scholarly journals Surviving ectopic Cushing’s syndrome: quality of life, cardiovascular and metabolic outcomes in comparison to Cushing’s disease during long-term follow-up

2018 ◽  
Vol 179 (2) ◽  
pp. 109-116 ◽  
Author(s):  
Andrea Osswald ◽  
Timo Deutschbein ◽  
Christina M Berr ◽  
Eva Plomer ◽  
Anne Mickisch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Psychiatric Morbidity ◽  
Serum Cortisol ◽  
Cushing's Syndrome ◽  
Ectopic Cushing’S Syndrome ◽  
Cortisol Levels

Objective Aim of our study was to analyze long-term outcome of patients with the ectopic Cushing’s syndrome (ECS) compared to patients with Cushing’s disease (CD) regarding cardiovascular, metabolic, musculoskeletal and psychiatric comorbidities. Design Cross-sectional study in patients with ECS and CD in two German academic tertiary care centers. Methods Standardized clinical follow-up examination was performed including health-related quality of life (QoL) in 21 ECS patients in long-term remission (≥18 months since successful surgery). Fifty-nine patients with CD in remission served as controls. Results Time from first symptoms to diagnosis of Cushing’s syndrome (CS) was shorter in ECS than in CD (8.5 (IQR: 30.3) vs 25 (IQR: 39.0) months, P = 0.050). ECS patients had lower self-reported psychiatric morbidity compared to CD (19% vs 43%, P = 0.050) at follow-up. Moreover, female ECS patients reported favorable scores for QoL in the SF-36 questionnaire (mental health: 92 (IQR: 30) vs 64 (IQR: 32) in CD, P = 0.010) and a Cushing-specific QoL questionnaire (73 (IQR: 18) vs 59 (IQR: 36) in CD, P = 0.030). In a pooled analysis of ECS and CD patients, QoL correlated with time from first symptoms until diagnosis of CS, but not with urinary free cortisol levels or serum cortisol after dexamethasone at the time of diagnosis. Long-term outcomes regarding hypertension, metabolic parameters, bone mineral density and grip strength were comparable in ECS and CD. Conclusions Our data support the concept that time of exposure to glucocorticoid excess appears to be a better predictor than peak serum cortisol levels at the time of diagnosis regarding long-term psychiatric morbidity and QoL.

scholarly journals Long-Term Impaired Quality of Life in Cushing’s Syndrome despite Initial Improvement after Surgical Remission

2006 ◽  
Vol 91 (2) ◽  
pp. 447-453 ◽  
Author(s):  
John R. Lindsay ◽  
Tonya Nansel ◽  
Smita Baid ◽  
Julie Gumowski ◽  
Lynnette K. Nieman
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Initial Improvement ◽  
Impaired Quality

scholarly journals Negative illness perceptions are associated with impaired quality of life in patients after long-term remission of Cushing's syndrome

2011 ◽  
Vol 165 (4) ◽  
pp. 527-535 ◽  
Author(s):  
Jitske Tiemensma ◽  
Adrian A Kaptein ◽  
Alberto M Pereira ◽  
Johannes W A Smit ◽  
Johannes A Romijn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vestibular Schwannoma ◽  
Cushing’S Syndrome ◽  
Intervention Program ◽  
Illness Perceptions ◽  
Illness Perception ◽  
Cushing's Syndrome ◽  
Chronic Obstructive

ObjectiveIllness perceptions pertain to the pattern of beliefs patients develop about their illness. Illness perceptions are determinants of quality of life (QoL). Factors contributing to persisting impaired QoL after Cushing's syndrome (CS) remain largely unknown. Therefore, the objective of this study was to explore illness perceptions, as potentially modifiable psychological factors, in relation to QoL in patients with long-term remission of CS.DesignCross-sectional study.MethodsWe included patients with long-term remission of CS (n=52). Illness perceptions were evaluated using the Illness Perception Questionnaire (IPQ)-Revised, and QoL was measured using the physical symptom checklist, EuroQoL-5D (EQ-5D), and the CushingQoL. Reference data were derived from recent studies and included patients with vestibular schwannoma (n=80), acute (n=35) or chronic (n=63) pain, and chronic obstructive pulmonary disease (COPD; n=171).ResultsIllness perceptions showed a strong correlation with QoL. Patients with CS scored distinctively more negative on the IPQ compared with patients with vestibular schwannoma and patients with acute pain, and also reported more illness-related complaints (all P<0.01). There were also some differences in illness perceptions between patients with CS and patients with chronic pain and patients with COPD, but there was no distinct pattern.ConclusionsPatients after long-term remission of CS report more negative illness perceptions compared with patients with other acute or chronic conditions. Further research is needed to assess whether QoL in CS can be improved by addressing these illness perceptions, for example, by a self-management intervention program.

Quality of life in patients with Cushing’s syndrome in remission: 10-year follow-up

2020 ◽  
Author(s):  
Alicia Santos ◽  
Eugenia Resmini ◽  
Momblan Mª Antonia Martinez ◽  
Marc Medina ◽  
Susan Webb
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome

Muscle dysfunction is associated with poor quality of life in patients with Cushing's syndrome long-term after remission

2019 ◽  
Author(s):  
Luciana Martel ◽  
Helena Bascunana ◽  
Jordi Cuartero ◽  
Betina Biagetti ◽  
Susan M. Webb ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Poor Quality ◽  
Cushing's Syndrome ◽  
Muscle Dysfunction

scholarly journals Impaired quality of life in patients in long-term remission of Cushing's syndrome of both adrenal and pituitary origin: a remaining effect of long-standing hypercortisolism?

2012 ◽  
Vol 167 (5) ◽  
pp. 687-695 ◽  
Author(s):  
M A E M Wagenmakers ◽  
R T Netea-Maier ◽  
J B Prins ◽  
T Dekkers ◽  
M den Heijer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Group ◽  
Cushing’S Syndrome ◽  
Negative Influence ◽  
Cushing's Syndrome ◽  
Control Group ◽  
Cross Sectional ◽  
Impaired Quality

Objective The determinants that cause impaired quality of life (QOL) in patients in long-term remission of Cushing's syndrome (CS) are unknown. The aim of this study was to get more insight into the patient and disease characteristics related to impaired QOL in these patients. Design Cross-sectional study. Methods The QOL of 123 patients in remission of CS (age 52.2±12.0 years, 106 women, duration of remission 13.3±10.4 years, 80% pituitary CS), assessed with seven validated questionnaires, was compared with the QOL of an age- and sex-matched control group (n=105). To investigate the influence of the aetiology of CS on QOL, patients in remission of pituitary and adrenal CS were compared. Furthermore, the influence of hormonal deficiencies, treatment strategy, duration of remission, gender and age on QOL was investigated. Results QOL in the total patient group and each patient subgroup was significantly worse on practically all dimensions of questionnaires compared with the control group (P<0.05), except for patients in remission of pituitary CS without hormonal deficiencies who had an impaired QOL on 50% of the QOL dimensions. Subgroup analysis revealed no difference in QOL between different patient groups, especially no difference between patients in remission of adrenal and pituitary CS. Female gender and a shorter duration of remission had a negative influence on QOL in the patient group. Conclusions QOL remains impaired in patients in long-term remission of CS regardless of aetiology, presence of hormonal deficiencies and treatment strategies. More research is needed to establish the causes.

Long term follow-up in quality of life after mitral valve surgery

2012 ◽  
Vol 60 (S 01) ◽  
Author(s):  
I Kammerer ◽  
M Höhn ◽  
AH Kiessling ◽  
S Becker ◽  
FU Sack
Keyword(s):  
Quality Of Life ◽  
Mitral Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Long Term Follow Up

Assessment of quality of life of patients with Cushing's syndrome depending on the disease course

2017 ◽  
Author(s):  
Gulchekhra Narimova ◽  
Zamira Yusupovna ◽  
Ravshan Fayzullaev ◽  
Iskandar Arifjanov
Keyword(s):  
Quality Of Life ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Disease Course

scholarly journals Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

2021 ◽  
Vol 11 (4) ◽  
pp. 416
Author(s):  
Carla Piano ◽  
Francesco Bove ◽  
Delia Mulas ◽  
Enrico Di Stasio ◽  
Alfonso Fasano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Cortex ◽  
Clinical Outcome ◽  
Motor Cortex Stimulation ◽  
Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

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