scholarly journals Quality of life, clinical outcomes and safety of early prophylactic levothyroxine administration in patients with Graves' hyperthyroidism undergoing radioiodine therapy: a randomized controlled study

2016 ◽  
Vol 174 (4) ◽  
pp. 491-502 ◽  
Author(s):  
David Taïeb ◽  
Claire Bournaud ◽  
Marie-Claude Eberle ◽  
Bogdan Catargi ◽  
Claire Schvartz ◽  
...  

ObjectiveWhile radioiodine therapy is commonly used for treating Graves' disease, a prolonged and clinical hypothyroidism may result in disabling symptoms leading to deterioration of quality of life (QoL) of patients. Introducing levothyroxine (LT4) treatment in the early post-therapeutic period may be an interesting approach to limit this phenomenon.MethodsA multicenter, prospective, open-label randomized controlled trial enrolled 94 patients with Graves' hyperthyroidism randomly assigned to the experimental group (n=46) (group A: early prophylactic LT4treatment) or the control group (n=48) (group B: standard follow-up). The primary endpoint was the 6-month QoL. The secondary endpoints were other QoL scores such as Graves' ophthalmopathy (GO) outcomes, thyroid function tests and safety.ResultsThe primary endpoint at 6 months was achieved: the mental composite score (MCS) of Short Form 36 (SF-36) was significantly higher in group A compared to group B (P=0.009). Four other dimension scores of the SF-36 and four dimension scores of the thyroid-specific patient-reported outcome (ThyPRO) significantly differed between the two groups, indicating better QoL in group A. After adjustment for variables, the early LT4administration strategy was found as an independent factor for only two scores of SF-36: the MCS and the general health (GH) score. There were no differences in GO, final thyroid status and changes in the anti-TSH receptor antibodies (TRAbs) levels between the two groups. No adverse cardiovascular event was reported.ConclusionEarly LT4administration post-radioactive iodine (RAI) could represent a safe potential benefit for patients with regard to QoL. The optimal strategy taking into account administered RAI activities and LT4treatment dosage and timing remains to be determined.

2021 ◽  
Vol 15 (7) ◽  
pp. 1801-1803
Author(s):  
Nazia Sajjad ◽  
Sara Qadir ◽  
Rukhsana Kasi ◽  
Tayyaba Rasheed ◽  
Fozia Unar ◽  
...  

Objectives: To compare the frequency of satisfactory quality of life between vaginal hysterectomy and abdominal hysterectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Obstetrics and Gynecology, Niazi Medical & Dental College, Sargodha from 1st April 2020 to 31st December 2020. Methodology: Ninety patients were comprised and they were divided in two groups; group A (vaginal hysterectomy) and Group B (abdominal hysterectomy) were performed. Hysterectomies (vaginal or abdominal) were performed by consultant gynecologist having experience at having least 5 years). Results: Mean age of the patients was 49.82±3.207 years, mean age of the patients of group A was 49.82±3.193 years and mean age of the patients of group B was 49.82±3.256 years. Satisfactory quality of life was noted in 38 (84.44%) patients of study group A and 29 (64.44%) patients of study group B. Statistically significant (P = 0.051) difference between the frequency of satisfactory quality of life between the both groups was noted. Conclusion: Results of this study reveals that post hysterectomy quality of life found more satisfactory in vaginal hysterectomy group as compared to abdominal hysterectomy group. Insignificant association of post hysterectomy quality of life with age group, marital status, parity and socio-economical status was found. Findings of this study also revealed that post hysterectomy satisfactory quality of life is not associated with education of the patients. Key words: Hysterectomy, Quality of life, abdomen, vagina, WHO, Uterus


2020 ◽  
Vol 14 ◽  
Author(s):  
Zhenkai Han ◽  
Tao Hong ◽  
Yuanyuan Ding ◽  
Shimeng Wang ◽  
Peng Yao

BackgroundPostherpetic neuralgia (PHN) is a form of long-lasting neuropathic pain that can severely affect patients’ quality of life. Pulsed radiofrequency (PRF) has been proven to be effective in treating PHN, but the optimal radiofrequency parameters are still not well defined. This retrospective study aimed to compare the efficacy and safety of CT-guided PRF at three different voltages for the treatment of PHN patients.MethodsThis study included 109 patients with PHN involving the thoracic dermatome who were treated in the Department of Pain Management of Shengjing Hospital, China Medical University, from January 2017 to May 2019. They were divided into three groups based on the PRF voltage used: group A (45 V), group B (55 V), and group C (65 V). The PRF therapy (voltage 45, 55, and 65 V) was performed in all patients by targeting the thoracic dorsal root ganglion. After surgery, patients were followed at 3 days, 1 month, 3 months, 6 months, and 12 months. Observation at each follow-up included basic patient characteristics, visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36) scores, patient satisfaction, complications, and side effects.ResultsVisual analog scale scores decreased and SF-36 scores increased for all patients in the three groups at each post-operative time point (1, 3, 6, and 12 months; all P < 0.01). Pain relief, improvement in quality of life, and overall satisfaction were more significant for patients in group C than for those in groups A and B at the 3-, 6-, and 12-month follow-ups (all P < 0.05). Patients in group B had lower VAS scores and higher overall satisfaction levels than those in group A (both P < 0.01). A small number of patients from each group (n ≤ 3) experienced mild intraoperative and post-operative complications, which bore no relationship with group assignment (all P > 0.05). At post-operative day 3, patients in group C had skin numbness affecting a larger area than patients in the other two groups (both P < 0.05), but the differences were no longer statistically significant at day 30 after the operation. All patients experienced a drop in numbness area of more than 30% after surgery.ConclusionCompared with PFR at 45 and 55 V, PFR at 65 V had superior efficacy in treating PNH, with a favorable safety profile.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Salvatore Sansalone ◽  
Rosario Leonardi ◽  
Gabriele Antonini ◽  
Antonio Vitarelli ◽  
Giuseppe Vespasiani ◽  
...  

We aimed to evaluate the efficacy of oral therapy with algaEcklonia bicyclis,Tribulus terrestris, and glucosamine oligosaccharide (Tradamix TX1000) in patients with erectile dysfunction (ED) at 3 months of follow-up. From January 2013 to September 2013, 177 patients diagnosed with mild-moderate ED (IIEF-EF < 26) were enrolled in this multicenter, single-blinded, placebo-controlled study and randomized in Group A (Tradamix,n=87) and Group B (placebo,n=90). Penile color Doppler ultrasound measures, IIEF-15 questionnaire, male sexual health questionnaire-ejaculation disorder (MSHQ-EjD), and sexual quality of life (SQoL-M) were collected. We observed significant changes of the IIEF-15 in Group A (mean difference: 11.54;P<0.05) at 3 months versus Group B (P<0.05). PSV (P<0.05), IIEF-intercourse satisfaction (P<0.05), IIEF-orgasmic function (meanP<0.05), IIEF-sexual desire (P<0.05), IIEF-overall satisfaction (P<0.05), MSHQ-EjD (mean difference: 1.21;P<0.05), and SQoL-M (mean difference: 10.2;P<0.05) were significantly changed in Group A versus baseline and Group B. Patients with moderate arterial dysfunction showed significant increase of PSV (P<0.05), IIEF-EF (P<0.05), MSHQ-EjD (P<0.05), and SQoL-M (P<0.05) in Group A. Therapy with Tradamix improves erectile and ejaculation function and sexual quality of life in patients with mild-moderate ED and in particular for those with moderate arterial dysfunction.


2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 95-98 ◽  
Author(s):  
Ai-wu Lin ◽  
Jia-qi Qian ◽  
Qi-ang Yao ◽  
Ai-ping Gu

Objective In the present study, we determined the characteristic of quality of life (QOL) in elderly peritoneal dialysis (PD) patients by using the Medical Outcomes Study Short Form 36 (SF-36) to compare QOL between two age groups of continuous ambulatory PD patients. Patients and Methods Patients were allocated to one of two groups according to age: patients in group A were ≥65 years of age, and patients in group B were <65 years of age. We compared SF-36 scores, serum albumin, prealbumin, hemoglobin, lipid profile, normalized protein catabolic rate (nPCR), dialysis adequacy (Kt/V), creatinine clearance (CCr), and glomerular filtration rate (GFR) between the two groups. Results Group A contained 25 patients, and group B, 53 patients. Mean age in the two groups was 68.6 ± 3.3 years and 47.7 ± 10.2 years respectively. Elderly patients showed lower QOL scores with regard to physical problems. Quality-of-life scores with regard to psychological problems were similar in the two groups. Duration of PD, body mass index, serum albumin, prealbumin, hemoglobin, and lipid profile were not different between the two groups. However, nPCR, GFR, and total solute clearance were lower in group A than in group B (nPCR: 0.70 ± 0.13 g/kg daily vs 0.95 ± 0.21 g/kg daily, p < 0.001; GFR: 1.03 ± 1.21 mL/min vs 3.19 ± 2.22 mL/min, p < 0.001). Conclusions In elderly patients, QOL scores were lower, mainly because of a perception of being more physically impaired. Nutritional indices and QOL scores reflecting psychological processes were similar between the two groups. These descriptive data show that PD is an ideal choice in elderly patients with end-stage renal disease. More attention needs to be paid to “healthy start” dialysis and maintenance of nutritional status in elderly patients because of lower GFR and nPCR.


2018 ◽  
Vol 33 (4) ◽  
pp. 661-669 ◽  
Author(s):  
María Reina-Bueno ◽  
María del Carmen Vázquez-Bautista ◽  
Sergio Pérez-García ◽  
Carolina Rosende-Bautista ◽  
Antonia Sáez-Díaz ◽  
...  

Objective: To determine the effect of custom-made foot orthoses versus placebo insoles on pain, disability, foot functionality, and quality of life. Design: Double-blinded randomized controlled trial. Setting: University Podiatric Clinical Area. Subjects: Patients with rheumatoid arthritis. Interventions: Patients were randomly assigned to either group A, which received custom-made foot orthoses, or group B, which received placebo, flat cushioning insoles, for three months. Main measures: The primary outcome was foot pain, measured by visual analog scale. Foot functionality, foot-related disability, and quality of life were measured using the Foot Function Index, the Manchester Foot Pain and Disability Index, and 12-Item Short Form Health Survey (SF-12) questionnaires, respectively, at the beginning and at days 30, 60, and 90. Results: A total of 53 patients, aged 59.21 ± 11.38 years, received either the custom-made foot orthoses ( N = 28) or the placebo ( N = 25). For the analysis of the data, only participants who had been measured at the four time points (0, 30, 60, and 90 days) were included. In group A, all variables showed statistically significant differences when comparing the initial and final measurements. Pain showed 6.61 ± 2.33 and 4.11 ± 2.66 in group A, at baseline and at 90 days, respectively, and Group B showed 6.16 ± 1.77 and 5.60 ± 2.71 at baseline and at 90 days, respectively. This was the only variable that showed statistically significant difference between groups ( P = 0.048). Conclusion: The custom-made foot orthoses significantly reduced the participants’ foot pain, although they did not have positive effects on disability, foot functionality, and quality of life compared with only cushioning.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jing Luo ◽  
Xiaohua Dong ◽  
Jing Hu

Abstract Background Nursing intervention following discharge is a long-term rehabilitation process that is essential for improving hip joint function and quality of life in affected patients. This study aimed to assess the effect of nursing intervention via WeChat on the rehabilitation of patients after total hip arthroplasty (THA). Methods We conducted a retrospective analysis of 232 patients who underwent THA at our hospital from January 2013 to October 2015. Of the 232 patients, 114 received nursing intervention via telephone (Group A), and 118 received nursing intervention via WeChat (Group B). Furthermore, the Harris hip score and Short-Form 36 (SF-36) health survey score were used to evaluate hip joint function and quality of life in patients in the two groups at discharge and 1, 3 and 6 months following discharge. Moreover, the functional independence measure was applied to assess the recovery of joint function in the patients. Results No significant difference was observed in the Harris hip score and the SF-36 health survey score between the two groups at discharge and 1 month following discharge (p > 0.05). However, the Harris hip score and SF-36 health survey score were lower in group A than in group B at 3 and 6 months following discharge (p < 0.05). Furthermore, no obvious difference was observed in terms of functional independence between the two groups at discharge (p > 0.05). However, more individuals were completely independent in group B than in group A at 1, 3 and 6 months following discharge (p < 0.05). Conclusions Nursing intervention via WeChat can improve the effect of rehabilitation after THA and promote the recovery of joint function in patients.


2021 ◽  
Vol 18 (1) ◽  
pp. 28-32
Author(s):  
Shashank Sangoli

Aim: Sciatica is one of the most severe form of low back pain, with a lifetime prevalence of approximately 30 percent. To assess the short-term and long-term efficacy of surgical and conservative care in the incidence of sciatic symptoms and quality of life in standard clinical settings in patients with lumbar disc herniation. Material and method: It is a retrospective study conducted at Medical Trust Hospital, Kochi who underwent micro lumbar discectomy for single level lumbar disc herniation, and of those with the same diagnosis but who refused surgery or were still waiting for the surgery to be scheduled. The patients were divided into two groups as Group A- treated surgically and Group B – awaiting for surgery and managed non-surgically. Cases between 20-60 years of age, male or female, with low back pain and lower limb radiculopathy, positive signs of root tension (SLRT between 30-70 degrees or severe femoral root stress), associated neurological dysfunction (with respect to corresponding abnormal reflexes, reduced sensation in dermatomal distribution or weakness in myotomal distribution) and multiple disc herniation cases if only one of the level was symptomatic, were included. The study excluded patients with scoliosis of more than 15 degrees, segmental instability, spondylolisthesis, spine or tumor infection, psychiatric disease, refusal of patients and age < 20 and > 60 years.  All patients recruited had to fill the consent and a clinical evaluation by means of established questionnaires which included the Short Form 36 (SF36), 16 the Oswestry Disability Index (ODI), 17 and the visual analog scale for pain (VAS). Then were grouped into: Group A, for those who had already undergone surgical treatment and Group B, those awaiting surgery. Results:Total 60 patients fulfilling the inclusion criteria were included in present study. Mean age of the patients in Group A was 36.7 ± 5.8 and in Group B was 37.01 ± 5.56 years. Male preponderance was observed in our study with male to female ratio of 1.7:1. At the time of admission, patients in both the groups suffered similar scale of pain and agony. The VAS and ODI did not show significant difference in the pain and disability in both group of patients. During follow-up of 6month and 2 years, surgically treated patients showed a significant improvement in the scores of VAS and ODI. Also the SF-36 also showed a similar results and was better in patients treated by surgery contrary with conservative treatment. Conclusion:the study concluded with positive benefits from surgery with a reduction in pain reported in the lower limbs (VAS leg with p<0.05) and improved function (Oswestry with p<0.05); however, it did not show any much significant change in quality of life according to the SF-36 scale.  


2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Philippe-Richard Domeyer ◽  
Smaragda Ch. Giannakidou ◽  
Panagiota Kyriakou ◽  
Vasiliki Katsari ◽  
Antonios P. Antoniadis ◽  
...  

Objective. This study aims to (i) translate, culturally adapt, and preliminarily validate the arrhythmia-specific Umea22 (U22) questionnaire and (ii) assess the impact of radiofrequency (RF) ablation and medical treatment on the quality of life of patients with supraventricular tachycardias (SVTs). Methods. A total of 140 patients with atrioventricular nodal re-entry tachycardia (AVNRT) and atrioventricular re-entry tachycardia (AVRT) were enrolled in the study. Of these, 100 patients underwent RF ablation (group A) and 40 patients were managed with antiarrhythmic medications (group B). Health-related quality of life (HRQoL) was assessed for both groups using the Short Form-36 Health Survey (SF-36) and the arrhythmia-specific Umea22 (U22) questionnaire at baseline and 3-month follow-up. Exploratory and confirmatory factor analyses were performed to assess the validity of the U22 questionnaire. Univariate comparisons of HRQoL scores between study timepoints and multivariate regression analyses adjusting for baseline confounders were conducted. Results. The factor analysis of the U22 questionnaire yielded a six-factor model (“burden of spells”; “heart contractility”; “character of spells”; “general/non-specific feeling”; “other specific somatic symptoms”; “fear”) with acceptable fit results. Patients of group A showed significant improvement in all SF-36 and U22 scores at 3 months’ follow-up compared to baseline (all p<0.05). Patients of group B presented deterioration of the total SF-36 score (p=0.001) and improvement of certain U22 measures, namely, well-being (p=0.004), heartbeat speed, and intensity during arrhythmia spells (p<0.0001 for both measures) at 3 months’ follow-up, compared to baseline. Employment status, male sex, and urban residence emerged as important predictors. Conclusion. The Greek version of the U22 questionnaire is a valid tool to assess SVT-related symptoms. RF ablation appears to exert more pronounced beneficial outcomes on HRQoL of patients with SVTs compared to medical treatment. Prompt referral of patients with SVTs to specialist centers may favorably affect their quality of life and should be encouraged.


The Physician ◽  
2012 ◽  
Vol 1 (1) ◽  
pp. 22-26
Author(s):  
Rajdeep S Bhilku ◽  
Anne S Ewing ◽  
Vipin Zamvar

BACKGROUND AND AIMS The radial artery has become an increasingly popular arterial conduit in coronary artery bypass graft surgery (CABG), however little data exists with regard to the comparison of quality of life in patients undergoing CABG with radial artery grafts and those with conventional saphenous vein grafts. The aims of this study were therefore to identify any difference in long term quality of life in surviving patients between those undergoing CABG with radial artery grafts and those with saphenous vein grafts. METHODS Standardised questionnaires (SF-36 and Euroqol EQ5D) were sent to assess the quality of life in 130 patients who had undergone CABG with venous grafts (Group A) and 130 patients who had undergone CABG with radial artery grafts (Group B). Information was also gathered to determine any angina recurrence following CABG in the patients included in the study. In addition, information on any major adverse cardiac events (MACE) occurring post-CABG was collected. RESULTS 70 responses were received from Group A and 82 from Group B. The mean follow up time was 6 years in both groups. On analysis, there was no statistically significant difference between both groups with regard to the quality of life (based on SF-36 and EQ5D scores), angina recurrence or MACE. CONCLUSION Our study identified no additional benefit in using radial artery grafts over saphenous vein grafts with regard to the quality of life, MACE or angina recurrence in the medium term.  


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