scholarly journals Anorectal dysfunction in multiple sclerosis patients: A pilot study on the effect of an individualized rehabilitation approach

2021 ◽  
pp. 1-11
Author(s):  
Martina Kovari ◽  
Jan Stovicek ◽  
Jakub Novak ◽  
Michaela Havlickova ◽  
Sarka Mala ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Repeated Measures ◽  
Area Under The Curve ◽  
Rehabilitation Program ◽  
Anorectal Dysfunction ◽  
Repeated Measures Analysis ◽  
Resting Pressure ◽  
Maximal Pressure ◽  
Multiple Sclerosis Patients ◽  
Over Time

BACKGROUND: Anorectal dysfunction (ARD), especially bowel incontinence, frequently compromises the quality of life in multiple sclerosis (MS) patients. The effect of rehabilitation procedures has not been clearly established. OBJECTIVE: To determine the effect of an individualized rehabilitation approach on bowel incontinence and anorectal pressures. METHODS: MS patients with ARD underwent 6-months of individually targeted biofeedback rehabilitation. High resolution anorectal manometry (HRAM) and St. Mark’s Fecal Incontinence Scores (SMIS) were completed prior to rehabilitation, after 10 weeks of supervised physiotherapy, and after 3 months of self-treatment. RESULTS: Ten patients (50%) completed the study. Repeated measures analysis of variance (ANOVA) demonstrated significant improvement in the SMIS questionnaire over time [14.00 baseline vs. 9.70 after supervised physiotherapy vs. 9.30 after self-treatment (p = 0.005)]. No significant improvements over time were noted in any HRAM readings: maximal pressure [49.85 mmHg baseline vs. 57.60 after supervised physiotherapy vs. 60.88 after self-treatment (p = 0.58)], pressure endurance [36.41 vs. 46.89 vs. 49.95 (p = 0.53)], resting pressure [55.83, vs 52.69 vs. 51.84 (p = 0.704)], or area under the curve [230.0 vs. 520.8 vs. 501.9 (p = 0.16)]. CONCLUSIONS: The proposed individualized rehabilitation program supports a positive overall effect on anorectal dysfunction in MS patients.

scholarly journals Effect of Aerobic Exercise Program on Quality of Life in Male Patients with Multiple Sclerosis

2020 ◽  
Author(s):  
Mojtaba Dehestani Ardakani
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Aerobic Exercise ◽  
Repeated Measures ◽  
Therapeutic Approach ◽  
Exercise Program ◽  
Repeated Measures Analysis ◽  
Significant Difference ◽  
Multiple Sclerosis Patients

Introduction: The purpose of this study was to determine the effect of aerobic exercise program on quality of life in multiple sclerosis men as a complementary therapeutic approach to multiple sclerosis. Methods: This was a semi-experimental study. The statistical sample consisted of 60 people was selected by the available sampling method from Kahrizak Nursing Home where was also a member of the Iranian MS society. They were randomly divided into control and test groups. After an introductory session of the patients with the aims and intervention method in the experimental group, 27 sessions of 60 minutes of aerobic exercise program were performed in 9 weeks. Data collection tools consisted of a demographic questionnaire, a short quality of life (SF-8) questionnaire, and self-report checklist with a significant level of p≤0.05. Descriptive statistical tests, independent t-test and repeated measures analysis of variance were used for analysis using SPSS version 16 statistical software with a significance level of p≤0.05. Results: The results showed that there was no significant different between the two groups in terms of the total score (df = 48 = T 21.1, p = 0.23) and dimensions of quality of life (Physical: df = 48, T = 1.31, p = 0.19; mental: df = 48, t = 0.96, p = 0.31) There was no significant difference between the control and experimental groups. The results of repeated measures analysis of variance showed that there was a significant difference between the experimental and control groups in terms of quality of life dimensions. Conclusion: In general, aerobic exercise, which was chosen as an exercise program in this study, improves the quality of life of multiple sclerosis patients. Therefore, this complementary therapeutic approach is recommended as an effective and cost-effective method in cost and time, as well as the ability to learn and easy to administer to multiple sclerosis patients.

scholarly journals Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

2012 ◽  
Vol 2012 ◽  
pp. 1-12
Author(s):  
Rachel E. Maddux ◽  
Lars-Gunnar Lundh
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Psychological Symptoms ◽  
Self Report ◽  
Treatment Results ◽  
Repeated Measures Analysis ◽  
Depressive Personality ◽  
Symptom Changes ◽  
Psychotherapy Clients ◽  
Over Time

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

Longitudinal single-cell cytokine responses reveal recurrent autoimmune myelin reactivity in relapsing-remitting multiple sclerosis patients

2005 ◽  
Vol 11 (3) ◽  
pp. 251-260 ◽  
Author(s):  
I R Moldovan ◽  
R A Rudick ◽  
A C Cotleur ◽  
S E Born ◽  
J-C Lee ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Amino Acid ◽  
Ex Vivo ◽  
Proteolipid Protein ◽  
Myelin Proteins ◽  
Immune Reactivity ◽  
Cytokine Responses ◽  
Relapsing Remitting ◽  
Multiple Sclerosis Patients ◽  
Over Time

The relationship between multiple sclerosis (MS) disease activity and myelin protein-induced cytokine responses over time is not elucidated. We addressed this relationship by examining longitudinal cytokine responses to myelin proteins every three months for one year, in the context of gadolinium (gad)-enhancing brain lesions and of clinical relapses. The ELISPOT assay was used to determine the ex vivo cytokine production in response to nine amino acid long peptides spanning the entire proteolipid protein (PLP) and myelin basic protein (MBP) molecules in relapsing—remitting (RR) MS patients and matched healthy controls. We identified three longitudinal levels of myelin-induced cytokine secretion by adding up the positive responses for all PLP or MBP peptides obtained for five timepoints, at three- month intervals: low reactivity (<200 cumulative cytokine-secreting cells), isolated peptide reactivity (201-450 cumulative cytokine- secreting cells) and recurrent protein-wide bursts of cytokine reactivity (> 451 cumulative cytokine-secreting cells). The majority of MS patients showed recurrent bursts to PLP and MBP. In contrast, controls showed a more even distribution between all levels of cytokine reactivity. The majority of patients with gad-enhancing lesions showed PLP/IFNg and MBP/IFNg recurrent burst responses. This is the first longitudinal study on MS patients in which nine amino acid long myelin peptides are used to reveal the broad range of PLP- and MBP- peptide cytokine reactivity across the whole molecule of these two major myelin proteins. This study also reveals the extremely dynamic nature of the immune reactivity to numerous regions of myelin, which can fluctuate dramatically over time. Such fluctuation could hamper the efficacy of antigen-based therapies for MS.

Stability of Intravenous Famotidine Stored in Polyvinyl Chloride Syringes

DICP ◽  
1989 ◽  
Vol 23 (7-8) ◽  
pp. 588-590 ◽  
Author(s):  
Linda S. Bullock ◽  
Joseph F. Fitzgerald ◽  
Helen I. Mazur
Keyword(s):  
Polyvinyl Chloride ◽  
Repeated Measures ◽  
High Performance ◽  
Hplc Analysis ◽  
Time Effect ◽  
Sterile Water ◽  
Reverse Phase ◽  
Repeated Measures Analysis ◽  
The Stability ◽  
Over Time

The stability of intravenous famotidine in dextrose 5% injection (D5W), NaCl 0.9% injection (NS), and sterile water for injection stored in polyvinyl chloride (PVC) syringes at 4°C for 14 days was studied. The concentration of famotidine samples was determined at time 0, 7 days, and 14 days by reverse-phase high-performance liquid chromatography. Samples were inspected for visual changes and tested for changes in pH. Results of the HPLC analysis indicated that the famotidine samples remained within 94-100 percent and 99-103 percent of the time 0 concentrations at 7 and 14 days, respectively. Repeated measures analysis of variance demonstrated a significant time effect on famotidine concentration as concentrations changed over time (p<0.01). This change was small in magnitude, however, and concentrations decreased at 7 days and increased at 14 days. Famotidine is stable at a concentration of 2 mg/mL in D5W, NS, and sterile water for injection stored in PVC syringes at 4°C for 14 days.

scholarly journals Randomized Split-Mouth Study on Postoperative Effects of Palmitoylethanolamide for Impacted Lower Third Molar Surgery

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Bacci ◽  
Giulia Cassetta ◽  
Bruno Emanuele ◽  
Mario Berengo
Keyword(s):  
Postoperative Pain ◽  
Repeated Measures ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Third Molar Extraction ◽  
Drug Tolerability ◽  
Repeated Measures Analysis ◽  
Surgical Extraction ◽  
Over Time ◽  
Molar Extraction

The aim of this study was to assess the efficacy of Normast 300 mg in reducing swelling and pain after the surgical extraction of impacted lower third molars. Materials and Methods. A randomized, split-mouth, single-blind study was conducted on 30 patients between 18 and 30 years of age requiring lower third molar extraction. Patients underwent bilateral extractions in a randomized sequence, one extraction being performed under Normast treatment. The Normast treatment involved 2 tablets a day for 15 days. The parameters assessed at each procedure were trismus, swelling, pain, NSAID consumption, postoperative complications, drug tolerability, and safety. The results obtained were processed using repeated measures analysis of variance. Results. Perceived postoperative pain was reportedly significantly milder on Normast treatment than control. The trend of the means differed over time (P<.0001) and between the two extraction groups (P<.0221). On the other hand, for edema and trismus, the trend differed over time for both groups but did not differ between the two groups. Discussion. Our analyses indicate that patients experienced significantly less postoperative pain when they were treated with Normast. Conclusions. Administering Normast improves the postoperative course—in terms of pain—after lower third molar extraction.

Bimonthly assessment of magnetization transfer magnetic resonance imaging parameters in multiple sclerosis: a 14-month, multicentre, follow-up study

2010 ◽  
Vol 16 (3) ◽  
pp. 325-331 ◽  
Author(s):  
S. Mesaros ◽  
MA Rocca ◽  
MP Sormani ◽  
P. Valsasina ◽  
C. Markowitz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Effect ◽  
Repeated Measures ◽  
Magnetization Transfer ◽  
Random Effect ◽  
Lesion Volume ◽  
Sample Sizes ◽  
Double Blind ◽  
Over Time

This study was performed to assess the temporal evolution of damage within lesions and the normal-appearing white matter, measured using frequent magnetization transfer (MT) MRI, in relapsing—remitting multiple sclerosis (RRMS). The relationship of MT ratio (MTR) changes with measures of lesion burden, and the sample sizes needed to demonstrate a treatment effect on MTR metrics in placebo-controlled MS trials were also investigated. Bimonthly brain conventional and MT MRI scans were acquired from 42 patients with RRMS enrolled in the placebo arm of a 14-month, double-blind trial. Longitudinal MRI changes were evaluated using a random effect linear model accounting for repeated measures, and adjusted for centre effects. The Expanded Disability Status Scale (EDSS) score remained stable over the study period. A weak, but not statistically significant, decrease over time was detected for normal-appearing brain tissue (NABT) average MTR (—0.02% per visit; p = 0.14), and MTR peak height (—0.15 per visit; p = 0.17), while average lesion MTR showed a significant decrease over the study period (—0.07% per visit; p = 0.03). At each visit, all MTR variables were significantly correlated with T2 lesion volume (LV) (average coefficients of correlation ranging from —0.54 to —0.28, and p-values from <0.001 to 0.02). At each visit, NABT average MTR was also significantly correlated with T1-hypointense LV (average coefficient of correlation = —0.57, p < 0.001). The estimation of the sample sizes required to demonstrate a reduction of average lesion MTR (the only parameter with a significant decrease over the follow-up) ranged from 101 to 154 patients to detect a treatment effect of 50% in a 1-year trial with a power of 90%. The steady correlation observed between conventional and MT MRI measures over time supports the hypothesis of axonal degeneration of fibres passing through focal lesions as one of the factors contributing to the overall MS burden.

scholarly journals Evaluation of intra-articular injection of bupivacaine with morphine or methylprednisolone or alone on pain after knee arthroscopy

2020 ◽  
pp. 314-322
Keyword(s):  
Side Effects ◽  
Pain Intensity ◽  
Repeated Measures ◽  
Knee Arthroscopy ◽  
Sedative Effect ◽  
Visual Analog Scales ◽  
Repeated Measures Analysis ◽  
Recorded Data ◽  
Spss Software ◽  
Over Time

Background and Aim: Knee arthroscopy is used to diagnose and treat intra-articular lesions. Controlling acute pain after arthroscopy requires the use of a method with the least side effects and the most efficiency. The aim of this study was to compare the sedative effect after intra-articular injection of bupivacaine combination with morphine or methylprednisolone or alone in knee arthroscopy. Materials and Methods: In this study clinical-randomized three-blind trial, 99 volunteer patients with knee arthroscopy were randomly divided into three groups: 1. Bupivacaine (0.5%), 2. Morphine (5 mg)+ bupivacaine (0.5%) and 3. Methylprednisolone (40 mg) + bupivacaine (0.5%). At the end of the operation, drugs were injected intra-articular and the amount of postoperative pain was evaluated and recorded based on visual analog scales 6, 12, 18, and 24 hours after injection. Also, receiving the injected analgesic within 24 hours, was recorded. Data were analyzed using SPSS software and repeated measures analysis of variance. Results: In all three groups, the pain intensity decreased significantly over time. The pain intensity of the methylprednisolone + bupivacaine and morphine+bupivacaine group was the similar, at different postoperative periods, but the pain intensity of these groups was significantly lower than the control. Also, consumption of the analgesics was significantly reduced in methylprednisolone+bupivacaine group compared to the two other groups. Conclusion: The results of this study showed that intra-articular injection of methylprednisolone + bupivacaine and morphine+bupivacaine was more effective than bupivacaine alone in reducing pain and the need for injectable analgesia.

Stress in Migrant Farmworkers During Premigration

2011 ◽  
Vol 14 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Evelyn M. Clingerman ◽  
Adama Brown
Keyword(s):  
Perceived Stress ◽  
Repeated Measures ◽  
Area Under The Curve ◽  
Self Report ◽  
Middle School Education ◽  
Lower Rio Grande Valley ◽  
Repeated Measures Analysis ◽  
Education Design ◽  
The Relationship ◽  
Pilot Feasibility Study

Purpose: This study explored the relationship between migrant farmworker (MFW) stress and salivary cortisol (sC) in a sample of MFWs prior to migration. Sample: The sample, 40 ( N = 14 male, 26 female) adult MFWs residing in the lower Rio Grande Valley of Texas, primarily comprised middle-aged immigrants with a middle-school education. Design: This pilot feasibility study included a self-report farmworker stress inventory and five serial sC specimens in 24 hr. Results: The sC measures reflected an expected diurnal pattern. Lower total cortisol (area under the curve with respect to ground) was significantly associated with greater waist circumference ( r = –.63, p ≤ .01). Repeated measures analysis of variance (ANOVA) indicated that participants who perceived high levels of farmworker stress exhibited a significant change in sC over time; F(2.14, 72.65) = 43.90, p < .001. High- and low-perceived-stress groups differed significantly in the trajectory of changes in sC over the five time points. Conclusion: MFWs experienced significant levels of stress during premigration. Their sC responses varied significantly by level of perceived farmworker stress. Lower perceived stress may reflect blunting of the sC response pattern.

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