scholarly journals Five-Month Follow-Up Assessing Defecography and Urodynamics after Laparoscopic Nerve-Sparing Colorectal Resection for Endometriosis

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Claudio Peixoto Crispi ◽  
Claudio Peixoto Crispi ◽  
Alice Cristina Coelho Brandão Salomão ◽  
Claudia Maria Vale Joaquim ◽  
Bruna Rafaela Santos de Oliveira ◽  
...  
Keyword(s):  
Short Form ◽  
Abdominal Distension ◽  
Bowel Function ◽  
Nerve Sparing ◽  
Pain Scores ◽  
Magnetic Resonance Defecography ◽  
Related Quality ◽  
Health Related

Introduction. Large resections may be necessary in cytoreductive surgery for endometriosis, which present risk of urinary and bowel complications. Presentation of Case. A 29-year-old woman underwent multidisciplinary laparoscopy for endometriosis in a private practice setting for acyclic pelvic pain and cyclic abdominal distension with changes in bowel habits and frequent sensation of incomplete defecation. After surgery, urodynamics remained normal and bowel function improved subjectively and objectively per dynamic magnetic resonance defecography (DMRD). The five-month follow-up found improvements in pain scores, bowel function, and health-related quality of life (assessed by the full versions of the Short Form 36 and Endometriosis Health Profile 30 scales). Discussion. Animus may contribute to the bowel symptoms in women with endometriosis. DMRD provides additional objective parameters for comparing pre- and postoperative functions. Conclusion. A nerve-sparing segmental rectosigmoidectomy for endometriosis carefully executed by a multidisciplinary team can preserve the function of different pelvic organs.

scholarly journals Health-related quality of life in Marfan syndrome: a 10-year follow-up

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Thy Thy Vanem ◽  
Svend Rand-Hendriksen ◽  
Cathrine Brunborg ◽  
Odd Ragnar Geiran ◽  
Cecilie Røe
Keyword(s):  
Quality Of Life ◽  
Marfan Syndrome ◽  
Health Survey ◽  
Short Form ◽  
Physical Domain ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background Marfan syndrome, a rare hereditary connective tissue disorder caused by mutations in fibrillin-1, can affect many organ systems, especially the cardiovascular system. Previous research has paid less attention to health-related quality of life and prospective studies on this topic are needed. The aim of this study was to assess changes in health-related quality of life after 10 years in a Norwegian Marfan syndrome cohort. Methods Forty-seven Marfan syndrome patients ≥ 18 years were investigated for all organ manifestations in the 1996 Ghent nosology and completed the self-reported questionnaire, Short-Form-36 Health Survey, at baseline in 2003–2004 and at follow-up in 2014–2015. Paired sample t tests were performed to compare means and multiple regression analyses were performed with age, sex, new cardiovascular and new non-cardiovascular pathology as predictors. Results At 10-year follow-up: a significant decline was found in the physical domain. The mental domain was unchanged. Older age predicted a larger decline in physical health-related quality of life. None of the chosen Marfan-related variables predicted changes in any of the subscales of the Short-Form 36 Health Survey or in the physical or the mental domain. Conclusion Knowledge of decline in the physical domain, not related to organ affections, may be important in the follow-up of Marfan syndrome patients.

scholarly journals Post-COVID-19 Long Hauler Clinical Program: Change in Health-Related Quality-of-Life

2021 ◽  
Vol 10 ◽  
pp. 216495612110590
Author(s):  
Marc Brodsky
Keyword(s):  
Quality Of Life ◽  
Process Improvement ◽  
Short Form ◽  
Health Related Quality ◽  
Clinical Program ◽  
Related Quality ◽  
Standardized Treatment ◽  
Health Related

Background and Objective An Integrative Medicine Center created a post–COVID-19 myalgiac encephalomyelitis (ME) program in response to a July 2020 Centers for Disease Control and Prevention document that described fatigue and other functional symptoms. The objective is to present process improvement data on change in health-related quality-of-life (HRQOL) in patients who participated in the “long hauler” program. Methods For process improvement purposes, 39 consecutive patients who participated in the post–COVID-19 ME program from August 2020–August 2021 were asked to complete the 12-Item Short Form Survey (SF-12) before treatment and a month later. Results Twelve participants (31%) completed a baseline and follow-up survey. Mean SF-12 physical component summary scores improved 5 (SD 9) and mental component summary scores improved 4 (SD 9) in patients who completed baseline and follow-up surveys. Case studies of two patients who completed the SF-12 at baseline and after 4 weekly treatments illustrate the program’s standardized treatment approach. Conclusion Data collected for process improvement reasons describe changes in HRQOL for participants in a post–COVID-19 ME program. Follow-up practice-based clinical trials may discern optimal approaches for patients with this chronic condition.

scholarly journals Does Smoking Status Influence Health-Related Quality of Life Outcome Measures in Patients Undergoing ACDF?

2019 ◽  
Vol 11 (1) ◽  
pp. 50-56
Author(s):  
John J. Mangan ◽  
Dhruv K. C. Goyal ◽  
Srikanth N. Divi ◽  
Daniel R. Bowles ◽  
Kristen J. Nicholson ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Smoking Status ◽  
Short Form ◽  
Health Related Quality ◽  
Arm Pain ◽  
Related Quality ◽  
Health Related ◽  
Former Smokers

Study design: Retrospective comparative study. Objective: Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology. Methods: Patients with tumor, trauma, infection, and previous cervical spine surgery and those with less than a year of follow-up were excluded. Smoking status was assessed by self-reported smoking history. Patient outcomes, including Neck Disability Index, Short Form 12 Mental Component Score, Short Form 12 Physical Component Score (PCS-12), Visual Analogue Scale (VAS) arm pain, VAS neck pain, and pseudarthrosis rates were evaluated. Outcomes were compared between smoking groups using multiple linear and logistic regression, controlling for age, sex, and body mass index (BMI), among other factors. A P value <.05 was considered significant. Results: A total of 264 patients were included, with a mean follow-up of 19.8 months, age of 53.1 years, and BMI of 29.6 kg/m2. There were 43 current, 69 former, and 152 nonsmokers in the cohort. At baseline, nonsmokers had higher PCS-12 scores than current smokers ( P = .010), lower VAS neck pain than current ( P = .035) and former ( P = .014) smokers, as well as lower VAS arm pain than former smokers ( P = .006). Postoperatively, nonsmokers had higher PCS-12 scores than both current ( P = .030) and former smokers ( P = .035). Smoking status was not a significant predictor of change in patient outcome in multivariate analysis. Conclusions: Whereas nonsmokers had higher function and lower pain than former or current smokers preoperatively, smoking status overall was not found to be an independent predictor of outcome scores after ACDF. This supports the notion that smoking status alone should not deter patients from undergoing ACDF for cervical degenerative pathology.

scholarly journals Health-Related Quality of Life Among Individuals with Visual Conditions Requiring Eyecare During COVID-19 Lockdown.

2020 ◽  
Author(s):  
Khader A. Almhdawi ◽  
Munsif F. Alsalem ◽  
Donia Obeidat ◽  
Laith T. Al-Khateeb ◽  
Mohammad N. Al Aqarbah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Short Form ◽  
Service Planning ◽  
Health Related Quality ◽  
Cross Sectional Survey ◽  
Related Quality ◽  
Health Related

Abstract Background: Individuals with chronic vision diseases need regular ophthalmic follow-up. However, access to non-urgent ophthalmic services was limited in areas of strict lockdown during SARS-COV-2 (COVID-19) pandemic. This article aimed to o assess Health-Related Quality of Life (HRQoL) and its predictors in individuals with chronic vision conditions during COVID-19 lockdown. Methods: A cross-sectional, survey-based study targeted Jordanians adults with variety of chronic vision conditions require regular ophthalmic follow-up. Outcome measures included HRQoL measured by 12-item Short Form health survey (SF-12), mental health symptoms measured by Depression Anxiety Stress Scale (DASS 21), vision ability measured by the National Eye Institute Visual Functioning Questionnaire (VFQ-25) General Vision and Role Limitation subscales. Data were analyzed descriptively and using a multiple variable linear regression to identify HRQoL predictors. Results: A total of 201 participants completed the study with a mean age of 52.09 (±15.41) years and SF-12 mean score of 57.90 (±18.15). Level of HRQoL was significantly and negatively predicted by VFQ-25 Role Limitation subscale, presence of diabetes, the need of ophthalmic follow-up during lockdown, and stress. The regression model explained 47.1% of the variance in HRQoL (r2=0.471, F=35.57, P<0.001).Conclusions: Jordanian individuals with chronic vision conditions requiring non-urgent ophthalmic follow-up demonstrated a relatively low level of HRQoL during COVID-19 lockdown. Participants also showed adverse impact on mental health and reported low accessibility to ophthalmic care. Access to non-urgent ophthalmic care in individuals with chronic vision diseases should be carefully considered by healthcare administrations and policymakers for optimal service planning during pandemics and crises.

Outcomes of an Integrated Urology-Palliative Care Clinic for Patients With Advanced Urological Cancers: Maintenance of Quality of Life and Satisfaction and High Rate of Hospice Utilization Through End of Life

2019 ◽  
Vol 36 (9) ◽  
pp. 801-806 ◽  
Author(s):  
Kathy Huen ◽  
Cher Huang ◽  
Hui Liu ◽  
Lorna Kwan ◽  
Stephanie Pannell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Short Form ◽  
Health Related Quality ◽  
Care Clinic ◽  
Urological Cancers ◽  
Related Quality ◽  
Health Related

Introduction: Systematic integration of palliative care in a surgical setting is important, but has yet to be achieved. Despite evidence of early palliative care improving patients’ quality of life, hospice utilization remains low. Through an integrated palliative care-urology clinic, we aim to assess the effect of early outpatient palliative care on hospice utilization, health-related quality of life (HRQOL) and satisfaction in patients with advanced urological cancers. Methods: Participants were recruited from 2012 through 2016 in the Greater Los Angeles Veterans Affairs Hospital. We partnered with palliative care clinicians to develop an integrated urology-palliative care clinic, where participants were seen by the palliative care team on the same day as their urological visit. The 12-item Short-Form Survey, Patient Satisfaction Questionnaire Short-Form, Patient Health Questionnaire, and Brief Pain Inventory were administered at initial and subsequent visits. Follow-up questionnaire results were compared between baseline and the 2 follow-up visits, and hospice utilization rates were assessed. Results: Fifty-three participants completed baseline questionnaires. Of those 22 (42%) patients completed at least one follow-up assessment. The median time for the first and second follow-up visits was 2.9 and 7.8 months, respectively. There were no significant differences in HRQOL and satisfaction between baseline and subsequent follow-up visits. A total of 36 (68%) of 53 participants who were enrolled at the start of the study were deceased. Of those, 29 (81%) expired within a home or inpatient hospice. Conclusions: Rates of hospice use were high in an integrated palliative care-urology model. Health-related quality of life and satisfaction did not worsen over time.

Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People

2018 ◽  
Vol 25 (4) ◽  
pp. 140-151
Author(s):  
Markus A. Wirtz ◽  
Matthias Morfeld ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer
Keyword(s):  
Quality Of Life ◽  
Representative Sample ◽  
Short Form ◽  
Physical Symptoms ◽  
German Population ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.

Effectiveness of the Chiari Health Index for Pediatrics instrument in measuring postoperative health-related quality of life in pediatric patients with Chiari malformation type I

2020 ◽  
pp. 1-6
Author(s):  
Georgina E. Sellyn ◽  
Alan R. Tang ◽  
Shilin Zhao ◽  
Madeleine Sherburn ◽  
Rachel Pellegrino ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Type I ◽  
Health Related Quality ◽  
Health Index ◽  
Chiari Malformation Type I ◽  
Related Quality ◽  
Health Related ◽  
Over Time

OBJECTIVEThe authors’ previously published work validated the Chiari Health Index for Pediatrics (CHIP), a new instrument for measuring health-related quality of life (HRQOL) for pediatric Chiari malformation type I (CM-I) patients. In this study, the authors further evaluated the CHIP to assess HRQOL changes over time and correlate changes in HRQOL to changes in symptomatology and radiological factors in CM-I patients who undergo surgical intervention. Strong HRQOL evaluation instruments are currently lacking for pediatric CM-I patients, creating the need for a standardized HRQOL instrument for this patient population. This study serves as the first analysis of the CHIP instrument’s effectiveness in measuring short-term HRQOL changes in pediatric CM-I patients and can be a useful tool in future CM-I HRQOL studies.METHODSThe authors evaluated prospectively collected CHIP scores and clinical factors of surgical intervention in patients younger than 18 years. To be included, patients completed a baseline CHIP captured during the preoperative visit, and at least 1 follow-up CHIP administered postoperatively. CHIP has 2 domains (physical and psychosocial) comprising 4 components, the 3 physical components of pain frequency, pain severity, and nonpain symptoms, and a single psychosocial component. Each CHIP category is scored on a scale, with 0 indicating absent and 1 indicating present, with higher scores indicating better HRQOL. Wilcoxon paired tests, Spearman correlations, and linear regression models were used to evaluate and correlate HRQOL, symptomatology, and radiographic factors.RESULTSSixty-three patients made up the analysis cohort (92% Caucasian, 52% female, mean age 11.8 years, average follow-up time 15.4 months). Dural augmentation was performed in 92% of patients. Of the 63 patients, 48 reported preoperative symptoms and 42 had a preoperative syrinx. From baseline, overall CHIP scores significantly improved over time (from 0.71 to 0.78, p < 0.001). Significant improvement in CHIP scores was seen in patients presenting at baseline with neck/back pain (p = 0.015) and headaches (p < 0.001) and in patients with extremity numbness trending at p = 0.064. Patients with syringomyelia were found to have improvement in CHIP scores over time (0.75 to 0.82, p < 0.001), as well as significant improvement in all 4 components. Additionally, improved CHIP scores were found to be significantly associated with age in patients with cervical (p = 0.009) or thoracic (p = 0.011) syrinxes.CONCLUSIONSThe study data show that the CHIP is an effective instrument for measuring HRQOL over time. Additionally, the CHIP was found to be significantly correlated to changes in symptomatology, a finding indicating that this instrument is a clinically valuable tool for the management of CM-I.

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