scholarly journals Holistic approach in the management of PCOS: a pilot study of an online PCOS-reversal program

2018 ◽  
Vol 7 (7) ◽  
pp. 2829
Author(s):  
Manthan N. Mehta ◽  
Mahesh Jayaraman ◽  
Sharda Agarwal
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Patient Reported Outcomes ◽  
Polycystic Ovary ◽  
Holistic Approach ◽  
Physical Symptoms ◽  
Herbal Products ◽  
Complex Disorder ◽  
Patient Reported

Background: Polycystic ovary syndrome (PCOS) is a complex disorder that can be managed but not permanently cured. Each woman has her own PCOS symptoms and its own root causes. A number of medications are prescribed to women with PCOS. However, a holistic approach could be the best way forward in managing a disease as complex as PCOS. Authors conducted this pilot study called the Sepalika 5-petal PCOS reversal program which consisted of individualized diet plans, magnet acutherapy, fitness regimens, dietary supplements and herbal products to evaluate whether these interventions improve PCOS symptoms, insulin resistance and hyperandrogenism.Methods: A total of 30 patients were recruited online from all parts of India using the PCOS symptom quiz. Various baseline investigations were performed at recruitment. They were suggested personalized diet plans, followed by exercise videos, magnetic acutherapy and herbal and micronutrient supplements. The program spanned over a period of 90 days and patients outlook and quality of life were also assessed at the end of the program.Results: The main goal of most participants was improvement in weight and energy issues, and regularization of periods. Each of these goals were achieved in all participants of the program. Patient-reported outcomes showed a definite improvement in the quality of life of the participants at the end of 90 days.Conclusions: PCOS is a physical - sexual, psychological and social syndrome; therefore, it is necessary to taking a more holistic approach to patient care beyond treating physical symptoms. Larger studies with more objective and subjective endpoints is the way forward.

scholarly journals Immune Thrombocytopenia (ITP): Current Limitations in Patient Management

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 667
Author(s):  
Deirdra R. Terrell ◽  
Cindy E. Neunert ◽  
Nichola Cooper ◽  
Katja M. Heitink-Pollé ◽  
Caroline Kruse ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Immune Thrombocytopenia ◽  
Patient Reported Outcomes ◽  
Physical Symptoms ◽  
Health Related Quality ◽  
First Line ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Primary immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia caused by increased platelet destruction and impaired platelet production. First-line therapies include corticosteroids, intravenous immunoglobulin, and anti-D immunoglobulin. For patients who are refractory to these therapies, those who become corticosteroid dependent, or relapse following treatment with corticosteroid, options include splenectomy, rituximab, and thrombopoietin-receptor agonists, alongside a variety of additional immunosuppressive and experimental therapies. Despite recent advances in the management of ITP, many areas need further research. Although it is recognized that an assessment of patient-reported outcomes in ITP is valuable to understand and guide treatment, these measures are not routinely measured in the clinical setting. Consequently, although corticosteroids are first-line therapies for both children and adults, there are no data to suggest that corticosteroids improve health-related quality of life or other patient-related outcomes in either children or adults. In fact, long courses of corticosteroids, in either children or adults, may have a negative impact on a patient’s health-related quality of life, secondary to the impact on sleep disturbance, weight gain, and mental health. In adults, additional therapies may be needed to treat overt hemorrhage, but unfortunately the results are transient for the majority of patients. Therefore, there is a need to recognize the limitations of current existing therapies and evaluate new approaches, such as individualized treatment based on the probability of response and the size of effect on the patient’s most bothersome symptoms and risk of adverse effects or complications. Finally, a validated screening tool that identifies clinically significant patient-reported outcomes in routine clinical practice would help both patients and physicians to effectively follow a patient’s health beyond simply treating the laboratory findings and physical symptoms of ITP. The goal of this narrative review is to discuss management of newly diagnosed and refractory patients with ITP, with a focus on the limitations of current therapies from the patient’s perspective.

scholarly journals Patient reported outcomes of symptoms and quality of life among cancer patients treated with palliative pelvic radiation: a pilot study

2011 ◽  
Vol 4 (1) ◽  
Author(s):  
Marte G Cameron ◽  
Christian Kersten ◽  
Rene van Helvoirt ◽  
Gudrun Rohde ◽  
Sophie D Fosså ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Cancer Patients ◽  
Patient Reported Outcomes ◽  
Pelvic Radiation ◽  
Patient Reported

Association of Physical Morbidity and Health-Related Quality of Life in a Representative Sample of Older German People

2018 ◽  
Vol 25 (4) ◽  
pp. 140-151
Author(s):  
Markus A. Wirtz ◽  
Matthias Morfeld ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer
Keyword(s):  
Quality Of Life ◽  
Representative Sample ◽  
Short Form ◽  
Physical Symptoms ◽  
German Population ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract. The association between health-related quality of life (HRQoL; Short-Form Health Survey-12; SF-12) and patient-reported morbidity-related symptoms measured by the Patient Health Questionnaire-15 (PHQ-15) is analyzed in a representative sample of older people in the general German population. Data from 1,659 people aged 60 to 85 years were obtained. Latent class analysis identified six classes of patients, which optimally categorize clusters of physical symptoms the participants reported: musculoskeletal impairments (39.8%), healthy (25.7%), musculoskeletal and respiratory/cardiac impairments (12.8%), musculoskeletal and respiratory impairments, along with bowel and digestion problems (12.9%), general impairments (4.9%), and general impairments with no bowel and digestion problems (4.8%). The participants’ SF-12 Physical Health Scores (η2 = .39) and their Mental Health Scores (η2 = .28) are highly associated with these latent classes. These associations remain virtually identical after controlling for age. The results provide evidence that profiles of patient-reported physical impairments correspond strongly with reduced HRQoL independently from aging processes.

P048 QUALITY OF LIFE AND OTHER PATIENT REPORTED OUTCOMES IN PATIENTS WITH POUCHITIS

2020 ◽  
Vol 158 (3) ◽  
pp. S107
Author(s):  
Edward Barnes ◽  
Millie Long ◽  
Laura Raffals ◽  
Xian Zhang ◽  
Anuj Vyas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Reported Outcomes ◽  
Patient Reported

Understanding quality of life and treatment history of patients with Bertolotti syndrome compared with lumbosacral radiculopathy

2019 ◽  
Vol 31 (2) ◽  
pp. 222-228 ◽  
Author(s):  
Joshua L. Golubovsky ◽  
Arbaz Momin ◽  
Nicolas R. Thompson ◽  
Michael P. Steinmetz
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Propensity Score ◽  
Disc Herniation ◽  
Symptom Onset ◽  
Patient Reported Outcomes ◽  
Lumbosacral Radiculopathy ◽  
Patient Reported ◽  
Age And Sex

OBJECTIVEBertolotti syndrome is a rare spinal condition that causes low-back pain due to a lumbosacral transitional vertebra (LSTV), which is a pseudoarticulation between the fifth lumbar transverse process and the sacral ala. Bertolotti syndrome patients are rarely studied, particularly with regard to their quality of life. This study aimed to examine the quality of life and prior treatments in patients with Bertolotti syndrome at first presentation to the authors’ center in comparison with those with lumbosacral radiculopathy.METHODSThis study was a retrospective cohort analysis of patients with Bertolotti syndrome and lumbosacral radiculopathy due to disc herniation seen at the authors’ institution’s spine center from 2005 through 2018. Diagnoses were confirmed with provider notes and imaging. Variables collected included demographics, diagnostic history, prior treatment, patient-reported quality of life metrics, and whether or not they underwent surgery at the authors’ institution. Propensity score matching by age and sex was used to match lumbosacral radiculopathy patients to Bertolotti syndrome patients. Group comparisons were made using t-tests, Fisher’s exact test, Mann-Whitney U-tests, Cox proportional hazards models, and linear regression models where variables found to be different at the univariate level were included as covariates.RESULTSThe final cohort included 22 patients with Bertolotti syndrome who had patient-reported outcomes data available and 46 propensity score–matched patients who had confirmed radiculopathy due to disc herniation. The authors found that Bertolotti syndrome patients had significantly more prior epidural steroid injections (ESIs) and a longer time from symptom onset to their first visit. Univariate analysis showed that Bertolotti syndrome patients had significantly worse Patient-Reported Outcomes Measurement Information System (PROMIS) mental health T-scores. Adjustment for prior ESIs and time from symptom onset revealed that Bertolotti syndrome patients also had significantly worse PROMIS physical health T-scores. Time to surgery and other quality of life metrics did not differ between groups.CONCLUSIONSPatients with Bertolotti syndrome undergo significantly longer workup and more ESIs and have worse physical and mental health scores than age- and sex-matched patients with lumbosacral radiculopathy. However, both groups of patients had mild depression and clinically meaningful reduction in their quality of life according to all instruments. This study shows that Bertolotti syndrome patients have a condition that affects them potentially more significantly than those with lumbosacral radiculopathy, and increased attention should be paid to these patients to improve their workup, diagnosis, and treatment.

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