Epidemiology of Swallowing Disorders in Rheumatoid Arthritis: Prevalence, Risk Factors, and Quality of Life Burden

2018 ◽  
Vol 127 (9) ◽  
pp. 577-587 ◽  
Author(s):  
Nelson Roy ◽  
Kristine M. Tanner ◽  
Ray M. Merrill ◽  
Charisse Wright ◽  
Jenny L. Pierce ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Disease Severity ◽  
Daily Basis ◽  
Swallowing Disorders ◽  
Voice Disorder ◽  
Swallowing Disorder ◽  
A Current

Objective: This investigation examined the prevalence, symptoms, risk factors, and quality-of-life burden of swallowing disorders in rheumatoid arthritis (RA), a chronic, progressive autoimmune inflammatory disease. Methods: One hundred individuals with RA (84 women, 16 men; mean age = 61.1 years, SD = 13.1) were interviewed regarding the presence, nature, and impact of swallowing symptoms and disorders. Associations between swallowing disorders, medical factors, RA disease severity, and quality of life were examined. Results: Forty-one percent of participants reported a current swallowing disorder that began gradually and was longstanding (most experiencing symptoms on a daily basis for at least 4 years). Symptoms compatible with solid food dysphagia contributed disproportionately to reporting a current swallowing disorder. Risk factors for dysphagia included a self-reported voice disorder, thyroid problems, esophageal reflux, and being physically inactive. Swallowing disorders increased with self-reported RA disease severity and contributed to a significantly greater burden on overall quality of life. Conclusion: Chronic, longstanding swallowing disorders are common in individuals with RA and appear to increase with disease severity. Those individuals with dysphagia reported greater reductions in quality of life as compared to those without, highlighting the need for improved awareness, exploration, and management of swallowing disorders in this population.

Voice Disorders in Obstructive Sleep Apnea: Prevalence, Risk Factors, and the Role of CPAP

2018 ◽  
Vol 128 (3) ◽  
pp. 249-262 ◽  
Author(s):  
Nelson Roy ◽  
Ray M. Merrill ◽  
Jenny Pierce ◽  
Krishna M. Sundar
Keyword(s):  
Quality Of Life ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Voice Disorders ◽  
Acid Reflux ◽  
Voice Disorder ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
A Current

Objective: Obstructive sleep apnea (OSA) is characterized by frequent interruptions in breathing related to upper airway collapse during sleep and may adversely affect phonatory function. This study aimed to: (1) establish the prevalence, risks, and quality of life burden of voice disorders in OSA and (2) explore the relation between voice disorders and positive airway pressure (PAP) therapy. Study Design: Cross-sectional, descriptive epidemiology study. Methods: Analyses were based on 94 individuals with OSA (53 men, 41 women; mean age = 54.7 ± 12.8 years) who completed a telephone interview. Results: Twenty-eight percent of participants reported having a current voice disorder. Of those with a current voice disorder, 83% had experienced symptoms for at least a year, and 58% had symptoms for at least 4 years. The prevalence of a current voice disorder was greater in women than men (44% vs 15%, P = .0020) but did not vary significantly across different age groups, body mass index (BMI), apnea/hypopnea index (AHI) severity, or medical history. After adjusting for sex, consistent use of PAP therapy (with humidification) was associated with (1) lower occurrence of voice disorders in women (Mantel-Haenszel [MH] χ2 P = .0195), (2) reduced snoring severity accompanied by fewer voice disorders in men (MH χ2 P = .0101), and (3) fewer reports of acid reflux as a possible trigger for voice problems (MH χ2 P = .0226). Patients with OSA who also had a current voice disorder experienced lower overall quality of life compared to those without. Conclusions: Chronic, longstanding voice disorders are common in women with OSA and produce significant adverse effects on quality of life. Nightly PAP use (with humidification) was associated with fewer voice symptoms and reduced severity of snoring and acid reflux as possible contributors. Further research is necessary to better understand the origin of these voice disorders in OSA and their potential response to treatment.

scholarly journals Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

2021 ◽  
Author(s):  
Jarkko Mäntylä ◽  
Tanja Törölä ◽  
Witold Mazur ◽  
Paula Bergman ◽  
Paula Kauppi
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Disease Severity ◽  
Bacterial Colonization ◽  
Severe Disease ◽  
Poor Quality ◽  
Physical Capacity ◽  
Bacterial Colonisation ◽  
Cross Sectional

Abstract BackgroundTo study the risk factors associated with quality of life (QoL) in a cohort of Finnish non-cystic fibrosis bronchiectasis (BE) patients. We aimed to evaluate which of the clinical characteristics were risk factors for poor quality of life, how patients with frequent exacerbations differed from those with only few exacerbations and if QoL symptom domains were correlated with dyspnoea or severity of BE.MethodsA cross-sectional study and part of the EMBARC study including questionnaire data and medical record data. Study participants were recruited between August 2016 and March 2018 from three different pulmonary clinics in Helsinki University Central Hospital (HUH) catchment area, Finland. The study included 95 adult patients with (mean age was 69 (SD± 13) years).A Finnish translation of the disease-specific quality of life-bronchiectasis (QoL-B) questionnaire was applied, and scores in the lowest quarter (25%) of the scale were considered to indicate poor QoL. The bronchiectasis severity index (BSI) and FACED (including FEV1, age, pulmonary bacterial colonization, affected lobes and dyspnoea) score were used. The severity of dyspnoea was examined using the modified Medical Research Council (mMRC) dyspnoea scale.ResultsAlmost all (82%) presented with chronic sputum production and exacerbations, with a median rate of 1.7 (SD ±1.6). Exacerbations (OR 1.7, p < 0.01), frequent exacerbations (OR 4.9, p < 0.01), high BSI score (OR 1.3, p < 0.01) and extensive disease (OR 3.7, p = 0.05) were predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in one second (FEV1) and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, whereas 11.6% were classified as severe according to the FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) were negatively correlated with physical domain in QoL-B questionnaire. ConclusionFrequent exacerbations, radiological disease severity and high BSI score were predictive of poor QoL. Reduced physical capacity was correlated with dyspnoea and severity of disease. Interventions to reduce bacterial colonisation and to maintain physical functioning should be used to minimize exacerbations and to improve quality of life in BE patients.Study registrationUniversity of Helsinki, faculty of medicine; 148/16.08.2017

scholarly journals Quality of Life, Social Support, Coping Strategies, and Psychiatric Morbidity in Patients with Rheumatoid Arthritis

2022 ◽  
Author(s):  
Naresh Nebhinani ◽  
Surendra Kumar Mattoo ◽  
Ajay Wanchu
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Social Support ◽  
Coping Strategies ◽  
Psychiatric Disorders ◽  
Disease Severity ◽  
Psychiatric Morbidity ◽  
Psychological Morbidity ◽  
Physical Functions

Abstract Background and Objectives Patients with rheumatoid arthritis (RA) have greater psychological morbidity, despite that research in this area is scarce from developing countries. This study was aimed to assess the association of quality of life, social support, coping strategies, and psychological morbidity in patients with RA. Materials and Methods In this cross-sectional study, 40 patients with RA, who were not receiving steroids or disease modifying antirheumatic drugs, were recruited through purposive sampling. Social support questionnaire, coping strategy check list, and World Health Organization quality of life-BREF (WHOQOL-BREF) were administered to assess social support, coping, and quality of life, respectively. Results More than half of the patients had psychiatric disorders (60%), with depression being the commonest disorder (52.5%). Internalization coping and disease severity indicators like tender joints counts, swollen joints counts, pain, and disease activity were found as significant predictors for psychiatric disorders, while externalization coping, quality of life (all domains), and physical functions were found to protect against psychiatric morbidity. Conclusions Coping, quality of life, disease severity, and physical functions predicted the psychiatric disorders in RA. Multipronged interventions to enhance quality of life with promoting adaptive coping and timely treatment may further improve their mental health and overall disease course.

Swallowing Disorders in Sjögren’s Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life

Dysphagia ◽  
2015 ◽  
Vol 31 (1) ◽  
pp. 49-59 ◽  
Author(s):  
Jenny L. Pierce ◽  
Kristine Tanner ◽  
Ray M. Merrill ◽  
Karla L. Miller ◽  
Katherine A. Kendall ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Sjögren’S Syndrome ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Swallowing Disorders ◽  
Sjögren‘S Syndrome

Comorbidity in rheumatoid arthritis

2020 ◽  
pp. 145-158
Author(s):  
Kimme Hyrich ◽  
Sarah Skeoch
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Treatment Decisions ◽  
Direct Result ◽  
High Prevalence ◽  
Impact On Treatment

A high prevalence of comorbidity is observed in patients with rheumatoid arthritis (RA) and the presence and type of comorbidity has a significant impact on mortality and quality of life in RA. Comorbidity also has an impact on treatment decisions and recognizing and managing comorbidities is an important aspect in the care of patients with RA. Some comorbidities occur as a direct result of RA or the treatments used, while others can be unrelated but have an effect on treatment and outcomes. In this chapter we describe the burden of comorbidity and the prevalence, risk factors, and management of important comorbidities seen in RA.

scholarly journals Clinical characteristics and quality of life in seborrheic dermatitis patients: a cross-sectional study in China

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Meiling Xuan ◽  
Chuanjian Lu ◽  
Zehui He
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Logistic Regression ◽  
Disease Severity ◽  
Skin Disease ◽  
Clinical Characteristics ◽  
Seborrheic Dermatitis ◽  
Severe Disease ◽  
Pm 10

Abstract Background Seborrheic dermatitis (SD) is a common, chronic, inflammatory skin disorder, yet few studies have reported its clinical characteristics, or addressed its effect on quality of life (QoL). This study assesses the clinical characteristics and QoL of SD patients in China. It also identifies the clinical, demographic and environmental factors that may influence QoL. Methods Three hundred twelve SD outpatients from 9 hospitals completed a survey. QoL was measured with the dermatology-specific instrument Skindex-29. We collected social demographic characteristics and disease severity, and conducted logistic regression to determine the factors associated with QoL impairment. Results 67.3% of the patients were females. The mean Skindex-29 overall score was 33.97 (SD = 20.55). The breakdown was 40.79 (SD = 24.24) for emotions, 32.83 (SD = 19.84) for symptoms and 28.3 (SD = 23.24) for functioning. 48.1% had severe emotional problems. Logistic regression analysis showed that BMI less than 25 (OR = 0.223; 95% CI: 0.072–0.692; P = 0.009), skin disease-related hospitalization (OR = 6.882; 95% CI:1.767–26.795; P = 0.005), environmental PM 10 levels above 120 μg/m3 (OR = 3.386; 95% CI: 1.253–9.15; P = 0.016) and severe disease conditions (OR = 4.438; 95% CI:1.26–15.626; P = 0.02) were risk factors for severe emotional impairment. Moreover, skin disease-related hospitalization (OR = 6.057; 95% CI:1.351–27.149; P = 0.019), environmental PM 10 levels between 70 and 120 μg/m3 (OR = 6.317; 94% CI: 1.704–23.42; P = 0.006), moderate (OR = 2.388; 95% CI: 1.272–4.487; P = 0.007) and severe disease conditions (OR = 5.732; 95% CI: 1.838–17.88; P = 0.003) were each risk factors for overall severe impairment. Conclusion In China, nearly half of SD patients had severely emotional problems. Disease severity, BMI, dermatologic hospitalization, and ambient PM 10 levels are each risk factors for QoL impairment in SD patients. These implications are alarming, and warrant public health attention in SD disease management.

FRI0450 MEASURES OF DISEASE SEVERITY PREDICT DISABILITY AND QUALITY OF LIFE DIFFERENTLY IN RHEUMATOID ARTHRITIS AND CHRONIC CHIKUNGUNYA DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 822-822
Author(s):  
H. Watson ◽  
R. L. Nogueira-Hayd ◽  
M. Rodrigues-Moreno ◽  
F. Naveca ◽  
G. Calusi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Regression Analysis ◽  
Disease Severity ◽  
Patient Outcomes ◽  
Life Domains ◽  
Tender Joint ◽  
Anxiety Depression ◽  
Tender Joint Counts

Background:Chronic rheumatological manifestations similar to those of rheumatoid arthritis (RA) have been described after chikungunya virus infection. However, the clinical significance of the symptoms and disease severity in the two conditions has not been directly compared.Objectives:To compare, using identical measures of disease severity and patient outcomes, the impact of disease severity measures and symptoms on outcomes in RA and chronic chikungunya disease.Methods:Forty patients with chronic chikungunya arthralgia two years post-infection and 40 matched patients with RA were enrolled in Roraima, Brazil. Twenty-eight joints were assessed for tenderness and swelling, a pain intensity visual analogue scale, musculoskeletal stiffness questionnaire, modified Health Assessment Questionnaire and the EuroQol EQ5D-5L quality of life assessment were completed. The importance of the various measures of disease severity were analysed using Spearman’s rank correlation and regression analysis.Results:Tender and swollen joint counts, pain and stiffness were all predictive of the HAQ disability index in RA, but only stiffness was significantly associated with disability in chikungunya patients (Table 1). Tender and swollen joint counts, pain and stiffness were predictive for all EQ5D quality of life domains (except anxiety/depression) in RA patients. In contrast, in chikungunya disease, tender joint counts were predictive only of usual daily activities; pain was predictive of impaired mobility, self-care and discomfort, while stiffness was predictive for the mobility and anxiety/depression domains (Figure 1). Swollen joint counts were not associated with any of the patient outcomes in chikungunya disease. Linear regression analysis confirmed (p=0.003) that the effect of swollen joint count on the HAQ disability index depends on the underlying disease.Table 1.Association of disease severity with HAQ disability index in rheumatoid and CHIKV+ arthritisSeverity measureRheumatoid arthritisCHIKV+ arthritisr (p)r (p)Tender joint count0.56 (0.0002)0.24 (0.14)Swollen joint count0.60 (<0.0001)0.002 (0.99)Joint pain (VAS)0.55 (0.0002)0.29 (0.07)Stiffness severity0.57 (0.0001)0.38 (0.02)Figure 1.Association of disease severity with quality of life domains in rheumatoid and CHIKV+ arthritisConclusion:The value of all the disease severity measures tested in RA were confirmed, but tender joint counts may have more limited value in the assessment of chronic chikungunya disease. Joint swelling appears to have little impact for chikungunya patients, while stiffness appears to be an important metric to quantify chikungunya arthritis disease severity.Disclosure of Interests:Hugh Watson Shareholder of: Sanofi, Employee of: Sanofi, Ramão Luciano Nogueira-Hayd: None declared, Maony Rodrigues-Moreno: None declared, Felipe Naveca: None declared, Giulia Calusi: None declared, Richard Amdur: None declared, Karol Suchowiecki: None declared, Gary S. Firestein: None declared, Gary Simon: None declared, Aileen Chang: None declared

Descriptive Epidemiology of Voice Disorders in Rheumatoid Arthritis: Prevalence, Risk Factors, and Quality of Life Burden

2016 ◽  
Vol 30 (1) ◽  
pp. 74-87 ◽  
Author(s):  
Nelson Roy ◽  
Kristine Tanner ◽  
Ray M. Merrill ◽  
Charisse Wright ◽  
Karla L. Miller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Voice Disorders ◽  
Descriptive Epidemiology
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