scholarly journals Restoration of ankle movements with the ActiGait implantable drop foot stimulator: a safe and reliable treatment option for permanent central leg palsy

2016 ◽  
Vol 124 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Klaus Daniel Martin ◽  
Witold Henryk Polanski ◽  
Anne-Kathrin Schulz ◽  
Michael Jöbges ◽  
Hansjoerg Hoff ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gait Speed ◽  
Drop Foot ◽  
Activation Time ◽  
Test Stimulation ◽  
Number Of Patients ◽  
Stimulation System ◽  
Ankle Function ◽  
Peroneal Nerve Stimulation

OBJECT The ActiGait drop foot stimulator is a promising technique for restoration of lost ankle function by an implantable hybrid stimulation system. It allows ankle dorsiflexion by active peroneal nerve stimulation during the swing phase of gait. In this paper the authors report the outcome of the first prospective study on a large number of patients with stroke-related drop foot. METHODS Twenty-seven patients who experienced a stroke and with persisting spastic leg paresis received an implantable ActiGait drop foot stimulator for restoration of ankle movement after successful surface test stimulation. After 3 to 5 weeks, the stimulator was activated, and gait speed, gait endurance, and activation time of the system were evaluated and compared with preoperative gait tests. In addition, patient satisfaction was assessed using a questionnaire. RESULTS Postoperative gait speed significantly improved from 33.9 seconds per 20 meters to 17.9 seconds per 20 meters (p < 0.0001), gait endurance from 196 meters in 6 minutes to 401 meters in 6 minutes (p < 0.0001), and activation time from 20.5 seconds to 10.6 seconds on average (p < 0.0001). In 2 patients with nerve injury, surgical repositioning of the electrode cuff became necessary. One patient showed a delayed wound healing, and in another patient the system had to be removed because of a wound infection. Marked improvement in mobility, social participation, and quality of life was confirmed by 89% to 96% of patients. CONCLUSIONS The ActiGait implantable drop foot stimulator improves gait speed, endurance, and quality of life in patients with stroke-related drop foot. Regarding gait speed, the ActiGait system appears to be advantageous compared with foot orthosis or surface stimulation devices. Randomized trials with more patients and longer observation periods are needed to prove the long-term benefit of this device.

scholarly journals ActiGait implantable drop foot stimulator in multiple sclerosis: a new indication

2017 ◽  
Vol 126 (5) ◽  
pp. 1685-1690 ◽  
Author(s):  
K. Daniel Martin ◽  
Witold H. Polanski ◽  
Anne-Kathrin Schulz ◽  
Michael Jöbges ◽  
Tjalf Ziemssen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Gait Speed ◽  
Therapeutic Option ◽  
Drop Foot ◽  
Direct Stimulation ◽  
Test Stimulation ◽  
Surface Test

OBJECTIVEDirect stimulation of the peroneal nerve by the ActiGait implantable drop foot stimulator is a potent therapy that was described previously for stroke-related drop foot. The authors report here successful long-term application of the ActiGait implantable drop foot stimulator in patients with multiple sclerosis (MS).METHODSSix patients with MS and 2 years of persisting central leg paresis received an implantable ActiGait drop foot stimulator after successful surface test stimulation. Ten weeks and 1 year after surgery, their gait speed, endurance, and safety were evaluated. Patient satisfaction was assessed with a questionnaire.RESULTSIn the 20-m gait test, stimulation with the ActiGait stimulator significantly reduced the time needed, on average, by approximately 23.6% 10 weeks after surgery, and the time improved further by 36.3% after 1 year. The median distance covered by patients with the stimulator after 6 minutes of walking increased significantly from 217 m to 321 m and remained stable for 1 year; the distance covered by patients after surface stimulation was 264 m. Patients with an implanted ActiGait stimulator noticed pronounced improvement in their mobility, social participation, and quality of life.CONCLUSIONSThe ActiGait implantable drop foot stimulator improved gait speed, endurance, and quality of life in all patients over a period of 1 year. It may serve as a new therapeutic option for patients with MS-related drop foot.

PENINGKATAN KUALITAS HIDUP MELALUI LOGOTERAPI PADA KLIEN YANG MENJALANI HEMODIALISIS

2019 ◽  
Vol 11 (1) ◽  
pp. 9-18
Author(s):  
Abdul Wakhid ◽  
Ana Puji Astuti ◽  
Maya Kurnia Dewi
Keyword(s):  
Quality Of Life ◽  
Renal Failure ◽  
Test Group ◽  
Sampling Technique ◽  
T Test ◽  
P Value ◽  
Number Of Patients ◽  
Post Test ◽  
The Mean

Logoterapi merupakan terapi untuk menemukan makna positif dibalik sebuah kejadian yang tidak diharapkan. Logoterapi dilaksanakan secara individu maupun berkelompok dalam bentuk konseling dan berorientasi pada pencarian makna hidup individu. Tujuan logoterapi meningkatkan makna pengalaman hidup individu yang diarahkan kepada pengambilan keputusan yang bertanggung jawab. Penelitian ini dilakukan dengan menggunakan rancangan pre-experiment dengan metode pre and post test group, artinya pengumpulan data dilakukan terhadap responden untuk membandingkan kualitas hidup sebelum dan sesudah dilakukan intervensi. Teknik pengambilan sampel dilakukan dengan metode total sampling yaitu pengambilan seluruh sampel dengan tetap memperhatikan kriteria yang telah ditetapkan. Jumlah pasien yang menjalani hemodialisis di RSUD Ungaran sebanyak 21 orang dan di RSUD Ambarawa sebanyak 25 pasien. Analisis data dilakukan dengan menggunakan uji t test dependent. Hasil penelitian didapatkan bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 60.22 dengan skor terrendah 55 dan skor tertinggi 69. Bahwa dari 46 responden didapatkan rata-rata skor kualitas hidup pasien yang mejalani hemodialisis sebesar 88.72 dengan skor terrendah 79 dan skor tertinggi 103. Hasil uji statistik dengan uji t test dependent diketahui ada pengaruh logoterapi terhadap kemampuan memaknai hidup pada klien yang menjalani hemodialisis di RSUD Kabupaten Semarang (p value: 0,0001). Saran perlunya peningkatan kemampuan perawat dalam memberikan layanan kesehatan termasuk pemberian atau pemanduan penemuan makna hidup bagi pasien hemodialysis, agar selain dengan hemodialysis, ada faktor internal dari pasien yang dapat dijadikan sebagai motivasi untuk sembuh dari penyakit.   Kata Kunci: Logoterapi, kualitas hidup   IMPROVE THE QUALITY OF LIFE OF PATIENTS WITH RENAL FAILURE WHO UNDERWENT HEMODIALYSIS   ABSTRACT Logotherapy is a therapy to discover the positive meaning behind an unexpected event. Logotherapy is carried out individually or in groups in the form of counseling and oriented to the search for the meaning of individual life. This study aims to improve the quality of life of patients with renal failure who underwent hemodialysis. This research was conducted by using pre-experiment with pre-post test study. The sampling technique was done by the convenience sampling. The number of patients undergoing hemodialysis as many as 46 respondents. Data analysis was done by using test t test dependent. The result showed that from 46 respondents got the mean of quality of life of patients who had hemodialysis 60.22 with lowest score 55 and highest score 69. Whereas from 46 respondents got the mean score of life quality of patients who had hemodialysis 88.72 with score the lowest score 79 and the highest score 103. The result of statistical test with t test dependent is known there is influence of logoterapi to the ability of meaningful life on client who undergo hemodialysis at Semarang Regency hospitals (p value: 0.0001). Advice on the need to improve the nurse's ability to provide health services, including the provision or guidance of the discovery of the meaning of life for hemodialysis patients, in addition to hemodialysis, there are internal factors of the patient that can be used as a motivation to recover from illness.   Keywords: Logotherapy, quality of life, kidney failure.  

Features and methods of assessing health-related quality of life and cognitive functions in patients with glial tumors

2020 ◽  
pp. 47-56
Author(s):  
Vera Arsenyeva ◽  
Boris Martynov ◽  
Gennadiy Bulyshchenko ◽  
Dmitriy Svistov ◽  
Boris Gaydar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Functions ◽  
Well Being ◽  
Health Related Quality ◽  
Number Of Patients ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
Patients With Epilepsy

Gliomas make up about 8 cases per 100,000 population and the number of patients with this disease is only increasing. There can be not only various types of neurological deficits among the symptoms, but also personal and emotional changes, that seriously affects the quality of life. The modern model of health care includes not only recovery of the patient’s physical functions, but also his or her psychosocial well-being. In particular, the assessment and study of the characteristics of health-related quality of life, as well as cognitive functions in patients with gliomas, is increasingly recognized as an important criterion when considering the effectiveness of treatment. To date, the features of health related quality of life and cognitive functions of patients with epilepsy and acute cerebral circulation disorders have been studied sufficiently, and, as a result, techniques have been developed that accurately assess the QOL and CF in patients with these diseases. These are QOLIE-31 and QOLIE-AD-48 questionnaires for patients with epilepsy. This is the National Institutes of Health Stroke Scale (NIHSS), Orgogozo stroke scale (OSS), World Federation of Neurological Surgeons (WFNS) scale for the clinical assessment of subarachnoid hemorrhage (SAH) for patients with acute cerebrovascular accident. At the same time, there are no generally accepted methods for assessing quality of life and neurocognitive functions that are sensitive to changes in the condition of patients with gliomas in the early postoperative period by the time of discharge from the hospital. As a result, there is no systematic information on the dynamics of the quality of life of such patients, their neurocognitive functioning. The purpose of this article was to study the literature on QOL and CF in patients affected by neurological and neurosurgical disorders for the further selection of optimal methods for assessing dynamics of the condition of patients with glial brain tumors before and after surgery. At the moment, such requirements are only partially met by the EORTC QLQ-C30 questionnaire and its application EORTC QLQ-BN20.

Quality of life after anti-reflux surgical interventions: possible solutions to the problem

2020 ◽  
pp. 3-25
Author(s):  
D. Lukanin ◽  
G. Rodoman ◽  
M. Klimenko ◽  
A. Sokolov ◽  
A. Sokolov
Keyword(s):  
Quality Of Life ◽  
Hiatal Hernia ◽  
Antireflux Surgery ◽  
Nissen Fundoplication ◽  
Laparoscopic Nissen Fundoplication ◽  
Partial Fundoplication ◽  
Surgical Interventions ◽  
Number Of Patients ◽  
Laparoscopic Nissen

The article presents the results of a prospective controlled parallel clinical study of a new modification of laparoscopic antireflux surgery in the treatment of gastroesophageal reflux disease in combination with a hiatal hernia compared with laparoscopic Nissen fundoplication in terms of assessing quality of life after surgery. Clinical and instrumental examination of patients was carried out a year after surgical interventions. In accordance with the results of instrumental examination after surgery, the proposed modification of laparoscopic partial fundoplication is not inferior to laparoscopic Nissen fundoplication both, in terms of relief of reflux esophagitis symptoms and in relation to the recurrence of hiatal hernia. Clinical monitoring indicates a significantly higher quality of life for patients after the modified antireflux surgery, which is associated with a number of factors. The implementation of this fundoplication led to a decrease in the number of patients with complaints of dysphagia, the development of which is directly related to the surgery performance, as well as to a statistically significant reduction of bloating in the upper abdomen. Another advantage of the modified surgery is a significantly smaller number of cases of gas-bloat syndrome. In addition, the disorders developing in the framework of the gas bloat syndrome after laparoscopic Nissen fundoplication are more severe.

scholarly journals Quality of Life in Hidradenitis Suppurativa: An Update

2021 ◽  
Vol 18 (11) ◽  
pp. 6131
Author(s):  
Pavel V. Chernyshov ◽  
Andrew Y. Finlay ◽  
Lucia Tomas-Aragones ◽  
Francoise Poot ◽  
Francesca Sampogna ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hidradenitis Suppurativa ◽  
Acne Inversa ◽  
Health Related Quality ◽  
Number Of Patients ◽  
Related Quality ◽  
Health Related ◽  
Positive Effect ◽  
Specific Health

Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.

scholarly journals Cannabis and Canabidinoids on the Inflammatory Bowel Diseases: Going Beyond Misuse

2020 ◽  
Vol 21 (8) ◽  
pp. 2940
Author(s):  
Antonelly Cassio Alves de Carvalho ◽  
Gabriela Achete de Souza ◽  
Samylla Vaz de Marqui ◽  
Élen Landgraf Guiguer ◽  
Adriano Cressoni Araújo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Diseases ◽  
Literature Search ◽  
Cannabis Sativa ◽  
Antioxidant Properties ◽  
Number Of Patients ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Anti Inflammatory

Inflammatory bowel diseases (IBD) are characterized by a chronic and recurrent gastrointestinal condition, including mainly ulcerative colitis (UC) and Crohn’s disease (CD). Cannabis sativa (CS) is widely used for medicinal, recreational, and religious purposes. The most studied compound of CS is tetrahydrocannabinol (THC) and cannabidiol (CBD). Besides many relevant therapeutic roles such as anti-inflammatory and antioxidant properties, there is still much controversy about the consumption of this plant since the misuse can lead to serious health problems. Because of these reasons, the aim of this review is to investigate the effects of CS on the treatment of UC and CD. The literature search was performed in PubMed/Medline, PMC, EMBASE, and Cochrane databases. The use of CS leads to the improvement of UC and CD scores and quality of life. The medical use of CS is on the rise. Although the literature shows relevant antioxidant and anti-inflammatory effects that could improve UC and CD scores, it is still not possible to establish a treatment criterion since the studies have no standardization regarding the variety and part of the plant that is used, route of administration and doses. Therefore, we suggest caution in the use of CS in the therapeutic approach of IBD until clinical trials with standardization and a relevant number of patients are performed.

Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis

Pain Medicine ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. 2220-2227 ◽  
Author(s):  
Kazuhiro Hayashi ◽  
Takkan Morishima ◽  
Tatsunori Ikemoto ◽  
Hirofumi Miyagawa ◽  
Takuya Okamoto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Gait Speed ◽  
Pain Catastrophizing ◽  
Hip Osteoarthritis ◽  
Cross Sectional ◽  
Japanese Orthopedic Association ◽  
Affected Side ◽  
Tertiary Center

AbstractObjective. Pain catastrophizing is an important pain-related variable, but its impact on patients with osteoarthritis is uncertain. The aim of the current study was to determine whether pain catastrophizing was independently associated with quality of life (QOL) in patients with osteoarthritis of the hip. Design. Cross-sectional study conducted between June 2017 and February 2018. Setting. Tertiary center. Subjects. Seventy consecutively enrolled patients with severe hip osteoarthritis who had experienced pain for six or more months that limited daily function, and who were scheduled for primary unilateral total hip arthroplasty. Methods. QOL was measured using the EuroQOL-5 Dimensions questionnaire, the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire, and a dissatisfaction visual analog scale. Covariates included pain intensity, pain catastrophizing, range of hip motion, and gait speed. The variables were subjected to multivariate analysis with each QOL scale. Results. The median age was 68 years, and the median Pain Catastrophizing Scale score was 26. In multiple regression analysis, pain catastrophizing, pain intensity in both hips, pain intensity on the affected side, hip flexion on the affected side, and gait speed were independently correlated with QOL. Conclusions. Pain catastrophizing was independently associated with each QOL scale in preoperative patients with severe hip osteoarthritis. Pain catastrophizing had either the strongest or second strongest effect on QOL, followed by pain intensity.

What Does Imaging Add to the Management of Alzheimer's Disease?

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S5) ◽  
pp. 20-23 ◽  
Author(s):  
Gary W. Small
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Imaging Techniques ◽  
Screening Tools ◽  
Surrogate Markers ◽  
Genetic Disposition ◽  
Number Of Patients

AbstractThe prevalence of Alzheimer's disease (AD) and dementia continues to rise. However, a significant number of patients are undiagnosed or untreated. Given the complexities of detecting cognitive impairment and the early signs of AD, this review discusses how advances in brain imaging can help assist in improving overall management. Imaging techniques and surrogate markers may provide unique opportunities to diagnose accurately AD in presymptomatic stages with practical consequences for patients, caregivers, and physicians. The possible outcomes for using imaging and surrogate markers as adjuncts to clinical examination and as screening tools for AD, as well as tangible and intangible advantages to early diagnosis and treatment, will be discussed. The specific value of using advanced serial imaging in patients with a genetic disposition to AD will be evaluated. If neurons can be protected from neurodegenerative damage in early stages, this may preserve patient cognition, function, and quality of life, and may confer considerable societal healthcare benefits.

scholarly journals 662 MICROVASCULAR MYOCUTANEOUS AND CUTANEOUS FREE FLAP RECONSTRUCTION FOR PATIENTS WITH TERMINAL ESOPHAGOSTOMY AFTER COMPLICATED ONCOLOGICAL ESOPHAGUS RESECTION

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Lukas Pölsler ◽  
Jaroslav Presl ◽  
Christian Brandtner ◽  
Alexander Gaggl ◽  
Jörg Hutter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Free Flap ◽  
Treatment Options ◽  
Graft Function ◽  
Oral Intake ◽  
Artificial Nutrition ◽  
Severe Problem ◽  
Promising Alternative ◽  
Number Of Patients

Abstract   Persisting anastomotic leak after oncological esophagectomy is a severe problem associated with high mortality and morbidity. Unfortunately, treatment options with promising results are scarce especially when conventional operative and endoscopic methods have failed. Due to limitation of oral intake and need for artificial nutrition quality of life is reduced. Microvascular myocutaneous and cutaneous free flap (MFF) reconstruction could be a promising alternative. Methods This retrospective cohort study presents seven patients treated between March 2017 and November 2020 at our surgical department, with terminal esophagostomy after complicated oncological esophagus resection without further feasible treatment options. All Patients received anastomotic MFF reconstruction. We have examined postoperative outcomes, complications according to Clavien-Dindo-Classification and patient contentment with a questionnaire. Additionally, we described important procedure related facts. Results The included seven male patients had median age of 65.15 years (range: 48–75). MFF function was adequate in six out of seven patients, graft rejection appeared in one patient. Five patients initially had good results, surgical revision was performed in one patient to ensure graft function. Postoperative complications appeared in 6/7 patients (Table 1). Mean duration of inpatient care was 63 days (Range: 24–156). At time of evaluation, one patient has died cancer related. No more additional nutrition was needed in 3/6 patients with adequate graft function. The majority of patients reported an improved quality of life compared to preoperatively. Conclusion MFF free flap can be a safe and feasible treatment option for patients with terminal esophagostomy after complicated oncological esophagus resection without further treatment options or in patients with complicated postoperative course with complex combined defects. The renewed ability of oral food intake results in a significant improvement of quality of life for the patients. No procedure related mortality was observed. Number of patients with regained ability of oral intake is encouraging.

scholarly journals Gambaran Kualitas Hidup pada Pasien Diabetik Retinopati Berdasarkan Tingkat Keparahan Visus

2020 ◽  
Vol 10 (2) ◽  
pp. 105
Author(s):  
Novita Dhewi Ikakusumawati ◽  
Dewi Magistasari ◽  
Novena Adi Yuhara ◽  
Tri Murti Andayani ◽  
Supanji Supanji ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Utility Score ◽  
Microvascular Complications ◽  
Cross Sectional ◽  
Number Of Patients ◽  
High Prevalence ◽  
Anxiety Depression

Diabetic retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM) which incidence increases with the high prevalence of DM. The presence of these complications will affect quality of life, especially vision-related. The purpose of this study was to determine the quality of life in RD patients assessed using the VFQ-25 and EQ-5D questionnaires, and to determine the of quality of life based on the visual acuity (VA) severity. This study was an observational study in outpatient with diabetic retinopathy during October 2018 – Januari 2019 period, in RSUP dr. Sardjito and RS Mata Dr. YAP, Yogyakarta. The design of this study was cross sectional which observed quality of life and vision. Quality of life was measured by specific for vision instrument (NEI-VFQ-25)  and  generic instrument  (EQ-5D-5L). The number of patients in this study were 100 patients with an average age of 55 years, the most frequent type of RD was 84% proliferative RD. The average quality of life scores in RD patients measured using the VFQ-25 and EQ-5D utility questionnaires were 64.1 ± 16.2 and 0.61 ± 0.24, respectively. Based on VFQ-25, the most affected subscales were driving, dependence, and role difficulties subscale. Meanwhile, domains that have the most problems with the EQ-5D were pain / discomfort and anxiety / depression (78%). The total VFQ-25 score decreased with increasing visual severity, i.e. normal / mild (n = 19) 73.50 ± 15.08; moderate (n = 15) 68.14 ± 15.33; and severe (n = 66) 60.48 ± 15.64. The EQ-5D utility score showed a similar pattern, with scores of 0.66 ± 0.27 (normal / mild); 0.65 ± 0.22 (medium); and 0.59 ± 0.24 (severe); respectively. The higher severity of visual acuity so the quality of life become lower.

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