)还是综合考虑(回归分析),希望、乐观和自我效能这三种积极人格都与主观幸福感呈正相关而与心身症状呈负相关。     

主动脉夹层术后患者心理状况及躯体症状对生活质量的影响

目的 探讨主动脉夹层术后患者心理状况、躯体症状对其生活质量的影响及作用机制，为制订干预计划提供参考。方法 采用广泛性焦虑障碍量表、患者健康问卷抑郁量表、躯体症状量表、12项简明健康状况调查表对327例主动脉夹层术后患者进行调查，根据相关性分析结果提出假设，应用AMOS软件进行结构方程模型分析。结果 主动脉夹层术后患者生活质量得分（81.56±7.36）分，焦虑得分2.00(0, 3.00)分，抑郁得分2.00(0, 3.00)分，躯体症状得分5.00(2.00, 8.00)分；焦虑、抑郁、躯体症状对生活质量有直接影响，焦虑、抑郁通过躯体症状对生活质量有间接影响（均P<0.05）。结论 主动脉夹层术后患者生活质量处于中等偏上水平，应早期对主动脉夹层术后患者的心理状况与躯体症状进行动态评估与监测，及时进行心理干预和症状管理，以改善其生活质量。     

Deliberate induction of alcohol tolerance: empirical introduction to a novel health risk

Aims Alcohol tolerance is a hallmark indicator of alcohol dependence. Even so, the allure of peers' admiration for having the ability to drink heavily may lead some adolescents and young adults to practice, or ‘train’, to increase their tolerance (particularly at US colleges, where heavy drinking is highly prevalent and central to the social culture). This is a potential health hazard that has not been documented empirically. Thus, we initiated a study of tolerance ‘training’ and its association to risky and heavy drinking. Design, setting and participants A cross‐sectional online survey of 990 college student life‐time drinkers at a large Midwestern US university. Findings Of the sample, 9.9% (n = 97) reported deliberately ‘training’ to increase tolerance. On average, they reported increasing from approximately seven to 10 US standard drinks in a night prior to ‘training’ to 12–15 drinks at the end of ‘training,’ over approximately 2–3 weeks' duration. Although the proportion of frequent binge drinking among ‘non‐trainers’ (34.4%) was similar to national rates, ‘trainers’ were much more likely to be frequent bingers (76.3%; OR = 6.15). Conclusions A number of students report deliberately inducing alcohol tolerance, probably directly increasing the risk for alcohol poisoning and other acute harms and/or dependence. This phenomenon might additionally be applicable to other populations, and deserves further study and attention as a potential personal and public health risk. Prevention efforts might aim to reduce the perceived importance of heavy‐drinking abilities.     

Prospective evaluation of the efficacy of peroral endoscopic myotomy in patients with achalasia

Peroral endoscopic myotomy (POEM) is an endoscopic alternative to surgical myotomy in patients with achalasia. This study aimed to evaluate the efficacy and clinical outcomes of POEM.A total of 20 patients with achalasia who underwent POEM between October 2016 and November 2017 were prospectively recruited. The intraoperative esophagogastric junction distensibility index (mm²/mm Hg) was measured pre- and post-myotomy using an endoluminal functional lumen imaging probe. Clinical response was defined as Eckardt score ≤3. Health-related quality of life was measured by the 36-item short-form health survey score.POEM was successfully completed in all cases. The median procedure time was 68.5 minutes (range 50.0–120.0), and the median myotomy length was 13 cm (range 11–18). Major adverse events were encountered in 2 cases. Overall, clinical responses were observed in all patients during a median follow-up of 11.9 months (range 1.2–26.2). Postoperative esophagogastric junction distensibility index was significantly higher than baseline (from 1.3 [range 0.8–6.9] to 6.3 [range 25–19.2], P < .001). The median Eckardt scores were decreased after POEM (5 [range 2–11] to 1 [range 0–3], P < .001), and the 36-item short-form health survey score was also improved significantly after POEM (67.5 [range 34.5–93.9] to 85.7 [range 53.4–93.3], P = .004).POEM is an effective treatment for achalasia, based on the improvement of both symptoms and objective measures.Clinicaltrial.gov {"type":"clinical-trial","attrs":{"text":"NCT 02989883","term_id":"NCT02989883"}}NCT 02989883