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1.
Pain Med ; 21(1): 185-194, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31343684

RESUMO

OBJECTIVE: To evaluate the efficacy of a new multimodal antidepressant, vortioxetine (VO), in the management of burning mouth syndrome (BMS). DESIGN: Longitudinal single-assessment open-label pilot study. SETTING: University hospital. Subjects. Thirty BMS patients were enrolled. METHODS: BMS patients were treated with topical clonazepam and a flexible dose of VO (10 mg, 15 mg, or 20 mg). The visual analog scale (VAS), the Total Pain Rating Index (T-PRI), the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A), and the Pittsburgh Sleep Quality Index (PSQI) were performed at baseline (time 0) and after two (time 1), four (time 2), six (time 3), and 12 months (time 4) of treatment. Descriptive statistics and the Wilcoxon nonparametric test for two paired samples were used. RESULTS: The BMS patients showed a statistically significant improvement in VAS and T-PRI scores from baseline (median [interquartile range {IQR}] = 10.0 [10-10] and 22.0 [20-24], respectively) to time 4 (median [IQR] = 0.0 [0-0] and 8.0 [7-9], P < 0.001, respectively). Similarly, the HAM-A and HAM-D and PSQI scores showed an improvement from time 0 (median [IQR] = 20 [15.8-22], 19 [16-20.3], and 4.0 [4-7.3], respectively) to time 4 (median [IQR] = 6.0 [6-7], 6.0 [6-7], and 3.0 [3-4], respectively, P < 0.001). CONCLUSIONS: VO is efficacious and well tolerated in the treatment of BMS in firstline therapy on account of its better receptor pharmacological profile and in second-line treatment for patients who have only partially responded or have reported adverse effects to previous treatments.

2.
J Oral Rehabil ; 47(1): 42-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31332814

RESUMO

OBJECTIVES: To evaluate the oral health-related quality of life (OHRQoL) of patients with burning mouth syndrome (BMS) by comparing the Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI) tests, assessing their dependence with pain, anxiety and depression and, secondly, to analyse the changes in time after treatment with psychotropic drugs. METHODS: Twenty-six patients and 26 controls were included. The GOHAI, OHIP-14, visual analogue scale (VAS) and the Hamilton Rating Scales for Depression and Anxiety (HAM-D and HAM-A) were performed at baseline (time 0) and after 6 months of treatment (time 1). Descriptive statistics, the Mann-Whitney non-parametric test for two independent samples and the Wilcoxon non-parametric test for two paired samples were used. RESULTS: The scores from all outcome measurements were statistically significantly different between the cases and controls (P < .001) with a strong correlation between the GOHAI and the OHIP-14 (P < .001). The BMS patients showed a statistically significant improvement in the VAS, HAM-D and HAM-A scores from time 0 to time 1 (P < 0.001), and in the OHIP-14 scores (P < .004**) after the treatment, but no statistically significant difference in the GOHAI score (.464). CONCLUSIONS: Burning mouth syndrome patients showed poorer scores on all scales compared to the healthy subjects with a lower OHRQoL. OHIP-14 gives a greater weight to psychological and behavioural outcomes in evaluating oral health than GOHAI, and therefore, it is a more effective questionnaire in terms of the evaluation of the treatment response. The management of BMS can improve pain, anxiety and depression and the OHRQoL.


Assuntos
Síndrome da Ardência Bucal , Saúde Bucal , Idoso , Avaliação Geriátrica , Humanos , Qualidade de Vida , Inquéritos e Questionários
3.
J Dermatolog Treat ; 29(6): 623-629, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29308937

RESUMO

OBJECTIVES: We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. MATERIALS AND METHODS: We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2 months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). RESULTS: R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2-10.0) and 10.5 (IQR: 7.0-13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (p < .001) and 3.0 (IQR: 2.0-4.7) (p < .001), respectively]. Similarly, the HAM-A and HAM-D scores showed an improvement from time 0 [(median: 15.0 (IQR: 10.2-17.8) and 13.0 (IQR: 12.0-15.0), respectively] to time 2 [median: 6.0 (IQR: 4.0-7.0) (p < .001) and 5.5 (IQR: 4.25-6.0) (p < .001), respectively]. CONCLUSIONS: Psychotropic drugs turned out to be effective in the management of BMS-like oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period.


Assuntos
Benzodiazepinas/uso terapêutico , Síndrome da Ardência Bucal/tratamento farmacológico , Clonazepam/uso terapêutico , Líquen Plano Bucal/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/efeitos adversos , Antidepressivos/uso terapêutico , Ansiedade/patologia , Ansiedade/prevenção & controle , Benzodiazepinas/efeitos adversos , Síndrome da Ardência Bucal/complicações , Síndrome da Ardência Bucal/patologia , Clonazepam/efeitos adversos , Constipação Intestinal/etiologia , Depressão/patologia , Depressão/prevenção & controle , Feminino , Humanos , Líquen Plano Bucal/complicações , Líquen Plano Bucal/patologia , Masculino , Pessoa de Meia-Idade , Dor/patologia , Dor/prevenção & controle , Projetos Piloto
4.
Eat Weight Disord ; 22(1): 105-115, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27068173

RESUMO

PURPOSE: The aim of this study is to show that the differences among eating behaviours are related to the emotional dysregulation connected to the mental dimensions being part of the obese psychopathology. Eating behaviours can be considered a diagnostic feature at the initial screening for determining the obesity treatment: nutritional or bariatric surgery. METHODS: 1828 Obese subjects underwent psychiatric assessment before entering obesity nutritional treatment or bariatric surgery following the multidisciplinary programme. 1121 subjects were selected and enrolled in this study: 850 were inpatients visited or hospitalised at the Obesity Centre or at the Bariatric Surgery Units, 271 were outpatients visited at the Eating Disorder and Obesity Unit. Psychiatric examination was used to exclude psychiatric disorders and investigate eating behaviours distinguished on the basis of food intake rhythm in: gorging, snacking, grazing and binge. They are related to the mental dimensions: impulsiveness, body image, mood and anxiety, taking part in the emotional regulation system. Specific psychometric tools were used to investigate the different mental dimensions of the single eating behaviours and their differences. Statistical analysis of the psychopathological features was performed using ANOVA, ANCOVA, Levene test, Bonferroni's and Tamhane post hoc test. Significance was set at p < 0.05. RESULTS: Data analysis shows significant differences of psychopathology among all the eating behaviours and an increase in the emotional dysregulation determining maladaptive behaviours. DISCUSSION: Eating behaviours are connected to the balance of the different features of mental dimensions implicated in the emotional regulation system. They could provide significant clinical information and therefore be part of the obesity diagnostic criteria and therapeutic programme.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Emoções/fisiologia , Comportamento Alimentar/psicologia , Comportamento Impulsivo/fisiologia , Saúde Mental , Obesidade/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Pain Med ; 16(11): 2171-9, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26301724

RESUMO

OBJECTIVE: To compare sociodemographic and clinical characteristics in patients with burning mouth syndrome (BMS) and their relationship with pain. DESIGN: Cross-sectional clinical study. SETTING: University-Hospital. SUBJECTS: 75 BMS patients were enrolled. METHODS: The study was conducted between September 2011 and March 2012 at the "Federico II" University of Naples. Demographic characteristics and clinical information including age, sex, educational level, marital status, job status, age at disease onset, oral symptoms, and triggers were collected via questionnaire interviews. To assess pain intensity the visual analogue scale (VAS) was administered. Descriptive statistics were collected, and Pearson Chi-square tests, Kruskal-Wallis nonparametric tests and the Spearman bivariate correlation were performed. RESULTS: The mean age was 61.17 (±11.75, female/male ratio = 3:1). The mean age at disease onset was 56.75 (±12.01). A low educational level (8.57 ± 4.95) and 80% of unemployment were found. Job status and age at disease onset correlated with the VAS scale (P = 0.019 and P = 0.015, respectively). Tongue morphology changes, taste disturbances, and intraoral foreign body sensation have a significant dependence on gender (P = 0.049, 0.001, and 0.045, respectively); intraoral foreign body sensation has a significant dependence on marital status (P = 0.033); taste disturbances have a significant dependence on job status. (P = 0.049); xerostomia has a significant dependence on age (P = 0.039); and tongue color changes and a bitter taste have a significant dependence on educational level (P = 0.040 and 0.022, respectively). Marital status and educational level have a significant dependence on the triggers (P = 0.036 and 0.049, respectively). CONCLUSIONS: The prevalence of BMS is higher in women, and in married, unemployed, and less highly educated patients. Burning is the most frequent symptom while stressful life events are the most frequent trigger reported.


Assuntos
Síndrome da Ardência Bucal/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Síndrome da Ardência Bucal/complicações , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Medição da Dor , Prevalência , Fatores Sexuais , Estresse Psicológico/complicações , Inquéritos e Questionários , Xerostomia/epidemiologia , Adulto Jovem
6.
Arch Ital Urol Androl ; 78(2): 71-4, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16929608

RESUMO

The authors describe the use of a percutaneous approach for treating secondary calyceal diverticular stones. This disease was once managed with open surgery, but today minimally invasive techniques are preferred such as percutaneous nephrostolithotomy (PCNL), ureteroscopic stone removal (URS), laparoscopy, extracorporeal shock wave lithotripsy (ESWL), with PCNL representing the gold standard. Various percutaneous techniques are described for treating both calculi and the diverticulum. The first essential step is a careful preoperative morphological assessment of the diverticulum in order to plan the most suitable treatment modality.


Assuntos
Divertículo/complicações , Cálculos Renais/cirurgia , Cálices Renais , Nefropatias/complicações , Adulto , Feminino , Seguimentos , Humanos , Cálculos Renais/diagnóstico , Cálculos Renais/diagnóstico por imagem , Cálices Renais/cirurgia , Cuidados Pós-Operatórios , Fatores de Tempo , Resultado do Tratamento , Urografia
7.
Eur Urol ; 44(4): 401-6, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14499672

RESUMO

OBJECTIVE: To compare morbidity in two groups of patients who underwent retropubic or laparoscopic radical prostatectomy in the same period. PATIENTS AND METHODS: The clinical and pathological data obtained in 50 consecutive patients who underwent retropubic radical prostatectomy (RRP) from January 2001 to December 2001 were compared to those obtained in 71 consecutive patients who were treated in the same year by extraperitoneal laparoscopic radical prostatectomy (LRP). The two groups were comparable in terms of mean pre-operative PSA and biopsy Gleason score. The peri-operative data included operative time, intra-operative and post-operative transfusion rates, complication rates, hospitalization length, and duration of catheterization. The following pathological parameters were considered: Gleason score, pathological stage, and positive surgical margin rate. A comparative evaluation of continence recovery (no pads and any leakage) was made only in patients with follow-up longer than 12 months. RESULTS: The two groups were comparable in terms of pathological stage and definitive Gleason score. Operating times were significantly shorter in RRP (p<0.0001). LRP patients showed higher autologous (p<0.001) and eterologous transfusion (p=0.03). No significant difference was observed in terms of complication rates (p=0.07). The rectal injury rate was 2.8% in the laparoscopic group. The mean post-operative hospital stay was 10.2+/-2 days in the surgery group and 7.2+/-3.4 days in the laparoscopy group (p<0.001). Catheterization time was 8.4+/-0.9 days in the surgery group and 8+/-2.8 days in the laparoscopy group (p=0.27). After 12 months, complete continence was achieved in 64% of RRP and 40% of LRP patients, respectively (p=0.29). CONCLUSION: The results of our non-randomized study show that up to now laparoscopic radical prostatectomy does not provide significant advantages in terms of peri-operative morbidity compared with the traditional retropubic approach.


Assuntos
Laparoscopia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Idoso , Seguimentos , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/patologia
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