scholarly journals Patient-Reported Outcomes of Arsenic-Related Skin Lesions in China

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yajia Li ◽  
Danrong Jing ◽  
Yi Xiao ◽  
Xiaoyan Huang ◽  
Minxue Shen

Purpose. Previous studies confirmed that chronic arsenic exposure could lead to pigmentary changes and hyperkeratosis. However, skin health-related quality of life (HRQoL) among people under lifetime arsenic exposure remains underappreciated. Our study is aimed at investigating several patient-reported outcomes in a population under chronic arsenic exposure. Patients and Methods. A cross-sectional study was conducted in communities in Shimen, China. Dermatologists performed skin examinations for participants. Patient-reported outcomes (PROs) included HRQoL, itch, sleep quality, and symptoms of anxiety and depression. The Dermatology Life Quality Index (DLQI) was used to measure skin HRQoL. The numerical rating scale (NRS) was used to measure the intensity of itching. Sleep disturbance was measured by Pittsburgh Sleep Quality Index (PSQI). Anxiety and depression were measured by two-item Generalized Anxiety Disorder (GAD-2) and Patient Health Questionnaire (PHQ-2), respectively. Results. A total of 464 participants suffering from arsenic-related skin lesions finished the assessment of DLQI. Pigmentary changes and arsenical keratosis were not associated with the patient-reported outcomes except PHQ-2. Hair arsenic exceeding 1 μg/g was associated with higher itch NRS and DLQI (P<0.05). Itch NRS (adjusted β=0.80, 95% CI: 0.70–0.90, P<0.01) and hair arsenic concentration (adjusted β=0.12, 95% CI: 0.01–0.24, P<0.05) were independently associated with the DLQI. Conclusion. HRQoL, sleep quality, and mental wellbeing are impaired in residents under chronic arsenic exposure. Itching and hair arsenic are independent risk factors for impaired HRQoL.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Minji K. Lee ◽  
Benjamin D. Schalet ◽  
David Cella ◽  
Kathleen J. Yost ◽  
Amy C. Dueck ◽  
...  

Abstract Background Researchers and clinicians studying symptoms experienced by people with cancer must choose from various scales. It would be useful to know how the scores on one measure translate to another. Methods Using item response theory (IRT) with the single-group design, in which the same sample answers all measures, we produced crosswalk tables linking five 0–10 numeric rating scale (NRS) and 15 items from Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE, scored on a 1–5 scale) to the T-Score metric of six different scales from the NIH Patient reported Outcomes Measurement Information System (PROMIS®). The constructs, for which we conducted linking, include emotional distress-anxiety, emotional distress-depression, fatigue, sleep disturbance, pain intensity, and pain interference. We tested the IRT linking assumption of construct similarity between measures by comparing item content and testing unidimensionality of item sets comprising each construct. We also investigated the correlation of the measures to be linked and, by inspecting standardized mean differences, whether the linkage is invariant across age and gender subgroups. For measures that satisfied the assumptions, we conducted linking. Results In general, an NRS score of 0 corresponded to about 38.2 on the PROMIS T-Score scale (mean = 50; SD = 10); whereas an NRS score of 10 corresponded to a PROMIS T-Score of approximately 72.7. Similarly, the lowest/best score of 1 on PRO-CTCAE corresponded to 39.8 on T-score scale and the highest/worst score of 5 corresponded to 72.0. Conclusion We produced robust linking between single item symptom measures and PROMIS short forms.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11574-11574
Author(s):  
VIKAS GARG ◽  
Sameer Rastogi ◽  
Adarsh Barwad ◽  
Rambha Panday ◽  
Sandeep Kumar Bhoriwal ◽  
...  

11574 Background: Desmoid type fibromatosis (DTF) is a rare benign neoplasm with infiltrative growth and high local recurrences. Due to long disease course, unpredictable growth pattern, and low mortality, using only survival outcomes may be inappropriate. In this study we assessed the impact of DTF on health related quality of life (HRQoL). Methods: This was a cross-sectional study done in patients with DTF. The study participants were asked to fill the EORTC QLQ-C30, GAD-7 and PHQ- 9 q uestionnaires to assess HRQoL, anxiety and depression . Outcomes were also compared with healthy controls. Results: 204 subjects (102 DTF patients and 102 healthy controls) were recruited. Study parameters have been summarized in Table. Appendicular skeleton (limbs + girdle) was most commonly involved in 59 % patients and abdominal wall or mesentery was involved in 22.5 %. Patients have received median of 2 lines of therapy. 54 % patients were currently on sorafenib and 41 % were under active surveillance. Mean global health status in DTF patient 65.58 ± 22.64, was significantly lower than healthy controls. Similarly, DTF patients scored low on all functional scales except cognitive functioning. Symptom scale showed significantly higher symptom burden of fatigue, pain, insomnia and financial difficulties. Anxiety & depression was observed in 39.22 % and 50 % of DTF patients respectively. DTF patients had higher rates of mild, moderate and severe anxiety and depression compared to healthy controls. No difference was observed based on site of disease. Conclusions: DTF patients have significant symptom burden, poor functioning, and heightened anxiety and depression. Patient reported outcomes should be routinely used to assess treatment efficacy in DTF patients.[Table: see text]


2019 ◽  
Vol 3 (1) ◽  
pp. 27-32
Author(s):  
Piscolia Dynamurti Wintoro ◽  
Wiwin Rohmawati ◽  
Ana Sulistyowati

Latar Belakang: Seorang ibu hamil biasa mengalami kecemasan. Pada TM III kecemasan disebabkan oleh kekhawatiran menghadapi persalinan dan apakah bayinya lahir normal atau cacat. Kecemasan meningkatkan kadar norepinefrin dalam darah melalui stimulasi sistem saraf simpatis. Perubahan kimia ini menyebabkan kurangnya waktu tidur tahap IV NREM dan tidur REM serta lebih banyak perubahan dalam tahap tidur lain dan lebih sering terbangun. Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat kecemasan dengan kualitas tidur pada ibu hamil trimester III di BPM Siti Sujalmi Socokangsi Jatinom. Metode: Desain penelitian deskriptif korelasional dengan pendekatan cross sectional. Populasi penelitian ini ibu hamil trimester III di BPM Siti Sujalmi Socokangsi Jatinom, sebanyak 40 responden dengan teknik total sampling. Alat pengambilan data menggunakan kuesioner Hamilton Rating Scale For Anxiety (HRS-A) untuk mengukur tingkat kecemasan dan Pittsburgh Sleep Quality Index (PSQI) untuk mengukur kualitas tidur. Analisis data yang digunakan chi square. Hasil : Penelitian ini menunjukkan ada hubungan tingkat kecemasan dengan kualitas tidur pada ibu hamil trimester III di BPM Siti Sujalmi Socokangsi dengan P value sebesar 0,021. Simpulan : Ibu hamil trimester III dapat memperbaiki kualitas tidur dengan mengurangi aktivitas dan istirahat yang cukup, perasaan cemas dengan cara relaksasi, senam ibu hamil, dan yoga.


2017 ◽  
Vol 44 (9) ◽  
pp. 1369-1374 ◽  
Author(s):  
Ian T.Y. Wong ◽  
Vinod Chandran ◽  
Suzanne Li ◽  
Dafna D. Gladman

Objective.We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).Methods.The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient’s global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.Results.The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).Conclusion.Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.


2018 ◽  
Vol 37 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Mst Karimon Nesha ◽  
Md Nazrul Islam ◽  
Nira Ferdous ◽  
Fahid Bin Nazrul ◽  
Johannes J Rasker

The well-documented fact that chronic arsenic exposure can lead to skin lesions, atherosclerotic diseases and cancers. The findings of association between arsenic exposure and diabetes mellitus indicate additional risk to human health. The aim of this study was to observe the association of chronic arsenic exposure from drinking water and risk of development of type 2 diabetes mellitus. To this end, a cross-sectional study was conducted in Comilla district of Bangladesh where ground water is heavily contaminated with arsenic. The individuals unexposed to arsenic were recruited from the Jhenaidah district. People with arsenic-related skin lesions were defined as subjects exposed to arsenic. Diabetes was defined if fasting blood glucose (FBG)>6.1 mmol/L following World Health Organization (WHO) guidelines. The common odds ratio for diabetes mellitus among subjects exposed to arsenic was 3.5 (95% confidence interval 1.1-10.9). After adjustment for age, sex and BMI, the Mantel-Haenszel weighted prevalence ratio was 3.5 (95% CI: 1.1-11.1); 3.7 (95% CI: 1.1-11.8) and 4.4 (95% CI: 1.1-17.2) respectively. The indicated relationships were significant (P<0.05). The observations suggested, chronic arsenic exposure through drinking water may be a risk factor of type 2 diabetes mellitus. J Bangladesh Coll Phys Surg 2019; 37(1): 5-12


2020 ◽  
Vol 10 (5) ◽  
pp. 307-318
Author(s):  
Barbara K Bujak ◽  
Christine E Blake ◽  
Paul F Beattie ◽  
Shana Harrington ◽  
Courtney M Monroe ◽  
...  

Aim: To examine the change in the Patient Activation Measure and physical and psychosocial outcome measures in a military interdisciplinary intensive outpatient program for persistent pain. Materials & methods: Pre- and post-intervention measures, which were also stratified by gender and baseline activation, included patient-reported outcomes and physical function assessment, obtained from 2017 to 2018 program database. Results: The majority of the participants were male (70.9%), with an average age of 29.18 years and pain duration of 4.78 years (n = 103). Patient activation, majority of the patient reported outcomes and functional assessments improved in the overall sample with fewer changes in females on the Defense and Veterans Pain Rating Scale. Conclusion: Improvements were noted on the Patient Activation Measure and majority of the other outcome measures suggesting that service members with persistent pain at any level of patient activation or baseline function, may benefit from an intensive outpatient program.


2019 ◽  
Vol 6 (6) ◽  
pp. 1706
Author(s):  
Karthik Nagaraj ◽  
Ramesh Patil

Background: An association between migraine and Restless Legs Syndrome (RLS) has been proposed due to shared dopaminergic dysfunction. Both have substantial effects on the quality of life. Identifying co morbidities of migraine helps in optimizing patient management. Objectives To study the prevalence of RLS in patients of migraine without aura, and associated co morbidities of RLS.Methods: This was a hospital based prospective observational study. All patients diagnosed as Migraine without aura as per ICHD-3 criteria completed the questions regarding migraine headache, Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria. Serological investigations were done to look for secondary causes of RLS.Results: Out of 200 consecutive patients of migraine without aura were included in the study over a period of 18 months. Frequency of RLS was 13.5% (n=27). All patients had primary RLS. Mean PSQI score was higher in the patients of migraine without aura with RLS than in non RLS patients of migraine without aura (3.30±2.66 vs 2.24±2.03 p≤0.0168). Poor sleep quality, anxiety, depression was found in 9%, 8% and 2.5% respectively in patients of migraine without aura.Conclusions: An association between migraine without aura and RLS was demonstrated. Migraine without aura was associated with increased frequency of poor sleep quality, anxiety and depression.


2021 ◽  
Vol 1 (3) ◽  
pp. 81
Author(s):  
Siti Annisa Rahmasita ◽  
Agustine Mahardika ◽  
Muhammad Rizkinov Jumsa

<p><strong>Pendahuluan: </strong>Kecemasan merupakan keadaan patologis yang ditandai dengan gejala fisiologis dan gejala psikologis, gejala-gejala tersebut dapat terjadi berbeda pada setiap orang dan situasi. Pada kehamilan, risiko terjadinya kecemasan akan meningkat. Memasuki trimester tiga, ibu hamil dapat merasa cemas akan keselamatan dirinya maupun keselamatan bayinya. Saat merasa cemas, akan terjadi peningkatan kadar noradrenergik akibat stimulasi sistem saraf simpatis yang akan menyebabkan berkurangnya siklus REM, sehingga meningkatkan frekuensi terbangun di malam hari dan menyebabkan kualitas tidur yang buruk. Kecemasan dapat menurunkan kadar GABA sehingga seseorang akan sulit untuk menginisiasi tidur.</p><p><strong>Metode: </strong>Desain penelitian ini adalah deskriptif analitik dengan pendekatan <em>cross sectional</em>. Jumlah responden pada penelitian ini adalah sebanyak 32 ibu hamil trimester tiga di Puskesmas tanjung Karang Mataram, dengan teknik <em>consecutive sampling</em>. Alat pengambilan data pada penelitian ini adalah kuesioner <em>Hamilton Anxiety Rating Scale </em>(HARS) untuk mengukur tingkat kecemasan dan kuesioner <em>Pittsburgh Sleep Quality Index </em>(PSQI) untuk mengukur kualitas tidur. Data pada penelitian ini dianalisis menggunakan uji korelasi spearman.<strong></strong></p><p><strong>Hasil dan pembahasan: </strong>Penelitian menyatakan bahwa tingkat kecemasan berpengaruh terhadap kualitas tidur ibu hamil trimester tiga di Puskesmas Tanjung Karang Mataram dengan P <em>value</em> &lt;0,001 (P <em>value</em> &lt; 0.5) dan r = 0.731 menunjukkan korelasi positif dengan kekuatan korelasi yang kuat.</p><strong>Kesimpulan: </strong>Tingkat kecemasan berpengaruh terhadap kualitas tidur ibu hamil trimester tiga di Puskesmas Tanjung Karang Mataram.


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