scholarly journals Clinical Manifestations, Histopathological Changes And Quality Of Life In Patients With Advanced Knee Osteoarthritis Caused By Age, Trauma, Obesity And Their Combination

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Kristina V. Korochina ◽  
Tatyana V. Chernysheva ◽  
Irina E. Korochina

Objective — to reveal and analyze clinical characteristics, knee joint histopathology, and quality of life in patients at late stages of knee osteoarthritis (OA) triggered by age, trauma, metabolic syndrome, or their combination. Material and methods — We studied 120 subjects with knee OA (sensu Altman R.D., 1991) of Kellgren-Lawrence Grades 3-4. They were distributed among 4 groups (30 participants in each) based on the presence of age-related, post-traumatic, metabolic, or combined phenotypes. Clinical examination of patients with pain and their functional status evaluation (via Visual Analogue Scale, WOMAC, Lequesne index), quality of life assessment (MOS SF-36 questionnaire), along with histopathological study of medial tibial plateau cartilage and synovial membrane, were caried out, followed by statistical data processing. Results — Age-related OA phenotype was characterized by the latest clinical onset [59.5 (54-68) years of age] with the largest average patient age [72.5 (63-77) years], moderate to severe pain and knee dysfunction [total WOMAC score of 160 (127-190) points and Lequesne index of 20 (8-21) points], severe degenerative cartilage lesions [8.5 (6-10) points sensu Mankin] with high-grade synovitis [5 (3-8) points sensu Krenn]. Post-traumatic OA phenotype was distinguished by the lowest pain, stiffness and knee functional limitations [total WOMAC score of 129 (100-166), Lequesne index of 15 (14-19)], the highest quality of life in patients [physical component summary of 34.1 (30.5-36.1) points, mental component summary of 40.4 (32.9-43.8) points] against the background of local severe cartilage lesions [8 (6-8) sensu Mankin] with reparative pattern and synovial fibrosis. For metabolic OA phenotype, the typical traits included female-biased sex ratio (87%), high prevalence of clinical synovitis (77%), severe pain and functional knee disorders [total WOMAC score of 188 (162-207) points, Lequesne index of 20 (19-23) points], the worst quality of life [physical component summary of 28.0 (24.3-31.9) points, mental component summary of 30.9 (26.9-35.9) points], vascular invasion of cartilage, and high-grade synovitis [4 (3-5) points sensu Krenn]. Combined OA phenotype was characterized by variable clinical and histopathological features. Conclusion — Comprehensive comparative clinical and morphological analysis of late-stage knee OA of various origin was completed, and age-related, post-traumatic, metabolic and combined OA phenotypes were studied. The methodological basis for differential approach to treating different categories of OA patients was developed.

2018 ◽  
Vol 75 (1) ◽  
pp. 62-67
Author(s):  
Slavica Jandric

Background/Aim. Osteoarthritis (OA) is the clinical manifestation of degenerative joint changes. The aim of this study was to investigate differences in quality of life (QoL) between patients with severe hip and knee OA. Methods. This is the cross-sectional study of 195 patients (average age 63.2 ? 11.1 yrs), with a diagnosis of OA of the hip and knee that were assigned to receive a total hip or knee replacement. The patients were divided into three groups in relation to localization of OA. The first group included patients with hip OA; the second group consisted of patients with knee OA and the third group with both hip and knee OA. Demographic and clinical data were collected for each patient. We measured health related quality of life (QoL) by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires. Statistical significance of differences was at the level of p < 0.05. Results. The best QoL was in the group of knee OA (42.7 ? 11.3) and the worst in the group with both hip and knee OA patients (35.8 ? 12.7). QoL assessed by WOMAC score and the domain of physical function were significantly different among three groups of patients with OA (F = 5.377, p < 0.01 and F = 5.273, p < 0.01) respectively). Results of three multiple linear regression models where WOMAC score was dependent variable and age, body mass index (BMI), social class, pain, stiffness, physical function, hypertension, cardiomyopathy, diabetes mellitus were independent variables, have shown that QoL was statistically significantly associated with pain and physical function in the hip and knee OA groups, whereas in the group with both hip and knee OA patients, QoL was associated with BMI, pain, physical function and diabetes mellitus. Conclusion. QoL of patients with severe hip and knee osteoarthritis in relation to localization was significantly different. QoL in severe hip and knee OA patients was significantly associated with pain and physical function, but in patients with both hip and knee OA QoL was also associated with BMI and diabetes mellitus.


Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.


2015 ◽  
Vol 33 (2) ◽  
pp. 1-14 ◽  
Author(s):  
Myoung-ran Yoo ◽  
Seon Young Choi ◽  
Hye Lee Han ◽  
Yu-mi Seo ◽  
Myoung In Noh

2020 ◽  
Author(s):  
Shaojie Li ◽  
Yongtian Yin ◽  
Lijun Chen ◽  
Guanghui Cui ◽  
Jiaqin Li ◽  
...  

BACKGROUND Older adults’ health literacy levels are crucial to improving health outcomes and health-related quality of life (HRQoL). However, the impact of eHealth literacy on HRQoL in older adults is unclear. OBJECTIVE The aim of this study was to examine the association between eHealth literacy and HRQoL of older adults and provide reference for the development of network intervention measures related to the health quality of life of the older adults. METHODS An anonymous cross-sectional survey was conducted among 1,201 adults aged 60 or older from Jinan, China. The eHealth Literacy Scale and Short-Form Health Survey (SF-12) were used to measure eHealth literacy and HRQoL. We used linear regression to test the adjusted association between eHealth literacy and HRQoL. RESULTS Most participants (88.9%) had inadequate eHealth literacy. Lower eHealth literacy was related to older age ( F=12.618, P<.001), female gender( t=3.303, P<.01), living in rural areas( F=11.356, P<.001), having less education( F=59.084, P<.001), being unmarried, divorced or widowed( t=4.416, P<.001), having a lower family income( F=38.017, P<.001), living with others(χ2=4.319, P<.05), and not having health insurance( F=12.713, P<.001). There were significant differences across physical functioning( t=-4.862, P<.001), role- physical( t=-2.485, P<.05), bodily pain( t=-3.470, P<.01), general health( t=-4.449, P<.001), vitality( t=-3.498, P<.001), role-emotional( t=-2.654, P<.01), mental health( t=-4.150, P<.001), physical component summary( t=-6.350, P<.001) and mental component summary( t=-4.483, P<.001) between adequate eHealth literacy and inadequate eHealth literacy. After controlling for age, gender, and other covariates, adequate eHealth literacy was positively related to physical component summary ( beta=7.6, P<.001) and mental component summary(beta=4.6, P=.001). CONCLUSIONS This study showed that Chinese older adults with higher eHealth literacy were more likely to contribute to higher HRQoL. Thus, Older adults’ eHealth literacy levels need to be taken into account when formulating health education and promotion programs for older adults, especially when the expected outcome is to improve HRQoL.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 96-96
Author(s):  
Victoria Raveis ◽  
Simona Kwon

Abstract Women have a 1-in-8 lifetime risk of breast cancer. Earlier diagnosis and treatment advances have improved 15- and 20-year survival rates. Increased survival can mean coping with the effects of cancer and its treatment over an extended period of time, while experiencing age-related changes in functioning and the emergence of other health issues. To explore breast cancer survivors’ perspectives on their issues and concerns across the life-course, focus groups were conducted with a culturally diverse sample (N=18) of survivors (72% white, 28% Black, 11% Hispanic). Participants were 44-82 years old. Most, 83% were 50 and older, 56% were 60 and older. The majority (83%) were diagnosed in their 40’s and 50’s. Two were diagnosed in their early 30’s and one at age 68. Participants reaffirmed the necessity, as a breast cancer survivor, of being a life-long health advocate on their own behalf, and the importance of being self-informed. As one woman commented: “Knowledge is power”. Survivors shared that their emergent health issues were complicated by their cancer history, and, that, as a cancer survivor, “I never stop worrying”. A widespread concern was not knowing if the health issues and co-morbidities they experienced (such as joint pain, neuropathy, tendinitis, heart disease), were age-related, a consequence of their cancer, or a late treatment effect. An overriding sentiment expressed was that clinicians have not recognized the importance of quality of life in cancer survival. As a survivor succinctly stated: “We are living longer, but we need to live long with quality of life.”


Sensors ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 517
Author(s):  
Ilia Adami ◽  
Michalis Foukarakis ◽  
Stavroula Ntoa ◽  
Nikolaos Partarakis ◽  
Nikolaos Stefanakis ◽  
...  

Improving the well-being and quality of life of the elderly population is closely related to assisting them to effectively manage age-related conditions such as chronic illnesses and anxiety, and to maintain their independence and self-sufficiency as much as possible. This paper presents the design, architecture and implementation structure of an adaptive system for monitoring the health and well-being of the elderly. The system was designed following best practices of the Human-Centred Design approach involving representative end-users from the early stages.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Funuyet-Salas ◽  
A Martín-Rodríguez ◽  
M A Pérez-San-Gregorio ◽  
M Romero-Gómez

Abstract Background To date, coping strategies have not been studied in patients with nonalcoholic fatty liver disease (NAFLD), despite evidence of their relevance in chronic liver pathology, Type 2 diabetes mellitus (T2DM) and obesity (OB). We therefore analyzed which coping strategies predicted quality of life in diabetic and obese NAFLD patients. Methods Four hundred and ninety-two biopsy-proven NAFLD patients (290 men and 202 women, mean age 54.90±11.74) were evaluated using The Brief COPE, 12-Item Short-Form Health Survey (SF-12) and Chronic Liver Disease Questionnaire-Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD). A stepwise multiple linear regression analysis was performed on four groups (G1, n = 335, absence of T2DM; G2, n = 157, presence of T2DM; G3, n = 249, absence of OB; and G4, n = 243, presence of OB) to analyze which coping strategies predicted patient quality of life (physical component summary SF-12, mental component summary SF-12, and total CLDQ-NAFLD). Results In both diabetic and obese patients, active coping (T2DM, p = 0.003, β = 0.26; OB, p = 0.000, β = 0.33) and denial (T2DM, p = 0.027, β=-0.19; OB, p = 0.004, β=-0.18) predicted the physical component summary. Denial (T2DM, p = 0.000, β=-0.30; OB, p = 0.001, β=-0.19), positive reframing (T2DM, p = 0.000, β = 0.28; OB, p = 0.000, β = 0.29), self-blame (T2DM, p = 0.000, β=-0.24; OB, p = 0.000, β=-0.26) and self-distraction (T2DM, p = 0.033, β=-0.13; OB, p = 0.023, β=-0.11) predicted the mental component summary. Denial (T2DM, p = 0.000, β=-0.34; OB, p = 0.000, β=-0.31), positive reframing (T2DM, p = 0.000, β = 0.30; OB, p = 0.005, β = 0.15) and self-blame (T2DM, p = 0.000, β=-0.26; OB, p = 0.000, β=-0.28) also predicted the total CLDQ-NAFLD in both groups. Conclusions Active coping and positive reframing predicted better quality of life, while denial, self-blame and self-distraction predicted worse quality of life in diabetic and obese NAFLD patients, suggesting the inclusion of coping strategies in future multidisciplinary NAFLD treatments. Key messages Importance of coping strategies for NAFLD patients: active coping and positive reframing predicted better quality of life, while denial, self-blame and self-distraction predicted worse quality. This study shows the need to design multidisciplinary strategies for managing NAFLD and improving patient quality of life, in which intervention in coping strategies should be a major element.


Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко

Целью исследования было изучение качества жизни лиц с нарушениями слуха в разных возрастных группах. Обследованы 100 пациентов, обратившихся в городской сурдологический центр для взрослых в связи с нарушением слуха: 50 человек - 34-59 лет, 50 - 60 лет и старше, из которых 32 человека были пожилого возраста (60-74 года)и 18 - старческого (75-86 лет). Степень тугоухости оценивали на основании результатов тональной пороговой аудиометрии. Для исследования качества жизни все пациенты заполняли общий опросник MOS SF-36, отражающий физический и психологический компоненты здоровья, а также специальный опросник HHIА(E)-S для лиц с нарушениями слуха. Установлено, что шкала HHIА(E)-S демонстрирует высокую корреляцию со степенью тугоухости у пациентов моложе 60 лет ( R =0,98; достоверность различий на уровне p <0,05), которая снижается у пациентов 60 лет и старше ( R =0,94; различия в оценках при разной степени тугоухости недостоверны). Значительные трудности в старшей возрастной группе могут быть связаны с тем, что людям пожилого и, особенно, старческого возраста сложно пользоваться слуховыми аппаратами (или они для них неэффективны) и оценивать свои затруднения по шкалам опросника. Целесообразно использовать шкалу HHIА(Е)-S в качестве скринингового инструмента для раннего выявления тугоухости, направления пациентов к сурдологу и своевременного слухопротезирования. The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old ( R =0,98 with statistically significant difference, p <0,05), with decreasing correlation in patients from 60 years and older ( R =0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.


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