Effectiveness and tolerability of rectal ointment and suppositories containing sucralfate for hemorrhoidal symptoms: a prospective, observational study.

BACKGROUND AND AIMS: A high number of topical products are available for the treatment of hemorrhoidal symptoms. Sucralfate-based topical products constitute a new treatment alternative that act as a mechanical barrier to facilitate healing. The aim of this prospective, observational study was to determine patient- and physician-assessed effectiveness and tolerability of rectal ointment and suppositories containing sucralfate for the treatment of hemorrhoidal symptoms in routine clinical practice. METHODS: Adult patients with diagnosed, mild-to-moderate, symptomatic non-bleeding hemorrhoids treated with rectal ointment or suppositories containing sucralfate were enrolled. Patients were administered treatment twice per day for at least 1 week until symptom resolution and/or for a maximum of 4 weeks. The primary endpoint was patient-assessed effectiveness on a modified Symptom Severity Score (mSSS, range 0 to 14). Physician-assessed effectiveness (9 symptoms, 0 to 5 Likert scale), hemorrhoid grade, and patient satisfaction were also determined. RESULTS: Five investigators enrolled 60 patients; mean age was 48.4 ± 16.6 years and 72.4% were female. Pain or pressure sensitivity was reported as the most severe symptom by patients, and pressure sensitivity, discharge, soiling, and prolapse by physicians. Mean patient-assessed mSSS at baseline was 6.6 ± 1.9 and was significantly improved overall and in the ointment and suppository groups individually by -4.6 ± 2.0, -4.4 ± 1.8, and -4.8 ± 2.2, respectively (p < 0.0001). Investigator-assessed mean baseline symptom score was 18.1 ± 3.9 and improved by -7.1 ± 4.5, -6.9 ± 5.4, and -7.3 ± 3.5, respectively (p < 0.0001). Investigator-assessed symptoms of pressure sensitivity, swelling, and discharge were improved to the greatest extent. Hemorrhoid grade was improved in 38% of patients at the end of treatment. Compliance with treatment was 97.4% and patient satisfaction with application and onset of action was high (81.3% and 76.2%, respectively). Both the ointment and suppository were well tolerated. CONCLUSIONS: The effectiveness of topical ointment or suppository containing sucralfate on patient- and investigator-assessed hemorrhoidal symptoms in real-life clinical practice was demonstrated. Patient satisfaction was high and treatments were well tolerated. Larger controlled trials are warranted to confirm the results.

Quantification of the Upper Extremity Motor Functions of Stroke Patients Using a Smart Nine-Hole Peg Tester.

This paper introduces a smart nine-hole peg tester (s-9HPT), which comprises a standard nine-hole peg test pegboard, but with light-emitting diodes (LEDs) next to each hole. The s-9HPT still supports the traditional nine-hole peg test operating mode, in which the order of the peg placement and removal can be freely chosen. Considering this, the s-9HPT was used in lab research to analyze the traditional procedure and possible new procedures. As this analysis required subjects with similar levels of dexterity, measurement data from 16 healthy subjects (seven females, nine males, 25-80 years old) were used. We consequently found that illuminating the LEDs in various patterns facilitated guided tests of diverse complexity levels. Next, to demonstrate the clinical application of the s-9HPT, the improvement in the hand dexterity of 12 hospitalized stroke patients (45-80 years old, six females and six males) was monitored during their rehabilitation. Here, we used traditional and guided tests validated by healthy subjects. Consequently, improvements were found to be patient specific. At the beginning of rehabilitation, traditional tests suitably indicate improvements, while guided tests are beneficial following improvements in motor functions. Further, the guided tests motivated certain patients, meaning the rehabilitation was more effective for these individuals.