Patients with functional gastrointestinal disorders-importance of communication between physician and patient assessed in a cross-sectional cohort study.

Functional gastrointestinal disorders are frequent diseases often associated with a pronounced burden reflected in a greatly reduced quality of life. Patients are seeking medical help but may be perceived as demanding and challenging. For successful diagnosis and treatment of these patients, a good doctor-patient communication is key. However, so far, only few studies focus on the physicians' perspective of the doctor-patient communication. The present study cross-sectionally investigated 520 physicians using the validated difficult doctor-patient relationship questionnaire and the treatment satisfaction questionnaire from the physician's perspective along with several ad hoc questions. Data from 5,354 physician-patient conversations (one conversation per patient) was included. Physicians participating in this study mostly suspected stress-related burdens as the cause of functional gastrointestinal disorders (65.4%), while patients rather suspected food (55.4%) or other somatic causes (43.6%). The physician-patient relationship was rated just below the threshold for difficult interactions (cut-off ≥30, mean ± SD in the current sample: 28.6 ± 9.6) with 49.1% of physicians reaching a score of ≥30. Although physicians overall felt confident in the doctor-patient communication even in difficult conversations (61.9%), only 33.1% reported to have enough time for these patients and only 5.6% felt sufficiently compensated for discussions with patients with functional gastrointestinal disorders. Therefore, education of physicians on functional gastrointestinal disorders, training of physicians in physician-patient communication as well as an improved reimbursement of speaking medicine should help to further improve care for these patients and also treatment satisfaction on both the side of the patients as well as the physicians.

Quantification of Nighttime Micturition With an Ambulatory Sensor-Based System.

Among elderly males, benign prostate syndrome (BPS) is the most common urinary disorder. Nocturia is one of the major symptoms of BPS and has a considerable influence on the quality of life. For assessment of BPS (including nocturia), the International Prostate Symptom Score is widely used, but questionnaires are prone to bias. To date, there is no objective measurement system available for nocturia. In this study, we present an unobtrusive and nonstigmatizing device for objective measurement of nighttime micturition. In a preliminary study of six males diagnosed with BPS and nighttime micturition ≥ 2×, we showed that the device is accurate, with an average misdetection rate of 0.32 events and a mean absolute deviation of 3.8% when comparing the average number of nighttime micturition occurrences. In this extended study, an additional nine males were recorded and data from an occupancy sensor were also included. The results of the preliminary study were confirmed with an average misdetection rate of 0.33 events and a mean absolute deviation of 9.1%. The system can, therefore, be used to objectively measure nighttime micturition and, thereby, provide the basis for treatment, e.g., medication efficacy assessment.

Hyperactivity, concentration difficulties and impulsiveness improve during seven weeks' treatment with valerian root and lemon balm extracts in primary school children.

BACKGROUND: Valerian root and lemon balm extracts have previously shown efficacy and excellent tolerability in children<12 years suffering from restlessness and insomnia. We now examined whether treatment with a fixed combination of both may also improve concentration, hyperactivity and impulsiveness. METHODS: 169 primary school children suffering from hyperactivity and concentration difficulties but not meeting ADHS criteria were treated in an observational study by 27 office based pediatricians with a recommended daily dose of 640 mg valerian root extract WS(®) 1014 and 320 mg lemon balm extract WS(®) 1303 (Sandrin(®)), and evaluated by pediatricians and parents using standardized questionnaires at baseline, weeks 2 and 7. RESULTS: The fraction of children having strong/very strong symptoms of poor ability to focus decreased from 75% to 14%, hyperactivity from 61% to 13%, and impulsiveness from 59% to 22%. Parent rated social behavior, sleep and symptom burden showed highly significant improvements. Only in two children mild transient adverse drug reactions were observed. CONCLUSION: In primary school children with restlessness, concentration difficulties and impulsiveness treatment with WS(®) 1014 and WS(®) 1303 (Sandrin(®)) provides a viable option in addition to counseling and education.

An ambulatory sensor-based system for quantification of nighttime micturition for accurate nocturia assessment.

Nocturia is a widespread condition where patients need to micturate frequently during the nighttime. In order to define treatment and measure therapeutic success in nocturia, questionnaires are traditionally used for ambulatory assessment. However, questionnaires were reported to suffer from compliance, embarrassment and subjective bias. An automatic sensor-based system for quantification of nighttime micturition for accurate nocturia assessment would not suffer from these disadvantages, and its development was therefore the purpose of this study. We defined a sensor-based system for ambulatory use, consisting of a sensor watch and a room occupancy sensor. Using this system, we so far collected data from 6 participants and 82 nights in an ongoing study. We report the details of the system, as well as the data analysis. The system is very accurate, with an average misdetection rate of 0.32 and a mean absolute deviation of 3.8 % when comparing the average number of nighttime micturitions. This novel sensor-based nighttime micturition quantification system has the potential to be used as an objective ambulatory assessment tool for nocturia diagnosis and treatment.