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Dementia and Geriatric Cognitive... 2020Neuropsychiatric symptoms (NPS) in dementia have received much attention due to their high prevalence and their significant implications. NPS in mild cognitive... (Review)
Review
BACKGROUND
Neuropsychiatric symptoms (NPS) in dementia have received much attention due to their high prevalence and their significant implications. NPS in mild cognitive impairment (MCI), a clinical concept proposed as an intermediate state between normal aging and dementia, is now gradually gaining in interest. We aimed to conduct a selective review to examine the prevalence rate of NPS in MCI and associations of NPS symptoms with disease progression.
SUMMARY
We searched the PubMed database for articles on NPS in MCI and included articles that fulfilled the inclusion criteria. NPS was present in 35-85% of MCI patients. The most common symptoms were depression, irritability, apathy, anxiety, agitation, and sleep problems. Although the associated risk for disease progression of some symptoms, such as apathy and anxiety, was more consistent across studies, evidence was conflicting for symptoms like depression and sleep problems. NPS tend to co-occur, and certain combinations of NPS had a mutual or cumulative effect on disease progression. Late-onset NPS, even in a mild form (mild behavioural impairment) were found to be associated with an increased risk of dementia, even in the absence of cognitive impairment. Key Messages: NPS are highly prevalent in MCI patients and associated with subsequent cognitive deterioration. Late-onset NPS should raise suspicions of neurodegeneration. Future studies with improvised methodology are required to understand the interrelations of NPS and the role they play in the prognosis for patients with MCI.
Topics: Aged; Aged, 80 and over; Aging; Anxiety; Apathy; Cognitive Dysfunction; Disease Progression; Female; Humans; Male; Neuropsychological Tests; Prevalence
PubMed: 32289790
DOI: 10.1159/000507078 -
Respiratory Medicine Sep 2023Patients living with mild disease represent the largest proportion of asthma patients. There are significant challenges in proposing a definition that would best...
Patients living with mild disease represent the largest proportion of asthma patients. There are significant challenges in proposing a definition that would best describe these patients, while also accurately identifying at-risk individuals. Current literature suggests considerable inflammatory and clinical heterogeneity within this group. Research has shown that these patients are at risk of poor control, exacerbations, lung function decline, and death. Despite conflicting data on its prevalence, eosinophilic inflammation appears to be a predictor of poorer outcomes in mild asthma. There is an immediate need to better understand phenotypic clusters in mild asthma. It is also important to understand factors that influence disease progression and remission, as it is evident that both vary in mild asthma. Guided by robust literature that supports inhaled corticosteroid-based strategies over short-acting beta-agonist (SABA) reliant regimens, the management of these patients has evolved considerably. Unfortunately, SABA use remains high in clinical practice despite strong advocacy from the Global Initiative for Asthma. Future mild asthma research should explore the role of biomarkers, develop prediction tools based on composite risk scores, and explore targeted therapies at least for at-risk individuals.
Topics: Humans; Administration, Inhalation; Asthma; Disease Progression; Adrenal Cortex Hormones; Biomarkers; Anti-Asthmatic Agents
PubMed: 37328016
DOI: 10.1016/j.rmed.2023.107326 -
The Laryngoscope Nov 2023The aim of this study was to gain quantitative insights into the role of daily voice use associated with mild phonotrauma via the Daily Phonotrauma Index (DPI), a...
OBJECTIVE
The aim of this study was to gain quantitative insights into the role of daily voice use associated with mild phonotrauma via the Daily Phonotrauma Index (DPI), a measure derived from neck-surface acceleration magnitude (NSAM) and difference between the first two harmonic magnitudes (H1 - H2).
METHODS
An ambulatory voice monitor recorded weeklong voice use for 151 female patients with phonotraumatic vocal hyperfunction (PVH) and 181 female vocally healthy controls. Three laryngologists rated phonotrauma severity from each patient's laryngoscopy. Mixed generalized linear models evaluated the accuracy, sensitivity, and specificity of the original DPI trained on all patients versus a mild DPI version trained on only patients rated with mild phonotrauma. Individual contribution of NSAM and H1 - H2 to each DPI model was also evaluated.
RESULTS
Reliability across the laryngologists' phonotrauma ratings was moderate (Fleiss κ = 0.41). There were 70, 69, and 12 patients with mild, moderate, and severe phonotrauma, respectively. The mild DPI, compared to the original DPI, correctly classified more patients with mild phonotrauma (Cohen's d = 0.9) and less controls (d = -0.9) and did not change in overall accuracy. H1 - H2 contributed less to mild phonotrauma classification than NSAM for mild DPI.
CONCLUSIONS
Compared with the original DPI, the mild DPI exhibited higher sensitivity to mild phonotrauma and lower specificity to controls, but the same overall classification accuracy. These results support the mild DPI as a promising detector of early phonotrauma and that NSAM may be associated with early phonotrauma, and H1 - H2 may be a biomarker associated with vocal fold vibration in the presence of lesions.
LEVEL OF EVIDENCE
Level 4, case-control study Laryngoscope, 133:3094-3099, 2023.
Topics: Humans; Female; Voice Disorders; Case-Control Studies; Reproducibility of Results; Vocal Cords; Voice
PubMed: 37194664
DOI: 10.1002/lary.30750 -
International Journal of Audiology 2015Acquired hearing impairment is recognized by the World Health Organization as the third leading cause of disability, with a mild impairment being the most prevalent. The... (Review)
Review
OBJECTIVE
Acquired hearing impairment is recognized by the World Health Organization as the third leading cause of disability, with a mild impairment being the most prevalent. The aim of this study was to review research literature concerned with adults with acquired mild hearing impairment; the definitions and prevalence, the resulting activity limitations and participation restrictions, and hearing-aid interventions.
DESIGN
This study involved a systematized review of research literature identified through searches in citation databases and through reference checking.
STUDY SAMPLE
A total of 151 papers were identified and of these, 33 papers were included in this review.
RESULTS
Prevalence rates are significantly influenced by the definition used for mild hearing impairment, and range from 1 in 3 to 1 in 5 adults. The weak correlations between audiological assessments and self-reported difficulties suggest that further assessment of individuals with mild hearing impairment is warranted. The most common intervention is the provision of hearing aids with varying rates of use, benefit, and satisfaction.
CONCLUSIONS
The development of appropriate audiological assessment in the clinic, and further evaluation of the real-world listening needs and performance of people with mild hearing impairment is required to provide a more effective pathway for this clinical population.
Topics: Hearing Aids; Hearing Loss; Humans; Speech Perception
PubMed: 26050524
DOI: 10.3109/14992027.2015.1046504 -
Current Opinion in Pulmonary Medicine Nov 2017To provide guidance in the management of mild obstructive sleep apnoea syndrome (OSAS) in the context of a very high prevalence, poor correlation with symptom profile,... (Review)
Review
PURPOSE OF REVIEW
To provide guidance in the management of mild obstructive sleep apnoea syndrome (OSAS) in the context of a very high prevalence, poor correlation with symptom profile, and lack of evidence that mild OSAS significantly contributes to comorbidity or early mortality.
RECENT FINDINGS
Mild obstructive sleep apnoea defined by hourly frequency of apnoeas or hypopnoeas (AHI) between 5 and 15 affects up to 35% of the general adult population but is much less prevalent when associated daytime symptoms are included. The poor correlation between symptoms and AHI complicates diagnosis and reports that mild OSAS is not significantly associated with comorbidity casts doubt on clinical significance. The diagnosis is complicated by night-to-night variability and by underestimation of AHI in ambulatory sleep studies that do not include sleep assessment. Active management of mild OSAS can be symptom-driven and offers a broad range of options. Lifestyle measures may be sufficient in many cases and mandibular advancement devices or positional therapy may be more effective in mild OSAS. Sleepy patients with low AHI may warrant a trial of continuous positive airway pressure therapy to establish the relationship between sleep disordered breathing and symptoms.
SUMMARY
Management of mild OSAS can focus on symptom relief to the individual patient.
Topics: Continuous Positive Airway Pressure; Health Behavior; Humans; Mandibular Advancement; Polysomnography; Severity of Illness Index; Sleep Apnea, Obstructive
PubMed: 28858969
DOI: 10.1097/MCP.0000000000000420 -
Expert Review of Respiratory Medicine Dec 2023Asthma is a common chronic respiratory disease characterized by chronic airway inflammation, airway hyperresponsiveness, reversible airflow limitation, and airway... (Review)
Review
INTRODUCTION
Asthma is a common chronic respiratory disease characterized by chronic airway inflammation, airway hyperresponsiveness, reversible airflow limitation, and airway remodeling. Mild asthma is the most common type of asthma, but it is the most neglected. Sometimes mild asthma can lead to acute severe exacerbations or even death.
AREAS COVERED
This article reviews the epidemiology, risk factors, and possible predictors of acute severe exacerbations and disease progression in mild asthma to improve the understanding of mild asthma and its severe acute exacerbations and progression.
EXPERT OPINION
There is a necessity to improve asthma patient categorization and redefine mild asthma's concept to heighten patient and physician attention. Identifying mild asthma patients that are highly vulnerable to severe acute exacerbations and researching the mechanisms are future prioritizations.
Topics: Humans; Disease Progression; Asthma; Lung; Risk Factors
PubMed: 38315090
DOI: 10.1080/17476348.2024.2314535 -
Current Opinion in Neurology Dec 2003Mild cognitive impairment is not an established diagnosis but a concept for which different criteria have been proposed and modified over time. Mild cognitive impairment... (Review)
Review
Mild cognitive impairment is not an established diagnosis but a concept for which different criteria have been proposed and modified over time. Mild cognitive impairment refers to the transitional zone between normal ageing and dementia. The mild cognitive impairment stage may be one of the optimum stages at which to intervene with preventive therapies. The heterogeneity of the term has been recognized. Multiple sources of heterogeneity have been described for mild cognitive impairment, including biological factors, clinical symptoms and clinical course. It is still not possible to consider mild cognitive impairment as an explicit predictor of Alzheimer's disease with the current criteria. The heterogeneity within mild cognitive impairment has been noted, and a classification has been proposed: amnestic or single memory mild cognitive impairment, multiple domains mild cognitive impairment, and single non-memory mild cognitive impairment. Future research should be focussed on redefining the criteria of the mild cognitive impairment entity. This could enable the better development of appropriate therapeutic interventions.
Topics: Alzheimer Disease; Brain Chemistry; Cognition Disorders; Humans; Severity of Illness Index
PubMed: 15129850
DOI: No ID Found -
Journal of Asthma and Allergy 2021Mild to moderate asthma makes up the greatest proportion of all asthma severities in childhood. Children who are treated with steps 1-2 are defined as having mild asthma... (Review)
Review
Mild to moderate asthma makes up the greatest proportion of all asthma severities in childhood. Children who are treated with steps 1-2 are defined as having mild asthma and step 3 as having moderate asthma, according to the guidelines. Although many studies focused on the management of severe asthma over the last decade, there have also been important changes and improvements in the management of mild to moderate asthma. In this article, new perspectives in the management of children with mild to moderate asthma will be reviewed and compared according to the two major guidelines.
PubMed: 33833531
DOI: 10.2147/JAA.S255218 -
Seminars in Respiratory Infections Mar 1998Clinicians define mild pneumonia as patients who are "not too sick," have normal respiratory and mental status, and are able to maintain oral intake. As yet there is no... (Review)
Review
Clinicians define mild pneumonia as patients who are "not too sick," have normal respiratory and mental status, and are able to maintain oral intake. As yet there is no uniform definition of mild pneumonia. By inference, mild pneumonia occurs in younger patients with less comorbidity and has a better outcome than pneumonia that is moderate to severe. "Atypical" pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae and respiratory tract viruses are common causes of mild pneumonia.
Topics: Ambulatory Care; Community-Acquired Infections; Global Health; Humans; Pneumonia; Risk Factors; Severity of Illness Index
PubMed: 9543470
DOI: No ID Found -
Allergy Jun 2007This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for... (Review)
Review
This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients. Mild asthma is more frequent, more symptomatic, and less well controlled in children than in adults. Cohort studies from childhood to adulthood show that asthma severity usually remains stable over time. Nevertheless, mild asthma can lead to severe exacerbations, with a frequency ranging from 0.12 to 0.77 per patient-year. Severe exacerbations in mild asthma represent 30-40% of asthma exacerbations requiring emergency consultation. In mild asthma, inflammation and structural remodelling are constant, of varying intensity, but nonspecific. Therapy with inhaled corticosteroids (ICS) decreases bronchial inflammation, but has only a slight effect on structural remodelling, and, when stopped, inflammation immediately recurs. Permanent low-dose ICS therapy is the reference treatment for persistent mild asthma. Effectiveness is to be reassessed at 3 months, and if it is insufficient the patient is no longer considered mildly asthmatic, and treatment has to be stepped up. As mild asthma is the most frequent form of the disease, diagnosis and management require physicians' particular attention.
Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adult; Age Factors; Asthma; Bronchodilator Agents; Child; Clinical Trials as Topic; Humans
PubMed: 17508962
DOI: 10.1111/j.1398-9995.2007.01394.x