scholarly journals Mental Fatigue and Executive Dysfunction in Patients with Cushing’s Syndrome in Remission

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Eleni Papakokkinou ◽  
Birgitta Johansson ◽  
Peter Berglund ◽  
Oskar Ragnarsson
Keyword(s):  
Cushing’S Syndrome ◽  
Executive Dysfunction ◽  
Cross Sectional Study ◽  
Cushing's Syndrome ◽  
Mental Fatigue ◽  
Cross Sectional ◽  
Part D ◽  
Trail Making ◽  
Impaired Quality

Patients with Cushing’s syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. The primary aim was to investigate the occurrence of mental fatigue, characterized by mental exhaustion and long recovery time following mentally strenuous tasks, in patients with CS in remission. The secondary aim was to examine whether the newly developed parts C and D of the trail making test (TMT) are more sensitive, compared to the conventional parts A and B, to evaluate attention and executive function. This was a cross-sectional study including 51 patients with CS in remission and 51 controls. All subjects completed the self-administrated mental fatigue scale (MFS) and performed all four parts of the TMT. The patients had worse outcome on all components of the MFS except for sensitivity to noise. After adjustment for mental fatigue, depression, and anxiety, the patients performed worse only on part D of the TMT (P<0.05). Mental fatigue is common in patients with CS in remission and can be captured by using the MFS. The most demanding part of the TMT, part D, is more useful to capture cognitive deficits in patients with CS in remission compared to the conventional parts A and B.

scholarly journals A direct comparison of quality of life in obese and Cushing's syndrome patients

2013 ◽  
Vol 168 (5) ◽  
pp. 787-793 ◽  
Author(s):  
Smita Baid Abraham ◽  
Brent S Abel ◽  
Domenica Rubino ◽  
Tonja Nansel ◽  
Sheila Ramsey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Cross Sectional Study ◽  
Cushing's Syndrome ◽  
Cross Sectional ◽  
Clinical Center ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

ObjectiveObese (OB) individuals and patients with Cushing's syndrome (CS) often have similar clinical presentations. While each group has reduced health-related quality of life (HRQL), it is not known whether the degree of impairment is different and might distinguish between them. The objective of this study was to compare HRQL in these two populations.DesignCross-sectional study.MethodsThree hundred and twenty-seven OB patients (48.1±11.7 years; 72.5% women) with weight gain and at least two features of CS were recruited from an outpatient weight management clinic. Sixty-six untreated patients with CS (41.6±13.2 years; 78.8% women) presented to the NIH Clinical Center for evaluation. Subjects completed the SF-36 survey and a locally created symptom questionnaire.ResultsAfter adjusting for symptom count, OB patients had a significantly higher (better HRQL) mean physical component summary (PCS) score than CS patients (44.9±0.6 vs 35.4±1.5, P<0.0001). However, the mean mental component summary (MCS) score was lower (worse HRQL) in the OB group (41.6±0.6 vs 50.7±1.6, P<0.0001). Symptom count showed significant correlations with PCS and MCS scores. BMI correlated with PCS (r=−0.29) in OB but not in CS patients. BMI was not associated with MCS in either group.ConclusionHRQL is significantly different between OB and CS patients. Surprisingly, after adjusting for symptom count, OB patients showed worse mental health scores than the CS population. Significant differences in HRQL and symptom count may suggest which OB patients should be screened for CS.

scholarly journals Impaired quality of life in patients in long-term remission of Cushing's syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism?

2012 ◽  
Vol 167 (5) ◽  
pp. 687-695 ◽  
Author(s):  
M A E M Wagenmakers ◽  
R T Netea-Maier ◽  
J B Prins ◽  
T Dekkers ◽  
M den Heijer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Group ◽  
Cushing’S Syndrome ◽  
Negative Influence ◽  
Cushing's Syndrome ◽  
Control Group ◽  
Cross Sectional ◽  
Impaired Quality

Objective The determinants that cause impaired quality of life (QOL) in patients in long-term remission of Cushing's syndrome (CS) are unknown. The aim of this study was to get more insight into the patient and disease characteristics related to impaired QOL in these patients. Design Cross-sectional study. Methods The QOL of 123 patients in remission of CS (age 52.2±12.0 years, 106 women, duration of remission 13.3±10.4 years, 80% pituitary CS), assessed with seven validated questionnaires, was compared with the QOL of an age- and sex-matched control group (n=105). To investigate the influence of the aetiology of CS on QOL, patients in remission of pituitary and adrenal CS were compared. Furthermore, the influence of hormonal deficiencies, treatment strategy, duration of remission, gender and age on QOL was investigated. Results QOL in the total patient group and each patient subgroup was significantly worse on practically all dimensions of questionnaires compared with the control group (P<0.05), except for patients in remission of pituitary CS without hormonal deficiencies who had an impaired QOL on 50% of the QOL dimensions. Subgroup analysis revealed no difference in QOL between different patient groups, especially no difference between patients in remission of adrenal and pituitary CS. Female gender and a shorter duration of remission had a negative influence on QOL in the patient group. Conclusions QOL remains impaired in patients in long-term remission of CS regardless of aetiology, presence of hormonal deficiencies and treatment strategies. More research is needed to establish the causes.

scholarly journals Improvement but no normalization of quality of life and cognitive functioning after treatment for Cushing’s syndrome

2019 ◽  
Author(s):  
Leonie H A Broersen ◽  
Cornelie D Andela ◽  
Olaf M Dekkers ◽  
Alberto M Pereira ◽  
Nienke R Biermasz
Keyword(s):  
Quality Of Life ◽  
Cognitive Functioning ◽  
Cushing’S Syndrome ◽  
Meta Analysis ◽  
Cushing's Syndrome ◽  
Treatment Quality ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Before And After

Abstract Background Cushing’s syndrome is characterized by glucocorticoid excess, which induces physical and mental symptoms, impairments in functional status and perceived health, resulting in impaired quality of life. Biochemical remission is urgently required; however, quality of life and cognitive function may remain impaired. Objective To perform a systematic review and meta-analysis evaluating changes in health-related quality of life and cognitive functioning in patients with Cushing’s syndrome after treatment. Methods Eight electronic databases were searched in March 2017, and PubMed again in May 2018, to identify potentially relevant articles. Eligible studies were (randomized controlled) trials, cohort studies, and cross-sectional studies assessing quality of life or cognitive functioning in patients treated for Cushing’s syndrome. Differences were expressed as standardized mean difference, and reported with 95% confidence intervals. We compared patients before and after treatment (improvement), and patients after treatment and healthy controls (normalization). Results We included 47 articles with 2,643 patients. Most patients had Cushing’s disease and were in remission after treatment. Quality of life and cognitive functioning improved after treatment in all studied domains. Compared to a healthy control population, quality of life did not normalize. Cognitive functioning normalized in part, but not all, of the studied domains. Conclusions Treatment of Cushing’s syndrome improves quality of life and cognitive functioning. As normalization was not achieved in quality of life and in some aspects of cognitive functioning, special and continuous attention should be given to these aspects for patients after treatment. Effective interventions for further improvement and possibly normalization are urgently needed.

scholarly journals Long-Term Impaired Quality of Life in Cushing’s Syndrome despite Initial Improvement after Surgical Remission

2006 ◽  
Vol 91 (2) ◽  
pp. 447-453 ◽  
Author(s):  
John R. Lindsay ◽  
Tonya Nansel ◽  
Smita Baid ◽  
Julie Gumowski ◽  
Lynnette K. Nieman
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Initial Improvement ◽  
Impaired Quality

Schizoaffective disorder and life quality

2017 ◽  
Vol 41 (S1) ◽  
pp. s844-s845
Author(s):  
W. Bouali ◽  
I. Marrag ◽  
F. Ellouze ◽  
A. Dekhil ◽  
M. Nasr
Keyword(s):  
Quality Of Life ◽  
Schizoaffective Disorder ◽  
Linear Regression Analysis ◽  
Life Quality ◽  
Multiple Linear Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Competing Interest ◽  
Impaired Quality

Introductionschizoaffective disorder is a nosographic entity characterized by a combination of symptoms of schizophrenia with mood episodes. The fact that its diagnosis is difficult, and often oscillates between schizophrenia and bipolar disorder raises the problem of its care and the outcome of patients who suffers from it.ObjectiveTo evaluate the quality of life of treated patients with schizoaffective disorder.Materials and methodsThis is a cross-sectional study realized at the psychiatric consultation of Mahdia hospital during a 6month period. Data were collected from patients and from their medical records using a predefined questionnaire.ResultsA total of 52 patients were included, the average age was 38 years. The majority of patients (63.5%) were unemployed. The use of psychoactive substances was noted in 63.5% of patients. Multiple linear regression analysis allowed us to find that 12 factors were more significantly associated with impaired quality of life which were, in descending order of importance: the EAS score > 39, the EGF score ≤ 70, the null or partial adherence, the presence of side effects seriously affecting daily activity, the depressive subtype, the lack of employment, the socio-economic level, the lack of stable budgetary resources, an age > 60years, the widowed and divorced marital status, the PANSS score (≥ 45) and negative symptomatology (PANSS).ConclusionThe diagnosis of schizoaffective disorder has a triple relevance: clinical, prognostic and therapeutic. Identifying a schizoaffective disorder and the risk factors that may affect the quality of life provides a significant practical impact for the patient's benefit.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Association between Neutrophilic Granulocyte Percentage and Diabetes Mellitus in Cushing’s Syndrome Patients: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Baomin Wang ◽  
Yumei Yang ◽  
Haoyue Yuan ◽  
Xiaomu Li
Keyword(s):  
Diabetes Mellitus ◽  
Blood Cell ◽  
Cushing’S Syndrome ◽  
Cross Sectional Study ◽  
Cushing's Syndrome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neutrophilic Granulocyte ◽  
Cell Parameters ◽  
Significant Independent Risk Factor

Background. Glucose metabolism is frequently impaired in patients with Cushing’s syndrome (CS) due to chronic exposure to excess glucocorticoids. Inflammation plays an essential role in the pathophysiology of diabetes mellitus (DM). The present study aimed to investigate the potential associations of inflammatory blood cell parameters, including white blood cell (WBC) count, neutrophil count, neutrophilic granulocyte percentage (NEUT%), lymphocyte count (LYM), and lymphocyte proportion (LYM%), with diabetes mellitus in Cushing's syndrome patients. Materials and Methods. The cross-sectional study was conducted in Zhongshan Hospital of Fudan University, China. A total of 150 patients with Cushing’s syndrome were retrospectively screened from 2017 to 2019. The demographic data, clinical data, and blood samples (lipids, adrenal, glucose, and inflammatory blood cell parameters) were recorded. Statistical analyses were carried out by using the SPSS software package, version 13.0. Results. In this study, the prevalence of diabetes mellitus was 38.7% in patients with Cushing’s syndrome. Patients with DM had higher WBC, neutrophil, NEUT% levels than patients without DM ( p < 0.05 ). As the NEUT% increased, a stepwise increase in glucose and glycated hemoglobin (HbA1c) level was observed. In addition, in the multivariate logistic regression, NEUT% was a significant independent risk factor for DM, regardless of gender, age, body mass index (BMI), and triglyceride and 12 midnight cortisol (12 MN cortisol) level (OR = 2.542, 95% CI 1.337–4.835, p < 0.001 ). Conclusions. In conclusion, elevated NEUT% level was linked to diabetes in patients with Cushing’s syndrome. The neutrophilic granulocyte percentage may be referred to as a new predictor for diabetes in Cushing’s syndrome patients.

scholarly journals Health related quality of life in COPD patients: a cross-sectional study

2018 ◽  
Vol 5 (5) ◽  
pp. 2038
Author(s):  
Nilam C. Gaude ◽  
Archana M. Desai
Keyword(s):  
Quality Of Life ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Copd Patients ◽  
Related Quality ◽  
Health Related ◽  
Impaired Quality

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that causes breathlessness (initially with exertion) and predisposes to exacerbations and serious illness. COPD is not curable, improvement of quality of life of such patients is thus of importance. The aims and objective of the study was to assess health related quality of life and its determinants in patients with COPD.Methods: Cases were first identified from the medical records of Department of RHTC, Mandur. Eligible cases were then interviewed by home visits. Health Related Quality of Life (HRQL) of participants was assessed using St. George’s Respiratory Questionnaire (SGRQ). ANOVA, student’s t test and correlation were used to interpret the data.Results: This study shows an impaired quality of life in COPD patients. Quality of life was impaired in all the domains. However, activity domain was the most affected while impact domain was least affected. Age, sex, smoking, BMI, socioeconomic status, occupation did not impact quality of life in significant manner.Conclusions: This study shows an impaired quality of life in COPD patients. As COPD is slowly progressing disease with no specific cure, we should focus more on treatable aspects of quality of life.

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