scholarly journals Utility of St. George’s respiratory questionnaire in predicting clinical recurrence in chronic pulmonary aspergillosis

2021 ◽  
Vol 8 ◽  
pp. 204993612110346
Author(s):  
Felix Bongomin ◽  
Akaninyene Otu
Keyword(s):  
Quality Of Life ◽  
Antifungal Therapy ◽  
Disease Recurrence ◽  
Self Assessment ◽  
Pulmonary Aspergillosis ◽  
Clinical Recurrence ◽  
St George's Respiratory Questionnaire ◽  
Chronic Pulmonary Aspergillosis ◽  
The Impact

Background and Aims: Patients with chronic pulmonary aspergillosis (CPA) who discontinue antifungal therapy commonly exhibit disease recurrence. We aimed to evaluate the utility of the St. George’s respiratory questionnaire (SGRQ) in predicting the likelihood of clinical recurrence of CPA in patients who come off antifungal therapy. Methods: This audit included CPA patients for whom antifungal therapy was discontinued for at least 1 month. Comparisons were made between the quality of life scores at the time of discontinuation of treatment and at the time of diagnosis of clinical recurrence. The change in patients’ self-assessment scores was also compared. Results: There were 33 cases and 44 controls. Of the 33 cases, 22 (67%) were males with a mean age of 62 ± 13 years. The median for the symptom component of quality of life (QoL) changed from 78.4 at the time of discontinuation of therapy to 83.1 units at the time of diagnosis of clinical failure ( p = 0.043), whereas that of the impact and activity components changed from 62.7 to 59.1 units ( p = 0.387) and 85.0 to 85.9 units ( p = 0.153), respectively. At 12 months, the symptoms domain of SGRQ was able to discriminate between cases of clinical recurrence and controls [area under the curve (AUC) 0.7, 95% confidence interval (CI): 0.6–0.8, p = 0.009]. The proportion of patients in very poor health status increased from 3/11 (9.1%) to 11/33 (33.3%) ( p = 0.046). Conclusion: A deteriorating symptoms component of the SGRQ and a worsening of patients’ self-assessment are associated with clinical recurrence. Failure to improve by >8 units in the symptoms domain appear to be a marker of disease recurrence. We propose that the clinical approach to diagnose recurrent CPA would be a combination of clinical history, SGRQ scoring, chest imaging and a workup to exclude other causes of the patients’ symptoms.

Impact of high baseline Aspergillus-specific IgG levels on weight and quality-of-life outcomes of patients with chronic pulmonary aspergillosis

2020 ◽  
Vol 58 (7) ◽  
pp. 1000-1004
Author(s):  
Felix Bongomin ◽  
Tomaz Garcez ◽  
David W Denning
Keyword(s):  
Quality Of Life ◽  
Antifungal Treatment ◽  
Weight Changes ◽  
Pulmonary Aspergillosis ◽  
Group A ◽  
Chronic Pulmonary Aspergillosis ◽  
Specific Igg ◽  
Group B ◽  
The Impact

Abstract This study aimed to evaluate the impact of quantitative baseline Aspergillus-specific immunoglobulin G (IgG) serum levels on weight changes of patients with chronic pulmonary aspergillosis (CPA) under antifungal treatment. We retrospectively reviewed data of patients diagnosed with CPA between April 2015 and March 2018 at the National Aspergillosis Centre (Manchester, UK). All patients were on continued antifungal treatment for 12 months. Data on Aspergillus-specific IgG levels, St George's quality of life (SGQoL) variables and weight at baseline, 6 months and 12 months were extracted. We defined a high serum Aspergillus-specific IgG as ≥ 200 mg/l (Group A) and low level < 200 mg/l (Group B). Forty-nine patients (37 male; 12 female), median age 65 years (range: 29–86) were studied. Overall, 33% (n = 16) of the patients were in Group A. The baseline characteristics between the two groups were similar. The median Charlson comorbidity index was 4 (range: 0–5) and 3 (range: 0–9) for Group A and Group B, respectively (P = .543). There was a sustained decline in median Aspergillus IgG levels from baseline, through 6 month to 12 months of continues therapy from 170 (range: 20–1110) to 121 (range: 20–1126), and finally 107 (15–937) mg/l, respectively (P < .001). Group A patients gained more weight at 6 months (9/15 [60%] vs. 7/33 [21%], P = .012) and at 12 months of treatment (9/15 [60%] vs. 7/33 [22%]), and more patients in Group B lost weight ((13/33 [41%] vs. 1/15 [7%]), P = .015). However, there was no difference in QoL outcomes across groups at 6 (P = .3) and 12 (P = .7) months. A very high Aspergillus IgG may confer a higher likelihood of weight gain as a key, objective marker of clinical response, if patients can tolerate 12 months of antifungal therapy.

Outcomes

2013 ◽  
pp. 221-226
Author(s):  
David L. Scott
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Short Form ◽  
Organ Damage ◽  
Confounding Factors ◽  
Short Term ◽  
Self Assessment ◽  
The Matrix ◽  
The Impact

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures capture the impact of treating rheumatic diseases. They are influenced by disease severity and effective treatment. They also reflect many confounding factors. These include demographic factors like age, gender, and ethnicity and also deprivation, as poverty worsens outcomes. Comorbidities affect outcomes and patients with multiple comorbid conditions have worse quality of life with poorer outcomes. Patient self-assessment has grown in importance; it is simple and understandable. However, self-assessment can vary over time and does not always reflect assessors’ perspectives. Caution is needed comparing outcomes across units; the various confounding factors and measurement complexities make such comparative analyses challenging.

What impact do specialist and advanced-level nurses have on people living with heart failure compared to physician-led care? A literature review

2020 ◽  
pp. 174498712094679
Author(s):  
Dean A Anderson ◽  
Victoria Clemett
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Length Of Stay ◽  
Literature Review ◽  
Hospital Admissions ◽  
Self Care ◽  
Self Assessment ◽  
Advanced Level ◽  
The Impact

Background The inclusion of specialist nurses in multi-disciplinary teams is the current gold standard for care of people with heart failure (HF) in the UK; however, they remain underutilised in practice. Though existing systematic reviews favourably compare advanced nursing roles to physician-led care, none has focused solely on HF. Aim To investigate the impact of specialist and advanced nurse-led care on the clinical outcomes, quality of life and satisfaction of people with HF compared to physician-led care. Methods Literature review and narrative synthesis. Results This review included 12 studies and categorised their measured outcomes into five domains: mortality; hospital admissions and length of stay; HF diagnosis and management; quality of life and patient satisfaction; and finally, self-assessment and self-care. Five studies appraised as medium or low risk of bias suggest the impact of specialist and advanced-level nurses on people with HF to be broadly equivalent to physicians regarding mortality, hospital admissions and length of stay, while superior in terms of self-assessment and self-care behaviours. Conclusions There were too few studies of sufficient methodological quality to draw definitive conclusions. However, no evidence was found to suggest that nurse-led services are any less effective or safe than physician-led services.

scholarly journals Brazilian version of the Overall Assessment of the Speaker's Experience of Stuttering - Adults protocol (OASES-A)

2012 ◽  
Vol 24 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Eliane Lopes Bragatto ◽  
Ellen Osborn ◽  
J. Scott Yaruss ◽  
Robert Quesal ◽  
Ana Maria Schiefer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Brazilian Portuguese ◽  
Emotional States ◽  
Self Assessment ◽  
Brazilian Version ◽  
Assessment And Treatment ◽  
Back Translation ◽  
The Impact

PURPOSE: To verify the applicability of the protocol Overall Assessment of the Speaker's Experience of Stuttering - Adults (OASES-A), translated into Brazilian Portuguese, in a sample of adults who stutter. METHODS: The Brazilian Portuguese version of the OASES-A protocol was individually applied to 18 people who stutter. The classification of stuttering severity was based on the Stuttering Severity Instrument for Children and Adults (SSI-3) protocol. Translation and back-translation processes were carried out by specialists, considering semantic, conceptual, cultural, and idiomatic equivalences. RESULTS: There was no correlation between the severity degrees of stuttering assessed by the SSI-3 protocol and the self-assessment performed using the OASES-A. Subjects reported impairments in perceived fluency; speech ability; level of knowledge about stuttering and treatment options; use of confrontational techniques; quality of life. They also mentioned having difficulty coping with emotional states such as anxiety and embarrassment, and with communication in daily situations. CONCLUSION: The OASES-A protocol is useful in the assessment and treatment of stutterers, as it provides specialized speech-language pathologists with sutterers' self-perception regarding their communication difficulties and the impact of stuttering on their quality of life.

scholarly journals Perceived dysphonia by the clinician's and patient's viewpoint

2012 ◽  
Vol 24 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Ana Celiane Ugulino ◽  
Gisele Oliveira ◽  
Mara Behlau
Keyword(s):  
Quality Of Life ◽  
Self Assessment ◽  
Perceptual Analysis ◽  
Related Quality ◽  
Vocal Quality ◽  
Patient’S Perception ◽  
The Impact ◽  
The Relationship ◽  
The Voice

PURPOSE: To verify the relationship between the clinician's vocal evaluation and vocal self-assessment and voice-related quality of life. METHODS: Participants were 96 individuals: 48 with vocal complaints and voice deviation (VCG), mean age of 51 years, with diagnosis and indication of voice therapy; and 48 with no vocal complaints and healthy voices (NVCG), mean age of 46 years. All participants answered the Voice-Related Quality of Life (V-RQOL) questionnaire, performed a vocal self-assessment and were submitted to auditory-perceptual analysis of voice. RESULTS: Mean V-RQOL scores were different between groups for all domains. Self-assessment results also showed differences between groups, which was not the case in the auditory-perceptual analysis of sustained vowel and connected speech, showing that the patient's perception was worse than the clinician's. There was correlation between the V-RQOL domains (Socio-emotional and Physical: 76.8%; Socio-emotional and Total: 90.8%; Physical and Total: 95.8%), as well as between the Socio-emotional (-52.9%), Physical (-43.1%) and Total (-52.2%) domains and the self-assessment. However, no correlation was found between auditory-perceptual analysis and self-assessment measures, except for a weak correlation between vocal self-assessment and auditory-perceptual analysis of the sustained vowel (33.3%). CONCLUSION: The clinician's perception does correspond to the individual's self-perception of his/her vocal quality and the impact of a voice deviation on his/her quality of life, but not directly. The individual's perception about his/her vocal quality and voice-related quality of life complements the clinician's perception regarding the overall degree of the voice deviation.

scholarly journals The Impact of Apathetic Disorders on the Quality of Life of Patients after Ischemic Stroke

2020 ◽  
Vol 9 (3) ◽  
pp. 108-113
Author(s):  
Jolanta Zielińska ◽  
◽  
Marek Zieliński ◽  
Robert Ślusarz ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Social Bonds ◽  
Self Esteem ◽  
Self Assessment ◽  
Sensory Aphasia ◽  
Significant Difference ◽  
Complete Breakdown ◽  
The Impact

Introduction. Strokes often cause dysfunctions in the reception and transmission of speech, which may be aphasia or dysarthria. These disorders can lead to disability, which imposes limitations on the patient, even leads to a complete breakdown of roles and social bonds. Aim. The main aim of the study was to assess the impact of the type and degree of apathetic disorders on the quality of life of patients after ischemic stroke. Material and Methods. The research was carried out at the Neurological Department of the Provincial Specialist Hospital in Włocławek. On average 68 patients with apathetic disorders and diagnosed ischemic stroke were qualified for the study. The study was conducted using the method of diagnostic survey. It consisted in the assessment of patients using the generally available SODA diagnostic tool — the Aphasia Dynamics Assessment Scale and a standardized tool, the WHOQOL-BREF questionnaire by Krystyna Jaracz. Results. When assessing the impact of the degree of aphasia on the quality of life, a statistically significant difference was observed in the overall quality of life in patients with complete (p = 0.012), significant (p = 0.012) and moderate (p = 0.031) aphasia. In self-assessment of health status, a statistically significant difference was found only in patients with complete aphasia (p = 0.048). In the physical, psychological and environmental domains, a statistically significant differences was observed in patients with severe aphasia (p = 0.05). Conclusions. The type and degree of apathetic disorders has been shown to affect the quality of life of patients. Each type of aphasia worsens the overall quality of life, and in addition, motor and sensory aphasia negatively affects functioning in the psychological field. It has also been shown that the more advanced the degree of apathetic disorders, the worse the overall quality of life, self-esteem of health, and worse physical, psychological and environmental functioning. (JNNN 2020;9(3):108–113) Key Words: apathetic disorders, ischemic stroke, quality of life

scholarly journals Socio-hygienic research and assessment of the quality of life of cosmetology patients

2021 ◽  
Vol 24 (3) ◽  
pp. 307-314
Author(s):  
Olga Yu. Olisova ◽  
Olga N. Krasilnikova
Keyword(s):  
Quality Of Life ◽  
Rating Scales ◽  
Skin Diseases ◽  
Rapid Development ◽  
Self Assessment ◽  
Age Related ◽  
Based Medicine ◽  
The Impact ◽  
Age Related Changes

Health is largely determined by environmental factors. A number of skin diseases, as well as its age-related changes, are a poorly studied medical and social problem. The procedures provided in cosmetology clinics can be considered a relative indicator of an improvement in the quality of life, directly related to the restoration and maintenance of balance and harmony of individual and public health of a person with the natural and social environment. The analysis of the quality of life of patients with cosmetology profile was carried out. It is noted that despite the rapid development of cosmetology, information proving the impact of surgical and non-surgical cosmetic procedures on the patients quality of life is limited; there are no effective, reliable rating scales for the patients self-assessment of the results of cosmetic therapy. Sociocultural and quality of life factors that force patients to undergo these procedures are not well understood. The results of a sociological survey of patients with a cosmetology profile allow cosmetologists to plan a complex of interventions for the prevention and correction of age-related changes in appearance, emphasize the professional image of a specialist. The development of rating scales and methods for assessing the quality of botulinum therapy and the patients self-assessment of the results of medical care provided on the principles of evidence-based medicine is an urgent issue.

scholarly journals Quality of life of students in polytechnic higher education at the Santarem and Leiria: the impact of COVID-19

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Maria do Carmo Figueiredo ◽  
José Amendoeira ◽  
Marta Rosa ◽  
Rui Matos ◽  
Mário Silva ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Higher Education ◽  
Social Relations ◽  
World Health ◽  
Educational Systems ◽  
Self Assessment ◽  
Quantitative Descriptive ◽  
Health Organization ◽  
The Impact

Abstract Background The epidemic of COVID-19 caused by the Coronavirus -SARS-CoV-2, was declared by the World Health Organization an International Public Health Emergency. The 2019–2020 coronavirus pandemic has affected educational systems worldwide, leading to the closure of educational institutions. This situation kept students socially distant, with little adaptation time, interfering with their quality of life. Methods The aim of this study is to evaluate the quality of life of higher education students in the face of the impact of the COVID-19 pandemic. 775 students were selected by convenience sampling. Study with a quantitative, descriptive, correlational approach. The WHOQOL-bref instrument adapted from WHO was applied. Data analysis was undertaken using the IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. Results Students' self-assessment about Quality of Life is globally superior to the self-assessment with their satisfaction with health, where the female students have lower average values than the male students. The WHOQOL-bref domains referring to Quality of Life with higher values were the Physical and the Environment ones, with the Social Relations and Psychological domains having the lowest values. Conclusions The development of this study made it possible to achieve the objective set. The domain of social relations has low average values, with students from IPSantarem standing out, with lower self-assessment of QoL in this domain, compared to those from IPLeiria. In the psychological domain, the low average values in both institutes stand out, especially in IPLeiria, where the average is less than 50%, in both genders.

scholarly journals Predictors of mortality in chronic pulmonary aspergillosis

2016 ◽  
Vol 49 (2) ◽  
pp. 1601062 ◽  
Author(s):  
David Lowes ◽  
Khaled Al-Shair ◽  
Pippa J. Newton ◽  
Julie Morris ◽  
Chris Harris ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Mycobacterial Infection ◽  
Cox Proportional Hazards ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Obstructive Pulmonary Disease ◽  
Kaplan Meier ◽  
St George's Respiratory Questionnaire ◽  
Chronic Pulmonary Aspergillosis ◽  
The Impact

Chronic pulmonary aspergillosis (CPA) is a chronic progressive infection that destroys lung tissue in non-immunocompromised patients. Contemporary series suggest 50–85% 5-year mortality, with few prognostic factors identified.A cohort of 387 CPA patients referred to the UK's National Aspergillosis Centre from 1992 to June 2012 was studied until June 2015. The impact of objective and subjective variables including age, sex, previous pulmonary conditions, dyspnoea score, quality of life, serum albumin and C-reactive protein and radiological appearances were assessed using Kaplan–Meier curves, log rank tests and Cox proportional hazards modelling. In samples of patients, retrospective review of time from likely onset of CPA to referral and cause of death were also investigated.Survival was 86%, 62% and 47% at 1, 5 and 10 years, respectively. Increased mortality was associated with nontuberculous mycobacterial infection (hazard ratio 2.07, 95% CI 1.22–3.52; p<0.001) and chronic obstructive pulmonary disease (1.57, 1.05–2.36; p=0.029) as well as higher age (1.053, 1.03–1.07 per year; p<0.001), lower albumin (0.92, 0.87–0.96 per g·L−1), lower activity (1.021, 1.01–1.03 per point increase in St George's Respiratory Questionnaire activity domain; p<0.001) and having one, and especially, bilateral aspergillomas (p<0.001).Several factors impact on mortality of CPA, and can be evaluated as tools to assess CPA prognosis.

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