Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms

WOS: 000370332900007PubMed ID: 27011627Background: Post-polio syndrome (PPS) is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG) evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient's self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5%) met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42%) limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013). Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS

Quality of life and neuropathic pain in hospitalized cancer patients: A comparative analysis of patients in palliative care wards versus those in general wards

Context: While the survival of cancer patients is prolonged due to the development of new treatment strategies and advancing technologies, the prevalence of symptoms such as neuropathic pain affecting the quality of life is also increasing. Aims: The aim of this study is to determine the relationship between neuropathic pain (NP) and quality of life in hospitalized cancer patients and to compare patients in general wards and those in palliative care wards in terms of NP and quality of life. Subjects and Methods: A total of 156 patients, 53 cancer patients hospitalized in the palliative care unit and 103 cancer patients hospitalized in general wards, were included in the study. The Douleur Neuropathic 4 test was used for NP assessment, and the Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HAD), Brief Fatigue Inventory (BFI), and Short Form of Brief Pain Inventory (SF-BPI) were used for assessing pain characteristics and their effects on quality of life. Results: NP was present in 39.7% of cases and nociceptive pain (NP) was present in 32.7% of cases. There were no complaints of pain 27.6% of cases. The patients with no pain complaint were excluded, 54.9% of the patients had NP and 45.1% had NS. The scores of BFI, HAD-depression, ESAS overall, and ESAS tiredness were signifi cantly lower in patients with NP treated general wards compared to patients with NP in the palliative care wards (P < 0.05). Cancer patients with NP in general wards had signifi cantly higher scores of SF-BPI effect, SF-BPI severity, ESAS overall, ESAS pain, ESAS tiredness, ESAS nausea, ESAS appetite, and ESAS well-being as compared to those of general cancer patients with NS (P < 0.05). Conclusions: Since there was a homogeneous distribution among the groups in terms of both cancer treatment and pain management, we directly related the deterioration of the patients' quality of life to NP

Urinary Symptoms in Multiple Sclerosis: Relation with Urodynamic Findings and Impact on Patient's Quality of Life

WOS: 000473218600009Objective: We aimed to investigate the correlations of urinary symptoms with urodynamic findings in patients with multiple sclerosis (MS) and their effects on quality of life. Methods: Nineteen MS patients with urinary symptoms were included. The data were obtained from files or with face-to-face interviews. Symptom types of patients were categorized as irritative, obstructive, and mixed. The Incontinence Quality of Life Scale, the King's Quality of Life Questionnaire (KQL) and the International Consultation on Incontinence Modular Questionnaire-Short Form were used to determine the effect of urinary symptoms on quality of life. The Extended Disability Status Scale (EDSS) was used to assess disability. All patients underwent urodynamic examination. Results: Of the 478 patients, 34.5% had visited a psychiatrist once in their lifetime, 13.6% were diagnosed with depression, and 13.8% did not know the diagnosis of mental disease; 32.2% were suggested medication by their doctor, 16.7% did not know the name of this medication, and 13.2% stated that the suggested drug was antidepressant. Moreover, 24.9% of the patients were known to use antidepressant at least once in their lifetime, and 16.3% were still using antidepressants. Among patients using antidepressants, 32% continued using this drug upon doctor's recommendation and 13.6% continued with the diagnosis of depression. Conclusion: The urinary symptoms significantly affect the quality of life in MS patients. Since symptoms do not always correlate with the underlying pathology, it is more appropriate to give the treatment based on the bladder type in urodynamic testing

Association between serum vitamin D levels and neuropathic pain in rheumatoid arthritis patients: A cross-sectional study

WOS: 000423817900009PubMed ID: 28857474Aim: Recent literature suggests that neuropathic pain (NP) and vitamin D deficiency can occur concurrently in patients with rheumatoid arthritis (RA). This study aimed to examine the development of NP in patients with RA and the relationship between NP and vitamin D. Methods: We used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire to evaluate NP in 93 patients with RA. Demographic and clinical data were obtained from patient files and interviews, and patients' serum vitamin D levels were recorded. Patients were requested to complete both the Short Form-36 survey and the Health Assessment Questionnaire. Results: Seventy-five of the eligible patients were female (80.6%), and 31 (33.3%) were diagnosed with NP according to the LANSS. There was a negative correlation between vitamin D levels and the LANSS score (P = 0.001). The prevalence of NP was 5.8 times higher among patients with serum vitamin D levels below 20 ng/mL than in patients with vitamin D levels >= 30 ng/mL. Based on the area under curve (AUC) values, we found that serum levels of vitamin D were a good predictor of NP diagnoses in patients with RA (AUC = 0.71). Conclusion: We found that vitamin D deficiency was asssociated with increased NP in patients with RA. Although further research is needed to clarify the association between serum vitamin D levels and NP, our study raises awareness of the need to screen for vitamin D deficiency in RA patients with NP

Association between serum vitamin D levels and neuropathic pain in rheumatoid arthritis patients: A cross-sectional study

Aim: Recent literature suggests that neuropathic pain (NP) and vitamin D deficiency can occur concurrently in patients with rheumatoid arthritis (RA). This study aimed to examine the development of NP in patients with RA and the relationship between NP and vitamin D

Reliability and validity of the Turkish version of the Danish Prostatic Symptom Score to assess lower urinary tract symptoms in stroke patients

WOS: 000413293600014PubMed ID: 28946578BACKGROUND: Lower urinary tract dysfunction (LUTD) is one of the most frequently encountered problems in stroke.OBJECTIVE: To assess the validity and reliability of the Turkish Danish Prostatic Symptom Score (DAN-PSS) in stroke patients with LUTD.METHODS: A total of 50 patients were included in the study. The reliability was assessed using Cronbach alpha and intraclass correlation coefficient (ICC) methods, and the validity using the correlations between the subgroup and overall scores of DAN-PSS and the scores of the Barthel Index (BI), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and Short Form 36 (SF-36).RESULTS: The Cronbach a values were found >0.97 and ICC 0.953-0.990 for all subgroup scores. We found a significant negative correlation between all the sub-scores of DAN-PSS and the BI, and a significant positive correlation between all the sub-scores of DAN-PSS and ICIQ-SF (p < 0.05). The symptom score of DAN-PSS had a significant negative correlation with the physical functioning, physical and emotional role subdomains of the SF-36 survey (p < 0.05).CONCLUSIONS: We have shown the reliability and validity of the Turkish DAN-PSS, and we think that it will be useful to utilize it in the monitoring of patients with stroke and in clinical studies

Critically ill elderly patient mortality: Is age a risk factor? Yoğun bakımda yaşlı hasta mortalitesi: Yaş risk faktörü mü?

© 2014, AVES Ibrahim Kara. All Rights reserved.Objective: The aim of this study is to evaluate mortality rates and risk factors for mortality among patients more than 65 years old admitted to the medical intensive care unit (ICU). Material and Methods: ICU admissions of patients older than 65 years were retrospectively analyzed. Patients divided into three groups according to their age: 65-74 (group 1), 75-84 (group 2), and 85 age and over (group 3). Results: A total of 442 patients were included into the study. The mean age of the patients was 75±7 years, and 49% of them was female. The overall mortality rate was 83%. Every 1-point rise in Sequential Organ Failure Assessment (SOFA) score was associated with a 1.48-fold (95% CI 1.32-1.68, p<0.001) increase in mortality rate. Mechanical ventilation (MV) was associated with a 5.02-fold (95% CI 2.57-9.80, p<0.001) increase in mortality rate. MV (both invasive and non-invasive together) was associated with 4.32 fold increase in mortality. (95% CI 1.71-10.45, p=0.002). Conclusion: The comorbid conditions of patients and severity of disease should be considered for mortality prediction for critically ill elderly patients

Assessment of voiding dysfunction in Parkinson's disease: Reliability and validity of the Turkish version of the Danish Prostate Symptom Score

WOS: 000408229600032PubMed ID: 28139847AimsTo investigate the reliability and validity of the Turkish version of the Danish Prostate Symptom Score (Dan-PSS) questionnaire in patients with Parkinson's disease (PD) and to compare the burden of LUTS (Lower urinary tract symptoms) in men and women. MethodsFor analysis of test-retest reliability, the Turkish version of the Dan-PSS scale was developed using the back translation method, and it was administered on the day of admission and repeated 1 week after in 60 patients with PD. The OAB-q (Overactive Bladder Questionnaire) and PDQ-39 (Parkinson's Disease Questionnaire-39) were administered to 73 patients for validity analysis. ResultsBoth the internal consistency (Cronbach's alpha coefficient: 0.99-1.00) and the test-retest reliability (intraclass correlation coefficient: 0.99-1.00) of the Dan-PSS were found to be high in patients with PD. Although weak to moderate correlations were found between the subscales of the Dan-PSS and PDQ-39 (r: 0.20-0.42; P<0.05), a strong correlation was found with the OAB-q (r: 0.60-0.79; P<0.05). Nocturnal urination was the most frequent (93.2%), and bothersome (54.8%) symptom. The majority of the symptom and bother responses were similar in men and women. ConclusionsCurrent study shows that the Turkish version of the Dan-PSS questionnaire is an internally consistent, reliable, and valid scale for patients with PD. Therefore, it can be used to evaluate frequency and severity of LUTS in PD. LUTS are commonly seen in patients with PD in both sexes. It is suggested that all patients with PD should be referred for urological assessment