Psoriasis: skin and nails

2018 ◽  
Author(s):  
Cheryl F. Rosen ◽  
Brian Kirby
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
The United States ◽  
Chronic Plaque Psoriasis ◽  
Increased Risk ◽  
Generalized Pustular Psoriasis ◽  
Erythrodermic Psoriasis ◽  
Guttate Psoriasis ◽  
Nail Involvement

Psoriasis is seen in many patients with psoriatic arthritis. It forms part of the CASPAR criteria for establishing the diagnosis of psoriatic arthritis (PsA). The psoriasis accompanying PsA may be mild or quite severe, with a very large impact on quality of life. The presence of cutaneous disease may alter the treatment of a patient’s PsA. Psoriasis affects up to 2–3% of the population of Europe, the United States and Canada. The majority of patients have chronic plaque psoriasis (80%). Other clinical phenotypes include guttate psoriasis, erythrodermic psoriasis, inverse psoriasis, sebopsoriasis and pustular subtypes including generalized pustular psoriasis. Nail involvement is a frequent occurrence and indicate an increased risk of developing psoriatic arthritis. In this chapter, the different psoriatic phenotypes are described as well as the histology and, briefly, the pathophysiology of psoriasis. Environmental factors that can impact psoriasis are reviewed.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Is Psoriatic Arthritis Associated With Higher Risk of Mortality?

2021 ◽  
pp. jrheum.210963
Author(s):  
Ying-Ying Leung
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Psoriatic Arthritis ◽  
Cardiovascular Events ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Systemic Inflammatory Disease ◽  
Impaired Quality

Psoriatic arthritis (PsA) is a systemic inflammatory disease affecting domains beyond the musculoskeletal system, and may lead to disability and impaired quality of life. It is associated with comorbidities such as hypertension, diabetes mellitus, obesity, metabolic syndrome, and increased risk of cardiovascular events.

scholarly journals Treatments for Nail Psoriasis: A Systematic Review by the GRAPPA Nail Psoriasis Work Group

2014 ◽  
Vol 41 (11) ◽  
pp. 2306-2314 ◽  
Author(s):  
April W. Armstrong ◽  
William Tuong ◽  
Thorvardur J. Love ◽  
Sueli Carneiro ◽  
Rachel Grynszpan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Psoriatic Arthritis ◽  
Health Outcomes ◽  
Work Group ◽  
Treatment Recommendations ◽  
Systematic Analysis ◽  
Nail Psoriasis ◽  
Nail Involvement

Nail involvement in psoriatic diseases causes significant physical and functional disabilities. Evaluating, measuring, and treating nail involvement is important in improving the health outcomes and quality of life among patients with psoriasis and psoriatic arthritis (PsA). We performed a systematic analysis of the literature on nail psoriasis to help inform an update of treatment recommendations by the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA).

scholarly journals POS1072 ASSOCIATION OF NAIL PSORIASIS WITH WORSE DISEASE OUTCOMES IN PSORIATIC ARTHRITIS PATIENTS. DATA FROM CLINICAL PRACTICE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 815.2-815
Author(s):  
E. Gubar ◽  
Y. Korsakova ◽  
E. Loginova ◽  
S. Glukhova ◽  
T. Korotaeva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Severe Disease ◽  
Work Productivity ◽  
Disease Status ◽  
Nail Psoriasis ◽  
Nail Involvement

Background:Limited data are available regarding the burden of nail disease in psoriatic arthritis (PsA). The latest data show that nail involvement in PsA patients (pts) is associated with significantly more severe disease status (1).Objectives:To analyze, in clinical practice, the association of nail psoriasis with disease activity, quality of life, and work productivity in PsA pts.Methods:588 pts (M/F–277 /311) with PsA according to CASPAR criteria were included in the study. Data were collected from 43 rheumatology clinics from different regions of the Russian Federation. Pts’ age 48.6±0.5 years (yrs), disease duration 7.0±0.3 yrs. Pts underwent standard clinical examination of PsA activity. Pts were split into two groups (gr.): those with nail psoriasis – gr.1, and those without it – gr.2. Demographics, disease activity, quality of life, and work productivity were compared between pts with and without nail psoriasis using Pearson’s chi-square test and Mann–Whitney U test.Results:Gr.1 includes 312 (53.1%) cases, gr.2 – 276 (46.9%) cases. More pts in gr.1 were males (51.9% vs 44.1%, р=0.013), disabled at work (37.20% vs 26.40%, р=0.000), chronic smokers (18.9% vs 8.7%, р=0.000) and with axial PsA disease signs according to physician (35.0% vs 26.4%, р=0.025) compared to pts in gr.2. Pts in gr.1 had higher tender and swollen joint counts: 8 [4-15] vs 5 [2-12] (р=0.002) and 5 [1-9] vs 2 [0-7] (р=0.003) respectively. Gr.1 pts had higher disease activity measured by DAPSA 25 [15-39] vs 20 [12-33] (p= 0.001), higher frequency of dactylitis (24.4% vs 16.7% р=0.022) and heel enthesitis (17.0% vs 10.1% р=0.016) respectively, higher frequency of erosive radiographic arthritis of feet (45.0% vs 31.2% р=0.003) compared to gr.2 pts. Pts in gr.1 had worse skin psoriasis measured by Psoriasis Area Severity Index – 6 [2-14] vs 3 [1-6] (р=0.000). Less pts in gr.1 than in gr.2 (27.0% vs 52.0% р=0.004) achieved minimal disease activity (MDA). Pts’ reported outcomes (PRO’s) in gr.1 were worse than in gr.2 in regard to reduced health-related quality of life according to PsAID (4.9±2.3 vs 4.0±2.3, р=0.040) and to EQ-5D (0.56±0.19 vs 0.64 ±0.21, р=0.024) questionnaires, overall work impairment (0.0 [0.0-0.3] vs 0.0 [0.0-0.2], р=0.034) and overall activity impairment (0.4 [0.1-0.7] vs 0.3 [0.0-0.5], р=0.006) according to WPAI.Conclusion:Nail involvement in PsA pts is associated with male gender and axial disease. PsA pts with nail involvement are more often disabled, more often are chronic smokers, have significantly worse disease status as measured by disease activity; they are more likely to have more severe (erosive) peripheral arthritis of feet, higher frequency of heel enthesitis and dactylitis, higher psoriasis disease severity, lower frequency of MDA achievement, and worse quality of life and work productivity according to PRO’s. Detection of nail involvement is critical for choice of treatment approach and better outcomes.References:[1]Mease PJ et al.J Rheumatol, 2020Disclosure of Interests:None declared.

scholarly journals Burnout, Compassion Satisfaction, and Personality Among Nursing Assistants: Who is at Risk?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 853-853
Author(s):  
Mallory Richert
Keyword(s):  
Quality Of Life ◽  
Compassion Satisfaction ◽  
The United States ◽  
Nursing Assistants ◽  
Term Care ◽  
Resident Care ◽  
Increased Risk ◽  
Quality Of Life Scale ◽  
Care Outcomes

Abstract Nursing assistants often experience high rates of turnover and burnout, which may lead to poor resident care outcomes and quality of life, as well as continued staff shortages and increased workload for nursing assistants. This study examined personality correlates of burnout and compassion satisfaction among 100 nursing assistants employed as nursing assistants in long-term care (LTC) and hospitals throughout the United States. Participants completed the Professional Quality of Life Scale 5 (ProQOL 5) and the Big Five Inventory – 2 Short (BFI-2-S). There was a significant positive correlation between compassion satisfaction and agreeableness, and extraversion, and between burnout and neuroticism. Additionally, there were significant negative correlations between compassion satisfaction and neuroticism, and between burnout and agreeableness, and extraversion. These results indicate which nursing assistants may be more likely to experience burnout and may be at an increased risk of turnover. Specific interventions may be developed for such individuals to increase compassion satisfaction, reduce burnout, and reduce staff turnover. Furthermore, information regarding personality types of individuals at greater or lesser risk for burnout may be helpful for LTC administrators in the recruitment and hiring of nursing assistants, and thus may reduce rates of turnover. Resident care outcomes may also improve as nursing assistant hiring efforts are focused more on individuals who are less likely to experience burnout. Future researchers might investigate potential risk and protective factors for burnout and compassion satisfaction in nursing assistants.

Efficacy of Etanercept in the Management of Plaque Psoriasis and Psoriatic Arthritis

2007 ◽  
Vol 11 (2_suppl) ◽  
pp. S14-S22
Author(s):  
Yves Poulin ◽  
Aditya K. Gupta ◽  
John D. Amiss
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Plaque Psoriasis ◽  
Large Scale ◽  
Case Reports ◽  
Severity Index ◽  
The United States ◽  
Biologic Agent ◽  
Factor Α

Etanercept is a fully human dimeric fusion protein that reversibly binds tumor necrosis factor α. The first approved indication for etanercept was for the treatment of rheumatoid arthritis. It has also been shown to be highly efficacious in numerous large-scale trials for the treatment of plaque psoriasis; this indication was approved in Canada, the United States, and Europe. The recommended dosing of etanercept for plaque psoriasis is 50 mg twice weekly for 12 weeks, followed by a maintenance dose of 50 mg per week. Etanercept given at 50 mg twice weekly for 12 weeks significantly improved plaque psoriasis, as assessed by the Psoriasis Area and Severity Index (PASI), in which 75% reduction in PASI scores (PASI 75) has been the gold standard for judging effective therapy. Dosing given for 12 weeks produced PASI 75 rates of 47 to 49% in the phase 3 clinical trials. Longer treatment periods at this dosage have been investigated, from 24 to 48 weeks, with PASI 75 increasing to 63%. The importance of quality of life for psoriasis patients has been the focus of recent trials, and etanercept has been shown significant improvement in quality of life measures. Interim results from a phase 3b study suggest that etanercept may help reduce the burden of health care resources use by psoriatics. Etanercept has also shown efficacy in nail psoriasis. Case reports indicate that etanercept may be useful in psoriatic erythroderma, pustular psoriasis, guttate psoriasis, and palmopustular psoriasis. Etanercept is an effective biologic agent currently approved for the management of plaque psoriasis and psoriatic arthritis.

Biomechanical Responses of Swine Esophagus Tissue to Irreversible Electroporation

2018 ◽  
Author(s):  
Lars M. Mattison ◽  
Chloe Johnson ◽  
Paul A. Iaizzo
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Irreversible Electroporation ◽  
The United States ◽  
Common Disease ◽  
Fatal Disease ◽  
Increased Risk ◽  
Biomechanical Responses ◽  
Ventricular Filling

Atrial Fibrillation (AF) is a common disease that may occur in the heart, especially as we age. AF is due to non-normal myocardial ectopic foci that then causes an uncoordinated atrium contraction. This effectively reduces the atrial kick to the ventricles, which can account for up to 20% of ventricular filling. While not an immediately fatal disease, it can cause reduced quality of life for patients and also puts them at increased risk for stroke. AF as a disease, is expected to affect over 50 million people in the United States alone by 2050 [1].

scholarly journals Innovative Population and Intervention Research for LGBTQ+ Older Adults With Dementia in a COVID World

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Charles Emlet ◽  
Karen Fredriksen Goldsen
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Controlled Trial ◽  
The United States ◽  
Improve Quality ◽  
Innovative Strategies ◽  
Care Partners ◽  
Increased Risk ◽  
Health Aging

Abstract This past year, the lives of vulnerable older adults, including those within the older LGBTQ+ community have been disrupted dramatically, as has the research agendas designed to improve their lives. Older people, including LGBTQ+ older adults with dementia, have been placed at increased risk for social isolation and mental health issues during COVID, making viable interventions even more crucial. Additionally, how research is conducted within these communities needed to be adjusted in order to preserve viability. This symposium draws upon data from the National Health Aging and Sexuality/Gender study, the first longitudinal study of LGBTQ+ older adults in the United States, as well as data from Aging with Pride: IDEA (Innovations in Dementia Empowerment and Action), the first randomized controlled trial (RCT) designed to improve quality of life of LGBTQ+ adults living with dementia and their care partners. (1) Kim and Fredriksen Goldsen examine modifiable behavioral and social factors that can improve quality of life among LGBTQ+ older adults with cognitive impairment. (2) Fredriksen Goldsen, Teri, Emlet and colleagues present initial efficacy findings from the IDEA study and how the intervention needed to be altered to be viable in a COVID world. (3) The importance of Motivational Interviewing (MI) as part of a LGBTQ+ sensitive intervention designed for LGBTQ+ older adults with dementia and their care partners is discussed by Petros, Fredriksen Goldsen and Teri. As COVID continues to impact vulnerable populations as well as research and service delivery, identifying new and innovative strategies will become increasingly important.

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Body Mass ◽  
Geriatric Patients ◽  
The Elderly ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Climbing Stairs ◽  
Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

Lung Function and Quality of Life in Workers with Chemical and Dust Exposure

2018 ◽  
Vol 69 (2) ◽  
pp. 346-349 ◽  
Author(s):  
Marina Ruxandra Otelea ◽  
Oana Cristina Arghir ◽  
Corina Zugravu ◽  
Eugenia Naghi ◽  
Sabina Antoniu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Occupational Exposure ◽  
Lung Function ◽  
Lung Diseases ◽  
Dust Exposure ◽  
Chronic Lung Diseases ◽  
Respiratory Exposure ◽  
Increased Risk ◽  
Occupational Settings

Regarding the widely distribution of respiratory exposure hazards in occupational settings, workers have an increased risk for chronic lung diseases. For assessing the quality of life and lung function in workers exposed to chemicals and dust, St George�s Respiratory Questionnaire (SGRQ) and spirometry were performed among 40 patients, admitted in Occupational Clinic Department of Colentina Hospital, Bucharest, Romania, during February, 2017. SGRQ showed different predictors for patients according to their occupational exposure and total symptoms score correlated better with decreased spirometric parameters in defining lung function deterioration. Quality of life is earlier affected than lung function deterioration and emphasises the need of more sensitive methods for an earlier identification and better evaluation of respiratory hazards in different workplaces.

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