BackgroundIrritable bowel syndrome (IBS) is a frequent, costly, and potentially disabling gastrointestinal disorder. Medical education is among the most challenging and the most stressful education, and this may predispose to high rates of IBS.ObjectiveTo determine the prevalence and predictors of IBS among medical students and interns in King Abdulaziz University, Jeddah, Saudi Arabia.MethodsA cross-sectional study was conducted among 597 medical students and interns selected by multistage stratified random sample method in 2012. A confidential, anonymous, and self-administered questionnaire was used to collect personal and sociodemographic data, level of emotional stress, and food hypersensitivity during the past 6 months. Rome III Criteria and the Standardized Hospital Anxiety and Depression Scale were also used.ResultsThe prevalence of IBS was 31.8%. Multiple logistic regression analysis revealed that the first predictor of IBS was female gender (aOR=2.89; 95.0% CI: 1.65–5.05). The second predictor was presence of morbid anxiety (aOR=2.44; 95.0% CI: 1.30–4.55). Living in a school dormitory, emotional stress during 6 months preceding the study, and the academic year were the next predictors.ConclusionsHigh prevalence of IBS prevailed among medical students and interns. Female gender, morbid anxiety, living in school dormitory, emotional stress, and higher educational level (grade) were the predictors of IBS. Screening of medical students for IBS, psychological problems, and reducing stress by stress management are recommended.
This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies.
Background:
Because heart rate variability (HRV) has been linked to important clinical outcomes in various cardiovascular disease states, we investigated whether preprocedural ultrashort-term HRV (UST-HRV) differs between 1-year survivors and nonsurvivors after transcatheter aortic valve replacement (TAVR).
Methods:
In our single-center, retrospective, nested pilot study, we analyzed data from patients with severe aortic stenosis undergoing TAVR. All patients had preprocedural UST-HRV measured before the administration of any medications or any intervention. To investigate whether preprocedural HRV is associated with 1-year survival, we performed a logistic regression analysis controlling for Kansas City Cardiomyopathy Questionnaire 12 score.
Results:
In our parent cohort of 100 patients, 42 patients (28 survivors and 14 nonsurvivors) were included for analysis. Root mean square of successive differences (RMSSD) and standard deviation of NN intervals (SDNN) were lower in patients who survived to 1-year post TAVR compared to nonsurvivors [10 (IQR 8–23) vs 23 (IQR 17–33),
P
= 0.04 and 10 (IQR 7–16) vs 17 (IQR 11–40),
P
= 0.03, respectively]. Logistic regression demonstrated a trend in the association of preprocedure RMSSD with 1-year mortality and a 5% higher risk of 1-year mortality with each unit increment in UST-HRV using SDNN (OR 1.05; 95%CI 1.01–1.09,
P
= 0.02).
Conclusion:
Our data suggest an inverse relationship between preprocedural UST-HRV and 1-year survival post-TAVR. This finding highlights the potential complexity of HRV regulation in chronic vs acute illness. Prospective studies are needed to validate our findings and to determine whether UST-HRV can be used for risk stratification in patients with severe aortic stenosis.
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