Hands-Free Cough and Speech in Long-Term Tube-Free Tracheostomy

2009 ◽  
Vol 19 (1) ◽  
pp. 34-42
Author(s):  
Claudio Milstein ◽  
Lee M. Akst ◽  
Isaac Eliachar
Keyword(s):  
Quality Of Life ◽  
Medical Decision Making ◽  
Cleveland Clinic ◽  
The Self ◽  
Medical Decision ◽  
Laryngotracheal Reconstruction ◽  
The Difference ◽  
The Impact

AbstractA surgical technique developed by Dr. Isaac Eliachar in the Section of Laryngotracheal Reconstruction, Cleveland Clinic Department of Otolaryngology, dramatically improves quality of life in patients who require a long-term tracheostoma. This procedure, called “long-term tube-free tracheostomy” (LTTFT), creates a self-sustaining tracheostoma that requires no tracheotomy tubes to maintain patency. The advantages of a tube-free procedure are numerous, and the improvements in quality of life of patients who have successfully undergone this operation are readily noticeable. These benefits include (a) removal of tracheal appliances, such as tracheal tubes, valves, vents, and stents; (b) prevention of tissue damage associated with appliances and a decrease in tissue irritation and formation of granulation tissue; (c) better secretion management, elimination of frequent clogging of tracheal appliances, and need for suction; (d) prevention of aspiration; (e) retention or re-establishment of the functions of sniffing and smelling; and (f) performance of hands-free cough and speech production due to the self-constricting capabilities of the stoma. The purpose of this article is to present the concept of LTTFT as an alternative to standard tracheotomy in select patients. The difference between LTTFT as an alternative to tracheotomy and the impact these differences have upon medical decision-making will be emphasized.

scholarly journals Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Naina Harinjara Razanakoto ◽  
Volatantely Ratovonjanahary ◽  
Onivola Raharolahy ◽  
Irina Mamisoa Ranaivo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

scholarly journals Quality of life in patients with psoriasis seen in the Department of Dermatology, Antananarivo Madagascar.

2020 ◽  
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Ratovonjanahary Volatantely ◽  
Razanakoto Naina Harinjara ◽  
Raharolahy Onivola ◽  
Rakotoarisaona Mendrika Fifaliana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Abstract BACKGROUND: Psoriasis is a chronic, inflammatory and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision making along with the effectiveness and the harmlessness of the treatments.OBJECTIVE: To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales.METHODS: A cross-sectional study, during ten months, was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana Antananarivo Madagascar including patients more than 15 years-old with moderate to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales.RESULTS: 80 patients were included, their mean age was 36.52 years and the male to female was 1.5:1. The mean DLQI score was 13.85. Symptoms, feelings and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, clinical presentation of psoriasis didn’t influence patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2).The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002).CONCLUSION: Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

scholarly journals Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations

2009 ◽  
Vol 161 (suppl_1) ◽  
pp. S51-S64 ◽  
Author(s):  
Maria Koltowska-Häggström ◽  
Anders F Mattsson ◽  
Stephen M Shalet
Keyword(s):  
Quality Of Life ◽  
Health Economic ◽  
Clinical Practice ◽  
Treatment Effects ◽  
Disease Onset ◽  
Medical Decision ◽  
Specific Patient ◽  
The Impact

Quality of life (QoL) has emerged as an important construct that has found numerous applications across healthcare-related fields, ranging from research and clinical evaluation of treatment effects to pharmacoeconomic evaluations and global healthcare policy. Impairment of QoL is one of the key clinical characteristics in adult GHD and has been extensively studied in the Pfizer International Metabolic Database (KIMS). We provide summarized evidence on GH treatment effects for both clinical and health economic applications based on the KIMS data. The primary focus is on those aspects of QoL research that cannot be investigated in the traditional clinical trial setting, such as specific patient subgroups, cross-country comparisons and long-term follow-up. First, the impact of age, gender, disease onset, primary aetiology, extent of hypopituitarism, previous radiotherapy and obesity on QoL before and during long-term GH replacement is discussed. Secondly, the studies on QoL in relation to country-specific normative values are reviewed. Finally, health economic data derived from KIMS including both burden of disease and utility assessment are evaluated. We conclude that the wide spectrum of analyses performed on the KIMS data allows for practical application of the results not only to research and clinical practice but also to health policy and global medical decision making.

scholarly journals Quality of Life in Patients With Psoriasis Seen in the Department of Dermatology, Antananarivo Madagascar.

2020 ◽  
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Ratovonjanahary Volatantely ◽  
Razanakoto Naina Harinjara ◽  
Raharolahy Onivola ◽  
Rakotoarisaona Mendrika Fifaliana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Abstract BACKGROUND: Psoriasis is a chronic, inflammatory and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision making along with the effectiveness and the harmlessness of the treatments.OBJECTIVE: To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales.METHODS: A cross-sectional study, during ten months, was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana Antananarivo Madagascar including patients more than 15 years-old with moderate to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales.RESULTS: 80 patients were included, their mean age was 36,52 years and the male to female was 1,5:1. The mean DLQI score was 13,85. Symptoms, feelings and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0,36). Furthermore, clinical presentation of psoriasis didn’t influence patient’s QoL (p=0,73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0,2).The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0,002). Furthermore, the higher the PASI, the more QoL is altered (p=0,002).CONCLUSION: Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

scholarly journals Quality of life and health of opioid-dependent subjects in India

2014 ◽  
Vol 05 (04) ◽  
pp. 363-368 ◽  
Author(s):  
Om Prakash Giri ◽  
Mona Srivastava ◽  
Ravi Shankar
Keyword(s):  
Quality Of Life ◽  
Substance Abusers ◽  
Care Center ◽  
Tertiary Care ◽  
Normal Subjects ◽  
The Difference ◽  
Long Term Prognosis ◽  
The Impact

ABSTRACT Background and Objectives: The quality of life (QoL) of substance abusers is known to be severely impaired. This study was carried out to assess the impact of opioid dependence on the QoL of subjects and compared it with the normal subjects. Materials and Methods: Based on specified inclusion criteria a total of 47 subjects were recruited from a tertiary care center from India. The WHOQoL-BREF scale domain scores obtained at baseline were compared to that of normal subjects. An assessment of dysfunction and reasons for continuing and other parameters were assessed. Results: WHOQoL-BREF domains (Physical, Psychological, Social relationships and Environment) showed significantly lower scores and the difference was statistically significant. Interpretation and Conclusions: The results showed that QoL is an important parameter in assessment of substance abusers and can be used for long-term prognosis of these individuals.

scholarly journals Quality Of Life In Patients With Psoriasis Seen In The Department of Dermatology, Antananarivo Madagascar.

2020 ◽  
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Ratovonjanahary Volatantely ◽  
Razanakoto Naina Harinjara ◽  
Raharolahy Onivola ◽  
Rakotoarisaona Mendrika Fifaliana ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Abstract BACKGROUND: Psoriasis is a chronic, inflammatory and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision making along with the effectiveness and the harmlessness of the treatments.OBJECTIVE: To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales.METHODS: A cross-sectional study, during ten months, was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana Antananarivo Madagascar including patients more than 15 years-old with moderate to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales.RESULTS: 80 patients were included, their mean age was 36.52 years and the male to female was 1.5:1. The mean DLQI score was 13.85. Symptoms, feelings and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, clinical presentation of psoriasis didn’t influence patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2).The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002).CONCLUSION: Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

scholarly journals The impact of lymphedema on health-related quality of life up to 10 years after breast cancer treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mads G. Jørgensen ◽  
Navid M. Toyserkani ◽  
Frederik G. Hansen ◽  
Anette Bygum ◽  
Jens A. Sørensen
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

AbstractThe impact of breast cancer-related lymphedema (BCRL) on long-term quality of life is unknown. The aim of this study was to investigate the impact of BCRL on health-related quality of life (HRQoL) up to 10 years after breast cancer treatment. This regional population-based study enrolled patients treated for breast cancer with axillary lymph node dissection between January 1st 2007 and December 31th 2017. Follow up and assessments of the included patients were conducted between January 2019 and May 2020. The study outcome was HRQoL, evaluated with the Lymphedema Functioning, Disability and Health Questionnaire, the Disabilities of the Arm, Shoulder and Hand Questionnaire and the Short Form (36) Health Survey Questionnaire. Multivariate linear logistic regression models adjusted for confounders provided mean score differences (MDs) with 95% confidence intervals in each HRQoL scale and item. This study enrolled 244 patients with BCRL and 823 patients without BCRL. Patients with BCRL had significantly poorer HRQoL than patients without BCRL in 16 out of 18 HRQoL subscales, for example, in physical function (MDs 27, 95%CI: 24; 30), mental health (MDs 24, 95%CI: 21; 27) and social role functioning (MDs 20, 95%CI: 17; 23). Age, BMI, BCRL severity, hand and dominant arm affection had only minor impact on HRQoL (MDs < 5), suggesting a high degree of inter-individual variation in coping with lymphedema. This study showed that BCRL is associated with long-term impairments in HRQoL, especially affecting the physical and psychosocial domains. Surprisingly, BCRL diagnosis rather than clinical severity drove the largest impairments in HRQoL.

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

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