scholarly journals Symbicort in steroid-dependent asthma: reduction of oral steroids requirements

2005 ◽  
pp. 71-79
Author(s):  
S. N. Avdeev ◽  
Z. S. Etteeva ◽  
N. A. Voznesensky ◽  
N. N. Mesheriakova ◽  
A. G. Chuchalin
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Stability Criteria ◽  
Short Acting ◽  
Asthma Symptoms ◽  
Steroid Dependent ◽  
Severity Scores ◽  
Oral Steroids ◽  
Clinically Significant

Objective: to study the ability of inhaled Symbicort to reduce daily oral steroids (OS) requirements in patients with severe steroid-dependent asthma. Methods: 16 patients with severe steroid-dependent asthma were included into the study (5 males, 11 females, mean age 53 ± 8 years, mean dose of OS 10.9 ± 5.2 mg / day, mean OS treatment duration 9.3 ± 4.1 years, mean FEV1 59.3 ± 15.1%). All patients received Symbicort administered by means of a multidose poder inhaler 4.5 / 160 mkg 2 inhalations twice daily, every 2 weeks patients underwent controlled OS reduction on the basis of predetermined asthma stability criteria. Results: OS was eliminated or reduced in 14 patients (87.5 %), the OS dose was reduced to 3.3 ± 6.8 mg / day (р < 0.001). At the end of 12 weeks of Symbicort therapy FEV1 and FVC increased by 18.6 % and 8.9 %, respectively. Daytime and nighttime asthma symptom severity scores improved in average by 1 point (р < 0.001). The number of inhalations of short-acting β2-agonists reduced from 3.4 ± 1.7 to 1.5 ± 1.3 puffs / day (р < 0.001). Statistically and clinically significant improvements were seen in all 4 domains of quality of life scores (AQLQ) (р < 0.001). The level of NOex reduced significantly form 18.6 ± 11.4 ppb at baseline to 7.9 ± 2.8 ppb after 12 weeks (р = 0.001). The side effects of OS were reduced to the end of study. Conclusion: in patients with severe steroid-dependent asthma therapy with Symbicort allows to eliminate or reduce OS therapy with improved lung function, improved daytime and nighttime asthma symptoms, improved asthma-specific quality of life, reduction of short-acting β2-agonists use and reduction of side effects of OS.

Cancer-related fatigue in carcinoma urinary bladder patients receiving chemotherapy: A single institutional study from northern India.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 361-361
Author(s):  
Vineet Talwar ◽  
Varun Goel ◽  
Prasanta DASH
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Urinary Bladder ◽  
Clinical Intervention ◽  
Fear Of Pain ◽  
Cancer Related Fatigue ◽  
Northern India ◽  
Clinically Significant ◽  
Loss Of Appetite

361 Background: Fatigue is one of the most disabling phenomenon among patients receiving anti cancer treatment, which has profound effect on their Quality of life (QOL). Although clinicians across the globe acknowledge the importance of regular assessment of fatigue, however it is seldom being assessed and documented in clinical practice in India and very few studies have reported Cancer Related Fatigue among Indian population. Methods: For this study an exploratory design was adopted, using a purposive sampling method. Patients (N=206,) undergoing chemotherapy at Rajiv Gandhi Cancer Hospital and Research Center, Delhi, India; aged 18-83 years were included. The level of fatigue was assessed using 16- item Multidimensional assessment of Fatigue (MAF) scale and a semi structured in depth interview schedule. These interviews were recorded, transcribed and analyzed. Results: Irrespective of age, and education, 81% patients experience clinically significant fatigue. Extreme level of fatigue was reported by 29% patients requiring immediate clinical intervention while 52% patients reported moderate level of clinically significant fatigue. Top four psychosocial issues reported were: apprehension of CT side effects (23.5%), fear of pain (19%), Loss of appetite (17.5%) and anxiety during CT (13.5 %), followed by financial issues (11%). Among all patients, (49.5%) were aware of their diagnosis of which 8% were either fully aware or partially aware about the prognosis (23%). Conclusions: Fatigue remains one of the most important clinical parameters among majority of Carcinoma Urinary Bladder patients receiving chemotherapy, and is neither assessed by clinicians nor reported by majority of the patients. While almost one fourth of the patients report fear of chemotherapy as their pressing psychosocial concern, others report fear of pain, loss of appetite, manifest anxiety symptoms or report financial and logistics issue during CT. Various exercise, educational material and psychotherapeutic interventions should be developed to prepare and support them during their treatment for better preparedness of side effects and their management, reduced symptoms and better quality of life.

scholarly journals Achieving control of steroid-dependent asthma with fluticasone propionate or salmeterol / fluticasone propionate: result of the Russian multicentre study GROZA

2005 ◽  
pp. 87-92
Author(s):  
R. S. Fassakhov ◽  
I. D. Reshetnikova ◽  
N. I. Ilyina ◽  
F. I. Petrovsky ◽  
L. M. Ogorodova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fluticasone Propionate ◽  
Multicentre Study ◽  
Asthma Control ◽  
Oral Steroid ◽  
Efficacy And Safety ◽  
Steroid Dependent ◽  
Asthma Patients ◽  
Oral Steroids

The aim of the study was to assess efficacy and safety of 24-month treatment with Seretide (salmeterol / fluticasone propionate, 100 / 1 000 mcg daily) or Flixotide (fluticasone propionate, 1 000 mcg daily) in 105 steroid-dependent asthma patients aged 18 to 60 yrs who had received oral steroids for at least 6 months but not longer than 10 years. Methods. The study was comparative, randomized, multicentre, open in parallel groups (15 visits with 2-week intervals). Reduction of oral steroid doses started at the 3-rd visit. Results. In spite of the continual treatment with oral steroids patients did not reach asthma control. After 6-month therapy with fluticasone propionate or salmeterol / fluticasone propionate the maintaining dose of prednisolone was 6 times lower in comparison with baseline. Moreover, oral steroids were abolished in each second patient receiving Seretide and each third patient receiving Flixotide. The asthma control and quality of life significantly increased. Conclusion. The therapy with fluticasone propionate or salmeterol / fluticasone propionate allows to reduce doses of oral steroids and to cease oral steroids in most causes. Moreover, the patients can maintain good asthma control.

▾ Lamotrigine – an add-on antiepileptic

1992 ◽  
Vol 30 (19) ◽  
pp. 75-76
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Antiepileptic Drug ◽  
Partial Seizures ◽  
First Line ◽  
Low Level ◽  
Clonic Seizures ◽  
Clinically Significant ◽  
The Brain

Lamotrigine (Lamictal – Wellcome) is a new antiepileptic drug. It is licensed as ‘add-on’ treatment for patients with partial seizures, either localised to one part of the brain or spreading to tonic-clonic seizures (secondarily generalised), who are not satisfactorily controlled with first-line drugs. The manufacturer claims that it “offers the hope of an improved quality of life” while having “a low level of clinically significant side-effects”. We examine these claims.

Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between

2021 ◽  
pp. 263451612110217
Author(s):  
Joshua A. Sloan ◽  
Philip O. Katz
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Drug Class ◽  
Life Threatening

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.

scholarly journals Quality of life, symptoms and dietary habits in oncology outpatients with malnutrition: A cross-sectional study

2021 ◽  
Vol 38 (2) ◽  
Author(s):  
Mira Sonneborn-Papakostopoulos ◽  
Clara Dubois ◽  
Viktoria Mathies ◽  
Mara Heß ◽  
Nicole Erickson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Side Effects ◽  
Dietary Habits ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
University Hospital ◽  
Cross Sectional ◽  
European Organization

AbstractCancer-related malnutrition has a high prevalence, reduces survival and increases side effects. The aim of this study was to assess oncology outpatients and risk of malnutrition. Reported symptoms and quality of life (QoL) in patients found to be at risk of malnutrition or malnourished were compared to patients without malnutrition. Using a standardized questionnaire, the European Organization for Research and Treatment of Cancer Questionnaire for Quality of Life and the Mini Nutritional Assessment (MNA), patients in an outpatient cancer clinic undergoing chemotherapy treatment at a German University Hospital were assessed for nutrition, risk of malnutrition and quality of life. Based on the MNA, 39 (45.9%) patients were categorized as malnourished or at risk for malnutrition. Loss of appetite (n = 37.6%, p < 0.001) and altered taste sensation (n = 30,3%, p < 0.001) were the symptoms most frequently associated with reduced food intake. Patients with risk of malnutrition scored lower on the global health status (n = 48.15%, p = 0.001). Side effects of cancer treatments lead to a higher risk of malnutrition and as a consequence lower QoL. These side effects should be addressed more efficiently in cancer care.

scholarly journals Estimating the minimum important difference in the DEMQOL instrument in people with dementia

2021 ◽  
Author(s):  
Ellen C. Lee ◽  
Jessica Wright ◽  
Stephen J. Walters ◽  
Cindy L. Cooper ◽  
Gail A. Mountain
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Minimum Important Difference ◽  
Absolute Change ◽  
People With Dementia ◽  
Related Quality ◽  
Registration Number ◽  
Clinically Significant ◽  
Randomised Controlled

Abstract Purpose The Dementia-Related Quality of Life (DEMQOL) measure and the DEMQOL-Utility Score (DEMQOL-U) are validated tools for measuring quality of life (QOL) in people with dementia. What score changes translate to a clinically significant impact on patients’ lives was unknown. This study establishes the minimal important differences (MID) for these two instruments. Methods Anchor-based and distribution-based methods were used to estimate the MID scores from patients enrolled in a randomised controlled trial. For the anchor-based method, the global QOL (Q29) item from the DEMQOL was chosen as the anchor for DEMQOL and both Q29 and EQ-5D for DEMQOL-U. A one category difference in Q29, and a 0.07 point difference in EQ-5D score, were used to classify improvement and deterioration, and the MID scores were calculated for each category. These results were compared with scores obtained by the distribution-based methods. Results A total of 490 people with dementia had baseline DEMQOL data, of these 386 had 8-month data, and 344 had 12-month DEMQOL data. The absolute change in DEMQOL for a combined 1-point increase or decrease in the Q29 anchor was 5.2 at 8 months and 6.0 at 12 months. For the DEMQOL-U, the average absolute change at 8 and 12 months was 0.032 and 0.046 for the Q29 anchor and 0.020 and 0.024 for EQ-5D anchor. Conclusion We present MID scores for the DEMQOL and DEMQOL-U instruments obtained from a large cohort of patients with dementia. An anchored-based estimate of the MID for the DEMQOL is around 5 to 6 points; and 0.02 to 0.05 points for the DEMQOL-U. The results of this study can guide clinicians and researchers in the interpretation of these instruments comparisons between groups or within groups of people with dementia. Trial Registration Number and date of registration: ISRCTN17993825 on 11th October 2016.

scholarly journals Pilates and dance to patients with breast cancer undergoing treatment: study protocol for a randomized clinical trial – MoveMama study

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Leonessa Boing ◽  
Tatiana do Bem Fretta ◽  
Melissa de Carvalho Souza Vieira ◽  
Gustavo Soares Pereira ◽  
Jéssica Moratelli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Activity ◽  
Body Image ◽  
Side Effects ◽  
Sleep Quality ◽  
Control Group ◽  
Belly Dance ◽  
Belly Dancing

Abstract Background Breast cancer is a global public health issue. The side effects of the clinical treatment can decrease the quality of life of these women. Therefore, a healthy lifestyle is essential to minimize the physical and psychological side effects of treatment. Physical activity has several benefits for women with breast cancer, and Pilates solo and belly dancing can be an enjoyable type of physical activity for women with breast cancer undergoing clinical treatment. The purpose of this study is to provide a Pilates solo and a belly dance protocol (three times per week/16 weeks) for women undergoing breast cancer treatment and compare its effectiveness with that in the control group. Methods The participants will be allocated to either the intervention arm (Pilates solo or belly dance classes three times per week for 16 weeks) or a control group (receipt of a booklet on physical activity for patients with breast cancer and maintenance of habitual physical activity routine). The Pilates solo and belly dance classes will be divided into three stages: warmup and stretching, the main stage, and relaxation. Measurements of the study outcomes will take place at baseline; postintervention; and 6, 12, and 24 months after the end of the intervention (maintenance period). The data collection for both groups will occur with a paper questionnaire and tests covering general and clinical information. The primary outcome will be quality of life (EORT QLQ-C30 and EORT QLQ-BR23), and secondary outcomes will be physical aspects such as cardiorespiratory fitness (6-min walk test and cycle ergometer), lymphedema (sum of arm circumference), physical activity (IPAQ short version), disabilities of the arm (DASH), range of motion (goniometer test), muscular strength (dynamometer test) and flexibility (sit and reach test), and psychological aspects such as depressive symptoms (Beck Depression Inventory), body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg), fatigue (FACT-F), pain (VAS), sexual function (FSFI), and sleep quality (Pittsburgh Sleep Quality Index). Discussion In view of the high prevalence of breast cancer among women, the implementation of a specific protocol of Pilates solo and belly dancing for patients with breast cancer is important, considering the necessity to improve their physical and psychological quality of life. Pilates solo and belly dancing are two types of physical activity that involve mental and physical concentration, music, upper limb movements, femininity, and social involvement. An intervention with these two physical activities could offer options of supportive care to women with breast cancer undergoing treatment, with the aim being to improve physical and psychological quality of life. Trial registration ClinicalTrials.gov, NCT03194997. Registration date 12 August 2017. Universal Trial Number (World Health Organization), U1111-1195-1623.

scholarly journals The impact of hyperbaric oxygen therapy on late radiation toxicity and quality of life in breast cancer patients

2021 ◽  
Author(s):  
Marilot C. T. Batenburg ◽  
Wies Maarse ◽  
Femke van der Leij ◽  
Inge O. Baas ◽  
Onno Boonstra ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Oxygen Therapy ◽  
Radiation Toxicity ◽  
Breast Pain ◽  
Breast Cancer Patients

Abstract Purpose To evaluate symptoms of late radiation toxicity, side effects, and quality of life in breast cancer patients treated with hyperbaric oxygen therapy (HBOT). Methods For this cohort study breast cancer patients treated with HBOT in 5 Dutch facilities were eligible for inclusion. Breast cancer patients with late radiation toxicity treated with ≥ 20 HBOT sessions from 2015 to 2019 were included. Breast and arm symptoms, pain, and quality of life were assessed by means of the EORTC QLQ-C30 and -BR23 before, immediately after, and 3 months after HBOT on a scale of 0–100. Determinants associated with persistent breast pain after HBOT were assessed. Results 1005/1280 patients were included for analysis. Pain scores decreased significantly from 43.4 before HBOT to 29.7 after 3 months (p < 0.001). Breast symptoms decreased significantly from 44.6 at baseline to 28.9 at 3 months follow-up (p < 0.001) and arm symptoms decreased significantly from 38.2 at baseline to 27.4 at 3 months follow-up (p < 0.001). All quality of life domains improved at the end of HBOT and after 3 months follow-up in comparison to baseline scores. Most prevalent side effects of HBOT were myopia (any grade, n = 576, 57.3%) and mild barotrauma (n = 179, 17.8%). Moderate/severe side effects were reported in 3.2% (n = 32) of the patients. Active smoking during HBOT and shorter time (i.e., median 17.5 vs. 22.0 months) since radiotherapy were associated with persistent breast pain after HBOT. Conclusion Breast cancer patients with late radiation toxicity reported reduced pain, breast and arm symptoms, and improved quality of life following treatment with HBOT.

scholarly journals QOLP-04. PILOT STUDY OF A VIDEOCONFERENCE-BASED PSYCHOLOGICAL INTERVENTION FOR FAMILY CAREGIVERS OF PATIENTS WITH MALIGNANT GLIOMAS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii175-ii175
Author(s):  
Deborah Forst ◽  
Michelle Mesa ◽  
Emilia Kaslow-Zieve ◽  
Areej El-Jawahri ◽  
Joseph Greer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Self Efficacy ◽  
Coping Skills ◽  
Malignant Gliomas ◽  
Anxiety Symptoms ◽  
Structured Interviews ◽  
Post Intervention ◽  
Clinically Significant ◽  
And Coping

Abstract BACKGROUND Caregivers of patients with malignant gliomas experience substantial anxiety symptoms while caring for someone with progressive neurological decline. Yet, interventions to reduce psychological distress and improve quality of life (QoL) in this caregiver population are lacking. METHODS We conducted an open pilot study evaluating feasibility and acceptability of a cognitive behavioral therapy-based intervention for caregivers of patients with malignant gliomas with clinically significant anxiety (Generalized Anxiety Disorder [GAD-7] score ≥ 5). Caregivers participated in six videoconference sessions with a mental health provider. We defined the intervention as feasible if ≥ 70% of eligible caregivers enrolled and ≥ 70% of those enrolled completed ≥ 50% of sessions. We evaluated intervention acceptability in semi-structured interviews. Caregivers completed baseline and post-intervention surveys assessing anxiety and depression symptoms (Hospital Anxiety and Depression Scale), QoL (Caregiver Oncology Quality of Life Questionnaire), caregiving burden (Caregiver Reaction Assessment), self-efficacy (Lewis Cancer Self-Efficacy Scale), and perceived coping skills (Measure of Current Status-Part A). We explored post-intervention changes using paired t-tests. RESULTS We obtained consent from 70.0% (21/30) of caregivers approached, of which 66.7% (14/21) had clinically significant anxiety and thus were eligible to participate (mean age=55.7 years, 64.3% female). Among enrolled caregivers, 71.4% (10/14) completed ≥ 50% of sessions. In semi-structured interviews, all participants found the intervention helpful and valued the ability to participate remotely via videoconference. Among caregivers who completed at least one session, 80.0% (8/10) completed all assessments and were included in analyses. Post-intervention, caregivers reported reduced anxiety symptoms (P=.02) and improved QoL (P=.03) and coping skills (P=.001). We found no significant change in depression, caregiving burden, or self-efficacy. CONCLUSION Our videoconference-based intervention is feasible and acceptable to caregivers. Participants reported significant improvements in anxiety symptoms, quality of life, and coping skills post-intervention, supporting further investigation of the intervention in a randomized controlled trial.

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